Clinical Etiologies of Fever of Unknown Origin in 500 Cases / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the distribution and change of the causes of fever of unknown origin(FUO).</p><p><b>METHODS</b>The clinical data of 500 inpatients with FUO in our center between December 2003 and June 2014 were retrospectively analyzed. The diagnostic methods,etiologies,and their possible relationship with age,sex,fever duration,and period.</p><p><b>RESULTS</b>Of these 500 FUO patients,452(90.4%)were confirmed to be with fever caused by conditions including infectious diseases [(n=231,46.2%;e.g.tuberculosis(32.9%,76/231)],connective tissue diseases(CTD)(n=99,19.8%),neoplasms(n=58,11.6%),miscellaneous causes(n=64,12.8%). The causes were not identified in 48 cases(9.6%).The proportion of CTD in female patients was significantly higher than that in male patients(26.3% vs. 14.5%,P=0.025),whereas the proportion of neoplasms in male patients was significantly higher than that in female patients(14.5% vs. 8.0%,P=0.001). Infectious diseases was the most common cause in all age groups,CTD ranked the second in the 21-39-year group and 40-59-year group,and neoplasm was the second most coomon cause in the over 60 year group. Thus,the distribution of FUO etiologies significantly differed in different age groups(χ(2)=43.10,P=0.000). The duration of fever in patients with neoplasms [60(28,90)d] was longer than that in patients with infectious diseases [28(21,42)d,Z=-4.168,P=0.000] or CTD [30(21,60)d,Z=-2.406,P=0.016)]. Compared with the level in 2003-2008,the proportion of CTD significantly increased in 2009-2014(13.7% vs. 23.8%,χ(2)=8.598,P=0.003),along with the dicrease of the proportions of infectious diseases,neoplasms and miscellaneous diseases were decreased(all P>0.05).</p><p><b>CONCLUSIONS</b>Infectious diseases(in particular,tuberculosis)remains the major cause of FUO. CTD and neoplasms also play important roles in the development of FUO. The distributions of the FUO etiologies have certain differences in terms of age,sex,duration of fever,and period.</p>

Determination of myclobutanil 25% WG degradation dynamics in ginseng root, stem, leaf and soil by HPLC-MS/MS / 中国中药杂志

A high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) method was developed for determining degradation dynamics and final residues of myclobutanil 25% WG in ginseng root, stem, leaf and soil. The samples were extracted with acetonitrile, cleaned-up with primary secondary amine (PSA) solid phase extraction cartridge, separated by Kromasil Eternity-5-C18 (2.1 mm x 150 mm, 5 microm) column with a gradient of acetonitrile and 0.1% formate in water as mobile phases, and analyzed with the multiple reaction monitoring (MRM) in positive ion mode by employing the external standard method. The average recoveries and the relative standard derivations (RSDs) of myclobutanil at the spiked level of 0.01-0.20 mg x kg(-1) were 80.9%-90.7% and 5.54%-9.29%, respectively, and the limit of quantification (LOQ) was 0.005 mg x kg(-1). The method with good reproducible, high precision and low detection limit could meet the requirements of residual analysis on ginseng production. The half-lives of myclobutanil were from 6.25 days to 9.94 days in ginseng root, stem, leaf and soil at spraying dosage of 1 152 g x hm(-2) The final residues were below 0.060 1 mg x kg(-1) in root, below 0.081 7 mg x kg(-1) in stem, 0.006 0-0.102 2 mg x kg(-1) in leaf and below 0.037 6 mg x kg(-1) in soil at spraying dosage range from 576 to 1 152 g x hm(-2). It is recommended that the MRLs of myclobutanil in dried ginseng may be suggested to be 0.10 mg x kg(-1) temporarily, and the preharvest interval was set at 35 days.

A family associated outbreak of Mycoplasma pneumoniae infection in a hospital ward / 中华流行病学杂志

Objective To describe the epidemiological and serological features on a family associated outbreak caused by Mycoplasma pneumoniae (MP) infection occurred in Beijing in August 2007.Methods Mutual exposure of the family members was investigated and retrospective medical record was reviewed for the hospitalized patients.Serum antibodies to MP were measured and chest X-rays were taken for all the family members.Results This family consisted of 5 members,with fixed members as the boy (13 years old ),his father (43 years old) and mother (44 years old),grandmother (64 years old) and uncle (32 years old ) who was involved in taking care of the sick boy and his father.During 23 days of the event,four of all the five family members were ill.Three (boy,father and uncle) had radiographic pneumonia,whose paired sera all showed a ≥ fourfold increase in antibody titer,and two of them were confnrmed by chest X-ray on day 2 after onset of fever.The grandmother suffered from bronchitis,with positive(PA) serum antibody to MR Serum MP-IgG from the father and uncle was positive,3 days and 2 days after the onset of fever.The chances of contact between grandmother with the boy and uncle with the father were both only in the hospital wards.Only the mother remained asymptomatic,with her serum MP-IgM (-)and MP-IgG ( + )for which the blood sample was collected 37 days after close contact with the boy.The longest time of exposure to the patients was between mother and the boy but only the mother did not increase her total workload or feeling for fatigue.Conclusion Results of MP-IgG from post-infection did not completely defend against the repeated MP infection.Combined risk factors as index patients with severe cough,prolonged close contact,poorly ventilation of the environment,and family members with excessive fatigue might work as the causes of this family MP outbreak.