Objective To compare the clinical features of patients with myasthenia gravis at various age groups,and to evaluate the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid and acetylcholinesterase inhibitor plus thymectomy in children,young adults,and elderly patients with myasthenia gravis (MG).Methods The clinical data of 300 MG patients admitted to the department during the same period were reviewed retrospectively.The patients with MG were divided into three groups based on the age of disease onset:childhood group (age≤14,n=77),young adult group (age=15～59,n=183) and elderly group (age≥60,n=40).The clinical features of MG patients in various age groups were compared including the incidence,sex ratio,initial symptoms,clinical classification,positive rates of neostigmine test and repetitive nerve stimulation,and thymic abnormalities.Furthermore,the therapeutic effects of acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid,and acetylcholinesterase inhibitor plus thymectomy were investigated.Results The most common ages of MG onset were ranged from 15 to 59 years (young adults group).With increase in age,the incidence of MG lowered in females,while in males it became higher.Extra ocular muscles involvement as the initial symptom was higher in children and elderly patients than in young adults.The limb muscles involvement as the initial symptom was more common in young adults group.About 72.73% patients in childhood group were classified as type Ⅰ,while type ⅡB was the most commonly seen in young adults group (55.74%) and elderly group (50.00%).No significant difference was found among the three groups in the positive rates of neostigmine test and repetitive nerve stimulation.In childhood group,hyperplastic thymus was commonly observed,while thymoma was more common in elderly group.The therapeutic effects of acetylcholinesterase inhibitor alone were better in childhood group than in the other 2 groups (P0.05).The therapeutic effect of acetylcholinesterase inhibitor plus thymectomy was most satisfactory in childhood group,less satisfaetory in elderly group and paorest in young adults group ( P

Objective To evaluate the relationship between concentrations of nitric oxide (NO) and antigen-specific immunoglobulin G (IgG) in CSF and intracranial hypertension and epilepsy in patients with neurocysticercosis.Methods The NO concentration and the IgG level were measured in 40 cases of neurocysticercosisk, and the results were compared according to the patients whether had intracranial pressure or epilepsy. 23 patients with varicosis of great saphenous vein required subarachnoid anesthesia were served as control group.Results Compared with control group, the NO concentration in CSF significantly increased in patient group (P0.05) in the patients with epilepsy as compared with the cases without epilepsy.Conclusions The CSF NO concentrations are higher in the patients with neurocysticercosis who had intracranial hypertension or epilepsy. The IgG levels are also increased in the patients who had intracranial hypertension.

Objective To analyze the clinical characteristics of myasthenia gravis(MG) associated with thyroid abnormalities.Methods A total of 300 MG patients admitted to the department of neurology from July 2008 to September 2009 were reviewed retrospectively.Based on the thyroid function and abnormality of thyroid related antibodies (thyroglobulin antibody and peroxidase antibody), the patients with MG were divided into two groups (260 cases without thyroid disease and 40 cases with thyroid abnormalities).The different clinical features, the relationship between the antithyroid antibodies and antiacetylcholine receptor antibody (AChRAb) and the distribution of T cell subsets between the two groups were compared.Results ( 1 ) Among the 300 MG patients, 13.3% of them was accompanied with thyroid disease and the most common abnormality was positive thyroid antibody.(2) Between the groups of MG with and without thyroid abnormalities, no significant differences on the sex percentage, age of onset, duration of disease, clinical classification and thymic abnormalities were found ( P ＞ 0.05 ).( 3 ) The blood levels of AChRAb in postsynaptic membrane in the thyroid antibody-positive patients were 1.15 ± 0.11, being much higher than those in the antibody-negative patients ( 1.01 ±0.11 ).(4) The percentage of CD8+ T cells was significantly decreased [(21.63 ±5.17)% vs (24.28 ±5.79)%] and the ratio of CD4+/CD8+ T cells was increased (2.10 ± 0.67 vs 1.81 ± 0.61, P ＜ 0.05 ) in the group of MG with thyroid abnormality as compared with the group of MG with normal thyroid.Conclusion In MG patients the incidence positive thyroid related antibodies was much higher than that of other thyroid abnormalities.It is suggested that there are higher levels of AChRAb in MG coexisting with positive thyroid antibodies and more abnormalities of T lymphocyte subset distribution in MG patients with thyroid disease.

