Objective To observe the morphological changes of corneal nerve in experimental herpes simplex keratitis (HSK) in rabbit eyes. Methods Inoculation of the scarified cornea with herpes simplex virus-Ⅰ(HSV-Ⅰ)leads to herpetic infection of cornea. The HSK was detected by slit lamp and polymerase chain reaction(PCR), and the changes of corneal nerves in various periods with methylene blue vital staining and ultrastructure of corneal nerve were studied. Results Under light microscope, fewer corneal nerve bundles were observed, scattered with lower density of nerve fiber at center of cornea on the 4th day after the infection. At days 7 and 14, the seriously damaged nerve fiber was intermittent. The neuraxon became shorter with little polarity and the density of nerve fiber was extremely low. At day 30, the density was still low while the nerve fiber was approximately normal. Under electromicroscope, at day 4, the lamellar sheath of nerve fiber in the epitheliums appeared intermittent, and the neuroplasm of endings was partly lysed. During day 7 to day 14,neuroplasm was damaged and became vacuolar. The mitochondria swelled with vacuolar crest, and then were destroyed and lysed. The nerves in stroma were also injured. On day 30, neurilemma sheath was still intermittent with the decrease of microfilament and racuole. Conclusion HSK leads to the damage of nerve and the decrease of nerval density, and the damage of corneal nerve repairs very slowly.

ObjectiveTo investigate the effect of endovascular stent with or without coil graft on intracranial wide-necked aneurysms. Methods12 cases with intracranial wide-necked aneurysms, among whom, 10 cases were treated with stents and coils, 2 C4 aneurysms were treated with graft stent, were analyzed retrospectively. ResultsOf the 10 cases who were treated with stents and coils, 8 patients were completely occluded and other 2 patients were incompletely (>95%) occluded. 2 cases accepted graft stent were obliterated. Follow-up with angiography in 10 patients for 3～12 months revealed that all the aneurysms were completely occluded. 1 patient among them died. ConclusionEndovascular stent with or without coil graft is effective on intracranial wide-necked aneurysms.

Objective To compare and analyze clinical effects of extended thymectomy for the treatment of thymoma with myasthenia gravis(MG) between subxiphoid and subcostal arch thoracoscopic resection(SR) and the median sternotomy(MS) with a propensity-matched analysis.Methods We retrospectively analyzed 528 patients presented with MG and admitted in Tangdu Hospital of Air Force Military Medical University from December 2011 to December 2016,among whom 402 underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy(SR group) and 126 median sternotomy(MS group).Another 126 patients were produced by a propensity-matched analysis in these 402 patients,to match with MS group.Perioperative outcomes were compared between SR group and MS group.Results All operations were accomplished successfully,without conversion to thoracotomy in SR group.Most postoperative outcomes were equal in remission of MG and postoperative complication between the two groups(P ＞ 0.05).There were statistical differences between MS group and SR group in operation time [(106.3 ±32.7)min vs.(533.2 ±37.3) min],intraoperative blood loss[(138.2 ±26.7)ml vs.(38.2 ± 10.3) ml],chest drainage duration[(3.3 ± 1.6) days vs.0 day],hospital length of stay [(5.0 ± 2.5) days vs.(2.5 ± 1.8) days],patients'satisfaction level(6.1 ±2.3 vs.8.9 ± 1.2),the incidence of postoperative wound infections(4.8％ vs.0.8％),the incidence of myasthenic crisis(7.1％ vs.1.6％)and pain scores,all P ＜0.05.Conclusion Subxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for tmanagement of MG with thymoma.

Objective To analyze the effects of extended subxiphoid thymus resection on inflammatory factors,T lymphocyte subsets and stress response in thymoma patients.Methods The clinical data of 118 patients with thymoma admitted to our hospital from May 2021 to May 2023 were retrospectively analyzed,of which 61 patients underwent subxiphoid enlargement thymectomy(recorded as the study group)and 57 patients underwent lateral thoracotomy enlargement thymectomy(recorded as the control group).The postoperative and perioperative pain,stress response,inflammatory response,T lymphocyte subsets and complications were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss and postoperative drainage volume between the two groups(P＞0.05).The visual analogue scale(VAS)of the study group(3.21±0.47,2.47±0.34 points)was lower than that of the control group(3.62±0.53,2.61±0.39 points)at 24 h and 48 h after surgery(P＜0.05).The levels of adrenaline(Adr)and cortisol(Cor)48 h after operation were higher than those before operation(P＜0.05).The levels of Adr and Cor[(101.94±12.83)ng/L,(276.84±31.05)nmol/L]in the study group were lower than those in the control group[(108.15±14.72)ng/L,(308.91±35.24)nmol/L]48 hours after operation(P＜0.05).The levels of TNF-α and IL-6 48 h after surgery were higher than those before surgery(P＜0.05).The levels of tumor necrosis factor a(TNF-α)and interleukin-6(IL-6)in the study group[(40.91±6.93)pg/ml,(55.62±8.67)pg/ml]48 h after surgery were lower than those in the control group[(45.85±8.12)pg/ml,(61.98±10.51)pg/ml](P＜0.05).The levels of Thl/Th2 and Th17/Treg in both groups 48 h after surgery were lower than those before surgery(P＜0.05).The levels of Th1/Th2 and Th17/Treg in the study group(4.75±0.74,0.95±0.17)were lower than those in the control group(5.16±0.89,1.06±0.19)48 h after surgery(P＜0.05).The changes of Th1/Th2 and Th17/Treg in two groups were different(P＜0.05).Conclusion Compared with lateral thoracotomy,transxiphoid enlargement of thymus can reduce perioperative pain,inhibit perioperative inflammatory response and stress response,improve T lymphocyte subpopulation,and is safe and reliable.

