Objective To explore the diagnosis, surgical treatment and prognosis of thymoma complicated with myasthenia gravis(MG). Methods A retrospective analysis was performed in 33 thymoma patients with MG, who underwent surgical treatment. Results The total effective rate of operation was 75.8%, and the 5 and 10 years survival rates of the patients after operation were 85% and 78.7%, respectively. According to the Masaoka staging system, the 5 and 10 years survival rates of stages I and II were obviously higher than those of stages III and IV (P

Objective To investigate the relationship between the variation of cerebrospinal fluid pulse pressure and that of intracranial perfusion pressure during the process of increasing intracranial pressure.Methods Fourteen dogs were installed epidurally with latex sacculus to establish models of increased intracranial pressure. The degree of intracranial pressure and volume could be altered by changing the volume of fluid in the sacculus. During the process, pressure transducers were arranged to monitor and record the systematic blood pressure and the variation of the pressure of cerebral ventricle and lumbar subarachnoid space.Results With the continual increasement of intracranial pressure, the cerebral perfusion pressure decreased, and the cerebrospinal fluid pulse pressure correspondingly increased. A positive linear relationship between the variation of intracranial pressure and that of cerebrospinal fluid pulse pressure and a negative linear relationship between the variation of cerebral perfusion pressure and that of cerebrospinal fluid pulse pressure were found.Conclusion During the experimental process of increased intracranial pressure, with the decrease of cerebral perfusion pressure , the cerebrospinal fluid pulse pressure increases. The relationship of variations between them shows a negative linear one. It seems that in the circumstances when the autoregulation of cerebral vessel is injured, the variations of cerebrospinal fluid pulse pressure may produce some useful information as to the changes of intracranial blood flow.

Objective To study the changes of low-frequency-component of intracranial pressure (ICP) fluctuation during intracranial hypertension. Methods 15 healthy mongrel dogs were used to make models of intracranial hypertension by arranging latex sacculus epidurally.The different amount of normal that was injected into latex sacculus led to fluctuation of ICP and alteration of intracranial volume. The pressures in ventricle and lumbar spinal canal were recorded continuously by baroceptor, and the changes of low-frequency-component of ICP fluctuation were studied by frequency-spectrum analysis. Results After increase of intracranial pressure and volume,pulse wave (M wave) with its frequency at 0.1～0.2 Hz showed continually. Conclusion Emerge of M wave may reflect some decrease of intracranial compliance and the beginning of volume compensation failure.

Objective:To study the clinical efficacy of salmon calcitonin combined with calcium in the treatment of osteoporosis and the effect on bone metabolism index. Methods:Totally 360 cases of patients with osteoporosis were randomly divided into the ob-servation group and the control group with 180 ones in each. The patients in the control group were given compound calcium carbonate tablets, po, qd, and those in the observation group were given 50IU salmon calcitonin injection additionally, im, qd. After two months of treatment, the changes in pain score, bone density and bone metabolism related indicators of the two groups were compared before and after the treatment. The clinical efficacy and adverse reactions of the two groups were observed as well. Results: After the treat-ment, both groups showed lower pain scores (P<0. 01) when compared with those before the treatment, and the reduction in the ob-servation group was more significant than that in the control group. After the treatment, the bone density had no significant change in the two groups(P>0. 05). The bone metabolism parameters including serum BGP,β-CTX, PTH, BNALP and 25OHVitD were signif-icantly improved when compared with those before the treatment (P<0. 01), and the improvement in the observation group was better than that in the control group (P<0. 01). The incidence of adverse reactions in the observation group was significantly higher than that in the control group (P<0. 01). Conclusion:Salmon calcitonin combined with calcium can significantly improve the efficacy in the treatment of osteoporosis with improved pain scores and bone metabolism related indicators, and the combination is much better than calcium alone, however, the adverse reactions are significantly increased.

