Objective To investigate epidemiological and clinical features of human ehrlichiosis.Methods The epidemiological, clinical, laboratory, therapeutic and prognostic data of 21 clinically diagnosed cases of human ehrlichiosis were retrospectively analyzed. Results The epidemic regions where the ticks' activity was high located at the boundary between Hubei and Henan Provinces. All cases were farmers. The median age was 50 years ranged from 19 to 69 years. The male female ratio evident history of tick bite 1 week before the onset. The common symptoms included fever, diarrhea,cough, nausea and vomiting, abdominal pain and expectoration. The complications included hemorrhage, toxic encephalopathy, acute renal insufficiency, secondary infection and respiratory failure. The common abnormalities of routine lab data were thrombocytopenia, hypoeosinophilia,elevated lactate dehydrogenase, creatine kinase and aminotransferases, leucopenia and proteinuria.Nine cases were tested with peripheral blood smear and intracytoplasmic inclusions in neutrophils were found in one case. Seventeen cases were tested with serological assay and antibodies against Ehrlichia were positive in five cases. After doxycycline, symptomatic and supportive treatments, 14 cases were recovered and seven died. The average age of the deaths was 56 years. Conclusions Human ehrlichiosis is an acute tick-borne zoonosis and multiorgan could be involved. The older cases prone to develop complications and the prognosis is poor.

BACKGROUNDTo study the predictive factors associated with clinical deterioration in SARS patients.

METHODSThe clinical data of 60 SARS patients were analyzed by logistic regression and Cox's proportional hazards analysis.

RESULTSIn logistic regression models, both older age (P=0.009) and severe lymphopenia (P=0.004) were significant predictors of clinical deterioration. In Cox's proportional hazard models, severe lymphopenia was significant predictor associated with prolongation of stay in hospital.

CONCLUSIONOlder age and severe lymphopenia seem to be statistically significant for predicting the clinical deterioration in SARS patients.

Adult ; Aged ; Disease Progression ; Female ; Humans ; Logistic Models ; Lymphopenia ; virology ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Random Allocation ; SARS Virus ; Severe Acute Respiratory Syndrome ; complications ; diagnosis ; immunology ; virology

Distribution behavior of lipophilic drugs in the oil-in-water (O/W) microemulsions was studied. Fluorescence spectra analysis was performed to investigate the effect of the compositions of microemulsions on the fluorescence spectra of armillarisin and ofloxacin which were used as the model drugs. The fluorescence spectra of the model drugs in the microemulsions with various amount of the compositions were compared. The results showed that the armillarisin were both localized in the interfacial film of microemulsion systems with both phenylmethanol and PEG 400 as the co-surfactants, separately. Ofloxacin was localized in the interfacial film of microemulsion systems with Gradamol GTCC as the oil phase, but in the oil pool of microemulsion systems with oleic acid/olive oil (OA/OO) (1:1) as the oil phase. Besides, it was found that the drug would have the tendency to locate in the microenvironment where the composition with the largest solubility to model drug is located, and its actual localized position would be dependent on the amount of this composition. The results indicate that the localized region of lipophilic drug in the O/W microemulsion systems is related with the solubility of the model drug in various compositions.
Benzopyrans ; chemistry ; Benzyl Alcohols ; Emulsions ; Ofloxacin ; chemistry ; Oils ; Polyethylene Glycols ; Solubility ; Spectrometry, Fluorescence ; methods ; Surface-Active Agents ; Water

OBJECTIVETo explore the efficacy and feasibility of color Doppler flow imaging (CDFI)-guided inferior vena caval filter (IVCF) insertion through the right internal jugular vein for prevention of pulmonary embolism in patients with deep venous thrombosis (DVT).

METHODSThirty-eight patients with lower extremity DVT confirmed by clinical and CDFI examinations underwent IVCF insertion through the right internal jugular vein under guidance of CDFI for prevention of pulmonary embolism. The shape and position of IVCF were monitored by CDFI regularly. After 32 to 45 days, the retrievable filters were removed under CDFI guidance via the right internal jugular vein. All patients were followed up to monitor the occurrence of filter complications and pulmonary embolism PE.

