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Objective To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen,and to accumulate experience in the diagnosis and treatment of HFRS in this area.Methods A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018.The demographic characteristics,epidemiological,clinical manifestations,examinations,treatments and prognosis,and other characteristics were analyzed.Results All the 46 patients with HFRS were residens in Shenzhen,with a male-to-female ratio of 6.67:1.00 (40:6),aged (40.18 ± 15.63) years old,and 38 patients (82.61％) aged 23-45 years old.There were 41 patients (89.13％) with a history of HFRS epidemiology,and there were mice in their houses or workplaces.The houses of 39 patients (84.78％) were rented,and 34 patients (87.18％) rented their houses in urban villages.There were morbidity throughout the year,and 33 patients (71.74％) were ill from January to June.In clinical classification,44 cases (95.65％) were mild,2 cases (4.35％) were medium,and there were no severe or critical cases.The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia.Thirty-nine patients (84.78％) were presented with systemic aches,headaches,low back pain and eyelid pain,and 28 patients (60.87％) had skin and mucous membrane hyperemia flushing.Clinical stages showed that all patients had pyretogenesis stage and polyuria stage,including pyretogenesis stage [(7.34 ± 6.82) d],polyuria stage [(9.94 ± 5.77) d],only 4.35％ (2/46) patients with hypotension shock stage,all patients did not have oliguric stage.On the next day of admission,the number of white blood cells in 46 patients was (8.17 ± 3.19) × 109/L,and 38 cases (82.61％) in the normal range;platelet was (61.92 ±32.53) × 109/L,and 42 cases (91.30％) were decreased;the procalcitonin was (1.62 ± 0.38) ng/ml,and 41 cases (89.13％) were increased;C-reactive protein was (74.33 ± 30.48) mg/L,and 46 patients (100.00％) were elevated;creatinine was (176.25 ± 55.15) μmol/L,and 19 cases (41.30％) were increased.Abnormal liver function was manifested by increased enzymology,alanine aminotransferase was (137.58 ± 46.76) U/L,and aspartate aminotransferase was (129.82 ± 40.29) U/L.All patients were positive for Hantavirus IgM.B-ultrasound results showed that in 58.70％ (27/46) patients,both kidneys were plump and the parenchymal echo was enhanced.Liver injury occurred in 39 patients (84.78％) and sinus bradycardia in 2 patients (4.35％).All the 46 patients were clinically cured.Conclusion The epidemiological characteristics of patients with HFRS in Shenzhen are typical,the clinical manifestations are mild,and the curative effect and prognosis are good.
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Objective@#To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen, and to accumulate experience in the diagnosis and treatment of HFRS in this area.@*Methods@#A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018. The demographic characteristics, epidemiological, clinical manifestations, examinations, treatments and prognosis, and other characteristics were analyzed.@*Results@#All the 46 patients with HFRS were residens in Shenzhen, with a male-to-female ratio of 6.67∶1.00(40∶6), aged (40.18 ± 15.63) years old, and 38 patients (82.61%) aged 23-45 years old. There were 41 patients (89.13%) with a history of HFRS epidemiology, and there were mice in their houses or workplaces. The houses of 39 patients (84.78%) were rented, and 34 patients(87.18%) rented their houses in urban villages. There were morbidity throughout the year, and 33 patients (71.74%) were ill from January to June. In clinical classification, 44 cases (95.65%) were mild, 2 cases (4.35%) were medium, and there were no severe or critical cases. The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia. Thirty-nine patients (84.78%) were presented with systemic aches, headaches, low back pain and eyelid pain, and 28 patients (60.87%) had skin and mucous membrane hyperemia flushing. Clinical stages showed that all patients had pyretogenesis stage and polyuria stage, including pyretogenesis stage [(7.34 ± 6.82) d], polyuria stage [(9.94 ± 5.77) d], only 4.35% (2/46) patients with hypotension shock stage, all patients did not have oliguric stage. On the next day of admission, the number of white blood cells in 46 patients was (8.17 ± 3.19) × 109/L, and 38 cases (82.61%) in the normal range; platelet was (61.92 ± 32.53) × 109/L, and 42 cases (91.30%) were decreased; the procalcitonin was (1.62 ± 0.38) ng/ml, and 41 cases (89.13%) were increased; C-reactive protein was (74.33 ± 30.48) mg/L, and 46 patients (100.00%) were elevated; creatinine was (176.25 ± 55.15) μmol/L, and 19 cases (41.30%) were increased. Abnormal liver function was manifested by increased enzymology, alanine aminotransferase was (137.58 ± 46.76) U/L, and aspartate aminotransferase was (129.82 ± 40.29) U/L. All patients were positive for Hantavirus IgM. B-ultrasound results showed that in 58.70% (27/46) patients, both kidneys were plump and the parenchymal echo was enhanced. Liver injury occurred in 39 patients (84.78%) and sinus bradycardia in 2 patients (4.35%). All the 46 patients were clinically cured.@*Conclusion@#The epidemiological characteristics of patients with HFRS in Shenzhen are typical, the clinical manifestations are mild, and the curative effect and prognosis are good.
