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BACKGROUND: The use of vancomycin in total knee arthroplasty is a controversial strategy for the prevention of incisional infection. At present, there is little evidence to evaluate the efficacy of this preventive measure in China. OBJECTIVE: To evaluate the efficacy of local vancomycin in the prevention of early postoperative incision infection during total knee arthroplasty. METHODS: 120 patients with osteoarthritis of the knee who received unilateral total knee arthroplasty for the first time at Department of Joint Surgery of First Affiliated Hospital of Anhui Medical University from March to June 2022 were included in this study. They were randomly divided into the observation group and the control group, with 60 cases in each group. All patients gave informed consent to the treatment plan. In the observation group, 1 g of vancomycin was applied intraoperatively; in the control group, no vancomycin was applied intraoperatively. Erythrocyte sedimentation rate, C-reactive protein, fever rate on seven consecutive days after surgery, degree of knee joint swelling, cumulative drainage volume, and incidence of periprosthetic joint infection were recorded in two groups of patients on days 1, 3, and 5 after surgery so as to evaluate the efficacy of topical vancomycin in total knee arthroplasty for the prevention of incision infection in the early postoperative period. RESULTS AND CONCLUSION: (1) The differences in erythrocyte sedimentation rate and C-reactive protein between the two groups on days 1, 3, and 5 after surgery were not significant (P > 0.05). (2) The difference in fever rate between the two groups for 7 consecutive days after surgery was not significant (P > 0.05). (3) There was no significant difference in the degree of postoperative knee swelling and cumulative drainage flow between the two groups (P > 0.05). (4) The difference in the incidence of periprosthetic joint infection one year after surgery was not significant between the two groups (P > 0.05). (5) The results suggest that the local use of vancomycin in total knee arthroplasty has not shown significant efficacy in preventing incision infection in the early postoperative period. [ABSTRACT FROM AUTHOR]

Objective To evaluate the predictive value for serum albumin-globulin ratio (A/G) for the risk of Kawasaki disease (KD) in febrile children. Methods In this single-center retrospective cohort study, the big-data platform of a certain thirdtier A-level hospital was employed. Clinical and laboratory data of 432 febrile children aged 0-16 were collected. The children were divided into 4 groups based on the quartiles and median of their serum A/G ratios. The correlation between the A/G and the risk of KD was analyzed. Results The total incidence rate of KD in 432 children with fever was 14.4% (62/432).A significant negative correlation was observed between the A/G and the risk of KD. For each increase of 0.1 in the A/G, the risk of KD was decreased by 18% (OR=0.82, 95% CI 0.76-0.88, P < 0.001). Subgroup analysis showed a consistent negative correlation between the A/G and KD risk across different ages, genders, and biochemical markers. Conclusions A/G may be a useful biomarker for assessing the risk of KD in febrile children. As the A/G increases, the risk of KD is gradually decreased. This finding has potential clinical application value for early diagnosis and risk assessment of KD. [ABSTRACT FROM AUTHOR]

目的　总结白血病/骨髓增生异常综合征患者异基因造血干细胞移植术后（allo-HSCT）新型冠状病毒感 染的临床特点及预后。方法　对 53 例血液肿瘤 allo-HSCT 后感染 COVID-19 患者的临床资料作回顾性分析。结 果 53例患者中男28例（53%），女性25例（47%），中位年龄47（18～66）岁；其中急性髓系白血病25例、急性淋巴细 胞白血病21例、骨髓增生异常综合征7例；临床表现为发热36例、咳嗽34例及呼吸困难21例，36例发热患者中37. 3～ 38 ℃者6例、38. 1～39 ℃者25例、39. 1～41 ℃者4例、>41 ℃者1例，34例咳嗽患者中轻度25例、中度6例、重度3例； 胸部X线检查可见肺外带多发小斑片影及间质改变47例；新型冠状病毒感染临床分型为轻型15例、中型29例及重 型9例。53例患者均予抗病毒药物、糖皮质激素治疗，其中19例同时输注康复者恢复期血浆、34例同时予白细胞介 素 6（IL-6）抑制剂治疗。53例患者治疗后痊愈 49例、死亡 4例。与痊愈患者相比，死亡患者的合并其他病原体感 染比例、疾病处于进展状态及合并移植物抗宿主病比例高（P 均<0. 05）。结论 allo-HSCT 术后新型冠状病毒 感染患者常表现为低热及轻度咳嗽。合并其他病原体感染比例、疾病处于进展状态及合并移植物抗宿主病的 allo-HSCT术后新型冠状病毒感染患者的预后较差。 [ABSTRACT FROM AUTHOR]

目的归纳与分析类鼻疽肺炎的临床特征与CT影像学表现，以提高对其的认识。方法回顾性分析2012年1月1日至2023年4月1日间68例类鼻疽肺炎的临床与CT影像资料。结果在68例确诊患者中，62例患者为急性感染，6例患者为慢性感染。88.2%患者为男性，85.3%患者是海南原籍居民，85.3%患者职业为农民，77.9%患者发病于夏、秋两季，66.2%患者有糖尿病，100%患者的首发临床症状为发热。88.2%患者经血液培养试验阳性确诊。多数患者的白细胞计数、中性粒细胞比例、C-反应蛋白以及降钙素水平升高，而淋巴细胞比率则普遍下降，但是在急性感染和慢性感染组间的差异无统计学意义（P > 0.05）。36.8%患者治愈，42.6%患者较治疗前好转，11.8%患者迁延不愈，8.8%患者死亡。肺内病变在CT图像上的形态主要表现为结节或肿块、斑片状磨玻璃影和大片状实变影，三种形态可同时并存。急性感染和慢性感染组的影像学表现差异在于主要的病变形态（P = 0.01），其余的影像征象的差异并无统计学意义。此外，36.8%患者出现肺外感染，其中8.8%患者为多部位脓肿形成。结论对于有疫区旅居史、糖尿病、高热、病情进展迅速的患者，并且CT提示肺内存在多发炎症性病灶，医务人员应提高对此病的警惕。