RESULTSPreoperative CDFI clearly displayed the locations of the right internal jugular vein, inferior vena caval (IVC), bifurcation of the common iliac vein, and the bilateral renal veins in all the 38 patients. All the veins were free of anatomical variations or embolism. Under CDFI guidance, 23 retrievable IVCF and 15 permanent IVCF were placed without technical difficulty via the right internal jugular vein. Follow-up examination with CDFI and abdominal plain X-ray film showed that all the filters were placed in right positions with complete opening. The 23 retrievable filters were retrieved via the right internal jugular vein after 32-45 days. IVCF captured venous emboli in 14 cases (36.5%). None of the patients had filter displacement, tilting, or fracture or showed IVC perforation or the occurrence of pulmonary embolism.

CONCLUSIONCDFI-guided IVCF insertion via the jugular vein is safe and feasible. Compared with X-ray guidance, CDFI guidance is convenient and substantially reduces the procedural cost and avoids the risk of radiation exposure.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Jugular Veins ; surgery ; Male ; Middle Aged ; Pulmonary Embolism ; diagnostic imaging ; surgery ; Ultrasonography, Doppler, Color ; Ultrasonography, Interventional ; methods ; Vena Cava Filters ; Venous Thrombosis ; diagnostic imaging ; surgery ; Young Adult

Objective To evaluate the effect of an integrated control strategy and to quantify the spatial-temporal variation of infected snails in the bottomland areas after the strategy was implemented.Methods Based on the geographic database of infected snail distribution at the village level during 2004-2010 in Anxiang county,Hunan province,spatial autocorrelation analysis and spatial scan statistics were applied to analyze the spatial-temporal characteristics on the distribution of infected snails.Results The number of embankments with infected snails in Anxiang county decreased from 23 in 2004 to 10 in 2010,while the rate of frame with infected snail in embankments decreased from 4.32‰ in 2004 to 0.12‰ in 2010.The spatial distribution of infected snails was nonrandom,only in 2004 and 2005 with Moran's I=0.21 (P＜0.10) and Moran's I=0.13 (P＜0.10) respectively.Data from the local spatial auto-correlation analysis showed that the number of villages with H-H types of auto-correlation model had been gradually decreasing.The results of SaTScan statistics appeared the same as from the local spatial auto-correlation analysis,showing that the number of areas with increased risk was decreasing.Conclusion The comprehensive measures with emphasis on infectious source control seemed effective for schistosomiasis control program.The current distribution characteristics provided us with evidence that the resource assignment could be more reasonably implemented so as to control schistosomiasis in a more effective way.

OBJECTIVETo study the mechanism of paraquat-induced renal injury in rats.

METHODSAdult healthy Sprague-Dawley (SD) rats (female and male in half) were randomly divided into two groups, the control group and the paraquat poisoned group. The rats in the paraquat poisoned group were treated with PQ (25 mg/kg) intraperitoneally while the rats in the control group were treated with the same dose of normal saline. Its histopathological change was observed and the expression of HO-1 and the mRNA expression of HO-1 were detected by RT-PCR at 3rd h, 6th h, 12th h, on 1st d, 2nd d, 3rd d and 5th d.

RESULTS(1) In the control group, the tissue structure was clear without edema, vacuolar degeneration, cloudy swelling and necrosis. In the paraquat poisoned group, there were obvious lesions in the renal tubule of cortical part, including cellular swelling, the narrow cannula, the mesenchymal congestion and edema. These pathologic changes gradually became more severe, reached the peak on the 1st day, and did not relieve until the end of this study; there was the karyopyknosis and the cyto-architecture disappeared in some severe cases; Some glomerulus and medulla were also involved. (2) In the control group, there was no or weak expression of HO-1 and HO-1 mRNA. At the 3rd hour, the expressions of HO-1 in the paraquat poisoned group were observed in the membrane and cytoplasm of renal tubular epithelial cell of cortical part. Immunohistochemistry score (IHS) in the paraquat poisoned group was higher than that in the control group (P<0.05), except the HIS of the 5th day. At the 3rd hour, the expression of HO-1 mRNA increased, reached the peak on the 1st day, and then decreased. The expression of HO-1 mRNA was (0.53 +/- 0.21), (0.55 +/- 0.31), (0.56 +/- 0.22), (0.64 +/- 0.14) and (0.43 +/- 0.25) at the time point other than on the 3rd and 5th day. It showed statistical difference between the paraquat poisoned group and the control group from the 3rd hour to the 2nd day (P<0.05).

CONCLUSIONThe mechanism of paraquat induced-renal injury is multiple. The higher expression of HO-1 and HO-1 mRNA were involved in the procedures of paraquat-induced renal injury.

