Tsutsugamushi disease is an acute infectious disease caused by Rickettsia tsutsugamushi.The clinical symptoms of tsutsugamushi disease are varied and non-specific,such as sudden onset fever with chills,rash,skin eschar of ulcer,lymphadenectasis,et al.Patients could combine with multi-organ dysfunction,include respiratory failure,heart failure,mild renal or hepatic dysfunction,circulatory shock or hematological abnormalities.Since the symptoms and signs are non-specific and resemble other tropical infections like malaria,enteric fever,dengue or leptospirosis,appropriate laboratory tests are necessary to confirm diagnosis,and reduce misdiagnosis and missed diagnosis rate.The mainstay of treatment is the tetracycline,chloramphenicol,macrolide and quinolone group of antibiotics.In mild cases,recovery is complete.In severe cases with multi-organ failure,mortality may be as high as 24％.Improve the early diagnosis and timely treatment of the disease,for improving the prognosis of patients,reduce the disease burden is of great significance.

Wrist-ankle acupuncture is a type of special acupuncture therapy, featured by simple operation, swift efficiency, and few adverse effects. In the recent years, ankle-wrist acupuncture has become more and more popularized in clinic. By retrieving the relevant medical literatures from VIP, CNKI, and Wan Fang databases, this manuscript was to analyze the history of wrist-ankle acupuncture and to review it from both mechanism and clinical reports. Meanwhile, this article also pointed out the existing problems in the research of wrist-ankle acupuncture during the recent years, and expected further standardization and studies.

Objective To observe the clinical efficacy of different doses of warm needling in treating knee osteoarthritis (KOA). Method Sixty-seven KOA patients were randomized into group A of 16 cases, group B of 17 cases, group C of 18 cases, and group D of 16 cases. Group A, B, and C were intervened by warm needling, 1 moxa cone for group A, 2 cones for group B, and 3 cones for group C. Group D was intervened by intra-articular injection with Sodium hyaluronate. The Visual Analogue Scale (VAS) and Lysholm Knee Scoring Scale (LKSS) were evaluated before and after intervention.Result The VAS and LKSS scores were significantly changed in the four groups after intervention (P<0.01). After intervention, the VAS and LKSS scores in group B and C were significantly different from that in group A (P<0.05,P<0.01). After intervention, the VAS and LKSS scores in group B and C were significantly different from that in group D (P<0.05,P<0.01).Conclusion Warm needling is an effective method in treating KOA, and warm needling with 2 moxa cones can produce the best effect.

OBJECTIVE:To probe into the utilization of sedative hypnotics in outpatient prescriptions of our hospital. METHODS: In Mar. 2008, 1 317 prescriptions of sedative-hypnotics randomly selected from total 49 791 outpatient prescriptions were analyzed regarding the rationality of the utilization of top 5 drugs on the list of DDDs. RESULTS: The top 5 sedative hypnotics on the DDDs list were Alprazolam tablets, Estazolam tablets, Lorazepam, Zolpidem tablets (Stilnox) and Clonazepam tablets, and their DUIs were 0.54, 0.73, 0.19, 0.81 and 0.53, respectively. CONCLUSION: The dosages of sedative hypnotics in our hospital were basically reasonable and in conformity with the indications listed in package inserts.

Objective: To evaluate the reliability and validity of the Chinese version of Frost's Multidimensional Perfectionism Scale(FMPS).Methods: One thousand two hundred and eighty Chinese undergraduate students participated in the study and responded to the FMPS and instruments measuring psychological distresses such as anxiety,depression,and obsession-compulsion.Both exploratory and confirmatory factor analyses were used to examine the factor structure of the Chinese FMPS.The association between FMPS and psychological distresses was analyzed as an investigation for criterion validity.Results: Factor analyses extracted five of the original six factors of FMPS.PC did not emerge as a dimension.The five subscales were shown to have satisfactory internal consistencies with Cronbach's alpha between 0.64 and 0.81 and test-retest reliability 0.63~0.82.Chinese FMPS was associated with anxiety,depression,and obsession-compulsion.Particularly,CM and DA are correlated with these psychological distresses with coefficients between 0.30 and 0.70.Conclusion: Chinese FMPS is satisfactorily valid and reliable.It is suitable to use in Chinese college students.

Six cases of T-cell lyrnphoma associated with reactive histiocytic hyperplasia with hemophagocytosis (HHH) localized primarily to the skin and subcutaneous fat were described. Initial biopsy findings may he misinterpreted as benign panniculitis. Four of which were progressive, recurrent, even fatal (follow-up for 8-36 months). Histologically the lesions of all cases were composed of a mixture of small and medium sized atypical lymphoid cells and benign hemophagocytes infiltrated with neutrophils and eosinophils between fat cells. The mechanism and differential diagnosis of the disease were discussed.

OBJECTIVE:To offer references for clinical rational use of Chinese patent drugs. METHODS:The basic theory of Chinese medicine was applied to analyze the current common problems encountered by western medicine physicians in the use of Chinese patent drugs. RESULTS & CONCLUSION:In the clinical use of Chinese patent drugs, the western medicine physicians should give consideration of the specific condition and get a detailed knowledge of drug constituents and the related clinical data as well as strictly follow the specification of drug package inserts.

Glutamate is an essential excitatory neurotransmitter which regulates brain functions.An increase in extracellular glutamate could excessively activate ionotropic glutamate receptors,initiate calcium overload,and lead to cell death after cerebral ischemia.Glutamate transporter-1 (GLT-1) is one of the major glutamate transporters expressed predominantly in astrocytes.Astrocytes also express the enzyme glutamine synthetase (GS) which converts the glutamate to glutamine; the latter is then 'recycled' into neurons.Pretreatment with ceftriaxone (CEF),ischemia and intermittent hypobaric hypoxia could lead to neuroprotection by increasing the expression of GLT-1 and regulating the activity of glutamate transporter in brain.

Lipoxins, metabolites of arachidonic acid , are a strong“braking signal” towards inflammatory reac-tion.Due to their anti-inflammatory and pro-resolving properties , lipoxins have emerged to be the central targets in the re-search on inflammation .The present article reviews the research advances of synthesis , biological effects and the protective role of lipoxins in the diseases of liver , pancreas , stomach and colorectum , thus providing a novel approach for the treat-ment of digestive diseases .

OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy in the treatment of mycoplasma pneumonia in children. METHODS:67 children with mycoplasma pneumonia were randomly divided into control group(34 cases) and observation group (33 cases). All children received conventional treatment,such as fever,cough,supplemented by nutrition support;based on it,control group received 10 mg/kg Azithromycin for injection,adding into 5% Glucose injection by intrave-nous drip in 200 ml,once a day;observation group received azithromycin(the same dosage with control group)after intravenous drip 5 d,switched to 10 mg/(kg·d)Azithromycin dry suspension,orally,then stopped 4 d after continuous 3 d. The treatment course was 7-10 d. Clinical efficacy,disappearance time of fever,cough and lung rales,and lung indexes before and after treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the to-tal effective rate,disappearance time of fever,cough and lung rales in 2 groups(P>0.05). After treatment,the lung function in-dexes were significantly higher than before,the differences were statistically significant(P<0.01),but there was no significant dif-ference between 2 groups (P>0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Based on conventional treatment,azithromycin se-quential therapy shows similar efficacy to without sequential therapy in the treatment of mycoplasma pneumonia in children,but with better safety.