Objective To summarize the experience of clinical diagnosis and treatment for recurrence and progress of relieved myastbenia gravis after thymectomy. Methods 22 recurrent and progressive after relieved pa-tients with myasthenia gravis who underwent thymectomy were retrospectively analyzed. The remission therapy was conducted with combined glucocorticoid and anticholinesterase and its effectiveness was estimated. Results It was 1,17,4 as better Osserman scale Ⅰ , Ⅱ , Ⅲ respectively before operation but 15,6,1 as better Osserman scale Ⅱ , Ⅲ, Ⅳ respectively in recurrence and progress of relieved myasthenia gravis after thymectomy besides 6 with myas-thenic crisis. Complete remission and partial remission were gained in 9 patients and 12 patients respectively. There was 1 hospital-death. Conclusions Recurrence and progress can occur in any patient of relieved myasthenia gravis after thymectomy. Bulbar myasthenia gravis is usually presented as dysphagia. Reasonable administration of glucocor-tieoid could improve majority of recurrence and progress of relieved myasthenia gravis after thymectomy but responses poorly to the anticholinesterases.

Intracerebral hemorrhage (ICH) is the second most common type of stroke,and its fatality is high.The baseline hematoma volume and hematoma growth are the predictive factors for the poor outcome of the patients.Previous studies have shown that surgical evacuation of hematoma can reduce the hematoma volume and improve the outcome.However,several recent randomized controlled trials of craniotomy hematoma evacuation for ICH and a Meta-analysis have shown that it is no more beneficial than conservative treatment.The previous evidence of minimally invasive evacuation of hematoma for the treatment of ICH has suggested that it has potential benefits for patients with ICH; however,further research is needed to confirm it.

Objective To construct the bioartificial liver by bone mesenchymal stem cell (BMSC) and alginate scaffold. Method Alginate scaffold was used as the cell carrier for the cultivation of BMSC and the differentiation from BMSC into hepatic like cells was induced by the cell factors of HGF, EGF and FGF-4 in the scaffold in vitro. The compatibility of the cells and the scaffold was observed by microscopy and the function of the differentiatd cells was tested. The gene of AFP and ALB was detected by RT-PCR. The secretion of ALB and the urea synthesis of the cells were tested by ALB kit and urea kit respectively. The glycogen synthesis and the CK-18 was tested by the glycogen stanning method and the immunofluorescence test. Results BMSC was able to attach, grow and proliferate well in the alginate scaffold, the well compatibility was observed by microscopy. ALB and urea were detected in the cultivating medium, the gene of ALB and AFP was identified by RT-PCR. The glycogen synthesis ability and the expression of CK-18 were induced during the differentiation. Conclusion The three dimensional atginate scaffold exhibited well compatibility with BMSC, BMSC could be differentiated into the hepatic like cell in the scaffold. BMSC and the alginate scaffold could be used to construct the bioartificial liver for the hepatic tissue engineering.

Objective To study the effects of rehabilitation training on the expression of Nogo-A around the area of cerebral infraction using rats. Methods A total of 60 Wistar rats were randomly divided into a reha- bilitation group and a control group after an experimental cerebral infarction had been established in them. The ani- mals in the rehabilitation group were given exercise with a rotating bar, a balance beam and a rolling cage for one hour daily, while those in the control group were caged without any abnormal exercise. Nogo-A expression in the ar- ea surrounding the infarcts was detected by imunohistochemical techniques at the 3rd, 7th, 14th, 21st and 28th day after infarction. Meanwhile, neurobehavioral evaluations were also conducted. Results The animals in the rehabilitation group scored much lower than the controls in the behavioral evaluations at the 14th, 21st and 28th day. The expression of Nogo-A in tissues around the infracted area increased by the 7th day and peaked at the 21st day in both groups, but the expression of Nogo-A was significantly stronger in the rehabilitation group at the 14th, 21st and 28th days. Conclusion Rehabilitation training decreased the expression of Nogo-A in the brain of rats after infarction. This may have important implications for the functional recovery of the central nervous system.

Objective To investigate the curative effects of damage control surgery in treatment of borderline severe multiple fractures.Methods The study involved 37 patients with severe multiple fractures(ISS of 16-42,Pape classification of borderline type)surgically treated from January 2009 to June 2010.All patients underwent staged surgeries according to damage control principles:hemostasis,debridement and provisional fixation were given in the first stage;antishock,anti-coagulation dysfunction,anti-hypothermy,anti-infection were performed in the second stage;definitive operations for fractures were performed as soon as possible in the third stage,provided that their physiological condition was permitted.Results All the patients received effective treatments such as debridement,provisional fixation and antishock in the first and second stages,with no iatrogenic secondary injury.The patients had significant recovery in the 6-14 months of follow-up,with total disability rate of 16％.Conclusion The staged operations according to damage control principles are effective and safe in treatment of borderline severe multiple fractures.

Objective To discover the effect of pleurodesis with single utility port vido-assested thoracic surgery on patients with malignant pleural effusion.Methods Clinical pleurodesis data of 24 patients with malignant pleural effusion were analyzed retrospectively.Results After treatment,all the patients were no perioperative deaths.The operation time was 32 to 83 min,and average time was 34.5 min.The time of extubation was 4 to 15 d,and average time was 5.6 d.Among 24 patients with pleurodesis underwent regularly postoperative CT scan and follow-up,one case died of a brain metastasis after five months later,the other patients were survive more than six months.Conclusions Pleurodesis with single utility port video-assisted thoracoscopic surgery in the treatment of malignant pleural effusion is a minimally invasive,effective and practical method.