Objective To evaluate the correlation of interval from injury to surgery with outcome for central cervical spinal cord injury syndrome.Methods A retrospective analysis was done for 31 patients with central cervical spinal cord injury syndrome treated surgically between March 2007 and March 2011.According to the timing of surgical intervention,the patients were divided into early operative group (＜7 days from injury,n =14) and late operative group (≥7 days from injury,n =17).Japanese Orthopedic Association (JOA) score on admission,at postoperative half-year and at final follow-up were recorded and compared between the two groups.JOA recovery rate was determined and analyzed for correlation with operation time point.Results Mean follow-up was (16.1 ± 4.5) months (range,12-25 months).All patients had different degree of neurological recovery.JOA recovery rate in early operative group was apparently better than that in late operative group at final follow-up (P ＜ 0.01).JOA recovery rate at follow-up was negatively correlated with intervals between injury and surgery (r =-0.763,P ＜ 0.01).Conclusion For patients with central cervical spinal cord injury syndrome,time from injury to surgery is negatively correlated with outcome,indicating that early surgery may be associated with better outcomes.

Objective To investigate the effect of microRNA-101 (miRNA-101) on atrial fibrosis in human chronic atrial fibrillation (AF). Methods Right atrial appendages were obtained from 59 patients (30 with AF) undergoing cardiac surgery, including 47 patients with valve heart disease and 12 patients with congenital heart disease. The expression of miRNA-101 was determined by quantitative real-time PCR in the right atrial appendages of patients with and without AF. The cell-specific localization of miRNA-101 was detected by in situ hybridization assay. The mRNA and protein expression levels of transforming growth factor β typeⅠreceptor (TGFβRⅠ) and collagen type I (COL1) were determined by quantitative real-time PCR and Western-blot assay, respectively. Collagen in the right atrial appendages was observed by Masson staining assay. Results The expression of miRNA-101 was found to be significantly down-regulated in AF patients compared with patients with sinus rhythm (SR) (P < 0.05). The result of miRNA-ISH showed that miRNA-101, which was highly distributed within the connective tissues of heart, was down-regulated at about 24.9% in patients with AF compared with patients with SR. No significant differences at the mRNA expression level of TGFβRI was found between patients with AF and patients with SR (P > 0.05). But the protein expression of TGFβRI in patients with AF was significantly higher than that of patients with SR (P < 0.05). The mRNA and protein expressionsl of COL1 were significantly higher in patients with AF than thoset of patients with SR (P < 0.05). The collagen was significantly increased in patients with AF than that of patients with SR (P < 0.05). Conclusions Downregulation of miRNA-101 may contribute to atrial fibrosis in human atrial fibrillation by targeting TGFβRⅠ.

Objective:To explore the effect of endothelin-1 on atrial ifbrosis in patients with atrial ifbrillation (AF).
Methods: A total of 72 patients with thoracotomy were studied, the patients were divided into 2 groups:AF group, n=39 and Sinus rhythm (SR) group, n=33. The mRNA and protein expressions of endothelin-1 (ET-1), platelet derived growth factor-B (PDGF-B) and collagen I (COL1) in right atrial appendage (RAA) tissue were measured by RT-PCR and Western blot analysis;meanwhile, the impact of ET-1 stimulation and non-selective ET-1 receptor antagonist (sulfafurazole SIZ) on PDGF-B mRNA and protein expressions in H9c2 cells were measured.
Results: ①The RAA tissue mRNA and protein expressions in AF group were higher than those in SR group, as for ET-1 (2.830 ± 2.276) vs (1.220 ± 0.887) and (0.835 ± 0.241) vs (0.286 ± 0.083), both P<0.01;for PDGF-B (2.568 ± 2.348) vs (1.567 ± 0.831) and (0.807±0.241) vs (0.381 ± 0.105), both P<0.05;for COL1α1 (3.376 ± 1.598) vs (1.629 ± 0.833) and (0.652 ± 0.210) vs (0.312 ± 0.12), both P<0.05.②The protein expressions of ET-1 and COL1 had positive correlation (r=0.580, P<0.01).③ET-1 promoted PDGF-B secretion in H9c2 cells in a concentration and time-dependent manner;SIZ could reduce such promotion.
Conclusion: ET-1 plays an important role in AF occurrence which might be related to PDGF-B regulation.

