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 observe clinical efficacy and safety of minocycline for acute retrograde pulpitis (ARP) and its ef fects on pain.METHODS:One hundred (100 teeth) ARP patients in Hospital of Qingdao Agriculture University and the Affiliated Hospital of Medical College during Jan.-Oct.in 2015 were divided into observation group and control group according to random number table,with 50 cases in each group (50 teeth).Control group was given root canal therapy of Formaldehyde cresol formocresol solution;observation group was given was given root canal therapy of Minocycline hydrochloride cream.Both groups were re checked 3 days later,and therapeutic efficacy was evaluated after 5 month follow-up;pain score,IL-2 and TNF-α levels were ob served before and 3 d after treatment,and the occurrence of ADR was recorded in 2 groups.RESULTS:The total response rate of observation group was 98.00％,which was significantly higher than 86.00％ of control group,with statistical significance (P＜ 0.05).There was no statistical significance in percussion pain score,mobility score,IL-2 and TNF-αt levels between 2 groups before treatment (P＞0.05).Three days after treatment,percussion pain score,mobility score,IL-2 and TNF-α levels of 2 groups were significantly decreased;the observation group was significantly lower than the control group,with statistical significance (P＜ 0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞ 0.05).CONCLUSIONS:Minocycline shows significantly therapeutic efficacy for ARP,and can effectively improve pain symptoms with good safety.

Cyclic alternating pattern (CAP) during sleep is a kind of cyclic oscillation of EEG pattern in non-rapid eye movement sleep(NREM sleep), which reflects microstructure of sleep. It has been identified that CAP plays an important role in keeping the integrity of sleep. The purpose of the interview is to introduce the recording, identification, physiological meaning and clinic implication of CAP.

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 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

Insulinoma-glucagonoma clone 20 can express at least 6 isoforms in human cells.These isoforms can affect cell apoptosis and proliferation through apoptosis related signaling pathway,such as TRAIL or TNF signaling pathways.Furthermore,insulinoma-glucagonoma clone 20,as a GTP-GDP exchange factor,participates in the transportation of nerve synaptophysins.

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.

Objective To evaluate the reliability of a series of non-invasive methods in the presurgical lateralization of mesial temporal lobe epilepsy(MTLE).Methods The results of the interictal scalp electroencephalogram(EEG)and ictal scalp EEG,clinical seizure symptom,MRI and interictal SPECT obtained from 40 patients with MTLE who had been followed up 1 to 4 years without seizure after anterior temporal lobectomy(ATL)retrospectively were analyzed in Xuanwu Hospital from May 2002 to May 2005.Results (1)Unilateral anterior temporal spikes were found on interictal EEG in 37(92.5%)patients,of whom 35(94.6%)were in accordance with the lateralization of epileptogenic focus.(2)Ictal scalp EEGs were recorded in 32 patients,from which epileptogenic foci were lateralized in 26 of the 32 patients(81.2%),the concordant rate being 96.2%.(3)Twenty-three patients(57.5%)had clinical seizure symptoms referring to lateralization,of whom 19(82.6%)had symptoms identical to the lateralization of epileptogenic focus.(4)Thirty-eight patients(95.O%)showed structural abnormalities of unilateral hippocampus or temporal lobes on MRI which were in accordance with the lateralization of epileptogenic focus in 37 patients.(5)Interictal SPECT was measured in 23 patients,which was identical with the lateralization in 18/22(81.8%).Conclusions Among a series of non-invasive methods in the presurgical lateralization of mesial temporal lobe epilepsy,SPECT is the most sensitive one,then sequenfly comes MRI,ictal scalp EEG,interictal scalp EEG and clinical seizure symptom.MRI is the most reliable one,then comes ictal scalp EEG,interictal scalp EEG,clinical seizure symptom and SPECT in a sequent order.

BACKGROUND:How to promote homing of scarce limbal stem cel s is the key to improving transplantation efficiency. And stromal cel-derived factor-1 plays an important role in the repair of retinal pigment epithelial cel s injury. OBJECTIVE:To observe changes of stromal cel-derived factor-1 levels in rat and mouse limbal stem cel deficiency models in order to confirm whether these changes wil induce peripheral blood stem cel s homing into the cornea. METHODS:Eye models of limbal stem cel deficiency were prepared in rats and mice by cutting method, then peripheral blood samples were continuously drawn to detect the mass concentration of stromal cel-derived factor-1 by enzyme-linked immunosorbent assay within 1 month after modeling. RESULTS AND CONCLUSION:In the rat peripheral blood, the mass concentration of stromal cel-derived factor-1 started to increase at 24 hours after modeling and firstly peaked at the 3rd day;then it tended to decrease and reached a second peak lower than the first one at the 25th day;subsequently, it returned to the normal level. In the meanwhile, the mass concentration of stromal cel-derived factor-1 in the mouse peripheral blood, increased at 12 hours after modeling, peaked at the 3rd day, subsequently decreased until another peak lower than the former one presented at the 20th day, and final y it returned to the normal level. In conclusion, the level of stromal cel-derived factor-1 in the peripheral blood is significantly associated with limbal stem cel s deficiency, which may play an important role in corneal injury repair.

BACKGROUND:Stromal cel-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) play an important role in stem cel homing during bone marrow, organ and tissue transplantation. But there are few reports on limbal stem cel transplantation and homing as wel as the distribution and content of SDF-1/CXCR4 on the cornea. OBJECTIVE:To detect the expression levels of SDF-1/CXCR4 mRNA in rat corneal tissue by fluorescence quantitative PCR. METHODS: The normal rat cornea was taken completely, and subdivided into central cornea, peripheral corneal and limbal area. Fluorescence quantitative PCR method was employed to detect SDF-1/CXCR4 mRNA levels at corresponding positions. RESULTS AND CONCLUSION: The expression levels of SDF-1 and CXCR4 mRNA were 0.213±0.015 and 0.189±0.02 in the central cornea, 0.529±0.077 and 0.285±0.015 in the peripheral cornea, 0.666±0.069 and 0.258±0.067 in the limbal area, respectively. These data show that there are significant differences in the expression levels of SDF-1 and CXCR4 mRNA in the central cornea, peripheral corneal and limbal area, and these differences exert an important role in cel homing and migration during limbal stem cel transplantation for treatment of limbal stem cel deficiency.