Background
Human brucellosis has become one of the major public health problems in China, and increases atypical manifestations, such as fever of unknown origin (FUO), and misdiagnosis rates has complicated the diagnosis of brucellosis. To date, no relevant study on the relationship between brucellosis and FUO has been conducted.
Methods
We retrospectively reviewed the medical charts of 35 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. The patients were admitted to the Second Affiliated Hospital of Nanchang University between January 01, 2013 and October 31, 2019. Patient data were collected from hospital medical records.
Results
The percentage of males was significantly higher than that of female in FUO (78.95% vs. 21.05%, P < 0.05), and 80% of the patients had a clear history of exposure to cattle and sheep. Moreover, 19 (54%) cases were hospitalized with FUO, among which the patients with epidemiological histories were significantly more than those without (P < 0.05). The incidence of toxic hepatitis in FUO patients was higher than that in non-FUO patients (89% vs. 50%, P < 0.05). Meanwhile, the misdiagnosis rate was considerably higher in the FUO group than in the non-FUO group (100% vs. 63%; P < 0.05).
Conclusion
Brucellosis is predominantly FUO admission in a non-endemic area of China, accompanied by irregular fever and toxic hepatitis. Careful examination of the epidemiological history and timely improvement of blood and bone marrow cultures can facilitate early diagnosis and prevent misdiagnosis.
Amoxicillin is widely used by the Chinese population and available in pharmacies without prescription. We performed a retrospective study on patients with fever who took amoxicillin before going to the fever clinic of the Second Affiliated Hospital of Nanchang University from March 1, 2020 to March 31, 2021. Among the total of 9093 patients attending the fever clinic, 446 patients had a history of taking amoxicillin, from which 100 cases were randomly selected to evaluate the therapeutic effects of non-prescribed amoxicillin by changes in clinical symptoms, counts of white blood cells, neutrophils, and lymphocytes, and levels of C-reactive protein (CRP). The control group consisted of 100 randomly selected patients for who it was verified that they did not take antibiotics before attending the fever clinic. Our study showed that there were no significant differences between the group of patients taking amoxicillin and the control group in terms of symptom improvement, white blood cell, neutrophil or lymphocyte counts, or the levels of CRP. Therefore, our study indicated that although non-prescribed amoxicillin is widely used among patients with fever, it does not provide significant beneficial therapeutic effects. There is still a long way to go to standardize the application of antibiotics and popularize knowledge on proper antibiotics use among the population.
Aspirin decreases liver fibrosis index and inflammation levels. However, the exact mechanism underlying the effects of aspirin are yet to be elucidated. The aim of the study was to investigate the potential protective effects of aspirin on carbon tetrachloride (CCl 4 )-induced hepatic fibrosis in Sprague-Dawley rats. Rats were divided into four groups, including healthy and CCl 4 control and low-(aspirin 10 mg/kg + CCl 4 ) and high-dose aspirin group (aspirin 300 mg/kg + CCl 4 ). After 8 weeks treatment, the histopathological examinations of hepatocyte fibrosis in liver and serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), IL-1β, transforming growth factor-β1 (TGF-β1), hyaluronic acid (HA), laminin (LN) and type IV collagen (IV.C) were determined. Histopathological examination suggested that aspirin decreased CCl 4 -induced hepatic fibrosis and liver inflammation. The high-dose aspirin group significantly decreased the serum levels of ALT, AST, HA and LN compared with the CCl 4 control group. High-dose aspirin group significantly decreased the levels of pro-inflammatory cytokines IL-1β compared with CCl 4 group. The high-dose aspirin group significantly inhibited the expression of TGFβ-1 protein compared with CCl 4 group. Overall, the present study indicated that aspirin exhibited potent protective effects against CCl 4 -induced hepatic fibrosis via inhibition of the TGFβ-1 pathway and pro-inflammatory cytokine IL-1β.
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