Objective To analyze the clinical characteristics of brucellosis presenting as fever of unknown origin in non-endemic area.Methods Clinical data of 11 patients with fever of unknown origin,who were admitted in a general hospital of non-endemic area from Jan 2013 to Jan 2017 and diagnosed as brucellosis by blood culture,were retrospectively analyzed.Results There were 8 males and 3 females aged 40-70 years.The patients were admitted with or without accompanied symptoms.The patients were initially presented in rheumatology (1 case),neurology (1 case),emergency (4 cases),hematology (1 case),orthopedics (2 cases) and pneumology (2 cases) departments,respectively.The time from onset to presentation was 0.5-7.0 months.The clinical manifestations were nonspecific,and blood cultures of Brucella were positive between 2 to 5 weeks with a mean of 3 weeks.Time to diagnosis was 1 to 9 months with a mean of 4 months.All patients were transferred to infectious hospital when the diagnosis was confirmed.The telephone follow-up showed that none of the patients had fever after discharged.Conclusion Brucellosis should not be neglected in the differential diagnosis of FUO in non-endemic area,and blood culture is important for a definitive diagnosis.

BACKGROUND: The studies in recent years proved that the inflammatory reaction is of the main reasons in the damage of cerebral ischemia reperfusion. The nuclear factor κB (NF-κB), as a kind of transcription factor, plays an important role in regulating the expressions of various inflammatory cell factors in the inflammatory reaction of cerebral ischemia reperfusion. The previous experiments show that puerarin functions to resist the oxidated free radicals and the apoptosis of nerve cells. In case it has the functions of anti-inflammation, its brain protection can be explained further.OBJECTIVE: To study the effect of puerarin on NF-κB for the rats with the damage of ischemia reperfusion.DESIGN: A random parallel controlled study.SETTING: The Emergency Department of Beijing Hospital, Emergency Department of Tongji Hospital, Pathology Department and Experimental Animal Center of Tongji Medical College, and Health Statistics Department of Public Health College of Huazhong University of Science and Technology.MATERIALS: The experiment was started on April 12, 2003 in the Pathology Department of Tongji Medical College. The 75 healthy and clean Wistar rats were randomized into 3 groups with 25 in each, Sham operation group, cerebral ischemia reperfusion group, and puerarin group. Each group was reperfused at 2, 6, 12, 24, and 48 hours after ischemia and 5rats were used at each time point.METHODS: [1] Sham operation group: Without electric coagulation of bilateral vertebral arteries, without blockage of bilateral common carotid arteries, without medicinal administration. [2] Cerebral ischemia reperfusion group: Ten minutes after the blockage of bilateral common carotid arteries with non-invasive artery clamp, the reperfusion was given. At the beginning of reperfusion, the abdominal injection of normal saline 1 mL was applied and later every 6 hours the injection was repeated once. [3] Puerarin group:The procedure was the same as for the reperfusion group, only with normal saline changed to puerarin 100 mg/kg.MAIN OUTCOME MEASURES: At the time points of 2, 6, 12, 24, and 48 hours after reperfusion, the activity of NF-κB and inhibitory protein κB(IP-κB) in the hippocampus CA1 region was examined with immunohistochemical method; the expression of tumor necrosis factor-α (TNF-α) mRNA was measured with in situ hybridization method; and the number of surviving neurons was detected with hematoxylin-eosin (HE) staining.RESULTS: After supplement, 75 rats entered the result analysis. [1] Activity of NF-κB: In the ischemia reperfusion group, it was obviously increased at 2 hours after reperfusion, to the highest at 6 hours, and still higher than that of the sham operation group, (P ＜ 0.01). In the puerarin group, it was lower at each time point than that of the ischemia reperfusion group (P ＜ 0.01). [2] Expression of TNF-α mRNA: In the ischemia reperfusion group, it was obviously increased at 2 hours after reperfusion, to the highest at 12 hours, and still higher than that of the sham operation group at 48 hours (P ＜ 0.01). In the puerarin group, it was lower than that of the ischemia reperfusion group at 6-48 hours (P ＜ 0.01). [3] Activity of IP-κB:In the ischemia reperfusion group, it was obviously decreased at 2 hours after reperfusion, to the lowest at 6 hours, and then gradually increased to the level of 12 hours. In the puerarin group, it was higher than that of the ischemia reperfusion group at each time point (P ＜ 0.01 or 0.05). [4] Number of surviving neurons: In the ischemia reperfusion group, it was decreased gradually with the time prolonging after reperfusion (P ＜ 0.01). In the puerarin group, at each time point, it was higher than that of the ischemia reperfusion group (P ＜ 0.05 or 0.01).CONCLUSION: In the cerebral ischemia reperfusion, puerarin can protect the brain through decreasing the degradation of IP-κB, the activity of NF-κB, the expression of TNF-α mRNA, and the inflammatory reaction.

The paper introduces and summarizes the teaching purpose and content project,implementation and effect of the optional course in Excel and medical data analysis.

