Objective To investigate the diagnostic value and safety of medical thoracoscopy in unexplained exudative pleural effusion.Methods A retrospective analysis was conducted using the clinical data of 70 routine medical thoracoscopy examinations of unexplained exudative pleural effusion in patients.The lesions were examined pathologically under direct vision.Results White military nodules were observed under endoscopy,with multiple pro-truding nodules,focal irregular thickening of the pleura,pleural congestion,edema and adhesion.The diagnostic accu-racy of thoracoscopy was 95.7%.Among the diagnosed cases,there were 35 cases of tuberculous pleurisy,20 cases of malignant pleural effusion,8 cases of parapneumonic effusion,4 cases of pleural effusion from congestive heart failure and 3 cases of idiopathic pleural effusion,with no serious complications.Conclusion Medical thoracoscopy is a safe and accurate method in the diagnosis of unexplained exudative pleural effusion.Medical thoracoscopy is beneficial in the establishment of treatment method quickly and allows observation of the pleural lesions in pleural effusion patients using the naked eye.

Objective To discuss the significance and effect of tuberculosis of thoracic-lumbar vertebra treated by interfixation with Z-plate in anterior approach. Methods Summarize was made in 32 cases of patient with tuberculosis of thoracic-lumbar vertebra from January 2000 to June 2004 ,All were treated by focus eliminate through anterior approach in first intention, autobody bone transplantation inter vertebra and interfixation with Z-plate in anterior approach. Results Followed up for a average of 25 months. 32 cases with tuberculosis of vertebra were cure, whole transplantation bones were bone fusion ,the fusion time was a average of 5 months. rectification angle of back protruding was 17.50,no surgery complication of hemothorax,pheumothorax, aggravation of paraplegia, leak of cerebrospinal fluid,looseness of interfixation and rupture . Conclusion Treatment of tuberculosis of thoracic-lumbar vertebra by focus eliminate through anterior approach in first intention, fixation by bone transplantation and interfixation of Z-plate have importance significance and marked effect.

Objective To observe the clinical effect of modified B-lynch suture in the treatment of patients with pernicious placenta pre-via.Methods A total of 46 patients with pernicious placenta previa in our hospital were randomly divided into the modified B-lynch suture treatment group(modified group)and the conventional therapy group(convention group),with 23 cases in each group.The operation time, menstrual recovery time and lochia sanguinea time,postpartum hemorrhage,intraoperative blood soss,abnormal temperature time,placenta ac-creta,hysterectomy and neonatal asphyxia between the two groups were compared.Results The intraoperative blood soss and postpartum hemorrhage of modified group was less than those of convention group,the menstrual recovery time was shorter than that of convention group and the rate of resection of uterine was lower than that of conventional group,with significant difference (P <0.05).There was no statistically significant difference in operation time,abnormal temperature time,lochia sanguinea time,placenta accreta and neonatal asphyxia between two groups (P >0.05).Conclusion The clinical effect of modified B-lynch suture in the treatment of dangerous placenta previa is significant.

0.05. All arose in the pelvis. 5 year′s survival rate in group Ⅰ was (53.2?1.9)% and (67.3?1.6)% in group Ⅱ, P

0.05). Conclusion Epilepsy and short-term or long-term TPM treatment have no effect on serum thyroid hormone levels in adults with epilepsy.

Exosome is a self-secreted phospholipid bilayer nanovesicles, and has shown great potential in drug delivery field due to the important advantages of low immunogenicity and homologous targeting. Phototherapy, mainly includes photodynamic therapy (PDT) and photothermal therapy (PTT), utilize light to activate photoactive drug for tumor cell killing. The advanced therapeutic strategy shows low toxic side-effect and non-invasion precise advantages, and thus has made great progress in tumor treatment over the past few years. Therefore, using exosomes as a drug delivery system to deliver phototherapeutic agents can improve therapeutic performances with a reduced side-effect, and further enhance their application potential for clinical tumor therapy. This review focus on the rising cross-subjects field involving exosomes and phototherapy, and mainly introduce the research progress and relative case of exosomes-based delivery system for cancer phototherapy. Additionally, the advantages and challenges of exosome-based phototherapy are also discussed and proposed.

