Objective To analyze the clinical characteristics and treatment schemes of patients with severe Japa-nese spotted fever(JSF),and provide a basis for the diagnosis and treatment of severe JSF.Methods Data of JSF patients who admitted to Yichang Central People's Hospital from April 2022 to September 2024 were collected,and severe patients were selected for analysis.Epidemiological and clinical characteristics,as well as treatment schemes were investigated.Results A total of 19 JSF patients were admitted,including 10 mild cases and 9 severe cases.All 9 severe cases(100％)had a history of outdoor activities.All patients presented with multiple organ dysfunc-tion besides symptoms such as fever,rash,fatigue,poor appetite,and scab.Laboratory examination results were as follows:white blood cell count and neutrophil percentage elevated in 5(55.6％)and 9(100％)cases,respective-ly;lymphocyte percentage and platelets decreased in 9(100％)and 8 cases(88.9％),respectively;C-reactive pro-tein increases significantly in 9 cases(100％);alanine aminotransferase and aspartate aminotransferase increased in 9 cases(100％)and 8 cases(88.9％),respectively;total protein,albumin,and albumin/globulin ratio decreased in 6 cases(66.7％)and 9 cases(100％),respectively;blood sodium and blood calcium decreased in 3(33.3％)and 9 cases(100％),respectively;urea elevated in 8 cases(88.9％);creatinine,lactic dehydrogenase and α-hydroxybu-tyrate,and creatine kinase isoenzyme elevated in 6(66.7％),9(100％),and 4 cases(44.4％),respectively.In terms of treatment,all patients were treated with doxycycline combined with other antimicrobial agents.Six pa-tients(66.7％)received tracheal intubation for ventilator-assisted ventilation;8 patients(88.9％)received infusion of blood products such as platelets and plasma;9 patients(100％)received infusion of albumin and support treat-ment such as liver and stomach protection,water and electrolyte balance maintenance,et al;6 patients(66.7％)were finally cured.Conclusion Severe JSF not only causes typical symptoms such as fever,rash,and scab,but also leads to multiple organ dysfunction.Timely application of doxycycline supportive treatment for various organs can help patients get through the critical period and receive effective treatment.

Objective To analyze the clinical characteristics and treatment schemes of patients with severe Japa-nese spotted fever(JSF),and provide a basis for the diagnosis and treatment of severe JSF.Methods Data of JSF patients who admitted to Yichang Central People's Hospital from April 2022 to September 2024 were collected,and severe patients were selected for analysis.Epidemiological and clinical characteristics,as well as treatment schemes were investigated.Results A total of 19 JSF patients were admitted,including 10 mild cases and 9 severe cases.All 9 severe cases(100％)had a history of outdoor activities.All patients presented with multiple organ dysfunc-tion besides symptoms such as fever,rash,fatigue,poor appetite,and scab.Laboratory examination results were as follows:white blood cell count and neutrophil percentage elevated in 5(55.6％)and 9(100％)cases,respective-ly;lymphocyte percentage and platelets decreased in 9(100％)and 8 cases(88.9％),respectively;C-reactive pro-tein increases significantly in 9 cases(100％);alanine aminotransferase and aspartate aminotransferase increased in 9 cases(100％)and 8 cases(88.9％),respectively;total protein,albumin,and albumin/globulin ratio decreased in 6 cases(66.7％)and 9 cases(100％),respectively;blood sodium and blood calcium decreased in 3(33.3％)and 9 cases(100％),respectively;urea elevated in 8 cases(88.9％);creatinine,lactic dehydrogenase and α-hydroxybu-tyrate,and creatine kinase isoenzyme elevated in 6(66.7％),9(100％),and 4 cases(44.4％),respectively.In terms of treatment,all patients were treated with doxycycline combined with other antimicrobial agents.Six pa-tients(66.7％)received tracheal intubation for ventilator-assisted ventilation;8 patients(88.9％)received infusion of blood products such as platelets and plasma;9 patients(100％)received infusion of albumin and support treat-ment such as liver and stomach protection,water and electrolyte balance maintenance,et al;6 patients(66.7％)were finally cured.Conclusion Severe JSF not only causes typical symptoms such as fever,rash,and scab,but also leads to multiple organ dysfunction.Timely application of doxycycline supportive treatment for various organs can help patients get through the critical period and receive effective treatment.

