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Objective To perform an epidemiological investigation on a case of visceral leishmaniasis reported from Shule County, Kashi Prefecture, Xinjiang Uygur Autonomous Region in 2021, so as to provide insights into differential diagnosis of visceral leishmaniasis during the COVID-19 pandemic. Methods The epidemiological history of this case was collected, and the case was diagnosed for Leishmania infection with the immunochromatographic (rK39) strip test, bone marrow smear microscopy and PCR assay. Results The patient had typical clinical symptoms of leishmaniasis, including irregular fever, hepatosplenomeg- aly, low serum albumin and elevated globulin. Bone marrow smear microscopy identified L. donovani amastigotes, and both rK39 strip test and PCR assay were positive, while the case was tested negative for SARS-CoV-2. COVID-19 was therefore excluded and visceral leishmaniasis was diagnosed. Standard full-dose treatment with sodium stibogluconate was given, and no Leishmania was found on blood smears during the reexamination. No recurrence was found during the followup after discharge for hospital. Conclusions During the COVID-19 pandemic, it is recommended to increase the perception of differential diagnosis of visceral leishmaniasis among first-contact doctors, and reinforce the capability of differential diagnosis and health education of visceral leishmaniasis among medical and healthcare institutions at all levels, to prevent missed diagnosis and misdiagnosis of visceral leishmaniasis.
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Objective:To establish two differential gene expression profiles of qi-deficiency and blood stasis syndrome before or after safflower injection treatment by using gene chip technology;compared and analyzed to ensure the effective genes that are responsible for the therapeutic effects of safflower injection against qi-deficiency and blood stasis syndrome in rats.Furthermore,speculated the effect mechanism of the therapeutic genes.Methods:Fifteen SD rats were randomly divided into 3 groups (n=5):control group,model group,and medication group.Qi-deficiency and blood stasis model was established by subjecting the rats to hunger and fatigue for two weeks.After a week of the modeling,safflower injection (100 mg/kg/d) was administered daily via the tail vein for 7 days in medication group,and the rats in model group were injected with saline of the same volume.Control group received normal feeding.At the end of the experiment,rats were killed and whole blood was collected to evaluate the blood stream change and extract mRNAs in blood samples.Qualified mRNAs were reverse transcribed into cDNA which was then used in gene chip hybridization.The genes regulated by safflower injection were determined by the fluorescence signal and the functional mechanisms of safflower injection were confirmed by further querying genealogy databases and reviewing literatures.Results:After two weeks of the modeling,the whole blood viscosity under various shear rates was significantly increased in the model rats which showed faint,blood stasis and weight loss,indicating that the model is made successfully.The increased whole blood viscosity and qi-deficiency and blood stasis syndrome were obviously reversed by safflower injection treatment.Compared with the control group,252 genes up-regulated while 54 genes down-regulated in model group;compared with the model group,196 genes up-regulated while 32 genes down-regulated.Among these,16 differentially expressed genes were involved in inflammation and immune response.Conclusions:Safflower injection was effective in treating qi deficiency and blood stasis syndrome,which was achieved by regulating inflammation related genes.