This article reported a case of a patient with schizophrenia who experienced self-perceived fever and discomfort after taking atypical antipsychotic drugs with strong alpha 1 receptor antagonism, which included olanzapine, risperidone, paliperidone and clozapine. Such phenomenon was believed to be a medication side effect. Therefore, the patient switched to aripiprazole and the fever disappeared. This case report is intended to remind psychiatrists to pay attention to the side effects caused by atypical antipsychotic drugs with strong alpha 1 receptor antagonism as well as to suggest that various factors should be considered, including mechanisms of drug action, patient pathophysiology and individual differences, in order to improve treatment compliance and prognosis. [ABSTRACT FROM AUTHOR]

This paper summarized the Traditional Chinese Medicine (TCM) external treatment and nursing for a patient with recurrent fever of phlegm-heat stasis syndrome in the sequelae of stroke. Based on the TCM theory of syndrome differentiation and addressing both symptoms and root causes, the TCM external treatment and nursing interventions such as auricular acupoint pressing, five-element music therapy, scrapping therapy, auricular tip bloodletting, TCM enema and acupoint massage were carried out to relieve patient’s anxiety, control body temperature and improve the quality of life. (本文总结1例中风后遗症期痰热瘀结证反复发热患者中医外治护理经验。基于中医辨证施护和标本兼治原则, 在常规护理的基础上采用耳穴压豆、五行音乐疗法、刮痧疗法、耳尖放血、中药灌肠、穴位按摩中医外治干预, 有效缓解患者焦虑情绪, 体温恢复正常, 生活质量明显改善。)

Objective To evaluate the application of febrile patient triage system in emergency pre-examination and triage of COVID-19 patients. Methods In this study, 132 febrile patients treated at hospital from March 2019 to March 2022 were selected for a retrospective study. Patients were divided into two groups: 66 patients in the control group received routine triage management, while another 66 patients in the study group were managed by using a fever triage system. The triage management was evaluated and compared between two groups. Results Ten patients were triaged to receiving high-risk management in the fever clinic, and one suspected COVID-19 case was detected. After screening, there was no confirmed COVID-19 case, missed diagnosis or nosocomial infection occurred, and the diagnostic accuracy was 100. 00%. The study group had a less time spent on triage time higher patient satisfaction than those in the control group, with a significant difference (P

目的　观察宏基因组二代测序技术 (mNGS) 在发热血液肿瘤患者病原体检测中的应用效果, 并构 建 mNGS 细菌检出阳性预测模型. 方法　发热血液肿瘤患者 104 例, 同时行外周血 mNGS 检测及常规检测 (血培 养、真菌培养及涂片、G/GM试验、EBV及CMV病毒定量检测、痰抗酸染色、PPD试验、T-SPOT、IGRAs、十三项病原菌 检测及十一项病原菌检测), 比较 mNGS与常规检测技术的病原体检出率. 以 mNGS细菌检出阳性为因变量, 以性 别、年龄、白细胞、中心粒细胞、淋巴细胞、hs-CRP、降钙素原、血清血蛋白、IL-6、D-二聚体、合并肺部感染、低蛋白血 症、骨髓抑制、粒细胞缺乏症为自变量, Logistic回归分析发热血液肿瘤患者 mNGS 细菌检出阳性的独立影响因素. 基于独立影响因素建立发热肿瘤患者 mNGS 细菌检出阳性的预测模型. ROC评估细菌检出阳性预测模型的预测 效能. 结果　发热血液肿瘤患者 mNGS 细菌及病毒检出率高于常规检测技术 (P均<0. 05). hs-CRP 升高、合并肺 部感染、合并低蛋白血症是发热肿瘤患者mNGS 细菌检出阳性的独立影响因素 (OR 值分别为1. 010、5. 048、3. 563, P 均<0. 05). 发热肿瘤患者 mNGS 细菌检出阳性预测模型 (PRE) =-4. 768 + 0. 01×hs-CRP + 1. 619×肺部感染 + 1. 271×低蛋白血症 (合并肺部感染、合并低蛋白血症为1). PRE 预测发热肿瘤患者mNGS细菌检出阳性的AUC为 0. 822 (95% CI 0. 737~0. 907), 在 Cut-Off 值=0. 415 时, 灵敏度及特异度分别为 78. 9%、76. 2%. 结论 在发热肿瘤 患者中, mNGS 细菌及病毒检出率高于常规检测技术. 综合hs-CRP 升高、合并肺部感染、合并低蛋白血症成功建立 了发热肿瘤患者mNGS 细菌检出阳性预测模型. [ABSTRACT FROM AUTHOR]

目的：探究中西医结合治疗上呼吸道感染合并发热患者的疗效。方法：选取于2020年1月-2023年1月本 院收治的90例上呼吸道感染合并发热患者，随机分为观察组(中西医结合治疗), 对照组(常规治疗)各45人。结 果：相比对照组，观察组治疗效果高(P < 0.05)；治疗后，观察组生活质量, 炎性反应, 临床症状改善更明显(P < 0.05)。结论：中西医结合治疗上呼吸道感染合并发热患者可以获得更加理想的治疗效果。 [ABSTRACT FROM AUTHOR]