【Objective】 To investigate the therapeutic effect of Huaier on acute pancreatitis (AP) and its potential mechanism. 【Methods】 A mouse model of cerulean-induced AP was used to verify the therapeutic effect of Huaier in vivo. HE staining and immunohistochemical staining were used to evaluate the histopathological changes of the pancreas, and transmission electron microscopy was used to observe the pyroptosis morphology of the pancreas. In vitro, 266-6 cell line was used as the experimental carrier to verify the protective effect of Huaier on acinar cells. Electron microscopy and Western blotting were used to evaluate the pyroptosis level of acinar cells, and ROS fluorescence probe was used to detect the oxidative stress state of acinar cells. 【Results】 Huaier significantly alleviated the severity of AP in mice. HE staining of pancreas showed that necrosis and inflammatory cell infiltration were reduced, and the level of serum amylase was decreased. Immunohistochemical staining and Western blotting showed that Huaier effectively inhibited the expressions of pyroptosis-related molecules such as NLRP3 and GSDMD in pancreatic tissue. Electron microscopy showed that Huaier could reduce the pyroptosis level of pancreatic acinar cells under inflammatory state. In addition, the level of ROS in acinar cells was significantly reduced after the intervention of Huaier, and ROS-mediated pyroptosis of acinar cells could be effectively inhibited by Huaier. 【Conclusion】 Huaier can effectively reduce the severity of AP by inhibiting ROS-mediated pyroptosis of acinar cells.

Objective:To analyze the clinical characteristics of acute pancreatitis.Methods:The retrospective case-control study was conducted. The clinical data of 558 patients with acute pancreatitis who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from June 2015 to June 2023 were collected. There were 352 males and 206 females, aged (46±15)years. Observation indicators: (1) general situations of acute pancreatitis patients; (2) etiology of acute pancreatitis patients; (3) severity of acute pancreatitis patients; (4) chronic diseases in acute pan-creatitis patients; (5) complications in acute pancreatitis patients; (6) subgroup analysis of patients with recurrent acute pancreatitis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Bonferroni correction was used for pairwise comparison. Results:(1) General situations of acute pancreatitis patients. There were significant differences in gender, age, total duration of hospital stay, smoking, and alcohol consumption between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (2) Etiology of acute pancreatitis patients. There were significant differences in gallstones and hyperlipidemia between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (3) Severity of acute pancreatitis patients. Of the 443 patients with first episode of acute pancreatitis and 115 patients with recurrent acute pancreatitis, cases with mild acute pancreatitis, cases with moderate-severe acute pancreatitis, cases with severe acute pan-creatitis were 320 and 83, 24 and 9, 99 and 23, showing no significant difference between them ( P>0.05). (4) Chronic diseases in acute pancreatitis patients. There were significant differences in com-plication as hyperlipidemia, fatty liver and diabetes between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (5) Complications in acute pancrea-titis patients. There was no significant difference in terms of acute necrotic collection, acute peripan-creatic fluid accumulation, walled-off necrosis, pancreatic pseudocyst, infectious pancreatic necrosis, systemic inflammatory response syndrome, respiratory system complications, circulatory system complications, renal complications, sepsis, abdominal compartment syndrome, or pancreatic ence-phalopathy between the first episode of acute pancreatitis patients and the recurrent acute pancrea-titis patients ( P>0.05). (6) Subgroup analysis of patients with recurrent acute pancreatitis. ① Combination with chronic diseases. Of the 115 patients with recurrent acute pancreatitis, cases with mild acute pancreatitis, cases with moderate-severe acute pancreatitis, cases with severe acute pancreatitis were 83, 9, 23, and there were 25, 8, 11 cases of them with hyperlipidemia, respectively, showing a significant difference among them ( P<0.05). ② Complications. Of the 115 patients with recurrent acute pancreatitis, there were 44 cases with hyperlipidemia and 71 cases without hyper-lipidemia, and there were significant differences in acute peripancreatic fluid accumulation and renal complications between them ( P<0.05). Conclusions:Recurrent acute pancreatitis is more common in males. Compared with first episode of acute pancreatitis, cases with recurrent acute pancreatitis usually have younger age, shorter total duration of hospital stay, higher proportion of smoking and drinking. The etiology of recurrent acute pancreatitis is composed of lower levels of biliary diseases and higher levels of hyperlipidemia. Patients with recurrent acute pancreatitis have higher proportion of comorbidities as hyperlipidemia, fatty liver and diabetes. There was no signifi-cant difference in the incidence of complications between first episode of acute pancreatitis and recurrent acute pancreatitis. Compared with recurrent acute pancreatitis patients without concomi-tant hyperlipidemia, recurrent acute pancreatitis patients with concomitant hyperlipidemia are more prone to acute peripancreatic fluid accumulation and renal complications.