Objective To study the inhibition of lung cancer cells of primary culture and A549 cell line on the proliferation of tumor-infiltrating lymphocytes(TIL) in vitro and its clinical implications.Methods Human lung cancer cells and TILs were isolated from 8 cases of primary lung cancer and cultured.The inhibition of isolated human cancer cells and A549 cells to TILs was detected by MTT method.Results Lung cancer cells of primary culture and A549 cells can kill TILs to various degrees.Conclusion Inhibition of lung cancer cells to TIL may be one of the mechanisms of immune escapes.

Objective To observe the effects of recombinant human brain natriuretic peptide on the plasma endotoxin and systemic inflammatory response in patients undergoing cardiac valve replacement surgery during cardiopulmonary bypass (CPB) and to explore its mechanism.Methods 32 patients with elective heart valve replacement surgery during cardiopulmonary bypass were divided into a control group and a treatment group randomly.The patients of treatment group were recievel rhBN (1.5 μg · kg-1 · min-1 bolus intravenous injection before aortic cross-clamping followed by 0.0075 μg · kg-1 · min-1 for 24 hours),while the patients of control group received the same volume of 0.9％ sodium chloride.The plasma levels of endothelin -1 ( ET-1 ),diamine oxidase(DAO),lipopolysaccharide ( LPS),tumor necrosis factor-α (TNF-α) before skin incision ( T1 ),the end of CPB ( T2 ),4 h after the end of CPB ( T3 ),8 h after the end of CPB (T4),24h after the end of CPB (T5) respectively.Results Before skin incision ( T1 ),plasma ET-1,DAO,LPS,TNF-α of two group patients showed no significant difference ( P ＞ 0.05 ) ; At each time point after the end of CPB ( T2,T3,T4,T5 ) Plasma DAO,LPS,TNF-α levels of two groups patients were significantly higher than before skin incision ( T1 ) levels ( P ＜ 0.01 ).There was no significant difference of the plasma levels of ET-1 between T5 and T1 in treatment group patients ( P =0.24).At each time point after the end of CPB ( T2,T3,T4,T5 ),treatment group patients'plasma ET-1,DAO,LPS,TNF-α levels were significantly lower than the control group respectively (P ＜0.01 ).The increase in blood ET-1 was highly positive correlated with the increase in blood DAO (r=0.51,P ＜0.01 ).The increase in blood DAO was highly positive correlated with the increase in blood LPS (r =0.77,P ＜ 0.01 ).The increase in blood LPS was significantly positive correlated with the increase in blood TNF-α ( r =0.48,P ＜0.01 ).Conclusion Recombinant human brain natriuretic peptide can reduce gastrointestinal vasoconstriction,improve gastrointestinal mucosal perfusion and oxygenation,protect the gastrointestinal mucosal barrier function,preventing intestinal endotoxemia Shift,reduce plasma endotoxin levels and reduce systemic inflammatory response by inhibiting the release of ET-1 during CPB.

Objective To explore the clinical value of the ten-point scale in the early diagnosis of fat embolism syndrome.Methods The data of 129 patients with fat embolism syndrome diagnosed by Gurd criteria admitted from January 1993 to February 2012 were analyzed retrospectively.At the same time,another 97 patients with single or multiple long bone fracture and/or pelvic fracture without fat embolism admitted from July 2005 to February 2012 were enrolled as control group.Patients were excluded if they had any of the following diseases:simple brain trauma,thoracic injury,spine fracture,hemorrhagic shock and the complications of cardiopulmonary cerebral resuscitation (CPCR).The patients of two groups were comparable in respect of clinical setting.The clinical data were analyzed and scored by the ten-point scale.The x2 test were applied to statistical works.Results Among all the clinical characteristics,the incidence of increased D-dimer was the highest (74.1％) in early fat embolism syndrome,followed by the progressive decrease in hemoglobin (63.6％) and hypoxemia (57.4％),and the occurrence of dyspnea was the lowest (17.8％).The percentage of total scores over ten points in patients with fat embolism syndrome group was higher than that in those without fat embolism syndrome (x2 =202.6,P ＜ 0.01).The sensitivity of tenpoint scale was 96.12％ and the specificity was 99.8％.Conclusions Ten-point scale could be used to make early diagnosis of fat embolism syndrome,thereby reducing the occurrence of misdiagnosis and misseddiagnosis.