Brucellosis is a zoonosis with worldwide distribution.There is an upward trend in the incidence of this disease in recent years,and multiple systems and organs are affected.Complication of bone and joint is the most commonly seen of Brucellosis.Although cardiovascular complication is rare,it is the major reason for Brucellosis-related mortality.The author summarized domestic and foreign studies on Brucella endocarditis.

Objective To investigate the expression of vascular endothelial growth factorC(VEGF-C),its receptor3(VEGFR-3) and podoplanin in tissue of esophageal cancer,and the relationship between their expression and tumor lymphatic metastasis.Methods Expression of VEGF-C,VEGFR-3 and podoplanin in 76 cases of ESC was detected by immunohistochemical SP method and lymphatic vessel density(LVD) was calculated.Results Positive immunostaining of VEGF-C in esophageal cancer tissue was 63.1%;the expression of VEGF-C was significantly associated with the depth of lymph node metastasis and tumor invasion(P

OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.

Objective:To summarize the ultrasound features of renal arteriovenous fistula(RAVF)under various ultrasound imaging modes,so as to avoid missed diagnosis of RAVF on initial ultrasound examination.Methods:The clinical data of 6 patients with RAVF,including the ultrasound evidence,the timing of ultrasound diagnosis,the modes of ultrasound diagnosis, and the agreement between ultrasound diagnosis and selective renal arterial angiography,were retrospectively analyzed.Results: 2D ultrasound had 1 case of correct diagnosis,1 case of misdiagnosis and 4 cases of missed diagnosis.Color Doppler and spectral Doppler both had all the 6 cases correctly diagnosed.Ultrasound angiography in 3 cases demonstrated that the contrast agent reached the renal veins earlier than reached the renal parenchyma;large fistula lumen was associated with ischemia of downstream areas.3D ultrasound vividly reflected the structure of fistula lumen volume,and provided us with the profiles of blood signal in fistula at different planes and angles,improving our knowledge of blood flow on the fistula.Conclusion: Ultrasound is the first line screening method for RAVF.Color Doppler plays a decisive role in the diagnosis of RAVF and pulsed spectral Doppler plays a synergetic role and contributes to differential diagnosis.Contrast-enhanced ultrasound may help to discover the abnormality of venous circulation and the ischemic parenehyma area due to shunting.2D ultrasound has a poor diagnostic value and is liable to lead to misdiagnosis and missed diagnosis.

Objective To investigate the expression of vascular endothelial growth factor C(VEGF-C ) in tissue, serum and lymph fluid in esophageal cancer patients, and the relationship between its expression and tumor lymphatic metastasis. Methods Expressions of VEGF-C in 76 cases of ESC was detected by immunohisto-chemical SP method and VEGF-C levels in lymph fluid and serum were assessed by enzyme-linked immunosorbent assay. Results Positive immunostaining of VEGF-C in esophageal cancer tissue was 63.1%,The expression of VEGF-C in tissue was significantly associated with lymph node metastasis and TNM stage ( P<0.01, P<0.05 respectively), but not to patient age, tumor length or differentiation; VEGF-C in lymph fluid is significantly higher than in serum( P<0.05) ; The expression of VEGF-C in lymph fluid end serum were significantly associated with lymph node metastasis( P<0.05). Conclusion There are cliuical significance between VEGF-C expression and lymph node metastasis、TNM stage in tissue of esophageal cancer. The level of VFGF-C in lymph fluid is higher than that in serum, both associate with lymph-node metastasis closely.

Objective:To explore the protective effect of sodium channels antagonists HOE642 on lung ischemia reperfusion and the role of the p38 mitogen activated protein kinase (p38MAPK) signaling pathway in this process.Methods:A total of 36 mice were randomly divided into a sham operation group (SHAM group),a lung ischemia reperfusion group (I/R group) and a lung ischemia reperfusion+HOE642 group (HOE group).The water content was detected by electronic scales,and the lung tissue pathological changes were observed under optical microscope.The inflammatory cytokines including IL-6 and TNF-α were examined by ELISA.The intracellular calcium fluorescence intensity was examined and observed under fluorescence microscope,and the protein expression of p38MAPK was detected by Western blot.Results:Lung water content in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Lung interstitial edema,hemorrhage,lung tissue inflammatory cells infiltration were significantly alleviated in the HOE group than those in the I/R group,while the injury in the HOE group was aggravated than those in the SHAM group (both P＜0.05).T he IL-6 and TNF-α in lung tissues in the HOE group were lower than those in the I/R group,but higher than those in the SHAM group (both P＜0.05).Intracellular calcium fluorescence intensity in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).The protein expression of p38MAPK in lung tissues in the HOE group was lower than that in the I/R group,but higher than that in the SHAM group (both P＜0.05).Conclusion:HOE642 may exert protective effect on pulmonary I/R injury through regulation of the p38MAPK signaling pathway,resulting in reduction of intracellular calcium ion concentration and calcium overload,and decrease of inflammatory response.