Animals ; Female ; Heme Oxygenase (Decyclizing) ; genetics ; metabolism ; Kidney ; enzymology ; pathology ; Male ; Paraquat ; poisoning ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

OBJECTIVEAntiphospholipid antibody (APL) is a particularly important laboratory diagnostic criterion for antiphospholipid syndrome (APS). The significances of positive APL in childhood are seldom reported nor fully understood. The purpose of this study was to analyze 13 cases with positive APL seen in our hospital and to study the relationship between the positive rates of APL and various clinical diseases especially systemic lupus erythematosus (SLE) in order to improve the clinical diagnoses and treatment level of APS in children.

METHODSThe clinical data collected from 2000 to 2002 of 13 hospitalized children with positive APL were retrospectively evaluated. Enzyme linked immunosorbent assay (ELISA) and indirect immunofluorescence technique were used respectively to detect APL and antineutrophil cytoplasmic autoantibodies (ANCA) of sera from those children. Other various indexes were also detected according to different characteristics of different diseases.

RESULTSEight cases had SLE; 2 had acute post-streptococcal infections. The other 3 cases did not show any evidences of primary diseases; they probably had primary APS. SLE was the most common primary diseases to cause development of APL and the cases with SLE showed more severe cutaneous vasculitis than SLE patients who were negative for APL. There was no significant relationship between the positive rates of APL and that of ANCA. Eight APL positive cases complicated with thrombocytopenia and bleeding were treated with high dosage of immunoglobulin [400 mg/(kg.d), for 3 - 5 d] intravenously; the clinical conditions of these cases were ameliorated soon. While the 5 cases who had thrombotic vasculitis and thromboembolism were treated with anticoagulant and antithrombotic therapy with low molecular weight heparin [50 - 100 U/(kg.d)], which led to good clinical effects.

CONCLUSIONSThe clinical manifestations of children positive for APL were somehow different from those of adults. Positive APL itself may be nonspecific, it can occur from different causes of diseases. APL detection may be useful to suggest anticoagulant and/or antithrombosis therapy. Treatments for APS should be variable according to different causes and severity of diseases, in the cases of thrombocytopenia and bleeding, high dose intravenous immunoglobulin should be given as soon as possible, while in the cases of thrombotic vasculitis and thromboembolism, anticoagulant and antithrombotic therapy should be given soon.

Adult ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Antibodies, Antiphospholipid ; blood ; immunology ; Anticoagulants ; therapeutic use ; Antiphospholipid Syndrome ; blood ; complications ; diagnosis ; therapy ; Child ; Fibrinolytic Agents ; therapeutic use ; Hemorrhage ; etiology ; therapy ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Lupus Erythematosus, Systemic ; immunology ; Streptococcal Infections ; immunology ; Thrombocytopenia ; etiology ; therapy ; Thromboembolism ; drug therapy ; etiology ; Thrombosis ; drug therapy ; etiology ; Vasculitis ; drug therapy ; etiology

OBJECTIVETo study the changes of body composition in females patients with human immunodeficiency virus (HIV)-related lipodystrophy (LD) syndrome (HIV-LD).

METHODSTotally 25 female patients who were treated in our hospital from January 2002 to December 2009 were divided into LD group and non-LD group based on the existence of LD. All these patients were receiving highly active antiretroviral therapy (HAART). In addition, 12 healthy women were set as the controls. Total and regional body composition were measured by dual X-ray absorptiometry in all three groups.

RESULTSThe fat mass (FM) was correlated negatively with the duration of HAART (r=-0.431, P=0.029). Multiple linear regression analysis showed that FM had positive correlation with weight and negative correlation with lean mass (LM) (r = - 0. 973, P =0. 000). Total, trunk and leg FM were significantly lower in LD patients than that in controls (P <0.05).Meanwhile, total, trunk and leg bone mineral contents were statistically lower in LD patients than that in controls (P <0. 05). Lumbar bone mineral density of LD patients was lower than that of non-LD patients and controls, and there was significant difference between LD patients and controls (P = 0. 001). LM of LD patients was higher than that of non-LD patients but without statistical difference (P > 0. 05).

CONCLUSIONSThe peripheral and central FM and bone mineral contents remarkably decrease in female patients with HIV-LD. How-ever, HIV-LD patients tend to have higher LM than non-LD patients. .

