This report deals with 9 cases of brain paragonimiasis whose clinicalmenifestations are of several types, such as epulepsy, brain tumor menigitis.paralysis, vision disturbance and/or headache. Precipitation test and skintest are positive in 8 of the 9 patients, and electroencephalography is ab-normal to a certaln degree in 8 patients. All the cases received specifictherapy. After 4 month-2 and a half year follow-up, six cases returned to normal,one got recurrent episode and one got residual local damage in the brain. Bitin is a good choice in chemical therapy but should be used in combi-nation with dehydrants, cortisone, etc.

Objective In order to evaluate the efficacy of esophageal varices ligation( EVL) , ultrasonic microprobe (UMP) was used to observe the esophageal varices and their collaterals before and after EVL. Methods Sixty patients merely with esophageal varices underwent ultrosonography via UMP before and 4,8,12 weeks after EVL and were divided into three groups:( Ⅰ )esophageal varices(EV) ( Ⅱ )esophageal and paraesophageal vein(PEV) varices( Ⅲ ) esophageal, para esophageal and perforating vein( PV) varices. Results In the following-up, the effective rate of type Ⅰ , Ⅱ , Ⅲ were 75% , 25% , 0% ; The recurrence rate 16% , 75% , and 100% respectively. PEV occurred in 12 out of 24 cases of group Ⅰ and broadened in all of the cases of group Ⅱ and Ⅲ; PV occurred in 11 out of 20 cases of group Ⅱ and all cases in groups M , and broadened in all cases of group Ⅲ. Conclusion Endoscopic ultrasonography can be served as guidance in selecting therapeutic measure in treating EV. EVL is merely suitable in treating EV; in EV patients with PEV and/or PV measures other than EVL should he selected.

Objective To investigate the endoscopic feat ures and endoscopical treatment of gastric carcinoid tumors.Methods The clinical and endoscopic materials of 18 patients w ith gastric carcinoid tumors was retrospectively reviewed.Results Five of the 18 patients were benign and 13 were maligna nt. Benign gastric carcinoid tumors were found by biopsy at endoscopy ,and were resected by endoscopic mucosal resection(EMR).Their endoscopic appearance was mu ltiple polypoid masses. 13 malignant patients were confirmed by surgery. Their e ndoscopic appearance was ulcerating and infiltrating lesions.Conclusion Gastroscopy remains to be valuable to set correct di agnosis of gastric carcinoid tumors. EMR may be the first choice for benign gast ric carcinoid tumors.

Objective To investigate the characteristic findings of intestinal metaplasia revealed by magnifying endoscopy, and clarified their relationship with histopathological features. Methods One hundred and nine patients underwent magnifying endoscopy between March 2003 and November 2003. Patients with gastric adenocarcinoma, esophogeal and/or gastric varices, history of gastric surgery were excluded. Endoscopic examination was performed with a high-resolution magnification endoscope after methylene blue (1 % ) spraying. According to the differences in color and mucosal pattern, forms of endoscopic images were defined, and biopsies were taken (n = 115). Results Six patterns of endoscopic images were defined according to the microscopic findings. Pattern-4 and -5 were related to intestinal metaplasia. Histological features were used as the key standard. Conclusion High-resolution magnifying endoscopy is useful in detecting intestinal metaplasia of gastric mucosa pits from its normal shape changed into oval shape or villous like pattern. This procedure may improve the follow-up of individuals at high-risk of gastric cancer.

Objective To assess the value of a fibrin-targeted contrast agent (EP-2104R) for MR detection of thrombus, and to compare this modality with non-contrast-enhanced (NCE) MRI and Gd-DTPA injection at acute period after thrombus generation. Methods Thrombus was induced with external injury and stasis in 5 rabbits. MRI was performed before and after contrast agent injection at 6.0 h after injury, and the MRI findings were compared with that of histopathologically examinations. Results EP-2104R enhanced MRI accurately detected thrombus, which was superior to both NCE and Gd-DTPA injection (P<0.001). Gd-DTPA injection was not associated with improvement of thrombus detection. Conclusion Being a fibrin-targeted MR contrast agent for in vivo detection of acute thrombus, EP-2104R is superior to NCE MRI and Gd-DTPA injection.

Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.