Objective To investigate the influence factors for immediate outcome after thymectomy for patients with myasthenia gravis (MG). Methods The clinical data of 108 patients with MG who received thymectomy in the Department of Thoracic Surgery, the Second Affiliated Hospital of Zhengzhou University from July 2009 to July 2012 were retrospectively investigated, including gender, age, duration of disease, clinical classification, pathological classification of thymus and anti-acetylcholine receptor antibodies (AChRab). The immediate outcome after thymectomy was also observed. Thirty-two cases of MG who had immediate outcome after thymectomy were enrolled into experimental group, while 76 cases who did not have immediate outcome after thymectomy were regarded as control group. Results The immediate outcome after thymectomy was associated with duration of disease (χ2=98.550, P<0.01), clinical classification (χ2=40.434, P<0.01), pathological classification of thymus (χ2=11.154, P=0.004) and AChRab (χ2=5.590, P=0.018). There were statistically significant differences between the two groups in the one-year (31.3% in the experimental group vs 14.5% in the control group, χ2=4.046, P=0.044), two-year (40.6% vs 21.1%, χ2=4.392, P=0.036) and three-year complete remission rates (46.9% vs 25.0%, χ2=4.995, P=0.025). Conclusion Duration of disease, clinical classification, pathological classification of thymus and AChRab could be influence factors for immediate outcome and complete remission for patients with MG after thymectomy.

Objective To investigate the treatment measures of having trigeminocardiac reflex (TCR) for the primary trigeminal neuralgia via microvascular decompression.Methods From January 2016 to December 2016,the clinical data and anesthesia records of 79 consecutive patients with primary trigeminal neuralgia admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University and treated the first craniotomy microvascular decompression were analyzed retrospectively.They were divided into a no TCR group (n=63) and a TCR group (n=16) according to the intraoperative anesthesia monitoring.The differences of baseline conditions,preoperative complications and pain involved the trigeminal nerve branches were compared between the two groups.The treatment measures and short-term prognosis of the patients with TCR during operation were summarized.Results (1) The proportion of hypertension in the TCR group was 31.2％ (n=5),it was higher than 7.9％ in the no TCR group (n=5).There was significant difference (χ2=6.273,P<0.05).(2) During the operation of microvascular decompression,16 patients in the TCR group had 19-time TCR.The baseline heart rate was 74±10/min before operation,and the heart rate decreased to 51±6/min at onset of TCR.The mean baseline arterial blood pressure was 102±13 mmHg,and the mean arterial blood pressure decreased to 74±8 mmHg at the onset of TCR.There was significant difference (P<0.05).(3) After the onset of TCR,the operation of was stopped,heart rate and the blood pressure recovered spontaneously (n=4).Fifteen patients were treated with medications,including using atropine (12 times,dose 0.2-0.5 mg) and ephedrine hydrochloride (3 times,dose 5-10 mg).Heart rate and blood pressure returned to the baseline level within 20 seconds or 20 seconds after administration of medications.There was no TCR-related cardiac complication or neurological deficit from after procedure to before discharge.Conclusions In microvascular decompression of primary trigeminal neuralgia,if TCR occurs,the selective use of anticholinergic agents or vasoactive agents is needed as early as possible.The risk factors for the occurrence of TCR need to be further verified.

Objective To explore the expressions and clinical significance of epidermal growth factor receptor (EGFR),COOH-terminus tensin-like molecule (CTEN)and epithelial cadherin (E-cad)in non-small cell lung cancer (NSCLC).Methods The expressions of EGFR,CTEN and E-cad in 36 cases of normal lung tissue and 82 cases of NSCLC tissues were observed with immunohistochemical SP method and their correlation with NSCLC invasion,metastasis and prognosis was analyzed.Results The positive rate of EGFR,CTEN and E-cad was 58.5% (48/82),69.5% (57/82)and 28.1% (23/82)in 82 cases of lung cancer,while 13.9% (5/36),0.0% (0/36)and 100% (36/36)in normal tissues;the differences were all significant (P<0.05).EGFR,CTEN and E-cad expressions in NSCLC tissues were significantly correlated with tumor differentiation,TNM stage and lymph node metastasis (P<0 .0 5 ).The expressions of EGFR and CTEN were correlated with each other in NSCLC (r=0 .5 3 0 , P<0.001),while the expressions of EGFR and CTEN were correlated with that of E-cad (r=0.499,P<0.001;r=0.333,P=0.001 ).Multivariate Cox regression analysis showed that CTEN expression in NSCLC was an independent prognostic factor (P<0.05 ).Conclusion EGFR,CTEN and E-cad may play a role in the development,invasion and metastasis of NSCLC and have some significance in predicting the prognosis of NSCLC.

To improve the part of the hardware about Xin Hua SL-IC model X-ray radiotherapy simulative position finder, using CR and PACS, so that located-picture shooting for the simulative position finder have been realized digital upgrade.
Automatic Data Processing ; Radiographic Image Enhancement ; Radiotherapy ; methods ; Tomography, Spiral Computed ; methods