Adipose Tissue ; metabolism ; Adult ; Body Composition ; physiology ; Bone Density ; physiology ; Female ; HIV-Associated Lipodystrophy Syndrome ; metabolism ; Humans ; Middle Aged ; Young Adult

OBJECTIVETo study immunohistochemical expression of cytokeratin19 (CK19), galectin-3 (Gal-3) and HBME-1 in thyroid lesions and to assess their usefulness as markers in the differential diagnoses of thyroid nodular lesions.

METHODSImmunohistochemical staining was performed on formalin-fixed paraffin-embedded tissue of 21 cases of nodular goiters, 14 cases of toxic goiters, 15 cases of follicular adenomas (FA), 13 cases of follicular carcinomas (FC), 13 cases of follicular variant papillary carcinomas (FVPC) and 48 cases of classic papillary carcinomas (CPC).

RESULTSAll three markers were expressed in the cytoplasm with no or weak expression in benign lesions and diffuse and strong in malignant cases. Positive expressions of CK19, Gal-3 and HBME-1 were present in 11of 21, two of 21, four of 21 in nodular goiters, seven of 14, one of 14, one of 14 in toxic goiters, nine of 15, two of 15, two of 15 in FA, 10 of 13, eight of 13, seven of 13 in FC, 13 of 13, 11 of 13, 12 of 13 in FVPC, and 48 of 48, 45 of 48, 46 of 48 in CPC. The expression rates of the three markers between benign lesions (nodular goiters, toxic goiters and FA) and malignant lesions (FA, FVPC and CPC) were statistically significant. Among the three follicular lesions (FA, FC and FVPC), the differences were statistically significant as well. Nine, seven and six cases were negative for all three markers in nodular goiters, toxic goiters and FA, respectively. Only one case in FC was negative for all three markers, no case was all negative in FVPC and CPC; the rate of one case with two or more positive marker expression in nodular goiters, toxic goiters, FA, FC, FVPC and PC was 14.2% (3/21), 21.43% (3/14), 20.0% (3/15), 69.2% (9/13), 92.3% (12/13), 100.0% (48/48), the differences between benign lesions and malignant lesions and between FA, FC and FVPC were also statistically significant.

CONCLUSIONSImmunohistochemical stains of CK19, Gal-3 and HBME-1, especially when used in combination, can be an important adjunct to the histopathological diagnoses of thyroid lesions.

Adenocarcinoma, Follicular ; chemistry ; diagnosis ; pathology ; Adenoma ; chemistry ; diagnosis ; pathology ; Biomarkers, Tumor ; biosynthesis ; genetics ; Carcinoma, Papillary, Follicular ; pathology ; Diagnosis, Differential ; Galectin 3 ; biosynthesis ; genetics ; Goiter, Nodular ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Keratins ; biosynthesis ; genetics ; Thyroid Neoplasms ; chemistry ; diagnosis ; pathology ; Thyroid Nodule ; chemistry ; diagnosis ; pathology

OBJECTIVETo assess the usefulness of 2-(fluorine-18) fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in patients with cervical lymphadenopathy.

METHODSFrom March 1999 to October 2001, 27 patients with cervical lymphadenopathy were imaged with FDG-PET. Maximum and mean standard uptake value (SUVmax and SUVmean) of lymphadenopathy and SUV of normal cervical tissue (SUVneck) were measured. All 21 patients with malignant lymphadenopathy got pathologically confirmed.

RESULTSAll 26 malignant lymph nodes in 21 patients could be detected by FDG-PET. FDG uptake of these nodes was higher than that of cervical tissue (SUVmax, SUVmean and SUVneck were 4.62 +/- 2.31, 3.45 +/- 2.74 and 0.55 +/- 0.08, respectively P < 0.001). Other 9 benign lymph nodes in 6 patients couldn't be detected by FDG-PET. The accuracy of PET in 21 patients with malignant lymphadenopathy, was higher than those of routine examinations such as ultrasonography plus CT or MR (P < 0.001).

CONCLUSIONSFDG-PET allows effective diagnosis of patients with cervical lymphadenopathy and can contribute substantially to patient care.

Adult ; Aged ; Aged, 80 and over ; Female ; Fluorodeoxyglucose F18 ; Head and Neck Neoplasms ; diagnostic imaging ; Humans ; Lymph Nodes ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Young Adult