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Objective To study the clinical characteristics and treatment of adult patients with tsutsugamushi disease in Nantong area,and to reduce the misdiagnosis and missed diagnosis.Methods Clinical data of 24 adult patients with tsutsugamushi disease who were admitted between 2010 and 2012 at Department of Emergency Medicine in Affiliated Hospital of Nantong University were reviewed retrospectively.The patients were 13 males and 11 females who were aged from 25 to 70 years old.Minocycline capsule was orally administrated as the mainstay of the therapy.Results All of the 24 cases of tsutsugamushi disease were presented with fever,predominantly with high fever.The body temperature of higher than 39 ℃ was recorded in 23 cases,and temperature of 38.0 ℃ to 38.9 ℃ was recorded in one case.Three cases complained with sore throat and cough,and 1 case with palpitation and chest distress.One eschar or ulcer was seen in 21 cases,2 eschars or ulcers only in 1 case.Twenty-one cases were presented with lymphadenopathy,11 cases with rash,3 cases with enlargement of the liver,and 4 cases with splenomegaly.The distribution of eschar or ulcer included inaxillary fossa,groin,external genitalia and crissum,waist,popliteal fossa,the lower edge of the female breast and skin folds of chest wall,the inside of the wrist,ankle,neck,retroauricular region,chest-back and the buttocks.The white blood cell count of (2.5-3.9) × 109/L in blood routine test was seen in 4 cases,(10.1-18.6) × 109/L in 3 cases.The blood platelet count was decreased in 1 case.Urinary protein was positive in 4 cases by urine routine examination.Blood biochemical examination revealed that elevated serum alanine aminotransferase was seen in 2 cases,elevated serum creatinine was in 1 case,mildly elevated cardiac troporin I was in 1 case,increased C-reactive protein was found in 19 cases.On Weil-Felix test,17 cases showed OXk titers of 1∶160-1∶320.Four cases showed an increase in overall lung markings,localized pulmonary infiltration shadow and even small pleural effusion on chest radiography.Electrocardiogram showed premature ventricular beats and slight ST segment changes in 2 patients.Oral minocycline showed obvious effect.Conclusions The clinical manifestations of tsutsugamushi disease can be variable.Multi organ dysfunction could be presented besides fever.The skin eschar and ulcer are the most pathognomonic for this disease and thus should be thoroughly examined for its presence to avoid misdiagnosis.

As a member of tyrosine kinases(TK) family,Epidermal growth factor receptor(EGFR) has an activity of intrinsic protein tyrosine kinase,which plays an essential role in the regulation of signal transduction in the cells.Due to the abnormal expression of EGFR-TK,the certain type cancers may developed and progressed.Based on that,the inhibitors of EGFR-TK could be effective medicines for the treatment of cancer.The EGFR-TK domain was amplified by RT-PCR with RNA of HUVCEs cells as the template and expressed in E.coliBL21(DE3) using plasmid pET30a as vector.The recombinant protein was purified with the affinity chromatography(Ni-NTA),which was identified to have kinase activity catalyzing the substrate phosphorylated with ATP in the enzymatic reaction.Using the recombinant EGFR-TK as target,the screening model for enzymatic inhibitors was constructed.

Objective To design a system for real-time monitoring patients Based on Zigbee.Methods A wireless monitoring system was developed,the hardware of which was based on micro-cpu of MCS08 and Zigbee chip MC13192.Results Through this wireless system,doctors and nurses could know the location and physical situation of patients in real time so that the patients who were critically ill could be treated in time and the work of doctors and nurses could be relieved.Conclusion The system for monitoring patients in hospital based on Zigbee meets the nosocomial condition and can raise curative efficiency.