Objective To analyze the differences of morphological and microvascular characteristics between hyperplastic polyps and colorectal adenoma (CA) under narrow band imaging (NBI) without magnification endoscopy,and to evaluate the value of NBI in differential diagnosis.Methods Patients with rectal polyps diagnosed by common endoscopy and pathologically confirmed CA and hyperplastic polyps were recruited in this study and under NBI examination.The pit pattern was divided into type A and B according to modified Kudo pit pattern classification.And the vascular pattern was classified into three types,type Ⅰ with invisible microvascular,type Ⅱ with even microvascular arranged along pit and type Ⅲ with uneven microvascular and irregular arranged.The differences of morphological and microvascular characteristics between hyperplastic polyps and CA were compared and the inter-observer consistency of NBI without magnification endoscopy was evaluated.Results Overall,87 patients with 107 polyps (73 CAs,34 hyperplastic polyps) underwent NBI without magnification endoscopy examination.The maximum diameter and the proportion of polyps with sublobe was higher in CA group than that of hyperplastic polyps group (P =0.0023 and 0.0047).In CA group,most pit shapes were type B (86.3％,63/73),and most vascular pattern types were Ⅱ/Ⅲ (82.2％,60/73).The sensitivity,specificity and accuracy of CA diagnosed with features of type B pit shape or Ⅱ/Ⅲ vascular pattern type was 97.3％,82.4％ and 92.5％.The sensitivity,specificity and accuracy of CA diagnosed with combined features of type B pit shape and Ⅱ/Ⅲ vascular pattern type was 71.2％,91.2％ and 77.6％.The mean kappa value of inter-observer consistency was 0.761.Conclusions There are differences in pit shapes and vascular pattern characteristics between CA and hyperplastic polyps.According to these two facts,CA and hyperplastic polyps can be initially differential diagnosed by NBI without magnification endoscopy.

Objective To analyze the clinical and endoscopic characteristics of fundic gland polyps (FGPs).Methods A case-control study was carried out at the Afifliated Beijing Shijitan Hospital of Capital Medical University from 2008 to 2015. The patients who accepted an upper endoscopy and found the gastric polyps for the ifrst time (diagnosed by pathology) were included in the study. Then, we analyzed the clinic and pathological characteristics of FGPs and non-FGPs.Results During the study period, 867 patients were enrolled, and 319 (36.8%) patients had FGPs. Compared the cases with the controls, the size of FGPs was smaller, an average is (0.40 ± 0.15) cm, single accounted for 67.7%, and 88.1% of FGPs were located at fundus and body. Helicobacter pylori infection of the cases detected was found in 6.1%, less than non-FGPs. There were statistically signiifcant differences observed in these aspects. From 2008 to 2015, the proportion of FGPs in gastric polyps and the detection rate of FGPs are both gradually elevated.Conclusions FGPs are the common gastric polyps, and its detection rate is gradually elevated. Most of the FGPs are mainly located at fundus and body, and single. Helicobacter pylori infection detected in the patients who have FGPs is rare.