The medical ice cap is commonly used in the treatment of febrile patients. This paper introduced the design and application of a medical ice cap with bi-directional opening. The medical ice cap has been designed to facilitate the surgical wound observation and drainage. The ice cap with adjustable Velcro can accommodate a wide range of head sizes. (医用冰帽是医院救治发热患者常用的辅助装置。本研究设计一种双向开口型医用冰帽, 不仅有利于头部手术创口的观察, 方便引流管引流, 同时魔术贴可以灵活调整, 适用于各种头围大小的患者。)

Copyright of Journal of Central South University is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Acupuncture & Tuina Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

T he febrile convulsions is a common type of Convulsive disorders in children, affecting children and their parents physical and psychological health. This paper reviewed the studies about febrile convulsions in children in perspectives of clinical features, influencing factors, prognosis and fever management, anticonvulsive management and parental interventions, and provided reference for the clinical management and further studies on febrile convulsions. (高热惊厥(FC)是小儿时期最常见的惊厥性疾病, 影响患儿及家属的身心健康。本研究结合近年来国内外相关文献, 从临床特征、相关因素、预后及发热管理、抗惊厥管理、父母干预管理等方面进行综述, 旨在为FC的临床管理和后续研究提供参考依据。)

Objective To investigate pre-examination and triage managements of outpatient of the dental clinic in general hospitals during the normalization prevention and control of COVID-19 epidemic. Methods According to the relevant guidelines for epidemic prevention and control, combined with the situation of dental clinic, a series of management plans for pre-examination and triage were developed, and the changes of outpatient distribution were analyzed statistically. Results From June to August 2020, the total number of outpatients in dental clinic was 3821, among whom, 3776 (98. 82%) patients had normal temperature and their epidemiological questionnaire were negative. No suspected or confirmed COVID-19 patients were appeared, and no emergency management plan was carried out in the dental clinic. Conclusion The management plan of pre-examination and triage management in dental clinic, based on epidemiological investigation and risk classification of dental treatment, was conducive to screening high-risk patients, and improve efficiency. (目的 探讨新型冠状病毒肺炎疫情常态化防控期间综合医院口腔科门诊预检分诊管理方案实施效果。方法 根据国家及市级卫健委、中华口腔医学会等相关疫情防控指导文件, 结合科室情况, 制定一系列口腔科预检分诊管理方案并实施, 观察实施效果。结果 2020年6月—8月安全有序接诊3821名口腔门诊患者, 无疑似或新冠肺炎患者, 未启动口腔科应急管理预案, 未发生诊室交叉感染事件。结论 新冠肺炎疫情期间口腔科实施预检分诊管理方案, 基于流行病学调查登记和口腔诊疗风险分类, 有利于筛查高风险就诊患者, 在保护医患双方的前提下, 最大限度安全有序地恢复口腔门诊诊疗秩序, 为患者提供口腔诊疗服务。)

Objective To study the effects of body surface temperature sensory block level on the maternal body temperature, labor analgesia effect, labor progress and instrument assisted delivery during epidural labor analgesia. Methods One hundred parturients with epidural labor analgesia in this hospital from May 2021 to April 2022 were randomly divided into the high level group (T6 group) and low level group (T8 group), 50 cases in each group, and 0. 075% ropivacaine + 0. 5%μg/mL sufentanil mixture liquid was used for epidural analgesia. The T6 group: the temperature level of epidural block was controlled at T6;the T8 group: the temperature level of epidural block was controlled at T8. The effect of temperature sensory block level on maternal body temperature, as well as the influences of analgesic effect, intrapartum fever, labor process time, time from rupture of membrane to delivery, oxytocin use rate and instrument midwifery rate were observed. Results The analgesic effect in the T6 group was better than that in the T8 group, but the rate of intrapartum fever and use rate of oxytocin in the T6 group were higher than those in the T8 group, and the time of labor, time from rupture of membrane to delivery in the T6 group were longer than those in the T8 group, the differences were statistically significant (P＜0. 05). There was no statistically significant difference of the instrumental midwifery rate between the two groups (P＞0. 05). Conclusion During epidural labor analgesia, the control of temperature block level at T6 is better than at T8, but which will increase the rate of intrapartum fever, prolong the duration of labor and increase the use rate of oxytocin. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Zhejiang University: Science B is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Long-term alcoholic individuals may develop alcohol withdrawal syndrome （AWS） after abrupt cessation or reduction of alcohol intake. Mild symptoms include involuntary limb trembling， sweating， nausea and vomiting， anxiety and disorder of sleep rhythm， and severe signs consist of hallucination， delirium and even coma. AWS is likely to progress into severe AWS when unrecognized or untreated， which is a potential cause of death. Benzodiazepines are the optimal drugs for the treatment of AWS. Nevertheless， large-dose benzodiazepines alone fail to completely control the symptoms of acute-stage AWS， and it should be combined with other drugs when necessary. In this article， we reported one 41-year-old male case of acute AWS complicated with fever who progressed into severe AWS. The disease condition was finally controlled by combined use of dexmedetomidine and diazepam， a widely prescribed benzodiazepine. The diagnosis and treatment of this case prompt that dexmedetomidine can decrease the dosage of diazepam， ease respiratory depression and mitigate the disorder of sleep rhythm. [ABSTRACT FROM AUTHOR]

目的：分析发热疾病诊断中血细胞形态学检验的应用效果。方法：选取2022年7月-2023年7月本院75例 发热患者作为观察组，另选取同期75例健康体检者作为对照组，均进行血细胞形态学检验，观察相关指标，统计血细 胞检验正常、异常例数，比较两组诊断效果。结果：观察组的HCT、MCV、RDW-SD、MCHC、MCH、白细胞异常 变化、异常淋巴细胞、异常细胞、小细胞性贫血和大细胞性贫血检出率均明显高于对照组，正常形态细胞检出率明显 低于对照组 (P < 0.05)。结论：临床可通过血细胞形态学检查，判断是否出现发热，具有推广价值。 [ABSTRACT FROM AUTHOR]