Objective: To evaluate the therapeutic effect of gamma knife on patients with intracranial cavernous angioma (CA). Methods: The medical records of 122 patients (134 lesions) who underwent radiosurgery were reviewed retrospectively. Results: hT e average follow-up period was 43 months. No patient died. One patient underwent CA resection. In patients with epilepsy, 83% patients showed alleviation of seizures. About 44% of the lesions shrank in size after treatment with gamma knife radiosurgery (59/134). Seven cases had hemorrhage again after radiosurgery, and the overall annual hemorrhage rate was 1.6%. Edema was found in 11.5% patients (14/122) and all patients showed improvement atf er treatment. Conclusion: Gamma knife is a safe treatment for CA, which could obviously improve the symptoms of epilepsy. Gamma knife radiosurgery is the if rst option for the treatment of cavernous sinus angiomas.

Objective:To analyze the benefit incidence and evaluate the implementation effects on catastrophic disease insurance under the New Rural Cooperative Medical System ( NRCMS) in Jilin Province and put forward sug-gestions to perfect the catastrophic disease insurance under NRCMS. Method: In-depth interviews with related staff were conducted to gain an understanding of the operating status of catastrophic disease insurance under NRCMS;cat-astrophic disease patient data of Jilin Province from 2013 were collected, with a comparative analysis of implementa-tion effects among nine districts;the benefit incidence was analyzed by means of the Sperman rank correlation analy-sis; Results: The policy of catastrophic disease insurance under the NRCMS exhibited sound implementation effects and played an important role in reducing the economic burden of catastrophic disease patients. The average individual expenditure decreased by 4336. 52 yuan, while the reimbursement rate increased by 11. 15% after NRCMS cata-strophic disease insurance reimbursements. Additionally, statistical analysis results showed that there was a weak cor-relation between benefit incidence and economic level, the benefit equality of catastrophic disease insurance under NRCMS was relatively good, but the benefit level of rich patients was slightly higher. Conclusion:The reimbursement scheme of catastrophic disease insurance under NRCMS should be refined and improved, and the benefit fairness of different districts must be ensured, thus achieving the goal of relieving the“poverty caused by illness” phenomenon.

OBJECTIVE:To study the effects of Xiaoruzeng capsule on the gastric acid and pepsin in rats. METHODS:Rats were randomized into a blank group (distilled water),a positive control group (3.6 mg/kg omeprazole ) and the groups of low, middle and high doses of Xiaoruzeng capsule [2.25,4.5,9.1 g(crude drug)/kg]. These groups were respectively marked as groups A,B,C,D and E,with 10 rats in each group. All the rats were given corresponding drugs,ig,for consecutive 10 d. Their suc-cus gastricus was collected 3 h after the last administration,and determined for pH value with precision pH test strip and for free acidity and total acidity by acid-base neutralization titration method. The content and activity of pepsin were determined and calculat-ed with the test kit and microplate reader. The pathological change of the stomach was observed under the electron microscope. RE-SULTS:Compared with group A,groups B,C and D had higher pH value of succus gastricus;groups C,D and E had lower free acidity;groups B,C and D had lower total acidity,group E had higher total acidity;groups B,D and E had lower activity of pep-sin;and group C had higher content of pepsin. Compared with group B,group D had lower pH value of succus gastricus;group C had lower total acidity;group E had higher acidity;and groups C,D and E had higher activity of pepsin. There was statistical sig-nificance(P<0.01 or P<0.05). Gastric mucosal erosive haemorrhage was noted in three rats in group E,and other groups demon-strated no obvious pathological change. CONCLUSIONS:Low dose of Xiaoruzeng capsule can slightly inhibit the gastric acid in rats,but will not effect the activity of pepsin.

AIM: To investigate the effect of high concentration of chlorine gas(Cl 2) exposure on lung haemodynamic and respiratory function in intact and isolated perfused rabbit lungs (IPLs). METHODS: 8 intact and 10 IPLs were exposed to Cl 2 at high concentration(50?10 -4 )for 20 min, as measured group, 8 additional intact and 9 IPLs, which were similarly treated but not exposed to Cl 2, served as controls. The changes of lung weigh of IPL(△W)?pressure of pulmonary artery(Pa)and venous pressure(Pv)?airway pressure and tidal volume(TV) were continuously measured and recorded simultaneously. RESULTS: In IPL group: While the perfusing blood flow was kept constant (133.3 mL/min), and Pv did not change, following the exposure, the Pa increased slightly, then the lung weight were increased significantly and the TV decreased . Hematocrit of perfusate of EIPL and parameters of lung water increased also. In intact group : Pa increased slightly, respiratory rate accelerated immediately, and TV decreased. CONCLUSION:Although mean Pa increased continuously and slightly in both intact and IPL group following the exposure to high concentration of Cl 2, the primary cause of edema was most likely to alter pulmonary capillary permeability. The respiratory rate accelerated and TV decreased due to exposure to Cl 2 enhanced hypoxia of intact rabbits.