Brucella organisms are facultative intracellular bacteria capable of surviving inside professional and non-professional phagocytes.Upon cell contact the bacteria is internalized via receptor molecules.Once inside cells,Brucella localizes in early phagosomes,where it avoids fusion with late endosomes and lysosomes.Then,the bacterium redirects its trafficking to autophagosomes and finally reaches the endoplasmic reticulum,the replicating niche.Once inside the endoplasmic reticulum,Brucella extensively replicates without restricting basic cellular functions or inducing damage to cells.Invasion,intracellular trafficking and replication of Brucella organisms in professional and non-professional phagocytes and the molecular determinants involving Brucella intracellular life are reviewed in this article.

OBJECTIVE:To investigate the characteristic and regularity of antineoplastics-induced ADR,and to provide refer-ence for safety use of antineoplastics in clinic. METHODS:In retrospective study,309 cases of antineoplastics-induced ADR col-lected from a special hospital during Jan.-Dec. 2015 were summarized and analyzed statistically. RESULTS:Among 309 ADR cas-es,female (58.25％) was more than male (41.75％). The patients aged more than 40 years old occupied the highest proportion (78.64％). Main route of administration was intravenous dripping(94.82％). There were 225 cases of severe ADR(72.82％). To-tal 268 cases were improved after drug withdrawal or treatment(86.73％). A total of 24 kinds of antineoplastics were involved in 309 ADR cases;most of ADR were induced by docetaxel,followed by cisplatin,cyclophosphamide. Most common organs/system involved in ADR was hemopoietic system (64.24％),main clinical manifestation was myelosuppression. CONCLUSIONS:It is necessary to strengthen ADR monitoring,prevent,discover and treat antineoplastics-induced ADR timely,in order to reduce the harm to the patients and ensure the safety and effectiveness of drug treatment.

Limb-shaking transient ischemic attack (TIA), a rare manifestation, is commonly caused by severe stenosis or occlusion of an extracranial internal carotid artery. Such patients are usually treated with surgical revascularization or anti-platelet therapy. We present a 56-year-old woman with 6 months’ episodic attacks starting with mouth skewed to the right and a sensation of ‘weakness’ involving predominantly her left arm, and at times, also involved the left leg. This was immediately followed by rhythmic jerky movements of the left arm and at times, also involved the left leg. Magnetic resonance angiography revealed severe stenosis of M1 segment of the right middle cerebral artery. The patient’s symptoms were signifi cantly improved by treatment with anti-platelet drugs and nimodipine.

Objective:To analyse the degree of equality of New Rural Cooperative Medical Scheme (NRCMS) in different economic regions. We provide a reference for equal development of the NRCMS and the reform of the political system and mechanism under the provincial-controlled county fiscal system. Methods:A typical province was chosen with provincial-controlled county fiscal system was fully implemented several years. We collected data on coverage, financing and compensation for the NRCMS from 2005 to 2011. We used the variable coefficient, uniformity coefficient, Theil Index for comprehensive evaluation. Results:Per capita financing has not reached the bottom line. From 2005 to 2011, inter-re-gional and intra-regional variation coefficient, Theil index of service coverage, financing level and hospital actual compen-sation has declined year by year. The degree of inequality in economically developed regions was greater than in less eco-nomically developed regions and economic medium region. Conclusion:The degree of equalization of the NRCMS in the province continuously improved. Innovation of provincial-controlled county fiscal system and mechanism provides a favora-ble environment and forming conditions for equalizing the development of the NRCMS. The paper suggested exploring and building fiscal classification step transfer payment institution and dynamic prediction model of the NRCMS, further optimi-zing financing mechanism, promoting the provincial management system of the NRCMS as soon as possible in order to pro-mote the equalization development.