Long non-coding RNA ( lncRNA ) is a group of RNAs that exceed 200 nt in length without protein coding capacity .The tumorigenesis and progression of colorectal carcinoma relate to the aberrant expres-sion of lncRNAs closely.In this review,we summarize researches in the current status of lncRNAs in human color-ectal carcinoma to provide potential evidences for future diagnosis and gene therapies .

Objective To observe the neuroprotective effect of arcaine,an antagonist of receptor of N-methyl-D-aspartate(NMDA) and(or) channel complex polyamines site,on cerebral ischemia.Methods Forty-five Wistar rats were randomly divided into 5 groups: control group,ischemia model group,24h preoperative group,1h preoperative group and 1h postoperative group.Acute cerebral infarction model was reproduced in rats of the latter four groups with middle cerebral artery occlusion(MCAO) using ligature method.Once the ischemia model was successfully established,rats in the latter three ischemia model groups were given arcaine(3mg/kg) at 24h and 1h before operation and 1h after operation,respectively,while normal saline(0.4ml/kg) was injected to the rats in the control group.Neurological function behavior and cerebral infarct volume were assessed,and pathological features of brain tissue were observed under light-and electron microscope.Results Neural function scores of the rats in 24h preoperative group,1h preoperative group and 1h postoperative group were 1.25?0.46,1.33?0.50 and 1.40?0.58,respectively,which were significantly different from that in ischemia model group(2.63?0.52,P

OBJECTIVE To investigate the risk factors of fungal ventilator associated pneumonia(FVAP) and the characteristic of pathogenic fungi.METHODS Thirty seven VAP patients were divided into FVAP group and nonfungal ventilator associated pneumonia(NFVAP) group.Risk factors were compared between the two groups and the characteristic of pathogenic fungi was analyzed.RESULTS Compared to the NFVAP group,the FVAP group showed a significant higher rate in systemic usage of glucocorticosteriod and combined application of antibiotics.The cases of FVAP appeared frequently over the period since 7th to 14th days after intubation.Twelve strains of fungi were isolated from the sputum of patients in FVAP group.Ten strains(83.3%) of the isolates belonged to Candida species included(C.albicans 6 strains(50.0%),C.tropicalis 2 strains(16.7%),C.krusei 1 strain(8.3%),and C.parapsilosis 1 strain(8.3%),and 2 strains(16.7%) of the isolates belonged to Aspergillus.CONCLUSIONS The rate of tracheal intubation should be decreased and the time of mechanical ventilation should be shortened to avoid FVAP.Identifying the strains of fungi and their sensitivity are useful to direct the treatment.

objective To compare the clinical characteristics of early-onset and late-onset myasthenia gravis(MG).Methods A total of 819 MG patients admitted in our department during the sanle period were reviewed retrospectively.The patients with MG were divided into two groups by the age of onset, which were the early-onset MG(＜49 years)and late-onset MG(≥50 years).Several clinical features were compared in the two groups including the percentage, initial symptoms, MG types,the positive rates of neostigmine test and repetitive nerve stimulation, thyroid function and thymie abnormalities. Results The more common onset age of MG was 0-49 years(early-onset).In both groups the male and female ratio was presented as the most common type in both groups(41.51%and 51.37% respectively in early-onset and late-onset groups).Type Ⅰ was more common in early-onset group while typeⅡB Was more common in lateonset group(P＜0.05).There Was no significant difference in the positive rates of neostigmine test and repetitive nerve stimulation between the two groups.The thyroid function alnormality ratio was higher in early-onset group. Hyperplastic thymus was common in early-onset group(67.57%)while both hyperplastic thymus and thymoma were common in late-onset group(48.68% and 47.37%).Conclusions The clinical characteristics of early-onset and late-onset myasthenia gravis(MG)Was different in MG type, the positive rate of thyroid function abnormalities and thymic pathologic type.

