Abstract: Objective　To confirm three severe scrub typhus patients in Mianyang of Sichuan Province using laboratory diagnosis and analyze their clinical characteristics to provide theoretical evidence for the prevention and treatment of scrub typhus in this area. Methods　From June 2021 to August 2022, blood specimens and clinical data were collected from three severe scrub typhus patients in Mianyang of Sichuan Province. The epidemiological history was surveyed and the collected clinical data were analyzed. Acute-phase whole blood, serum samples at admission, and convalescent-phase serum samples two weeks later were collected, and the IgG titers of anti-Orientia tsutsugamushi were detected by indirect immunofluorescence assay (IFA) assays. Total DNA was extracted from anticoagulation whole blood using DNA extraction kit, and semi-nested polymerase chain reaction (PCR) was used to amplify the special gene of O. tsutsugamushi. Phylogenetic trees were constructed using the maximum likelihood (ML) method to determine the genotype of the strains. Results　The clinical symptoms of these three patients were extremely similar to other infectious febrile diseases, with two cases showing obvious eschars on physical examination and all three cases causing pneumonia. Epidemiological investigation revealed that all had a history of wild animal exposure or fieldwork. Specific IgG antibodies to O. tsutsugamushi tests showed that convalescent serum antibodies increased by four times or more compared to the acute-phase serum. The TSA56 gene sequence fragment was obtained by PCR amplification, and BLASTn comparison on the NCBI website showed a close phylogenetic relationship with the TA763 genotype and Karp genotype of Orientia tsutsugamushi. The results indicated that these three cases were indeed infections of O. tsutsugamushi. Conclusions　Laboratory diagnosis confirmed the clinical diagnosis of severe scrub typhus in three patients, providing specific evidence of etiology. This is the first report of etiology-confirmed cases of scrub typhus in Mianyang City, Sichuan Province. Analyzing their clinical features as well as the genotypes is of guiding significance for early diagnosis, differential diagnosis, and adjuvant therapy of scrub typhus in this region.

The study aimed to achieve enhanced targeted cytotoxicity and cell-internalization of cisplatin-loaded deoxyribonucleic acid-nanothread (CPT-DNA-NT),mediated by scavenger receptors into HeLa cells.DNA-NT was developed with stiff-topology utilizing circular-scaffold to encapsulate CPT.Atomic force microscopy (AFM) characterization of the DNA-NT showed uniformity in the structure with a diameter of 50-150 nm and length of 300-600 nm.The successful fabrication of the DNA-NT was confirmed through native-polyacrylamide gel electrophoresis analysis,as large the molecular-weight (polymeric) DNA-NT did not split into constituting strands under applied current and voltage.The results of cell viability confirmed that blank DNA-NT had the least cytotoxicity at the highest concentration (512 nM) with a viability of 92％ as evidence of its biocompatibility for drug delivery.MTT assay showed superior cyto-toxicity of CPT-DNA-NT than that of the free CPT due to the depot release of CPT after DNA-NT inter-nalization.The DNA-NT exhibited targeted cell internalizations with the controlled intracellular release of CPT (from DNA-NT),as illustrated in confocal images.Therefore,in vitro cytotoxicity assessment through flow cytometry showed enhanced apoptosis (72.7％) with CPT-DNA-NT (compared to free CPT;64.4％).CPT-DNA-NT,being poly-anionic,showed enhanced endocytosis via scavenger receptors.

Objective To know the influence of comprehensive nursing intervention on the prognosis of elderly patients with chronic heart failure. Methods By the prospective study method, 76 cases of elderly patients with chronic heart failure were selected from January 2014 to July 2015 as the research objects. According to the different methods of hospital care, they were divided into the observation group and control group, patients in the observation group had accepted the comprehensive nursing intervention measures, while the patients in the control group adopted conventional nursing intervention measures. Compared the nursing effect, anxiety scale (SAS), depression (SDS), left ventricular ejection fraction (LVEF), 6-minute walking distance and heart failure in the quality of life scores between the two groups. Results After 3 months of comprehensive nursing intervention, the rate of grasp nursing knowledge, compliance, nursing satisfaction and readmission in the observation group was 78.95%(30/38), 81.58%(31/38), 92.11%(35/38), 31.58%(12/38) respectively, which was significant better than that of in the control group 57.89%(22/38), 65.79%(25/38), 57.89%(22/38), 52.63%(20/38),respectively, the differences were statistically significant (χ2=3.897 4-7.916 7, P<0.05). The score of SAS, SDS, LVEF and the length of the 6-minute test in the observation group was 41.6±3.9, 45.3±5.2, (52.1±5.5)%, (568.3± 44.2) m, which was significant better than that of in the control group, 46.8 ± 4.7, 51.6 ± 4.9, (46.8 ± 4.6)%, (462.3 ± 46.5) m, t=4.556 6-10.185 1, P<0.05. Conclusions Comprehensive nursing intervention can effectivey improve the prognosis of patients with chronic heart failure, slow the progression of disease, and then strength the confidence of fighting disease.