目的 探索烟雾病（moyamoya disease，MMD）患者血运重建术后非感染性发热的发病率、临床特点及其影响因素。 方法 回顾性分析2019年11月-2021年2月连续接受血运重建术治疗的MMD患者，收集患者人口学信息、MMD发病类型、既往病史、Suzuki分期、烟雾血管（前后循环）、手术类型和侧别、手术时长、术后血常规检查、术后体温和出院时mRS（＞2分为预后不良）等临床信息。以术后14 d内的是否出现非感染性发热（1次体温>38 ℃且无系统性感染证据）分为发热组和无发热组，采用多因素logistic回归分析术后发热的影响因素。 结果 共纳入110例MMD患者，累及143个大脑半球，91例次（63.6%）出现术后非感染性发热，其中81例次（89.0%）发生于术后2 d内。单因素分析发现，术后发热组中成人比例（74.7% vs. 88.5%，P=0.049）、男性比例（37.4% vs. 63.5%，P=0.003）、术后红细胞压积[（33.6±4.2）% vs.（35.8±4.3）%，P=0.004）]、红细胞计数[（3.9±0.5）×1012/L vs.（4.1±0.5）×1012/L，P=0.004]和白细胞计数[（11.4±3.6）×1012/L vs.（12.8±3.5）×1012/L，P=0.031]低于无发热组，后循环受累比例（35.2% vs. 11.5%，P=0.002）高于无发热组，另外，术后发热组出院预后不良率低于无发热组（4.4% vs. 15.4%，P=0.049）。logistic回归显示后循环受累的患者更易出现术后非感染性发热（OR 3.731，95%CI 1.265～10.998，P=0.017）。 结论 MMD患者在血运重建手术治疗后非感染性发热较常见，其中后循环受累的患者更易出现术后发热。 Abstract: Objective To investigate the incidence and risk factors of postoperative non-infective fever (POF) after cerebral revascularization in moyamoya disease (MMD). Methods This retrospective study enrolled the consecutive patients with MMD who received revascularization surgery at Beijing Neurosurgical Institute between November 2019 and February 2021. Clinical information were collected and analyzed. The poor prognosis at discharge was defined as a mRS score >2. POF was defined as postoperative temperature > 38℃ without systematic infection evidence within 14 days after surgery. A multivariate logistic regression analysis was conducted to determine the risk factors for POF. Results A total of 110 patients including143 hemispheres were included in the final analysis. POFs occurred in 91 patients (63.6%), 81 (89.0%) of whom had a fever within 2 days after surgery. Univariable analysis showed the proportion of adults (74.7% vs. 88.5%, P=0.049) and males (37.4% vs. 63.5%, P=0.003) and poor prognosis at discharge (4.4% vs. 15.4%, P=0.049), and postoperative hematocrit [(33.6±4.2)% vs. (35.8±4.3)%, P=0.004], red blood cell counts [(3.9±0.5)×1012/L vs. (4.1±0.5)×1012/L, P=0.004)], and white blood cell counts [(11.4±3.6)×1012/L vs. (12.8±3.5)×1012/L, P=0.031)] were lower in patients with POF than those in patients without POF, while the proportion of posterior circulation involvement (35.2% vs. 11.5%, P=0.002) was higher in patients with POF than that in ones without POF. Logistic regression analysis showed that the patients with posterior circulation involvement were more likely to have POF (OR 3.731, 95%CI 1.265-10.998, P=0.017). Conclusions POF was more common in MMD patients after cerebral revascularization, especially ones with posterior circulation involvement.

目的　总结播散性堪萨斯分枝杆菌病的临床特征及有效诊治方法。方法　对1例播散性堪萨斯分枝杆 菌病患者的临床资料作回顾性分析。结果　患者主要临床表现为反复发热、全身多发淋巴结肿大，胸部影像学检查 可见双下肺实变伴不张，双侧胸腔积液、心包积液，痰液涂片和左侧锁骨上淋巴结抗酸染色阳性，右侧大腿背侧皮下 肿块穿刺液16S rRNA检测结果堪萨斯分枝杆菌阳性，结合患者临床症状明确诊断为播散性堪萨斯分枝杆菌病。予 四联（利福平、异烟肼、乙胺丁醇、克拉霉素）抗非结核分枝杆菌（NTM）药物治疗8周，疗效较好。结论　播散性堪萨 斯分枝杆菌病主要临床表现为反复发热、全身淋巴结肿大、皮肤包块及皮下结节。临床症状、抗酸杆菌检查阳性结 合皮下结节穿刺液 16S rRNA检测结果可明确诊断播散性堪萨斯分枝杆菌病，抗 NTM 药物治疗播散性堪萨斯分枝 杆菌病效果较好。 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of dexmedetomidine mixed with ropivacaine for programmed intermittent epidural bolus technique on labor analgesia and intrapartum maternal hyperthermia. Methods: A total of 104 singleton full⁃term parturients, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 20~35 years, weighing 60~85 kg, scheduled for elective labor analgesia, were divided into 0.1% ropivacaine mixed with 0.5 μg/ml dexmedetomidine (group RD, n=52) and 0.1% ropivacaine mixed with 1 μg/mL fentanyl (group RF, n=52) by a random number table method. Both groups received programmed intermittent epidural bolus technique in labor analgesia. The visual analogue scale (VAS) score and the maternal temperature were measured before anesthesia (T0), at 30 min (T1), 1 h (T2), 2 h (T3), 4 h (T4), 6 h (T5) post analgesia, 10 cm cervical dilatation (T6) and 2 h after delivery (T7) . Recording the incidence of breakthrough pain and the adverse effects, the Apgar scores were evaluated at 1 min and 5 min after the delivery. Venous blood samples were collected in non⁃infusion sides at T0 and T7 to detect the maternal white blood cell count and serum C⁃reactive protein. Results: Compared with group RF, the onset time of analgesia was significantly shortened, the VAS scores at T2~6 and the incidence of breakthrough pain (4.1% vs. 20.0%) were lower in group RD (P < 0.05). The incidence of intrapartum fever was lower in group RD (8.2% vs. 38.0%), and also the maternal temperature at T4~7 than those in group RF. Compared with T0, the maternal white blood cell count and C⁃reactive protein at T7 were significantly higher in both groups (P < 0.01), but there were no significant differences between the two groups at T0 and T7 (P > 0.05). The incidence of pruritus was lower in the group RD compared to group RF (P < 0.05). Conclusion: Dexmedetomidine may enhance the efficacy of epidural labor analgesia with ropivacaine and reduce the rate and degree of intrapartum maternal hyperthermia associated with epidural labor analgesia without increasing adverse effects on mother and infant. [ABSTRACT FROM AUTHOR]

