Objective To explore the changes of etiological factors,age of onset,misdiagnosis rates,length of stay and prognosis in central nervous system (CNS) infections between the near 2 decades.Methods A retrospective analysis was conducted between hospitalized patients with CNS infections in affiliated Yijishan Hospital of Wannan Medical College from January 1993 to December 2002 (group A,n =346) and from January 2003 to December 2012 (group B,n =412).The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections between the 2 groups were comparable.Age,gender,underlying diseases and prehospitalization applications of immunosuppressant in two groups were analyzed.The data of prehospitalization misdiagnosis rates,length of stay and prognosis of the two groups were also compared.Measurement data were analyzed by variance analysis or t test,and enumeration data were analyzed by x2 test.Results The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections in two groups were 24.3％ vs 20.1％,29.5 ％ vs 35.7 ％,6.6％ vs 11.4％ and 39.6％ vs 32.8％,respectively (x2 =10.61,P＜0.05).Compared with group A,patients in group B were older [(38.8±8.9) years vs (43.8±11.4) years,t=6.73,P＜0.05],with greater numbers of underlying diseases (1.21 ± 0.34 vs 1.72 ± 0.41,t=18.41,P＜ 0.05) and longer pre-use of immunosuppressants [(7.76 ± 3.58) d vs (12.43 ± 5.96) d,t =12.77,P＜ 0.05].There was no significant difference in sex distributions between the two groups (x2 =0.97,P＞0.05).In group A,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 9.5％,42.2％,69.6％ and 12.4％,respectively; average length of stay was (11.02±5.13) d,(19.18±8.34) d,(21.12±9.26) d and (8.24±3.17) d,respectively; and remission rates were 88.1％,60.8％,34.8％ and 80.3％,respectively.In group B,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 8.4％,29.3％,42.6％ and 11.1％,respectively; average length of staywas (10.13±4.25) d,(17.26±5.82) d,(23.05±7.97) d and (7.05±2.94) d,respectively; and remission rates were 90.4％,72.8％,61.7％ and 84.4％,respectively.The misdiagnosis rates and remission rates of Mycobacterium tuberculosis infections and Cryptococcus infections between group A and group B were of statistical significance (both P ＜ 0.05).Conclusions With the increase of underlying diseases and wide use of immunosuppressants,the causes of CNS infections are changing,among which Mycobacterium tuberculosis infections and Cryptococcus infections are increasing,with a tendency of misdiagnosis and poor prognosis.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

OBJECTIVETo observe the intervention of Xuezhikang (XZK) on patients of acute coronary syndrome (ACS) with different levels of blood lipids.

METHODSAdopting the double blind randomized controlled method, 105 patients of ACS were divided into two groups. The 53 patients in the treated group, 26 with normal blood lipids (NBL) and 27 with hyperlipemia (HL) were treated with conventional western medicine plus XZK 1.2 g per day for 12 weeks. The 52 patients in the control group, 25 with NBL and 27 with HL, were treated with conventional western medicine alone. Besides, a healthy control group consisted of 40 subjects was set up. The changes of brachial arterial endothelium-dependent diastolic function (FMD) before and after treatment was observed, the changes of blood levels of nitric oxide (NO), endothelin-1 (ET-1), C-reactive protein (CRP) and lipids were also recorded.

RESULTSBefore treatment, FMD value and serum NO level were lower and ET-1 and CRP levels in ACS patients were higher than those in the healthy subjects, and a significant correlation existed between CRP, NO and FMD with LDL-C. After treated for 12 weeks, FMD value and serum NO level increased, levels of ET-1 and CRP decreased significantly in the treated group, showing significant difference to those in the control group (P < 0.05, P < 0.01). Serum levels of TC, TG and LDL-C in the treated group lowered significantly. HDL-C level in patients with HL increased significantly while in those with NBL, it showed a trend of increasing but with no statistical significance.

CONCLUSIONApplying XZK in ACS patients in early stage, either with NBL or with HL, could improve the endothelial function, antagonize inflammatory response to stabilize the atheromatous plaque.

Adult ; Aged ; Angina, Unstable ; blood ; complications ; drug therapy ; Biological Products ; Cholesterol ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperlipidemias ; blood ; complications ; drug therapy ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Myocardial Infarction ; blood ; complications ; drug therapy ; Phytotherapy