BACKGROUND: Vascular endothelium growth factor (VEGF) is an endothelium mitogen and angiogenic factor with strong potential during recovery from cerebral infarction (CI). Can such therapeutic effect be detected with magnetic resonance diffusion imaging?OBJECTIVE: To study the therapeutic efficacy of VEGF plasmid in treating focal cerebral infarction in a dog experimental model with the aid of diffusion- and hemodynamic-weighted magnetic resonance imaging (MRI),with the morphological results compared with those of immunohistochemical examination.DESIGN: Completely randomized controlled, double blind evaluation,analysis of variance, Pearson correlation analysis, follow-up for 2 weeks.SETTING: Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University.MATERIALS: This study was carried out at the Department of Medical Iconography, the Second Affiliated Hospital of Hebei Medical University,between April 2001 and March 2002. Totally 18 healthy adult dogs weighing 10-15 kg were randomly divided into control group and experiment group with half in each.METHODS: All dogs were subjected to femoral intubation and then made into CI model by the occlusion of middle cerebral artery with an embolus injected through the internal carotid artery. Dogs in control group were put to death at postoperative 24 hours, 1 week and 2 weeks with three at each time point, while four dogs in experiment group were put to death at postoperative 1 week and five at 2 weeks. Dogs in experiment group received microinjection of 0.5 mL fluid containing pcD2/hVEGF121 (500-600 μg)instantly after operation, which was replaced with physical saline of the same volume at the same time point in control group. Then they were subjected to MRI scanning once an hour for 4 times, with the sequence of T1WI, T2WI, 3D-TOFMRA, DWI and CET1WI, which was repeated at postoperative 24 hours, 3 days, 1 week and 2 weeks. Based on the MR images, pathological focuses were selected for morphological observation of cells with the aid of HE staining, and CD34 IHC staining was used for counting micrangium, as well as VEGF staining for VEGF positive cells.Then the apparent distribution coefficient (ADC) was calculated, and the differences between different time points and groups were analyzed by analysis of variance. The number of capillaries and VEGF positive cells of each high-power field was counted, with the results compared with those of MR scanning so as to explore the correlation between MR signal changes and IHC results.MAIN OUTCOME MEASURES: ① The number of capillaries and VEGF positive cells in each high-power field was counted at postoperative 24 hours, 1 week and 2 weeks; ② MR images of each group.RESULTS: Data of the 18 dogs entered the final analysis. ① Diffusionweighted imaging (DWI) showed higher signals at infarctional region at postoperative 1 hour, which became strengthened as time went by. ②ADC decreased to (5.61 ±1.39) mm2/s at postoperative 3-4 hours, about 43% lower than that of the opposite hemisphere [(9.85±2.04) mm2/s]. It resumed to (9.83±1.11) mm2/s, but was still lower than the normal level.③ The subsequent MR scanning proved that ADC ratio presented an increasing tendency in contrast with the decreasing tendency at super-acute stage. The increment was even more marked in control group and the difference was significant at postoperative 2 weeks (P=0.032, 0.006). ④ The number of capillary positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 2 weeks [(28.80±3.29)/field, (20.70±4.47)/field, (P ＜ 0.01)]. ⑤ The number of VEGF positive cells on the affected side in experiment group was significantly higher than that in control group at postoperative 1 and 2weeks [(64.20±9.40)/field, (51.90±5.74)/filed; (72.70±6.98)/filed,(58.40±6.35)/field, (P ＜ 0.01)].⑥ The results of MR scanning and IHC were subjected to correlation analysis and revealed that ADC ratio was closely correlated with the number of capillary positive cells, with Pearson correlation coefficient being 0.679 (P ＜ 0.01). Moreover, the number of capillaries and the number of VEGF positive cells were significantly correlated (r=0.668, P ＜ 0.01).CONCLUSION:Morphological observation and IHC revealed that both the local capillaries and VEGF protein content increased markedly in timedependant manner due to VEGF plasmid gene therapy.Meanwhile,the change of ADC ratio was found to be closely correlated with the number of VEGF positive cells and the number of capillaries.

Objectives To investigate the clinical, pathological and endoscopic characteristics of colorectal polyps treated by endoscopic mucosal resection (EMR), then evaluate its therapeutic effect and security, and analyze its significance in diagnosis and treatment. Methods Clinical and pathological data of 437 patients (687 lesions), who underwent EMR from August, 2014 to August, 2015 were collected. A retrospective analysis was made, and lesions were statistically analyzed by variables such as age, sex, endoscopic features and clinical and pathological characteristics, and so on, according to the group procedure of adenoma cancerization and 'high risk adenomas - low risk adenomas - non-adenoma polyps' to observe the curative effect and safety on EMR. Results 48.28% of the patients who received colonoscopy examines were detected with polyps, and 34.90% of them were operated EMR, including advanced adenomas, which were 17.08% of the total quantity. From non-adenoma to advanced adenoma, with a increasing possibility of carcinogenesis, the location of polyps are transferred from proximal colon to distal colon and lesions are readily to be pedunculated ones with a higher level of mucosal lobulation and other kinds of mucosal changing. The degeneration of the colorectum is associated with pedunculated polyps, distal colorectal polyps, the size (>1.0 cm), adenomas containing villous structures and mucosal lobulation. As for EMR treatment, the en bloc resection rate can reach as high as 99.70%, with a complication rate of 1.14%. Conclusions Some special characteristics can be found in the site and the endoscopic feature of advanced adenomas and degenerated adenomas. To polyps sizing in 0.5 ~ 3.0 cm, EMR with endoclips has a remarkable effect and a low complication incidence. It can reduce the process of colorectal adenoma degenerates to multiple colorectal adenocarcinoma, which can be regarded as an effective method to prevent and cure the colorectal carcinoma.