This paper summarized the application effect of cold compress of Traditional Chinese Medicine (TCM) in a patient with wind-warm and pulmonary heat syndrome. According to the outcomes of nursing evaluation and diagnosis, the TCM cold compress therapy was carried out in combination with nursing interventions such as daily care, nutrition guidance, emotion nursing, and so on. The TCM cold compress therapy has obvious effect on body cooling during fever caused by wind-warm and pulmonary heat syndrome, and it demonstrates the characteristics of easy-to-use, convenience and cost-effectiveness. (本文总结中药冷敷技术在1例风温肺热病患者中的应用效果。结合护理评估和诊断结果, 给予患者中药冷敷技术, 同时配合生活起居、饮食、情志等护理干预措施。在常规治疗基础上, 中药冷敷技术降温效果明显, 体现了中医护理技术“简、验、廉、效”的特点。)

Objective 　To observe the antipyretic effect of Tuina antipyretic six methods on lipopolysaccharide (LPS)-induced fever in infant rabbits, and to explore the effects on the hypothalamic COX-2/PGE2/EP3 signaling pathway. Methods 　Using the random number table method, 24 New Zealand rabbits(two months old)were randomly divided into the control group, model group and Tuina six methods group, with eight rabbits per group. The fever model was replicated by LPS (0. 5 mg/L) injection at the ear margin, and the injection volume was 1 mL/kg in model group and Tuina six methods group. In the Tuina six methods group, the following Tuina six methods of antipyretic intervention were used 1 h after LPS injection: opening Tianmen 200 times in 2 min, pushing Kangong 200 times in 2 min, rubbing Taiyang 200 times in 2 min, rubbing Erhougaogu 24 times and pinching three times in 2 min, clearing the Tianheshui 500 times in 5 min, and pushing the spine 300 times in 5 min. Over the same period, the animals in the model and control groups were smeared with the same volume room temperature water in the same are, and grasped without Tuina intervention. The anal temperature was recorded once every 20 min after LPS injection, and the temperature was continuously measured for 180 min. The body temperature of each group was observed, and the maximum body temperature change value and thermal response index (TRI) were calculated. The expression levels of PGE2 and cAMP in the hypothalamus were detected by ELISA, the protein expression levels of COX-2, EP3, and cAMP were detected using Western blotting, and the mRNA expression levels of COX-2, EP3, and cAMP were detected using RT-PCR. Results　Compared with the control group, the anal temperature of the model group was increased (P<0. 01), and the anal temperature of the model infant rabbits in the Tuina six methods group was decreased after the intervention (P<0. 01). The maximum body temperature change value and the TRI in the model group and the Tuina six methods group were higher than those in the control group at 60 min after modeling (P <0. 01). Compared with the model group, there was no difference in the maximum body temperature change value and TRI 60 min after modeling in the Tuina six methods group. Moreover, 180 min after modeling, the maximum body temperature change value and TRI were increased in the model group(P<0. 01), and those were decreased in the Tuina six methods group compared with those in the model group (P < 0. 01). The ELISA result showed that compared with the control group, the expression levels of PGE2 and cAMP in the hypothalamus of the model group were increased (P<0. 01), while those in the Tuina six methods group were lower than those in the model group (P<0. 05, P<0. 01). The result of Western blotting showed that compared with the control group, the expression levels of COX-2, EP3, and cAMP in the hypothalamus of the model group were increased (P<0. 01), while those in the Tuina six methods group were lower than those in the model group (P<0. 05, P<0. 01). The RT-PCR result showed that compared with the control group,the mRNA expression levels of COX-2, EP3, and cAMP in the hypothalamus of the model group were increased (P <0. 01), and those in the Tuina six methods group were decreased, compared with those in the model group (P<0. 01). Conclusion　Tuina antipyretic six methods shows a good antipyretic effect on LPS-induced fever infant rabbits. Its mechanism is achieved by inhibiting the activation of the hypothalamic COX-2/PGE2/EP3 signaling pathway by pyrogen, reducing the level of positive regulatory medium cAMP at the terminal of the body temperature center. [ABSTRACT FROM AUTHOR]