Background The visual system of animal have to optimally adjust in various environmental conditions in order to obtain stable and effective visual funetion.However,the color vision system of animals which encounter uncertainty of spectral signals should be plastic.Whether the densities of various cones and expression of opsins change with long-time spectral deprivation is unclear.Objective This study was to investigate the changes of cone density as well as the expression of corresponding opsin and mRNA following the long-term illumination of monochromatic light.Methods Thirty 3-day-old guinea pigs were randomized into 3 groups and exposed tO the 530 nm green light,400 nm purple light and white light for consecutive 8 weeks respectively.The flat-mounted retinal sample was prepared and divided into dorsal zone,ventral zone and mixed zone anatomically according to the distribution of difierent light-sensitive cone.The changes in density of cone cells sensitivited to different colored light were detected by single-1abel or double-label immunocytochemistry.The levels of opsin and its mRNA were determined using Western-blot and real-time PCR respectively.Results The density of green-sensitivity cones was significantly different in the dorsal zone of retina among green light group,purple light group and white light group (F=234.28,P<0.01).Compared with white light group,the density of green-sensitive cones in dorsal retina of green light group was obviously higher but that of purple light group wag evidently lower(q=389.68,P<0.01；q=67.11,P<0.01).No significant difference was found in the density of purple-sensitive cones in the ventral zone of retina among green light group,purple light group and white light group(F=3.14,P>0.05).The density of coexpression of the mixed cone cells was increased in green light group(q=157.55,P<0.01)but decreased in purple light roup (q=254.85,P<0.01)in comparison with white light group.The expression levels of green-opsin and green-opsin mRNA in green light group was significantly elevated(q=184.45,P<0.01；q=4.71,P<0.05),but those of purple light group were evidently declined(q=5.87,P<0.05；q=346.66,P<0.01)in comparison with white light group.There was no statistically significant differences were found in the expression of purple-opsin and its mRNA among all the groups(F=1.24,P>0.05；F=3.27,P>0.05).Conclusion After the exposure of long-time monochromatic light illumination,monochromatic cones density and its opsin in guinea pig occur the corresponding alteration to gain good spatial vision as a compensatory reaction.These outcomes imply that there is some plasticity during the development of color vision.The increase of green-sensitive cones might be from the differentiation of coexpression cones in transition region.

Background An ethylnitrosourea(ENU)-induced mutant strain C57BL/6 mouse model has been established by our research group.This model is proved to have the spontaneous phenotype of corneal opacity and the typical pathological process similar to human keratitis.Therefore,this model is expected to be a good animal model in the research of the mechanism,hereditary property,and development of drugs for corneal infectious diseases.Objective The present study is to investigate the biological features of opportunistic pathogens using a mouse Staphylococcus-infected corneal model(C57BL/6 mouse) induced by N-ethyl-N-nitrosourea(ENU),and offers an evidence of stability in this animal model.Methods Ten-week-old male C57BL/6 mice were treated with ENU at 150mg/kg by intraperitoneal injection,and then mated with female mice after 60 days.Corneal opacity mutant mice in the F1 generation were selected to backcross with C57BL/6 mice.The bacteria were isolated from the eyeballs of the mutants and cultivated,purified and identified.Drug sensitivity assay was carried out to screen for effective antibiotics for clinic medical care.Results The staphylococcus-infected corneal mouse model(B6-Co) was established successfully,and the Staphylococcus sciuri strain was separated and purified,and then the sensitive antibiotics were distinguished from resistant ones.The sensitive drugs for Staphylococcus sciuri included azithromycin,clindamycin,chloramphenicol,gentamicin,rifampicin,tetracycline,amikacin,sulfamethoxazole compound sinomin,minocycline,levofloxacin,cephalothin,cefotaxime,and furazolidone;whereas this Staphylococcal strain was resistant to cefoxitin,penicillin,ampicillin,novobiocin.Nitrofurantoin showed an intermediate sensitivity.Conclusion The C57BL/6 mouse model is a spontaneous-derived animal model that is infected by coagulase-negative staphylococci,among which the most abundant strain is Staphylococcus sciuri.

Objective To observe the effects of sevoflurane and propofol on cerebral oxygen metabolism and postoperative cognitive function during cardiopulmonary bypass (CPB). Methods Fifty ASA Ⅱ or Ⅲ patients aged 40-65 years old scheduled for cardiac valve replacement surgery with CPB were randomly assigned into two groups,sevoflurane group (group S) and propofol group (group P),25 in each group.Two groups of patients used the same method of anesthesia induction:midazolam 0.1 mg?kg-1,sufentanil 0.7 μg?kg-1,vecuronium 0.1 mg?kg-1,and etomidate 0.2 mg?kg-1 were intravenously injected successively,and then tracheal intubation was performed.For maintenance of anesthesia,patients of group S continuously inhaled 3%-4% sevoflurane, and patients of group P were intravenous pumped with propofol 4-6 mg?kg-1?h-1 via vein;midazolam,sufentanil and vecuronium bromide were intermittently injected in both groups.At the time points of pre-bypass (t1), nasopharynx temperature dropping to constant temperature regularly ( t2 ) ,nasopharynx temperature rising to constant temperature regularly ( t3 ) ,1 h after the end of CPB ( t4 ) ,and 6 h after the end of CPB ( t5 ) ,blood from radial artery and right jugular bulb was harvested for blood gas analysis,and mini-mental state examination( MMSE) score were evaluated before and 24 and 48 h after the surgery. Results The jugular venous bulb oxygen saturation( SjvO2 ) in the two groups were both increased during T2 period and then decreased during t3 period, but arteriovenous oxygen content difference ( AVDO2 ) and oxygen extraction rate (O2ER) were both decreased during t2 period and then increased during t3 period.There was no significant difference between the two groups during t2 and t3 period (P>0.05).MMSE scores of the two groups after operation were all less than those before operation,but that was significantly higher in the sevoflurane group than in the propofol group 24 h after the surgery ( t=4.34,P<0.05) . Conclusion The two anesthesia methods can meet the need of valve replacement surgery and maintain the cerebral oxygen balance during CPB period, but sevoflurane anesthesia has fewer influences in post-operation mental nerve functional changes.