Objective To explore the effect of low-level laser therapy (LLLT)applied to the quadriceps muscle on the recovery of exhausting-cycling-exercise-induced fatigue.Methods According to a randomised,double-blind and crossover design,16 healthy male students were randomly assigned to an LLLT-1,LLLT-3,LLLT-5 and a placebo group,and received LLLT for 300 s at the dosage of 0.06 J· cm-2,0.18 J·cm-2,0.3 J·cm-2 and 0 to the bilateral rectus femoris after the exhausting-cycling-exercise-induced fatigue.The blood lactate(BL),heart rate(HR),rated perceived exertion(RPE)and visual analogue scale(VAS)were assessed before the exercise,immediately after exercise,10 and 20 min after exercise,as well as immediately after the first Wingate(WG)test,5 and 30 min after the WG test.Meanwhile,the second WG test was performed 40 min after the first WG test.Results The average HR value of LLLT-1 group was significantly lower than the placebo group at 10 min after exercise(P＜ 0.05)and immediately after the WG test(P＜0.01),while that of LLLT-3 and LLLT-5 groups was significantly lower than the placebo group immediately and 5 min after the WG test(P＜0.01).Compared to the placebo group,the average BL of LLLT-1,LLLT-3 and LLLT-5 groups was significantly lower 10 min after exercise(P＜0.05 for all)and that of LLLT-5 group was also significantly lower 30 min after the first WG test(P＜0.05).However,the average blood glucose of LLLT-5 group was significantly higher than the placebo group right after the first WG test(P＜0.05).Moreover,significant increase was observed in the mean(P=0.002)and peak power(P=0.006)at the second WG test and the mean(P=0.048) power at the first WG test of LLLT-3 group,compared to the placebo group.Conclusion LLLT applied to quadriceps muscles after exhausting exercise may enhance recovery,and LLLT at the dose of 0.18 J·cm-2 is of the best effect.

Objective    To compare clinical effects of extended thymectomy for the treatment of thymic abnormalities with myasthenia gravis (MG) between subxiphoid and subcostal arch thoracoscopic resection (SR) and the unilateral thoracoscopic resection (UR) by a propensity-score matching analysis. Methods    We retrospectively analyzed the clinical data of 612 patients who presented with MG and were admitted to Tangdu Hospital of Air Force Military Medical University between December 2011 and December 2018. Of these patients, 520 patients underwent subxiphoid and subcostal arch thoracoscopic extended thymectomy (a SR group) and 92 unilateral thoracoscopic extended thymectomy (a UR group). Ninety-two patients in the SR group were matched with the UR group by propensity-score matching analysis. There were 52 males and 40 females with an average age of 26-70 (50.2±10.3) years in the SR group, and 47 males and 45 females with an average age of 20-73 (51.5±12.1) years in the UR group. The operation time, intraoperative blood loss, thoracic drainage time, postoperative hospital stay, thorough adipose tissue removal, postoperative remission of MG, patients’ satisfaction score, pain and complications were compared and analyzed between the two groups. Results    All operations were accomplished successfully, without conversion to thoracotomy of the two groups. There were statistical differences between the two groups in operation time (46.2±19.5 min vs. 53.4±23.5 min), chest drainage duration (0 d vs. 3.4±1.2 d), hospital stay (2.9±1.9 d vs. 3.6±1.7 d), patients’ satisfaction score (7.9±2.1 points vs. 6.7±1.2 points) and pain scores (all P<0.05). There were no statistical differences between the two groups in intraoperative blood loss (52.2±12.7 mL vs. 51.2±10.3 mL), peripheral adipose tissue removal (8.1±0.6 vs. 7.9±0.9), remission rate of MG (89.1% vs. 85.9%) and rate of postoperative complications (10.9% vs. 6.5%) (all P>0.05). Conclusion    Subxiphoid and subcostal arch thoracoscopic extended thymectomy is a safe and feasible minimally invasive procedure for the management of MG with thymic abnormalities.

Objective    To compare clinical effects of enlarged thymectomy for the treatment of myasthenia gravis (MG) complicated with thymoma via subxiphoid and subcostal arch thoracoscopic resection versus median sternotomy resection. Methods    We retrospectively analyzed the clinical data of patients with MG complicated with thymoma admitted in Tangdu Hospital of the Air Force Military Medical University between December 2011 and December 2021. Patients who underwent subxiphoid and subcostal arch thoracoscopic enlarged thymectomy were allocated to a SR group, and patients who underwent median sternotomy enlarged thymectomy were allocated to a MR group. Perioperative outcomes were compared between the two groups. Results    A total of 456 patients were collected. There were 51 patients in the MR group, including 30 males and 21 females aged 23-66 (49.5±11.8) years. There were 405 patients in the SR group, among whom 51 patients were matched to the MR group by propensity score matching, including 28 males and 23 females aged 26-70 (47.2±12.2) years. The operations were accomplished successfully in all patients, and no conversion to thoracotomy occurred in the SR group. The SR group had advantages in the operation time, intraoperative blood loss,  chest drainage duration, hospital stay time, patients’ satisfaction level, pain score and complications (all P<0.05). No statistical difference was found in the number of intraoperative lymph node dissection stations, number of intraoperative lymph nodes dissected or remission of MG between the two groups (P>0.05). Conclusion    Subxiphoid and subcostal arch thoracoscopic enlarged thymectomy and lymphadenectomy is a safe, effective and feasible minimally invasive procedure for the treatment of MG complicated with thymoma.