This paper reviewed nursing management for a patient with erysipelas infection leads to sepsis combined with multiple organ dysfunction syndromes. A comprehensive treatment including anti-infective therapy, diuretic treatment, cardiac medication and circulation function treatment and related nursing management was carried out. Targeted nursing strategies including non-invasive ventilation nursing, medication care and fluid-management, fever nursing, catheter maintenance, skin care were carried out to ensure the therapeutic efficacy and symptom relieving. (本文总结1例丹毒感染致脓毒症合并多功能脏器衰竭患者的护理措施, 在给予抗感染、利尿、强心、维持循环功能治疗的同时还要加强护理, 从无创通气护理、用药监护及液体管理、发热护理、管路护理、皮肤护理等方面给予以针对性护理干预, 确保有效改善患者症状。)

目的 总结老年大肠埃希菌血流感染的临床特征及耐药特点。方法 回顾性分析94例老年大肠埃希菌 血流感染患者的临床资料。结果 94例老年大肠埃希菌血流感染患者中，女性占59例（62. 8%），患者来源前三的 科室分别是感染性疾病科（46例，48. 9%）、急诊内科（10例，10. 6%）、血液内科（7例，7. 4%），主要基础性疾病为高血 压（30 例，31. 9%）、糖尿病（26 例，27. 7%）、心脏病（25 例，26. 6%）、脑血管疾病（20 例，21. 3%）、肿瘤疾病（10 例， 10. 6%），感染途径前三位的分别是泌尿道感染（30. 9%）、呼吸道感染（28. 7%）、消化道感染（18. 1%），大多患者表现 为发热或非特异症状，白细胞、C反应蛋白（CRP）、降钙素原（PCT）明显增高。检出产超广谱β-内酰胺酶（ESBLs）大 肠埃希菌35株（37. 2%），同时检出1例多重耐药（MDR）大肠埃希菌菌株；大肠埃希菌对亚胺培南、厄他培南、头孢替 坦、妥布霉素、呋喃妥因、阿米卡星的耐药率均<5%，其中产ESBLs大肠埃希菌对头孢唑林、氨苄西林完全耐药，而非 产ESBLs大肠埃希菌对大多数药物敏感率较高。结论 老年大肠埃希菌血流感染患者以女性为主，主要分布在感 染性疾病科，均合并基础病，主要感染途径为泌尿道，临床症状非特异性，白细胞、CRP、PCT 是良好的辅助诊断指 标。产 ESBLs大肠埃希菌对多种抗菌药物耐药，其耐药率普遍高于非产 ESBLs大肠埃希菌，临床上需监测其耐药 性，加强抗生素的合理使用。 [ABSTRACT FROM AUTHOR]

Sjögren′s syndrome is a systemic autoimmune disease that does not affect the fertility of female patients, but it affects the growth of the fetus in the uterus, leading to spontaneous abortion and preterm birth. Because of the difficulty in differential diagnosis, pregnant women with the first episode of Sjögren′s syndrome pregnancy are more likely to delay treatment, leading to an exacerbation of the disease and an increased risk of serious adverse maternal and child outcomes. This is a case report about primary Sjögren′s syndrome with the first sign of fever and hepatic insufficiency. The purpose is summarizing the diagnostic basis and treatment of this disease, elaborating the clinical monitoring index and therapeutic effect. [ABSTRACT FROM AUTHOR]

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze potential problems in submission process of specimen for nucleic acid detection, and summarize targeted management strategies. Methods A total of 1085 patients who admitted fever clinic between July 27, 2020 and October 31, 2020 were included as research objects. The potential problems in submission process of specimen for nucleic acid detection were analyzed, and targeted interventions were carried out. Results After implementation of management strategies, there was a trend toward decrease in the duration between specimen collection and report issuing time, as well as patient’s duration of stay in the fever clinic. Conclusion It is effective to shorten the duration of stay in the fever clinic by optimizing the submission process of specimen for nucleic acid detection, and it has positive influence on reducing the risk of cross infection and improving the diagnosis efficiency. (目的 分析发热门诊患者核酸检测标本运送情况并总结相关管理措施。方法 选取2020年7月27日—10月31日医院发热门诊收治的1085例患者作为研究对象, 分析常规标本送检与交接模式中存在的不足, 针对问题实施干预措施。结果 改进核酸检测标本送检与交接模式后, 取样时间至出报告时间的用时呈现下降趋势, 患者在发热门诊停留的时间缩短。结论 针对发热门诊患者核酸检测标本送检与交接模式进行优化和改进, 能够缩短患者在发热门诊等待的时间, 对减少交叉感染风险、提高诊疗效率具有积极意义。)

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的 总结43例新生儿化脓性脑膜炎的临床特点及诊治方法。方法 回顾性分析43例化脓性脑膜炎患 儿的临床资料。结果 43例患儿中, 发热35例 (81. 4%), 病理性黄疸18例 (41. 9%), 皮肤发花18例 (41. 9%), 反应 差14例 (32. 6%), 腹胀12例 (27. 9%), 纳差11例 (25. 6%), 泌尿道感染9例 (20. 9%), 贫血9例 (20. 9%), 前囟膨隆2 例 (4. 7%). 血清 C反应蛋白 (CRP) 异常 31例 (72. 1%), 外周血白细胞计数异常 15例 (34. 9%), 脑脊液白细胞计数 升高 29例 (67. 4%), 脑脊液蛋白定性阳性 30例 (69. 8%), 葡萄糖含量降低 19例 (44. 2%). 患儿入院后均使用易透 过血脑屏障的抗生素治疗 (头孢曲松、头孢噻肟、头孢他啶、美罗培南等). 住院时间<14 d 4例 (9. 3%), 14～21 d 27 例 (62. 8%), 22～28 d 12例 (27. 9%). 37例 (86. 0%) 患儿治愈出院; 4例 (9. 3%) 经治疗后病情好转, 未完成足疗程 治疗, 家属要求出院; 2例 (4. 7%) 放弃治疗后72 h内死亡。结论 新生儿化脓性脑膜炎临床表现多样, 主要表现为 发热、病理性黄疸、皮肤花斑、反应差、腹胀等症状; 实验室检查血清CRP、外周血白细胞计数异常, 脑脊液白细胞计 数升高, 脑脊液蛋白定性阳性, 葡萄糖含量降低; 结合临床表现和实验室检查结果可以确诊。治疗上首先经验性选 择易进入脑脊液的杀菌药, 再根据药敏试验结果、临床表现及血、脑脊液培养结果进行调整. [ABSTRACT FROM AUTHOR]