BACKGROUND:The key of vertebroplasty and percutaneous kyphoplasty to success is whether the puncture needle can accurately reach the vertebral body through pedicle. Therefore, it is important to identify the correct point and direction of needling in the X-ray fluoroscopy. Among many methods published in present reports, the puncture point and the puncture angle are not fixed. Few reports concerned whether the puncture needle perforated pedicle medial wal . OBJECTIVE:To seek safe, effective puncture point and the puncture angle of percutaneous pedicle from the perspective of anatomy and radiography. METHODS:The best entry point during percutaneous vertebroplasty in the X-ray fluoroscopy:dissection was performed on thoracic, lumbar skeletal samples (T 6-L 5 ) to find the position of pedicle axis leading to the rear of the vertebral body, and this position is the best entry point of percutaneous vertebroplasty. It was fixed with mini-screw. The relationship of the best entry point and pedicle developing position in the X-ray fluoroscopy was analyzed to find the best entry point in the X-ray fluoroscopy. The best entry angle during percutaneous vertebroplasty:The average included angle of pedicle axis and vertebral sagittal line was measured using autopsy and CT scanning on adult thoracic and lumbar skeletal samples (T 6-L 5 ). The best entry angle during percutaneous vertebroplasty was found. RESULTS AND CONCLUSION:During percutaneous vertebroplasty, the best entry point in the X-ray fluoroscopy was the left pedicle projection 9 area and right pedicle projection 3 area. The optimal needle angle during percutaneous vertebroplasty:5°-10° in lumbar vertebra L1-L4;20° in L5, not more than 25°;about 5° in thoracic vertebra T6-T12 .

Objective To observe the influence of local-anaesthetic combined with dezocine on brachial plexus block and postoperative analgesia.Methods 60 patients scheduled for unilateral upper limb operation were randomly divided into two groups of C group and D group with 30 cases in each group.The brachial plexus block was performed under ultrasound guiding.Two groups received a bolus injection of local anesthetic 30ml,but the local bolus injection of D group consisted of Dezocine 10mg.The tine of sensory blocked producing effect,anesthesia effect,sensory blocked duration were observed.Two hours after sensory nerve recovered,the scores of VAS pain and Ramsay Sedation were recorded.Adverse reactions of perioperation were also observed(nausea,vomiting,dizzy,respiratory,urine retention,pruritus).Results The sensory blocked duration in D group was(7.1±1.1)h,which was significantly longer than that of C group[(4.5±0.8)h](t=10.47,P＜0.01);Two hours after sensory nerve recovered,the score of VAS pain in D group was(1.7±0.7)points,and significantly lower than that of C group[(3.9±1.0)points](t=9.87,P＜0.01).Both two groups had no adverse reactions.Conclusion Addition dezocine 10mg to local anesthetic solutions for interscalene brachial plexus block,it could prolong the sensory block duration,provide satisfactory postoperative analgesia,have no adverse reactions.

Objective To investigate the diagnosis value of the cytological examination of the cerebrospinal fluid of central nervous system leukemia.Methods Adopting cell smear centrifugal machine to collect the cerebrospinal fluid cells,the cells were stained and examinated under the microscope.Results Fifty-nine children with different type of leukemia had been examinated by 438 times by cerebrospinal fluid.The positive rates of the cases and samples were 15.3% and 8.7%,respectively.Conclusion The cytological examination of cerebrospinal fluid is especially valuable for the early diagnosis ,therapy and relapse of central nervous system leukemia of monitoring.