简介：Theinitialassessmentoftravellersisaimedprimarilyatearlydetectionandtreatmentofmalaria(seepage32),whichcanberapidlyfatal.

简介：AcuterheumaticfeverisinitiatedbygroupAstreptococcalphar-yngitis.Thisisfollowedbyalatentperiodof2-6weeks,afterwhichtheclinicalsyndromeofacuterheumaticfeverevolves,characterizedbypolyarthritis,carditis,chorea,erythemamarginatumandsubcutaneousnodules.Thesefeaturesmayoccursinglyorinanycombination.

简介：

简介：

简介：AbstractObjective:To evaluate the agreement and reliability of intrapartum nonreasurring cardiotocography (CTG) interpretation and prediction of neonatal acidemia by obstetricians working in different centers.Methods:A retrospective cohort study involving two tertiary hospitals (The First Affiliated Hospital of Sun Yat-sen University and Perking University Third Hospital) was conducted between 30th September 2018 and 1st April 2019. Six obstetricians from two hospitals with three levels of experience (junior, medium, and senior) reviewed 100 nonreassuring fetal heart rate (FHR) tracings from 1 hour before the onset of abnormalities until delivery. Each reviewer determined the FHR pattern, the baseline, variability, and presence of acceleration, deceleration, sinusoidal pattern, and predicted whether neonatal acidemia and abnormal umbilical arterial pH < 7.1 would occur. Inter-observer agreement was assessed using the proportions of agreement (Pa) and the proportion of specific agreement (Pa for each category). Reliability was evaluated with the kappa statistic (k-Light’s kappa for n raters) and Gwet’s AC1 statistic.Results:Good inter-observer agreement was found in evaluation of most variables (Pa>0.5), with the exception of early deceleration (Pa= 0.39, 95% confidence interval (CI): 0.36,0.43). Reliability was also good among most variables (AC1 > 0.40), except for acceleration, early deceleration, and prediction of neonatal acidemia (AC1 = 0.17, 0.10, and 0.25, respectively). There were no statistically significant differences among the three groups, except in the identification of accelerations (Pa = 0.89, 95% CI: 0.83,0.95; Pa= 0.50, 95% CI: 0.41,0.60, and Pa= 0.35, 95% CI: 0.25,0.43 in junior, medium and senior groups, respectively) and the prediction of neonatal acidemia (Pa= 0.52, 0.52, and 0.62 in junior, medium and senior groups, respectively), where agreement was highest and lowest in the junior-level group, respectively. The accuracy and sensitivity of the prediction for umbilical artery pH < 7.1 were similar among the three groups, but the specificity was higher in the senior groups (93.68% vs. 92.53% vs. 98.85% in junior, medium and senior groups, P= 0.015).Conclusion:Although we found a good inter-observer agreement in the evaluation of the most basic CTG features and FHR category statistically, it was insufficient to meet the clinical requirements for "no objection" interpretation for FHR tracings. Further specialized training is needed for standardized interpretation of intrapartum FHR tracings.

简介：Thesurvivalorientedadaptationofevolvedbiosystemstovariationsintheirenvironmentisaselectiveoptimizationprocess.Recognizingtheoptimisedendproductanditsfunctionalityistheclassicalarenaofbionicengineering.Inaprimordialworld,however,themolecularorganizationandfunctionsofprebioticsystemsweresolelydefinedbyformativeprocessesintheirphysicalandchemicalenvironment,forinstance,theinterplaybetweeninterfacialwaterlayersonsurfacesandsolarlight.Theformativepotentialoftheinterplaybetweenlight(laserlight)andinterfacialwaterlayersonsurfaceswasrecentlyexploitedintheformationofsupercubanecarbonnanocrystals.Inevolvedbiosystemstheformativepotentialofinterfacialwaterlayerscanstillbeactivatedbylight.Herewereportacaseofhayfever,whichwassuccessfullytreatedinthecourseofafacialreju-venationprogramstartinginNovember2007.Targetingprimarilyinterfacialwaterlayersonelastinfibresinthewrinkledareas,wepresumablyalsoactivatedmastcellsinthenasalmucosa,reportedtoprogressivelydecreaseinthenasalmucosaoftherabbit,whenfrequentlyirradiated.Hayfeverisinducedbythereleaseofmediators,especiallyhistamine,aprocessassociatedwiththedegranulationofmastcells.Decreaseinmastcellsnumbersimpliesadecreaseinthereleaseofhistamine.Tothebestofourknowledgethisisthefirstreportonthetreatmentofhayfeverwithvisiblelight.Thisapproachwasinspiredbybionicthinking,andcouldhelpamelioratingtheconditionofmillionsofpeoplesufferingfromhayfeverworldwide.

