Abstract: Objective　 This article aims to present a rare case of severe fever with thrombocytopenia syndrome (SFTS) complicated by with bacteraemia caused by Campylobacter jejuni, and to discuss the pathogenic characteristics, culture methods, clinical features and treatment points of Campylobacter jejuni and the patient's outcome, with a view to raising clinical awareness of blood culture and providing experience for the treatment of this disease. Methods　The clinical data of a case with SFTS complicated by bacteremia caused by Campylobacter jejuni admitted to Weihai Municipal Hospital were collected and the diagnostic process of the pathogenic bacteria as well as the treatment plan were retrospectively analysed. Results　The patient was a female who had been bitten by a tick bite half a month ago and presented to the hospital on 30th August with a fever, vague pain in the peribulbar abdomen and diarrhea for 5 days. Laboratory tests showed leukopenia and thrombocytopenia, and nucleic acid detection for SFTS was positive, resulting in a diagnosis of SFTS. After a week of antiviral treatment with ribavirin and symptomatic treatment, the patient suddenly experienced high fever at night, with a temperature reaching 39.5 °C. Blood cultures were immediately taken from both sides of the double bottle. Bilateral anaerobic bottles were tested for positive after 53.06 hours, and Gram-negative Campylobacter was cultured anaerobically in a transfer blood plate and further identified as Campylobacter jejuni using mass spectrometry MALDI-TOF MS. Vancomycin was stopped clinically on the basis of bacterial pathogenesis and meropenem was used for anti-infection and symptomatic treatment. During the treatment, blood culture and nucleic acid detection for SFTS turned negative, and the patient's symptoms improved. After normal results were achieved in the follow-up testing, the patient was discharged. Conclusions　This case serves as a reminder that Campylobacter jejuni not only causes intestinal infections, but can also lead to extra-intestinal infections in immunocompromised individuals. Clinical and laboratory personnel should increase their recognition of Campylobacter jejuni, prioritize blood culture methods, and utilize a multidisciplinary approach in diagnosis and treatment.

Acquired Immunodeficiency Syndrome ; microbiology ; Female ; Humans ; Mycoses ; diagnosis ; Young Adult

Aconitum, as a kind of common traditional Chinese medicine, contains multiple biological active substances, with a very high medicinal value but high toxicity. Its major toxic ingredients are aconitine, mesaconitine and hypaconitine, which are also efficient ingredients. Therefore, the safety of its clinical application has aroused wide attention. With the constant deepening of drug development studies, people want to learn about its toxic mechanism and the regularity of its emergence and development of its toxicology, so as to make a scientific and rational assessment for its safety. Therefore, toxicokinetics and metabonomics have gradually become important content in the new drug assessment. During the development of drug performance, it is crucial to establish a scientific, objective and standardized Aconitum safety evaluation system and correctly assess and utilize its toxicity. Having summarized studies on metabonomics and toxicokinetics of Aconitum drugs in recent years, authors proposed to strengthen the studies on Aconitum drug safety assessment and establish a scientific and standardized safety evaluation system as soon as possible, in order to make the national treasure more useful.
Aconitum ; chemistry ; toxicity ; Animals ; Drugs, Chinese Herbal ; pharmacokinetics ; toxicity ; Humans ; Metabolomics

In order to further improve the curative effect of the herb-participated moxibustion on umbilicus, we collected a wide range of literature on herb-participated moxibustion on umbilicus and then systematically arranged them to analyze and summarize the technology and operating methods of herb-participated moxibustion on umbilicus. We also briefly discussed issues on application of medicine, locust tree skin and ginger, the method of kneading dough for medical uses, and the appropriate size of moxa cone and its using frequency in order to form clear concepts and standardized operations to provide theories and operational basis for the clinical application of modern herb-participated moxibustion on umbilicus.
China ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Moxibustion ; history ; instrumentation ; methods ; Plants, Medicinal ; chemistry ; Umbilicus ; physiopathology