Objective Serum uric acid (SUA) levels have been identified to be associated with nonalcoholic fatty liver disease (NAFLD) which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index (BMI) people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people. Methods A total of 2 193 normal-BMI people (1 106 men and 1087 women) who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD. Results Compared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males,(339.0±47.6)μmol/L vs.(309.3±53.5)μmol/L, t=3.296, P<0.01;female,(273.6±41.6)μmol/L vs. (243.9 ± 47.6)μmol/L, t=3.178, P<0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher (P<0.05) odds ratio for the presence of NAFLD than the lowest quartile [males,odds ratio:2.508(1.255-3.374)and 3.383(2.058-5.490);females,odds ratio:2.186(1.090-4.384) and 2.420(1.214-4.821),respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status.Conclusions Increased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people.

Objective To investigate the immunoregulatory role of Th17 cell and the related cytokines in myasthenia gravis.Methods Totally 51 myasthenia gravis (MG) patients were divided into MG with thymomas ( TM group) and the MG with normal thymus ( NT group),as well as 22 healthy subjects as controls.Th17 cells from peripheral blood mononuclear cells were measured by flow cytometry.Th17 related cytokines were detected by ELISA and real-time quantitative-PCR.Results The quantity of Th17 cells in MG patients with thymomas (1.53 ± 0.59 )％ were significantly increased compared with that of healthy control (0.94％±0.32％,P ＜ 0.05 ).There was no significant difference in the number of Th17 cells between healthy controls and NT group.The expression levels of IL-17 mRNA ( 23.7 ± 4.5 ) were upregulated significantly versus those in healthy controls (13.4 ± 3.2,P ＜0.01 ).The levels of mRNA expression of IL-1 β,IL-6 and IL-23 were up-regulated significantly in TM group.The mean concentration of IL-17 was up-regulated significantly in TM group (30.4 ±7.3) ng/L versus healthy controls [ ( 19.2 ±4.9)ng/L,P ＜ 0.05].Serum levels of IL-23 and IL-1β were always increased in TM group versus healthy controls.Conclusion The elevated levels of IL-17 and other Th17 related cytokines in thymomas may aggravate the autoimmunity disorder.

Objective To investigation the clinical characteristics in myasthenia gravis (MG)patients with thymomas.Methods A total of 856 MG patients admitted to the department during 2008.7-2010.12 were reviewed retrospectively.The patients with MG were divided into two groups based on thymic pathology,which were 162 cases with thymoma and 694 cases without thymoma.We compared the different clinical features including the gender,age of onset,MG symptoms and the incidence rate of myasthenia crisis.And the relationship between the WHO types,Maosaoka stages of thymoma and the severe of MG was also studied.Results The percentage of thymoma-associated MG patients was 18.9 percent of hospitalized MG patients at the same period.Of the 162 thymoma-associated patients,94 were male and 68 were female,with a ratio of 1.38∶1 and a mean age of (42.9 ± 12.4)years old.Thymoma was more frequent in middle-old aged patients than in children.Compared with non-thymoma MG,more thymomatous patients showed generalised MG,but not only ocular muscles weakness (90.1％ vs 62.4％,P ＜ 0.001 ).There were significant differences of the incidence rate of myasthenic crisis in the two groups ( 14.8％ vs 2.3％ ).(2)WHO type B2 and Maosaoka Ⅰ,Ⅱ thymoma were the commonest types among all potentially MG-associated thymoma.No differences of Osserman MG classification was found in thymomatous patients with different pathologic changes.Conclusions The thymomatous MG patients had its distinctive clinical features:thymomas occured in about 19.7％ of MG patients with more men than women,more common in generalized,higher incidence of myasthenia crisis,with B2 type thymic pathology and Maosaoka Ⅰ,Ⅱstages.No correlation was found between pathologic and clinical stagcs.