This paper reviewed the clinical data and treatment of a patient with pulmonary infection-associated fever and coma, and summarized related nursing interventions. The patient received comprehensive therapy including mechanical ventilation, anti-infection and anti-inflammatory treatment, reducing edema and eliminating phlegm. During the anti-infection treatment, targeted nursing intervention against fever, airway management, skin care and enteral nutrition were carried out. (本文回顾1例发热、昏迷伴肺部感染患者的临床治疗措施, 总结相关护理经验。给予患者呼吸机辅助通气, 联合抗感染、抗炎、减轻局部水肿、化痰等综合治疗。抗感染治疗期间, 针对发热实施护理干预, 加强气道管理, 同时给予皮肤护理和肠内营养支持。)

Acute liver failure（ALF） in infants and children is a severe life-threatening disease caused by multiple etiologies. Recurrent acute liver failure（RALF） is defined as the occurrence of acute liver injury two or more times, with at least one episode meeting the diagnostic criteria for ALF. Biochemical parameters usually return to normal between acute liver injury episodes in children with RALF. Clinical etiologies of RALF include infections, immunologic disorders, drug, and toxin, as well as hereditary or metabolic disorders, and some episodes of RALF caused by hereditary liver disorders are always associated with fever. This article discusses the diagnosis and treatment of fever-related RALF caused by genetic defects of NBAS, SCYL1, and RINT1. [ABSTRACT FROM AUTHOR]

Vancomycin is a glycopeptide antibiotic that inhibits bacterial growth and reproduction by inhibiting bacterial cell wall protein synthesis, changing the permeability of bacterial cell membranes and hindering bacterial RNA synthesis, thereby killing bacteria. Adverse reactions such as nephrotoxicity, red man syndrome, gastrointestinal reactions, cytopenia (leukopenia, platelets, eosinophilia, etc.), hyperpyrexia, allergic reactions may occur during the application. Differentiated adverse reactions from uncontrolled infections could avoid blind surgery and over treatment. A case of refractory drug fever, leukopenia with suspected red man syndrome after 9 days of fever withdrawal with vancomycin was misdiagnosed as an uncontrolled infection and treated surgically was reported. The aim was to raise awareness of the adverse effects of vancomycin, thereby better improve the level of diagnosis and treatment of pelvic inflammatory diseases. [ABSTRACT FROM AUTHOR]

目的 总结儿童噬血细胞淋巴组织细胞增多症 (Hemophagocytic lymphohistiocytosis, HLH) 的有效诊治方 法. 方法 对5例 HLH 患儿的临床资料作回顾性分析. 结果 5例患儿均表现为不规则高热, 发热时间 7～21 天, 其中伴有皮疹 2 例, 咳嗽 3例, 眼睑水肿 2 例, 肝脾肿大 2 例, 淋巴结肿大 3 例. 实验室检查血小板 <100×109 /L 3 例, 中性粒细胞绝对数 <1. 0×109 /L 3 例; 血清甘油三酯, 乳酸脱氢酶水平升高 5 例, 纤维蛋白原降低 1 例; 血清铁蛋白 (SF) ≥500 µg/L 5例, 血清白细胞介素 2R 水平升高 5 例; 2 例患儿骨髓穿刺细胞学检查均可见噬血细胞; EB病毒感 染阳性2例, 自身免疫性疾病相关抗体阳性1例. 5 例患儿均予抗感染治疗, 同时联合激素, 免疫抑制剂治疗, 4 例患 儿好转出院. 结论 儿童HLH 的主要临床表现为发热, 可伴有皮疹, 肝脾肿大等. 实验室检查, 骨髓细胞学检查结 合临床表现可明确 HLH 诊断. 抗感染治疗联合激素, 免疫抑制剂治疗 HLH 效果较好. [ABSTRACT FROM AUTHOR]

发热是机体应对感染和损伤的一种病理性防御反应。瞬时感受器电位离子通道香草素受体4（TRPV4） 是瞬时感受器电位离子通道家族的成员，在机体中广泛表达，对体温具有负调节作用。当机体温度升高激活 TRPV4或使其表达增多时，可引起脑水肿和癫痫发作的加剧；TRPV4的活性及正常表达影响新生儿面部与心脏缺 陷和精子活动趋热性。通过对TRPV4的多方面研究，有望揭示TRPV4受热激活下与疾病的具体机制，探索新的药 物作用靶点和开发新的药物等。 [ABSTRACT FROM AUTHOR]

急性发热是婴幼儿最常见的就诊原因。急性发热小婴儿更易发生严重细菌感染（SBIs）。体温≥38. 5℃的 急性发热小婴儿发生SBIs风险较高。明确病毒感染可降低急性发热小婴儿发生细菌血症和细菌性脑膜炎的风险。 罗切斯特标准、序贯法等发热风险分层标准可对急性发热小婴儿SBIs的风险进行分层，评估的准确度和特异度较 高。血清降钙素原、蛋白基因组学等新型标志物用于诊断急性发热小婴儿SBIs的准确度较高。 [ABSTRACT FROM AUTHOR]

