Objective To study the morphologic and pathological characteristics of cat scratch disease(CSD).Methods Eight cases with clinical data and tissue blocks were collected in Guangxi Zhuang Autonomous Region and Hainan Province.The tissues were successively stained by hematox- ylin and eosin,Warthin-Starry(W-S),acid fast and periodic acid-schiff(PAS)methods to study the histopathological changes and pathogens.Results W-S positive Bartonella henselae was the major pathogen of CSD and there was no acid-fast or PAS positive pathogen could be found in the tissues. There were three forms of histological representation as follows:plasmocytoid monocytes(PMO)and monocytoid B-cells(MBC)hyperplasia plus neutrophils immersion in lymphatic sinus(2 cases); MBC rich granuloma and micro-abscess formation(3 cases); starlit abscess with little or no bacteria in the granuloma(3 cases).Conclusions Bartonella henselae mainly transmits through cats.Contact histo- ry with cats and lymphadenectasis suggest the possibility of CSD.The diagnosis can be confirmed by the presence of W-S staining positive bacteria,MBC rich granuloma or micro-abscess and neutrophil reactions in histopathological exam.

BACKGROUND:Morphological characteristics of the rabbit lumbar vertebrae are of great significance for animal experiments about lumbar spine, but there is a lack of study on the lumbar morphology in rabbits. OBJECTIVE:To establish a three-dimensional model of rabbit lumbar vertebrae, and to observe its morphological characteristics, thereby providing anatomical basis for the animal experiments about lumbar spine.METHODS:Twenty New Zealand rabbits were subjected to 64-row multi-detector CT (Siemens) scan, and the three-dimensional models were constructed based on the CT data from 140 lumbar vertebrae. The morphological parameters of L1-7 were measured, and the internal and external structures of lumbar vertebrae and changes of different segments were observed. RESULTS AND CONCLUSION:(1) Changes of the morphological parameters of each lumbar vertebra:the L1-7 height first increased and then decreased, and the shortest height was in the L7, which was (1.12±0.18) cm. L1 vertebral body exhibited the shortest transverse diameter, (1.03±0.15) cm, and the longitudinal diameter did not differ significantly among vertebrae. The transverse and longitudinal diameters of L1-6 spinal canals were on a rise, but decreased abruptly at L7. The pedicle width of L1-7 increased gradually;the pedicle height of L1-5 increased gradually, and then began to decrease markedly, and the shortest at L7, (0.58±0.11) cm. The width and length of L1-6 spinous process increased steadily, but decreased at L7. The length of L1-3 transverse process increased gradually, tended to be steady at L3-6, and increased notably at L6-7;there were significant differences in the transverse process angle at L1-6, but the angle increased markedly to (58±2)° at L7, (2) These results indicate that the internal and external structures of lumbar vertebrae and changes of different segments are obtained through morphological measurement of lumbar vertebrae in New Zealand white rabbit, which provides a detailed anatomical data for relative animal experiments.

Objective To observe the curative effect of warm needling therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine on patients with scapulohumeral periarthritis and its effects on immunoglobulin IgA, IgG and IgM;To explore the mechanism. Methods Ninety patients with scapulohumeral periarthritis were randomly divided into needle with medicine group, needle group and medicine group, 30 cases in each group. Patients in the needle with medicine group were treated with needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine, patients in the needle group were treated with needle warming therapy, patients in the medicine group were treated with kidney-supplementing and blood-activating Chinese herbal medicine, 30 days for medicine and every other day for acupuncture. Five time acupuncture was one course of treatment, and patients were treated for 3 courses. Shoulder pain index was evaluated, and the levels of IgA, IgG and IgM was determined before and after 3 courses treatment. The total curative effect of the three groups were compared. Results The total effective rates for needle and medicine group, needle group and medicine group were 93.33% (28/30), 73.33% (22/30), 66.67% (20/30), respectively, with statistical significance between needle and medicine group and the other two groups (P<0.05),without statistical significance between needle group and medicine group (P>0.05). There was statistical significance between the shoulder indexes before and after treatment of the three groups (P<0.05). Before treatment, the levels of IgA, IgG and IgM of all three groups increased significantly compared with the normal reference values (P<0.05). After treatment, the levels of IgA, IgG and IgM were reduced significantly in three groups after treatment (P<0.05), the levels of IgA, IgG and IgM in the needle and medicine group were significantly lower than those in the other two groups (P<0.05). Conclusion The curative effect of needle warming therapy combined with kidney-supplementing and blood-activating Chinese herbal medicine was better than alone needle warming therapy or kidney-supplementing and blood-activating Chinese herbal medicine. This combined therapy could significantly improve the symptoms of patients, reduce the levels of IgA, IgG and IgM, regulate the body immune function, which is probably one of the mechanisms in the treatment of scapulohumeral periarthritis.