Objective To detect the expressions of miR-155,T helper type 17 (Thl7) cells,and Th17 cellspecific transcription factor RORγt and effector cytokine interleukin (IL)-17 in peripheral blood and skin lesions from,and to evaluate their relationship in,patients with atopic dermatitis (AD).Methods Peripheral blood was obtained from 37 patients with AD and 33 age-and sex-matched healthy controls,and biopsy specimens from the lesional and perilesional skin of five patients with severe AD as well as from the normal skin of five healthy human controls.Real-time fluorescence-based reverse transcription (RT)-PCR was employed to measure the mRNA expression levels of miR-155,RORγt and IL-17 in peripheral blood mononuclear cells (PBMCs) and skin specimens,flow cytometry to detect the percentage of Th17 cells in PBMCs,enzyme-linked immunosorbent assay (ELISA) to determine the plasma concentration of IL-17.Statistical analysis was done using independent sample's t test,one-way analysis of variance followed by the least significant difference test,and linear correlation analysis.Results Compared with the healthy controls,the patients with AD showed a significant increase in Th17 cell percentage (1.78％ ± 0.52％ vs.0.47％ ± 0.15％,P＜ 0.01),mRNA expression levels of miR-155 (5.78 ± 1.78 vs.1.82 ± 0.46,P＜ 0.01),RORγt (6.08 ± 1.04 vs.1.64 ± 0.52,P＜ 0.01) and IL-17 (7.09 ± 1.75 vs.1.71 ± 0.46,P＜ 0.01),as well as in the plasma concentration of IL-17 ((2.51 ± 6.15) pg/ml vs.(11.80 ± 2.24) pg/ml,P＜ 0.01).There was a sequential decrease in the expression levels of miR-155,RORγt and IL-17 mRNA from lesional skin,perilesional skin to normal skin (F =41.803,17.040 and 37.064 respectively,all P ＜ 0.01).The miR-155 mRNA expression level in PBMCs was positively correlated with the SCORing Atopic Dermatitis (SCORAD) index,Th17 cell percentage,RORγt and IL-17 mRNA expression levels as well as IL-17 plasma concentration (r =0.405,0.426,0.402,0.410 and 0.408 respectively,all P ＜ 0.05).Similarly,the miR-155 expression level was positively correlated with RORγt and IL-17 mRNA expression levels in lesional and paralesional specimens (r =0.428 and 0.435 respectively,both P ＜ 0.05).Conclusion The up-regulated expression of miR-155,Th17 cells and their effector cytokine IL-17 may be associated with the development of AD.

The leukocytic phagocytosis rate and the index of phagocytosis of rats on cross-linked agar beads entrapped attapulgite clay (CAA) hemoperfusion were studied. The results revealed that the leukocytic phagocytosis rate and the index of phagocytosis descended significantly after 1 hour and rose gradually after 6 hours. Finally it reached the normal level after 48 hours. Hemoperfusion repeated two times gave similar results. In conclusion, the function of leukocytic phagocytosis declined temporarily during CAA hemoperfusion. Many times hemoperfusion will not notably affect the body's defense system of rats.
Agar ; Animals ; Biocompatible Materials ; Hemoperfusion ; methods ; Leukocytes ; drug effects ; physiology ; Magnesium Compounds ; Male ; Materials Testing ; Microspheres ; Phagocytosis ; drug effects ; Rats ; Rats, Wistar ; Silicon Compounds

To further explore the clinical effect of massage therapy on navel,the related ancient literatures were arranged and analyzed,and several methods in ancient clinical were introduced, including stroking navel, rubbing navel, pushing navel, tapping navel and puffing navel. In addition, the theoretical basis of massage therapy on navel were discussed. The results revealed ancient literatures offered abundant theoretical basis to modern clinical practice, and there were evidences of treating gastroenteric and gynecological diseases with this therapy. Comprehensively, through the study of ancient literatures and modern research, therapy of massage on navel is believed to be promising and will gain popularity in the future.
China ; History, Ancient ; Humans ; Massage ; history ; Medicine in Literature ; Umbilicus ; physiopathology