Objective To investigate the mechanisms and clinical characteristics of fatal asthma attack induced by amiodarone in the elderly,and to discuss its serious potent risks.Methods We reported two cases of fatal asthma attack in the elderly with fast atrial fibrillation induced by amiodarone,and discussed the clinical manifestation and emergency treatment,with literatures review.Results The two patients presented with respiratory arrest.After targeted therapies,including artificial ventilation and hormone injection,the patients were capable of spontaneously breathing,while still in severe asthma attack.And further anti-asthma treatment led to a complete remission.Conclusions Amiodarone may cause extremely severe asthma attack in elder patients with tachyarrhythmia complicated with bronchial hyper-responsiveness diseases such as asthma or chronic obstructive pulmonary diseases.Clinicians should pay great attention to this situation and be prepared to cope with serious adverse reactions.

Purpose To investigate the significance of PET/CT in differential diagnosis of incidental thyroid benign or malignant lesions with high fluorodeoxyglucose (FDG) uptake.Materials and Methods Forty cases with focal high FDG uptake lesion in thyroid accidently detected by PET/CT were retrospectively collected. The subjects were dived into physiological uptake group (n=18), benign lesion group (n=16) and malignant lesion group (n=6) according to the pathology or follow-up examinations. The average SUVmax of different groups was analyzed, and ROC curve was used todetect benign or malignant lesions.Results The average SUVmax was 3.7±1.1 in physiological uptake group, 4.9±2.3 in benign lesion group and 9.5±4.8 in malignant lesion group. Significant difference was noticed among the three groups. The average SUVmax in malignant lesion group was higher than that of the other two groups with statistical difference (P<005). No significant difference was observed between physiological uptake group and benign lesion group (P>0.05). ROC analysis showed that the sensitivity and specificity for thyroid malignant tumor were 100.0% and 87.2% at SUVmax of 8.5.Conclusion18F-FDG PET/CT plays an important role in differentiating benign lesions of thyroid from malignance, but it is not helpful to identify benign lesions from physiologic uptake.

Objective To explore the protective effect of atorvastatin on irradiated endothelium and the thrombomodulin(TM)expression.Methods Cultured human coronary artery endothelial cells(HCAEC)and human umbilical vein endothelial cells(HUVEC)were treated by atorvastatin at the final concentration of 10 μmol/ml for 10 min,and then irradiated with 2 and 25 Gy.Cell cycles status and TM expression were quantitatively measured by flow cytometry 24 hours after irradiation.Protein C activation in endothelial cells was also assessod.Results After administration with atorvastatin for 24 h,the TM expression increased by 77%,59% and 61% in normal control group,2 Gy group and 25 Gy group,respectively(t=27.395,26.420,58.065;P=0.000).The protein C levels decreased by 23% and 34% compared with the normal group post-irradiation to 2 and 25 Gy,but increased by 79% and 76% compared with the irradiated control group after administration with atorvastatin.The rates of cell apoptosis decreased by 6% and 16% in 2 Gy and 25 Gy groups,respectively after administration with atorvastatin for 24 h(t=4.178,17.863;P=0.000).Conclusions Atorva statin can protect endothelia cell from irradiation-induced apeptosis by increasing TM expression and protein C activation.

We mainly introduce the design of teaching objectives,teaching content,teaching strategies and teaching effect evaluation for the elective course of SPSS and statistical data processing and summarize and reflect on the implementation after teaching combined with the practical teaching of medical statistics.

When senescence induction is based on DNA damage, senescent cells display a unique phenotype, which has been termed “senescence-associated secretory phenotype”( SASP ) . SASP, including proinflammatory cytokines, growth factors, chemokines, matrix remodeling enzymes and other cytokines, may be an important driver of chronic inflammation and therefore may be part of a vicious cycle of inflammation, DNA damage and senescence. Senescence-associated secretory products released by such cells can affect the neighboring cells and further exacer-bate their regenerative capacity. SASP is associated with many chronic age-related diseases.

Objective:To investigate the effect of HLA-DRB1*07,13 allelic genes on the immune response to hepatitis B vaccination.Methods:896 healthy college students of Han nationality from Guangxi province,who had received standard courses of vaccination with recombinant hepatitis B virus vaccine,were tested the level of anti-HBs with ELISA method at the sixth month after their last vaccination.The non- or hypo-responders were selected to receive another 20 μg doses of recombinant vaccine and were examined anti-HBs once more four weeks later.99 non- or hypo-responders and 136 medium or hyper-responders were selected for the study subjects.HLA-DRB1*07,13 allelic genes of the subjects were detected by polymerase chain reaction using sequence specific primer (PCR-SSP) method.Results:The frequencies of HLA-DRB1*07 gene in the non- or hypo-responders group were significantly higher than that in the medium or hyper-responder group (16.16% vs 4.41%,P＜0.05). No significant difference of HLA-DRB1*13 gene between the two groups (1.01% vs 3.68%,P=0.389).Conclusion:There is a close relationship between the expression of HLA-DRB1*07 gene and the non- or hypo-response to HB vaccine;No relationship between HLA-DRB1*13 gene expression and the response to HB vaccine is found.