Objective:To investigate the changes of serum catecholamines (CST) and oxidative stress index in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with hypertension and the correlation with blood pressure.Methods:Total of 100 OSAHS patients admitted to Jingmen No.1 People′s Hospital from February 2018 to August 2020 were selected. According to whether patients combined with hypertension, they were divided into OSAHS group (54 cases) and OSAHS combined with hypertension group (46 cases). The changes of serum CST and oxidative stress index in the two groups were compared and analyzed the correlation of blood pressure and CST and oxidative stress index.Results:The level of myeloperoxidase(MPO) in the OSAHS combined with hypertension group was higher than that in the OSAHS group: (41.67 ± 3.02) U/L vs. (39.11 ± 2.65) U/L; the levels of catalase (CAT) and CST in the OSAHS combined with hypertension group were higher than those in the OSAHS group: (11.47 ± 2.54) kU/L vs. (15.88 ± 2.31) kU/L, (23.63 ± 4.38) ng/L vs. (28.61 ± 5.42) ng/L, there were statistically differences ( P<0.05). The levels of respiratory disturbance index, lowest oxygen saturation, triacylglycerol, total cholesterol, low density lipoprotein cholesterin, high density lipoproteincholesterol, epinephrine, noradrenaline in the two groups had no significant differences ( P>0.05). Spearman correlation analysis showed that the systolic pressure and diastolic pressure had positive correlation with MPO ( P<0.05), and had negative correlation with CAT and CST ( P<0.05). Conclusions:The serum CST and CAT are down-regulated in patients with OSAHS with hypertension, and serum MPO is up-regulated. Oxidative stress may be related to OSAHS with hypertension.

Objective To study the relationships of alcohol consumption to the prevalence of metabolic syndrome and its re‐lated components in Yichang professional population and provide decision making basis for lifestyle intervention to MS crowd in the city .Methods We examined baseline data from 3 640 participants (2 285 men and 1 355 women) aged 20 to 70 years who under‐went a careful drinking habits survey ,then physical examination and blood chemical examination .They were divided into three groups by average ethanol intake [non ,occasional (<10 g/day) ,moderate (≥10 and <30 g/day) ,and heavy (≥30 g/day) drink‐ers] .Results Compared with no drinking and occasional drinking group ,the prevalence of MS and abnormal rate of BMI ,DBP ,TG , UA increased significantly (P< 0 .05) while SBP decreased significantly in moderate drinking group;compared with moderate drinking group ,the prevalence of MS and abnormal rate of BMI ,DBP and SBP ,GLU ,TCH ,TG ,LDL C ,UA increased significantly (P<0 .05) in heavy alcohol consumption group;whether moderate or heavy drinking ,abnormal rate of CRP and HDL C did not change significantly(P>0 .05) .Conclusion Even moderate drinking has a significant effect to BMI ,DBP ,TG ,LDL C ,UA ,but not obvious to CRP ,GLU ,TCH ,HDL C .Excessive alcohol consumption has a very bad effect on BMI ,DBP ,SBP ,GLU ,TCH ,TG , HDL C ,LDL C ,UA .Both the prevalence of MS and the abnormal rate of its related components are proportional to the alcohol in‐take .Although moderate drinking could lower SBP and GLU ,but can not reduce the incidence of MS .