Clinical features of 9 cases of Brucella endocarditis / 中华心血管病杂志

Objective: To explore the clinical characteristics of patients with Brucella endocarditis. Methods: The clinical data of 9 patients with Brucella endocarditis admitted to Beijing Ditan Hospital from October 2008 to August 2018 were retrospectively analyzed. Through the electronic medical record system of the hospital. Through assessing the electronic medical record system of the hospital, demographic data, main symptoms, vital signs, blood culture, Rose Bengal Plate Agglutination Test, echocardiography, electrocardiogram, chest imaging and other clinical data of included patients were inquired and recorded. Patients were followed up by telephone for medication, operation and outcome. Results: The 9 patients were all Han nationality, aged from 25 to 66 years, 7 out of 9 patients were male, and they came from Hebei, Shandong, Shanxi, Inner Mongolia and Beijing. Of the 9 patients, 5 were farmers, 2 were self-employed, 1 was a technician, and 1 was unemployed. Of the 9 cases, 8 had a history of close contact with cattle and sheep, and 5 had a history of eating beef and mutton. Rose-Bengal Plate Agglutination Test and blood culture were positive in all 9 patients. Aortic valve was involved in 7 out of 9 patients, mitral and tricuspid valve was involved in 1 patient, respectively, and aortic dissection occurred in 1 patient. Condition of 1 patient rapidly deteriorated after admission and finally died during hospitalization despite antibiotic therapy, the remaining patients received long-term antibiotic treatment. A total of 7 patients who underwent valve replacement were followed up. One patient died of cerebral hemorrhage 6 months after operation, and the remaining 6 patients recovered well after valve replacement. Heart failure occurred in all 9 patients, and pericardial effusion occurred in 8 patients. Electrocardiogram showed low voltage of the QRS complex in the limb in 3 cases and poor R-wave progression in V(1)-V(3) lead in 2 cases, and sinus tachycardia in 2 cases. One patient developed non-specific ST-T abnormalities. All patients had fever, 7 patients complained of weakness, and 6 patients complained of palpitations. Among the 9 patients, 7 cases had anemia, 7 patients had pneumonia, 6 had bilateral pleural effusion, 4 had thrombocytopenia. Creatinine was above normal in 4 patients, urine protein was positive in 3 patients, Delta Bilirubin was higher in 3 cases. Conclusions: Patients with Brucella endocarditis often suffer from heart failure and have severe complications. Adequate antibiotic therapy in combination with valve replacement is effective for the treatment of patients with Brucella endocarditis.

Application of mouse nervous growth factor on hand-foot-mouth disease combined with central nervous system damage / 中华神经医学杂志

Objective To investigate the application of mouse nervous growth factor (mNGF) on patients with hand-foot-and-mouth disease (HFMD) combined with central nervous system damage. Methods Clinical data of 48 patients with HFMD combined with central nervous system damage, admitted to our hospital and received treatment of mNGF from May 2008 to September 2010, were analyzed retrospectively. Results Children under 5 years old, especially between 1-3 years old, were the high-risk group of having HFMD combined with central nervous system damage. The average time of appearing of acute flaccid paralysis (AFP) and recovering of muscle strength were (7.1±3.6) d and (17.5±6.0) d, respectively. A total of 31 patients (64.58%) appeared vomiting, with its average times of appearance and disappearance as (4.29±3.10) d and (5.74±2.90) d, respectively. A total of 33 patients (68.75%) tended to appear panic symptoms, which appeared on (2.67±1.76) d and disappeared on (7.80± 2.76) d averagely. Laboratory test showed number of white blood cells and CK values were elevated of certain degree, and cerebrospinal fluid pressure and protein expression level were increased to varying degrees. MRI showed that bulbus medulla was the most likely to be involved, followed by brain stem and other parts. Conclusion Application of mNGF on patients with HFMD combined with central system damage may help to improve the neurologic symptoms and prognosis.