Objective To seauch the ideal management for gross hematuria in autosomal dominant polycystic kidney disease (ADPKD).Methods ADPKD patients who were ever hospitalized and followed up in our department since 1993 were enrolled in the study.Demographic and clinical data were colloected,such as gender,age of gross hematuria,level of renal function,causative factors,management strategies,duration of gross hematuria,blood platelet count,activated partial thromboplastin time,prothrombin time,international normalized ratio,size of kidney cyst and so on.ADPKD patients were divided into different groups according to causative factors or management.The clinical data were compared among groups.Results A total of 905 ADPKD patients were screened,among whom 279 patients ever had gross hematuria (male/female:150/129),One hundred and forty-six patients had integrated therapeutic process records,while only 101patients could provide relevant laboratory examination results.In these 101 patients,gross hematuria was found in any stage of chronic kidney disease (CKD); the average eGFR was (56.4±44.1) mml·min-1 ·(1.73 m2)-1; the duration of gross hematuria was (8.8±8.0) d; no significant difference between male and female in duration of gross hematuria existed [(8.2±7.3) d vs (9.5±8.8) d,P=0.426]; coagulation parameters were all normal.The platelet count was also normal in 91 patients.Duration of gross hematuria among groups divided according to different causative factors was significantly different (P＜0.05).The patients in bed rest group had significantly shorter duration of gross hematuria compared with other groups (P＜0.05).The platelet count,prothromhin time and international normalized ratio were all at similar level in different groups.Conclusions The causative factors in ADPKD patients with gross hematuria should be confirmed as the first step of management strategies.Bed rest is the key point in management.Antifibrinolytic agent is a proper choice in the cases receiving bemostatic drugs.It is unnecessary to use antibiotic agent for prevention.

Objective:To determine the effect of Notch1 signaling pathway on the differentiation and function of Th17 cells in murine psoriasis model.Methods: BALB/c mice were randomly divided into psoriasis model group and control group.Murine psoriasis model was established by topical 5% imiquimod application in combination with intraperitoneal injection of α-2b interferon.The CD4+ T lymphocytes were isolated by magnetic activated cell sorter (MACS).Flow cytometric analysis (FCM) was performed to detect the percentage of Th17 cells.Real-time RT-PCR was employed to measure the mRNA levels of RORγt,IL-17A,Notch1 and Hes-1.The CD4+ T lymphocytes were then divided into γ-secretase inhibitor DAPT groups and control group,and the expression differences of Notch1 signaling molecule and its target gene Hes-1 mRNA levels,Th17 cell percentage,RORγt and IL-17A mRNA levels,and IL-17A concentrations in cell-free supernatant were detected.Results: The expression levels of Th17 cell percentage and RORγt,IL-17A,Notch1 and Hes-1 mRNA in CD4+ T lymphocytes of murine psoriasis model were significantly higher than control mouse[(2.97±0.86)% vs.(0.65±0.11)%,t=15.083;(5.75±0.61) vs.(1.57±0.43),t=21.630;(7.83±0.97) vs.(1.63±0.31),t=25.348;(7.10±1.37) vs.(1.47±0.34),t=17.386;(7.30±1.15) vs.(1.67±0.48),t=18.840,respectively,all P<0.01].Compared with control group,Th17 cell percentage,mRNA expression levels of Notch1,Hes-1,RORγt and IL-17A,and IL-17A concentrations in cell-free supernatant from cultured CD4+ T lymphocytes of murine psoriasis model were dramatically decreased in DAPT treated groups in a dose-dependent way (F=74.368,89.719,126.572,94.558,124.323 and 123.231 respectively,all P<0.01).Conclusion: Notch1 signaling pathway can regulate the differentiation and function of Th17 cells in murine psoriasis model,and may have potential value for the target immunotherapy of psoriasis.

OBJECTIVE To analyze the antimicrobial resistance of Acinetobacter baumannii.METHODS A.baumannii was collected in our hospital from Jan 2003 to Dec 2006.Antimicrobial susceptibility testing was performed by disk-diffusion method.RESULTS A total of 548 A.baumannii were collected during 4 years.Of these isolates,130(23.7%) strains were from intensive care unit(ICU),190 strains(34.7%)from surgical,and others from medical and emergency departments.Most of strains(78.5%) were isolated from sputum,next from wound.The prevalence of A.baumannii was increasing during last 4 years.Results of susceptibility test showed that imipenem was the most active antibiotic against A.baumannii.The resistance rates were high to most antibiotics.Most of the resistant strains was from the ICU and the general ward differentand had significant difference.More than 50% of isolates were resistant to all antimicrobial agents tested except imipenem and ciprofloxacin in ICU.CONCLUSIONS The prevalence of A.baumannii is increasing.A.baumannii isolates show high resistance to multiple antibiotics,especially in ICU.