简介：Oncomelania(Oncomelaniahupensis),adioecian,ovoviviparous,andamphibioussnail,isthesoleintermediatehostofSchistosomajaponicum,themostwide-spreadsnailfeverintheworld.Chemicaleliminatingthehostprovedunacceptablefortherewasseverecontaminationtowaterandsoil.TheriverbeachesandthedeltaareasoffiveprovincesinthemiddleandlowerreachesofYangtzeRiverinChinaprovidethemostfavorablehabitatsforOncomelania.Ourstudieshaverevealedthattheoccurrenceof...

简介：2CasesofMediterraneanspottedfeverinFrancewerereportedinthispaper.Bothhadtraveledintheendemicareasbeforeonset.Theirclinicalmanifestationsincludedfever,headache,myalgia,eruptionandblackeschar.SerologictestssuchasWeil-Felixreaction,Indirectimmunoflurescenceandcomplementfixationconfirmedthediagnosis.Thepatientsrecoveredwithoutcomplicationsandweredischargedfromhospitalaftereffectivetreatment.Simultaneously,theepidemiology,clinicaldiagnosis,treatmentandpreventionofthediseasewerereviewedandthepossibilityofthediseasebeingintroducedintothisterritorywasdiscussed.Theauthorheldthatattentionshouldbepaidtotheprophylaxisandtreatmentofthediseaseintheinternationaltravelhealthcare.

简介：AbstractPeriodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is the most common periodic fever condition in children, with most cases appearing by the age of 5. Although PFAPA is generally a self-limited condition, it can have a major impact on a child’s quality of life, as well as that of their family. Recent research has continued to shed light on the genetic and immunologic factors that play a role in the pathogenesis of PFAPA. There also exists significant heterogeneity in treatment strategies, and progress has been made to develop evidence-based management strategies and establish a standard of care. This review will outline current knowledge regarding the pathogenesis of PFAPA, as well as treatment strategies and our clinical experience.

简介：AbstractThere are only a few case reports of Q fever caused by Coxiella burnetii in China, despite the nature as a ubiquitous zoonotic disease worldwide. In the northeast part of China, a 52-year-old male presented with fever, cough, shortness of breath, and sputum production, accompanied by headache, dizziness, chill, myalgia, and arthralgia. Chest computed tomography images showed pneumonia accompanied by bilateral scattered infiltrates and localized upper-lobe emphysema. The abnormal liver function was indicated by the increased levels of alanine aminotransferase and aspartate aminotransferase. Through high-throughput sequencing and molecular detection, Coxiella burnetii was positive in the patient's blood specimens. After treatment with moxifloxacin hydrochloride and vidarabine monophosphate for 12 days, the patient completely recovered. To our knowledge, this was the first reported case of Q fever with pneumonia and hepatitis in this country.