Objective To investigate the short and longterm effect of the treatment on acute coronary syndrome(ACS) with percutaneous coronary angioplasty and stenting.Methods 65 patients suffering from ACS were treated with angiography to illuminate the features of lesions and proceeded with percutaneous coronary angioplasty and stenting when the angina was not completed controlled with internal medicine.All patients were treated with a new anti-thrombotic regimen,including aspirin,ticlopidine or clopidogrel, and low-molecular-weight heparin.Results The rates of success for patients and lesions were 96.9% and 82.7% respectively.One patient died without myocardial infarction or emergency bypass surgery.56 patients had no symptom of angina after procedure,and 5 patients had non-typical chest pain which disappeared within 2~3 days.During the 3~54 month follow-up,one patient died,one patient developed myocardial infarction and 4 patients underwent target vessel revascularization(repeated angioplasty 2 and bypass surgery 2).Conclusions With the widespread use of aspirin-ticlopidine-low molecular heparin regimen,ACS patients can undergo PTCA and stenting with high success rate,excellent immediate efficacy and long-term efficacy.

Objective:To investigate the clinical effect and mechanisms of ceftriaxone combined with ranitidine on the acute pancreatitis.Methods:92 cases of patients with acute pancreatitis were selected and randomly divided into the control group (n=46) and experimental group (n=46),the control group was treated with ceftriaxone,and the experimental group was treated with ranitidine based on the control group,the serum levels of intedeukin-6 (IL-6),c-reactive protein(CRP),platelet activating factor (PAF),superoxide dismutase (SOD),propylene glycol (MDA),gastric secrete element,stomach,heart rate (HR),mean arterial pressure (MAP),and the relief time of clinical manifestation and the clinical efficacy were observed and compared between the two groups.Results:After treatment,the serum levels ofIL-6,CRP,PAF,MDA,gastric secrete element and HR of experimental group were significantly lower than those of the control group (P＜0.05).The serum levels of SOD,stomach motion element and MAP of experimental group were higher than those of the control group (P＜0.05).The relief time of clinical manifestation and total efficiency of experimental group were better than those of the control group (P＜0.05).Conclusions:Ceftriaxone combined with ranitidine could effectively enhance the clinical efficacy of acute pancreatitis,which might be related to the anti-oxidation and anti-inflammation.

OBJECTIVE: To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA), to investigate whether there is a difference in the prevalence of depression and anxiety between PsA and rheumatoid arthritis (RA) patients and to identify associated risk factors for depression and anxiety in PsA patients. METHODS: PsA and RA patients who visited Department of Rheumatology and Clinical Immunology in Peking University First Hospital from May 2018 to Sep 2019 were recruited. Self-rating anxiety scale and self-rating depression scale were surveyed and compared between PsA and RA patients. Demographics and clinical features including age, gender, disease duration, disease activity score, psoriasis area and severity index (PASI), and medical application were collected. Power Doppler and grey-scale ultrasound of joints, tenosynovitis and enthesis were performed. Multivariate Logistic regression was used to identify the factors associated with mood disorders and the odds ratio of depression and anxiety between the PsA and RA patients. RESULTS: Among the 114 enrolled PsA patients, 37 (32.5%) had mood disorders, in which 36 (31.6%) with depression and 15 (13.2%) with anxiety. Compared with 201 RA patients, PsA patients showed greater odds for depression [adjusted OR (95%CI): 2.7 (1.1-6.4)]. Depression was more often observed in the PsA than in the RA patients (31.6% vs. 18.9%, P=0.011). The similar trend for anxiety was also observed, although the difference was insignificant (13.2% vs. 8.5%, P=0.185). Age (OR=0.95, P=0.008), psoriasis duration (OR=0.94, P=0.018), pain visual analogue scale (OR=1.47, P=0.011), PASI score (OR=1.07, P=0.007) and presence of ultrasound enthesitis (OR=4.13, P=0.009) were identified as factors associated with depression in the PsA patients. PASI score (OR=1.07, P=0.001) was identified as associated factor for anxiety in the PsA patients. CONCLUSION The prevalence of depression and anxiety is elevated in PsA patients. Depression is significantly more prevalent in PsA patients than in RA patients. Younger age, shorter psoriasis duration, worse pain and presence of ultrasound enthesitis are associated with depression, while severe psoriasis rash is associated with both depression and anxiety in PsA patients.
Anxiety/etiology* ; Arthritis, Psoriatic/epidemiology* ; Depression/etiology* ; Enthesopathy ; Humans ; Prevalence

OBJECTIVETo observe the analgesic effect of triptolide (TP) of high, middle and low doses on rats with adjuvant arthritis (AA), and the expressions of inducible nitric oxide synthase (iNOS) and substance P (SP) in spinal dorsal horn and dorsal root ganglion (DRG) of corresponding sections, in order to discuss the possible mechanism for the analgesic effect of TP on rats with adjuvant arthritis.