目的总结儿童噬血细胞性淋巴组织细胞增多症（HLH）的临床特点，探讨HLH的诊断及治疗方法。方 法对6例HLH患者的临床资料作回顾性分析，并总结其临床特点，诊断及治疗方法。结果6例患儿以发热为主 要临床表现，病情进展中存在持续高热、高甘油三酯血症、凝血功能异常、血象异常及血清铁蛋白异常增高等症状。 6例患儿骨髓穿刺细胞学检查均可见噬血细胞现象。5例患儿EB病毒衣壳VCA抗体+EBV-DNA阳性。2例患儿基 因存在T细胞激酶基因突变。6例患儿均根据HLH-2004或2019年诊疗指南进行化疗，并对各种临床症状进行对症 支持治疗。结论HLH患者以发热为主要临床表现，首发症状不一，病情进展迅速。骨髓穿刺细胞学、病原学及基 因诊断检查结合临床特征可明确HLH诊断。HLH主要采用HLH-2004或2019诊疗指南治疗方案化疗，同时给予对 症支持治疗。 [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of programmed intermittent epidural bolus (PIEB) and continuous epidural infusion (CEI) on fever during delivery. Methods A total of 180 cases of full-term, singleton and head primiparous were selected and divided into PIEB group and CEI group according to the random number table method, with 90 cases in each group. Both groups used a loading dose (0.125% ropivacaine + 0.4 mg/L sufentanil) 10 mL, and the analgesic pump 0.08% ropivacaine + 0.4 mg/L sufentanil. Pulsed administration was started 30 minutes after the loading dose in PIEB group, with an interval of 30 minutes, and the pulsed dose was 10 mL/h. The CEI group was given the background dose continuously after the loading dose injection. In both groups, the amount of PCEA was 5 mL, and the lock time was 30 min. The visual analogue scale (VAS) and fever of uterine contraction pain were recorded before analgesia, 1, 2, 3, 4, and 5 hours after analgesia, during delivery, 1 hour and 2 hours after delivery in the two groups. At the same time, the maternal oxytocin usage during analgesia, labor time, analgesic time, artificial membrane rupture ratio, analgesic drug dosage, PCEA compression ratio, labor analgesic effect satisfaction score and adverse reactions were collected. The birth weight, Apgar score at 1 and 5 minutes after birth, and fever 1 hour after birth of newborn were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) expression levels before analgesia, during delivery and 24 hours after delivery. Results The VAS scores of pain at 1 to 5 hours after analgesia and during delivery were lower in the PIEB group than those in the CEI group (P＜0.05). The incidence of fever at 4 to 5 hours after analgesia, during delivery, 1 hour after delivery and 2 hours after delivery was significantly lower in the PIEB group than that in the CEI group (P＜0.05). The PCEA compression demand ratio and the total amount of epidural analgesics were significantly lower in the PIEB group than those in the CEI group, and the analgesic effect satisfaction score was significantly higher in the PIEB group than that of the CEI group (P＜0.05). The expression levels of serum IL-6 and TNF-α were significantly higher after delivery analgesia than before the analgesia in the two groups (P＜ 0.05), and the serum IL-6 and TNF-α expression levels were significantly lower during delivery and 24 hours after delivery in the PIEB group than those of the CEI group (P＜0.05). Conclusion PIEB can reduce the incidence of fever during childbirth, reduce inflammation and have a good analgesic effect. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the hierarchical management of hospitalized fever patients under the background of new coronavirus infection. Methods From February to March 2020.91 patients with fever who were hospitalized in the Respiratory and Critical Care Medicine Center of the hospital were taken as the research objects. According to epidemiological history. blood routine and chest computed tomography (CT) performance. comprehensive evaluation and development of hierarchical management methods. The patients were divided into a general management group and an enhanced management group and the clinical characteristics. treatment effects, and risk of new coronavirus infection in the two groups were observed. Results The patients in the enhanced management group were similar to patients with new coronavirus infection in terms of clinical symptoms. blood routine and chest CT. The effective rate after treatment was 100.00% in the general management group and 97. 14% in the enhanced management group. There was no statistically significant difference between the two groups (P>0.05). The results of chest CT examination showed that most of the lesions were absorbed or completely absorbed after 8 days of treatment in 38 patients of the enhanced management group. There was no outbreak or spread of the epidemic in the enhanced management team. One patient in the enhanced management group got worse on the second day of hospitalization and was transferred to the Department of Critical Care Medicine after tracheal intubation and died 21 days later. Nucleic acid test of throat swab confirmed adenovirus pneumonia. Conclusion Combining various factors, formulating management methods that meet their own characteristics for hospitalized pneumonia patients with fever has certain value in preventing the spread and epidemic of the epidemic in wards and even in hospitals and it can be used as a reference for the prevention and control of other respiratory infectious diseases. [ABSTRACT FROM AUTHOR]

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发热感染相关性癫痫综合征(FIRES)是一种灾难性癫痫性脑病,是近期国内外学者的研究热点。与既往报道的 急性脑炎伴难治性重复性部分性癫痫、学龄期儿童灾难性癫痫性脑病及暴发性炎性反应癫痫综合征等是同一种疾病。FIRES发 病机制不明,可能与炎症介导及免疫机制有关。早期诊断困难,最新发现辅助性 T淋巴细胞1相关的细胞因子、内源性白细胞介 素-1受体拮抗剂和白细胞介素-1β可能成为特异性标志物。FIRES的治疗非常困难,患者预后差。近年来发现,生酮饮食及阿那 白滞素等免疫治疗可能有效。该文重点综述了 FIRES的发病机制及诊疗的最新研究进展,旨在加深临床医师对 FIRES的认识, 有助于早期诊疗。 [ABSTRACT FROM AUTHOR]

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Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)