简介：Inordertoanalyzethenucleoprotein(NP)geneofCrimean-Congohemorrhagicfevervirus(CCHFV),viralRNAwasamplifiedbyRT-PCRbyusingtheproof-readingDNApolymerasetoproducethecompleteNPgene.ThePCRproductwassequenced,analyzedforphylogenesisandclonedintotheexpressionvectorpE132aandtherecombinantplasmidexpressedinE.coilBL-21withhighyield.Theprimarilypurifiedfusedprotein.wasusedtocoatELISAplatesforthedetectantibodies.ItwasfoundthesimilaritiesbetweenNPgeneofBA88166andotherXHFVsinnucleotidelevelandaminoacidcontentswereverysignificant,andtheNPgeneofBA88166encodedanucleoproteinwith482aminoacidandadeducedmolecularweight(MW)of54kDa.Westernblotassayshowedthatthefusionproteinexpressedinbacteriapossessedgoodantigenicity.TheresultswithELISAforthedetectionofthehumanandanimalseracollectedinendemicareaswerefoundtobeingoodaccordancetotheclinicaldiagnosis.ItconcludedthattherelationsofNPgenesofXHFVBA88166andotherXHFVsappearedtobeevolutionallyclose.Themethodologiesestablishedinthisstudywereaccurate,specific,rapidandreproduciblefortheclinicalexaminationsandepidemiologicalsurvey.

简介：

简介：AbstractSevere fever with thrombocytopenia syndrome (SFTS) was first detected in China in 2009. The incidence of SFTS increases year by year, and there is no effective treatment. Considering that the reported prevalence of SFTSV infection varies from region to region, we aimed to quantitatively evaluate the epidemic characteristics of SFTSV infection in China from 2010 to 2020, including the distribution differences in infectious season, sex, age, occupation, and region. A meta-analysis framework was used to search for the related published data with keywords in electronic databases (CNKI, WanFang, CBM, and PubMed). According to the PRISMA statement, the studies that included SFTS diagnosed in China were analyzed. Furthermore, we used Revman and Stata to merge statistical effects, and used I2 and P-values for heterogeneity test and quality assessment. Eleven studies containing 4,932 cases confirmed by SFTSV infection were included in this meta-analysis. The ratio of male-to-female is 1.04 to 1. Cases were concentrated between 40 and 80 years of age (MD = 92%, 95%CI: 91%-93%). Farmers are at the highest risk of SFTSV infection (MD = 84%, 95%CI: 77%-90%). The risk of infection for consecutive period of April-August was significantly higher than the sum of the remaining months (MD = 82%, 95%CI: 78%-85%). In addition, the patient has an extensive history of exposure, including living in the mountains, exposure to ticks, livestock, mouse and the patient. We came to the conclusion that SFTSV is transmitted primarily through tick bites in China, so middle-aged and older adults living in mountains regions are at the highest risk for SFTSV infection in April through August each year.

简介：AbstractPurpose:There are many infectious and inflammatory causes for elevated core-body temperatures, though they rarely pass 40 ℃ (104 ℉). The term "quad fever" is used for extreme hyperpyrexia in the setting of acute cervical spinal cord injuries (SCIs). The traditional methods of treating hyperpyrexia are often ineffective and reported morbidity and mortality rates approach 100%. This study aims to identify the incidence of elevated temperatures in SCIs at our institution and assess the effectiveness of using a non-invasive dry water temperature management system as a treatment modality with mortality.Methods:A retrospective analysis of acute SCI patients requiring surgical intensive care unit admission who experienced fevers ≥ 40 ℃ (104 ℉) were compared to patients with maximum temperatures < 40 ℃. Patients ≥18 years old who sustained an acute traumatic SCI were included in this study. Patients who expired in the emergency department; had a SCI without radiologic abnormality; had neuropraxia; were admitted to any location other than the surgical intensive care unit; or had positive blood cultures were excluded. SAS 9.4 was used to conduct statistical analysis.Results:Over the 9-year study period, 35 patients were admitted to the surgical intensive care unit with a verified SCI. Seven patients experienced maximum temperatures of ≥ 40 ℃. Six of those patients were treated with the dry water temperature management system with an overall mortality of 57.1% in this subgroup. The mortality rate for the 28 patients who experienced a maximum temperature of ≤ 40 ℃ was 21.4% (p = 0.16).Conclusion:The diagnosis of quad fever should be considered in patients with cervical SCI in the presence of hyperthermia. In this study, there was no significant difference in mortality between quad fever patients treated with a dry water temperature management system versus SCI patients without quad fever. The early use of a dry water temperature management system appears to decrease the mortality rate of quad fever.