METHODFifty SD rats were selected and randomly divided into the normal group (group A), the model group (group B), and TP low (group C), middle (group D), high (group E) dose groups. Except for the group A, all of the remaining groups were injected with 0.1 mL of Freund's complete adjuvant through their right rear toes to establish the model. At 14 d after the model establishment, rats in C, D and E groups were intraperitoneally injected with different doses of TP (0.1 mg x kg(-1) for the group C, 0.2 mg x kg(-1) for the group D, 0.4 mg x kg(-1) for the group E) once a day for 9 days. Then the 50% mechanical withdraw threshold (MWT) was determined. And the expressions of iNOS and SP in lumbar5 (L5) spinal dorsal horn and DRG were detected with the immunohistochemical method.

RESULTThe 50% MWT of rats in the group B was significantly lower than that of the group A (P < 0.01). After being treated with TP, the Thermal withdrawal latencies of groups C, D and E were significantly higher than that of the group B (P < 0.01). TP could notably increase the MWT of AA rats, with a certain dose-effect relationship. The immunohistochemical results indicated that the iNOS and SP expressions significantly increased in the group B (P < 0.01), while the positive expression levels of iNOS and SP in groups C, D and E were significantly lower than that of the group B (P < 0.01), with a certain dose-effect relationship.

CONCLUSIONTP shows a good analgesic effect on AA, and could inhibit the iNOS and SP expressions in spinal dorsal horn and DRG in rats with adjuvant arthritis, which may be one of action mechanisms for the analgesic effect of TP.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Diterpenes ; pharmacology ; Dose-Response Relationship, Drug ; Epoxy Compounds ; pharmacology ; Female ; Ganglia, Spinal ; drug effects ; metabolism ; Immunohistochemistry ; Male ; Nitric Oxide Synthase Type II ; biosynthesis ; Pain Measurement ; methods ; Phenanthrenes ; pharmacology ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; drug effects ; metabolism ; Substance P ; biosynthesis ; Time Factors ; Treatment Outcome ; Tripterygium ; chemistry

ObjectiveTo investigate the pathogens and prognostic factors of AIDS-associated severe pneumonia. MethodsClinical data were collected from 95 patients with AIDS-associated severe pneumonia admitted to Guangzhou No. 8 People' s Hospital from January 2005 to December 2008. The pathogens of pulmonary infections were investigated. Univariate analysis and multivariate logistic regression analysis were performed to study the relationships between the outcome and influencing factors. Results The most prevalent pathogen was Pneumocystis jirovecii (64/95, 67.4％ ), followed by bacteria (61/95, 64.2％ ),fungi ( 50/95, 52. 6％ ), mycobacterium tuberculosis ( 27/95, 28. 4％ ) and cytomegalovirus ( CMV ) (25/95, 26.3％ ). Among 95 cases, monocontamination was detected in 15 cases ( 15.8％ ), while mixed infection in 80 cases (84. 2％ ). Logistic regression analysis showed that mechanical ventilation, higher serum lactic dehydrogenase (LDH) level and severe underlying diseases were risk factors for the death of AIDS-associated severe pneumonia, and higher serum albumin level was the protective factor. Conclusion Pneumocystis jirovecii, bacteria and fungi are the main pathogens for AIDS-associated severe pneumonia, and mixed infection is popular.

Objective To investigate gene polymorphisms of drug targets and mutations associated with drug resistance in Pneumocystis jiroveci (P.jiroveci) isolates.Methods Among 148 samples isolated from human immunodeficiency virus (HIV)infected patients with pneumonia in Guangdong,mitochondrid larg subunit rRNA (mtLSUrRNA) gene was amplified from 51 samples.Dihydropteroate synthase (DHPS),dihydrofolate reductase (DHFR) and Cytochrome b (CYB) genes of P.jiroveci were detected by gene sequencing,and compared with the reference sequences in GenBank to evaluate gene polymorphisms.Results P.jirovecii DHPS,DHFR and CYB genes were all successfully amplified from 51 samples.For DHPS gene,48 (94.1％) were wild-type and 3 (5.9％) had gene mutation associated with drug resistance.For DHFR gene,30 were wild-type,and 21 had a synonymous mutation at position 312,and 1 nonsynonymous mutation at position 188.There were no mutations associated with drug resistance.For CYB gene,polymorphisms of were detected at 5 sites,4 of which were synonymous mutations,1 was non-synonymous mutation.No mutation associated with drug resistance was found.Based on the gene polymorphism of CYB6,the strains can be classified into 6 genotypes,and 2 were first detected,including 25 CYB1,13 CYB2,2 CYB5,4 CYB8,as well as newly detected 4 CYB10 and 3 CYB11 strains.Conclusions The mutations associated with drug resistance in P.jiroveci isolates in Guangdong remain uncommon.CYB gene shows gene polymorphisms and can be selected as one of targeted genes for multilocus sequence typing.

Humans ; Jaw, Edentulous ; therapy ; Maxilla ; Prostheses and Implants