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Objective To analyze the clinical features of patients with acute stage brucellosis in Shenzhen,and provide a scientific basis for prevention and control of brucellosis in immigrant city.Methods A retrospective analysis was conducted to collect clinical data of patients with brucellosis admitted to the Department of Infectious Diseases,Shenzhen People's Hospital from May 2013 to May 2018.The patient's epidemiology manifestations,pathogen and laboratory examination results,diagnosis and treatment outcomes and prognosis were analyzed.Results Among the 39 patients with brucellosis,males were predominant,with a male to female ratio of 1.4 ∶ 1.0 (23 ∶ 16),an age of (44.91 ± 17.18) years and 24 cases were non-Guangdong natives.There were 23 cases with epidemiological history,including 14 cases with mutton,sheep viscera and goat milk history;the disease occurred throughout the year,mainly from February to July,a total of 26 cases.The clinical manifestations of the patients were mainly fever,sweating,fatigue,joint and muscle pain,weight loss,and liver or spleen or lymph nodes swelling.The blood culture was identified as 38 cases of Brucella melitensis and 1 case of Brucella suis.All strains were sensitive to common antibiotics in vitro.All cases were diagnosed as acute stage of brucellosis,2 cases with orchitis,1 case with brucellosis meningoencephalitis,3 cases with spondylitis,and 3 cases with misdiagnosis.Thirty-nine patients were cured according to the "Brucellosis Diagnosis and Treatment Guidelines (Trial)" and were followed up for 1 year.Conclusions Patients with brucellosis in Shenzhen are mainly infected with Brucella melitensis;fever,sweating,joint and muscle pain are the main clinical symptoms;the patient's efficacy and prognosis are better after treatment;for the occurrence of occasional misdiagnosis,it is recommended that in immigrant cities,medical staff should strengthen their understanding of brucellosis.
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Object To investigate the therapeutic effects and mechanism of traditional Chinese compound decoction of Radix Curcumae (RC), Rhizoma Sparganii (RS), and Rhizoma Zedoariae (RZ) (DRRR) on liver fibrosis in rats induced by carbon tetrachloride (CCl 4). Methods Fifty Wistar rats were randomly divided into four groups: group A was healthy control (n=8), group B was model rats of liver fibrosis induced by CCl 4 (n=14), group C and D were treated with DRRR after the liver fibrosis in rats induced by CCl 4 four weeks later (n=14). B, C, and D groups were injected subcutaneously with CCl 4; C and D groups were administrated with DRRR 0.6 and 1.2 g/100 g, once per day. After administration of DRRR four weeks all rats were sacrificed, their blood and liver were harvested for further examination. The effect of DRRR was explored by the expressions and sites of transforming growth factor-beta 1 (TGF-? 1), Smad3 and Smad7 in liver tissues by immunohistochemical staining. The liver function, serum hyaluronic acid (HA), and liver histopathology were also examined by biochemsitry, RIA, HE, and Van Gieson stainings respectively. Results To compare with model group, in rats that received DRRR, the expressions of TGF-? 1 and Smad3 were significantly decreased, while the expression of Smad7 was obviously increased in the livers (P
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Objective To investigate the effect and its mechanism of “JinSanE” on liver fibrosis induced by carbon tetrachloride (CCl4) in rats. Methods Thirty-six Wistar rats were divided into three groups: healthy controls, CCl4 induced cirrhotic rats, and CCl4 induced cirrhotic rats treated with “JinSanE”, which was begun at the fourth week after exposure to CCl4. “JinSanE” was given once a day. Rats were killed after the administration of “JinSanE” for 4 weeks. The anti-fibrosis effect was determined by the expressions of connective tissue growth factor (CTGF) and transforming growth factor-? 1 (TGF-? 1) in liver tissue. The CTGF and TGF-? 1 mRNA expressions were detected by RT-PCR, CTGF and TGF-? 1 were assessed after immunohistochemistry staining. The serum level of hyaluronic acid (HA) was determined by RIA, and the liver histopathology was observed with light and electronic microscopy. Results Compared with the CCl4 induced cirrhotic rats, the expressions of TGF-? 1 and CTGF were decreased in the liver of the rats which were given “JinSanE” (P