简介：AbstractAfrican swine fever virus (ASFV) is the causative agent of African swine fever, a highly fatal hemorrhagic disease of pigs, which has resulted in great economic losses to the global pork industry, especially in Asia. ASFV particles are comprised of multiple layers encompassing the genomic DNA. Though the capsid structure has been determined, very little is known about the structure of the core shell. The precursor polyprotein pp62 is the structural component of the core shell that gives rise to the p35 and p15 proteins. Herein, we describe the crystal structure of p15 at a resolution of 2.2 Å. The structure of p15 exhibits as a trimeric conformation that is mainly mediated by intermolecular disulfide bonds and supported by multiple hydrogen bond interactions. The button conformation on the surface of adjacent molecules may also play a role in trimeric formation of the ASFV p15. The center of the p15 trimer exhibits opposite electrostatic characteristics on each side. These findings benefit our understanding of ASFV core shell assembly and will aid in the design of antiviral drugs and vaccines.

简介：Flaviviruses包括约70个密切相关的RNA病毒。这些包括几忍受蚊子的病原体，例如黄发烧病毒(YFV)，登革热病毒(DENV)，和日本脑炎病毒(JEV)，它能引起重要人的疾病并且因此具有大医药重要性。对YFV和JEV的疫苗为decades;在人成功地被使用了；然而，一支DENV疫苗的发展遇到了可观的障碍。这里，我们考察疫苗对YFV得到提供一些卓见进一支保护的DENV疫苗的发展的保护的有免疫力的回答。

简介：无

简介：AlthoughanassociationbetweenthegroupAbetahemolyticstreptococcusandrheumaticfeverhasbeenrecognizedformorethanhalfacentury,manyimportantissuesaboutthisrelationshipremainincompletelydefined.Theinitiatingpharyngealthroatinfectionand

简介：无

简介：AbstractBackground:Fever is the most common chief complaint of emergency patients. Early identification of patients at an increasing risk of death may avert adverse outcomes. The aim of this study was to establish an early prediction model of fatal adverse prognosis of fever patients by extracting key indicators using big data technology.Methods:A retrospective study of patients’ data was conducted using the Emergency Rescue Database of Chinese People’s Liberation Army General Hospital. Patients were divided into the fatal adverse prognosis group and the good prognosis group. The commonly used clinical indicators were compared. Recursive feature elimination method was used to determine the optimal number of the included variables. In the training model, logistic regression, random forest, adaboost, and bagging were selected. We also collected the emergency room data from December 2018 to December 2019 with the same inclusion and exclusion criterion. The performance of the model was evaluated by accuracy, F1-score, precision, sensitivity, and the areas under receiver operator characteristic curves (ROC-AUC).Results:The accuracy of logistic regression, decision tree, adaboost and bagging was 0.951, 0.928, 0.924, and 0.924, F1-scores were 0.938, 0.933, 0.930, and 0.930, the precision was 0.943, 0.938, 0.937, and 0.937, ROC-AUC were 0.808, 0.738, 0.736, and 0.885, respectively. ROC-AUC of ten-fold cross-validation in logistic and bagging models were 0.80 and 0.87, respectively. The top six coefficients and odds ratio (OR) values of the variables in the logistic regression were cardiac troponin T (CTnT) (coefficient = 0.346, OR = 1.413), temperature (T) (coefficient = 0.235, OR = 1.265), respiratory rate (RR) (coefficient= –0.206, OR = 0.814), serum kalium (K) (coefficient = 0.137, OR = 1.146), pulse oxygen saturation (SPO2) (coefficient = –0.101, OR = 0.904), and albumin (ALB) (coefficient = –0.043, OR = 0.958). The weights of the top six variables in the bagging model were: CTnT, RR, lactate dehydrogenase, serum amylase, heart rate, and systolic blood pressure.Conclusions:The main clinical indicators of concern included CTnT, RR, SPO2, T, ALB, and K. The bagging model and logistic regression model had better diagnostic performance comprehesively. Those may be conducive to the early identification of critical patients with fever by physicians.