Objective To evaluate the risk factors of myasthenic crisis after thymectomy for myasthenia gravis.Methods Meta-analysis was performed to screen risk factors of myasthenic crisis after thymectomy for myasthenia gravis based on 21 associated articles published and carried out using Stata12.0.Results Twenty one studies were identified, including 3 092 patients and 698 patients developed myasthenic crisis after thymectomy.Complicated with thymoma(OR =3.93, 95％ CI 2.37-6.50, P =0.000), Ossermen classification (OR =0.12, 95 ％ CI 0.09-0.17 , P =0.000) , history of preoperative myasthenic crisis (OR =5.36, 95 ％ CI 3.82-7.51, P =0.000) , use steroid hormonea (OR =1.75,95 ％ CI 1.26-2.43, P =0.001) , postopertive lung infection(OR =4.27,95％ CI 1.63-11.18, P =0.003) , operation methods(OR =0.34,95％ CI 0.21-0.56, P =0.000) , the dose of preoperative anticholinesterase drags (OR =0.35, 95 ％ CI 0.18-0.66, P =0.000) ,pulmonary function(OR =0.18, 95％ CI 0.06-0.57, P =0.004), preoperative serum level of anti-acetylcholine receptor antibody(OR =0.06, 95％ CI0.03-0.13, P =0.000)were associated with myasthenic crisis after thymectomy.Gender, course of disease were not associated with myasthenic crisis after thymectomy.Conclusion With thymoma, Ossermen classification, history of preoperative myasthenic crisis, use steroid hormonea, operation methods, the high dose of preoperative anticholinesterase drugs, poor pulmonary function, postopertive lung infection, high preoperative serum level of anti-acetylcholine receptor antibody are risk factors affecting myasthenic crisis after thymectomy.

Objective To demonstrate that miR-483-5p and its targeted gene ERK1 involved in the regulation of proliferation and apoptosis of human granulosa cells.Methods ① The ERK1 mRNA and protein level expression were detected by PCR and Western blot after miR-483-5p overexpression in vitro normal human granular cells.De-tected the relative luciferase density after cotransfecting miR-483-5p mimics and its control respectively with wild or mutant ERK1 mRNA 3`UTR cloned luciferase report vector in granular cells.② Granular cells proliferation and ap-optosis were detected by MTT and TUNEL after transfecting miR-483-5p mimics or ERK1 siRNAs alone or simulta-neously.Results ① It showed that both ERK1 mRNA and protein in granular cells were markedly downregulated after the transfection of miR-483-5p mimics.A significant relative luciferase activity decrease were detected in the granular cells co-transfected with ERK1 wild and miR-483-5p mimics comparison with the control mimics,but not in the cells co-transfected with the ERK1 mutant and miR-483-5p mimics.② When miR-483-5p mimics and ERK1 siRNAs were alone or co-transfected into granular cells,the proliferation was inhibited while apoptosis trend was monitored to be promoted in all cases.No obvious statistic difference was shown between each other.Conclusion MiR-483-5p is involved in the regulation of the proliferation and apoptosis of human granulosa cells by directly binding to the target gene ERK1.

Objective To discuss the value of double stimulations and mild ovarian stimulation combined with Gn-RH-antagonist in patients with decreased ovarian reserve receiving in vitro fertilization and embryo transfer ( IVF-ET) . Methods 283 patients with decreased ovarian reserve who accepted in vitro fertilization were analyzed retro-spectively. 204 cases accepted double stimulations and 79 cases accepted mild ovarian stimulation combined with GnRH-antagonist, compared the outcomes of the two protocols. Results The average number of oocytes retrieved, viable embryos,high-quality embryos,consumption and duration of Gn,the serum progesterone( P) level on trigger day in the luteal phase were significantly higher than those in follicular phase. The serum luteinizing hormone( LH) level on trigger day was lower than that in follicular phase. The average number of oocytes retrieved,high-quality embryos,consumption and duration of gonadotropins( Gn) in mild stimulation combined with GnRH-antagonist were higher than those in follicular phase. LH level on trigger day was lower than those in follicular phase, while the numbers of viable embryos were similar. The consumption and duration of Gn in the luteal phase were higher than in stimulation combined with GnRH-antagonist, and there were no differences in the average number of oocytes re-trieved,viable embryos,high-quality embryos between the two groups. The cycle cancellation rate, available rate of oocytes and embryos were similar between the controlled ovarian hyperstimulation. The available rate of embryos in double stimulations was higher than mild ovarian stimulation combined with GnRH-antagonist,and the abortion rate was lower. Conclusion Controlled ovarian hyperstimulation during luteal phase can get better outcomes in patients with decreased ovarian reserve,double stimulations in the same menstrual cycle shortens the treatment time of IVF-ET,and it is a feasible method for patients with decreased ovarian reserve.

Objective To explore the principle and methods of surgical management of acute distal colon obstruction caused by colorectal cancer.Methods The data of the cases who received one stage resection in our hospital were analyzed retrospectively,and their surgical management was evaluated comprehensively.Results 34 patients received one stage resection and anastomosis and 6 received delayed anastomosis.All the patients were cured,and no anastomosis fistula or other complications occurred except for 3 cases who were complicated with infection.Conclusion One stage resection and anastomosis was safe for the patients of colorectal cancer complicated with acute disatal colon obstruction as long as the indications were determined appropriately.Colonic irrigation during the operation is essential for one stage anastomosis.

Purpose To investigate bax expression and induction of apoptosis in normal cultured retinal pigment epithelium (RPE) cells . [WT5”HZ]Methods [WT5”BZ]Cultured human RPE cells were transfected by P MDNA3 hbax ,which incoded the whole bax gene and may be induced by Zn 2+ under the MTII promoter, through lepofectin mediated protocol.The tested RPE cells were divided into three groups of A, P MDNA3 hbax transfected ;B,P MDNA3 (nude vector) transfected and C,normal RPE cells.After transfection, DNA gel electrophoreses were performed ,the tested RPE cell cycles were analyzed with flow cytometry (FCM). Results The gel electrophoretogram showed DNA ladder phenomenon,FCM confirmed the apoptosis of RPE cells P MDNA3 bax transfected , consisting of significant apoptotic peak sited before the G 1 phase and the apoptotic rate was 36%. Conclusion The foreign bax gene can be effectively conducted into the RPE cell through lepofectin mediated protocol and induced expression . The foreign bax overexpression may induce the cultured human RPE cell susceptibility to apoptosis.

Extracellular matrix remodeling plays a role in the pathogenesis of variety of diseases.Among these extracellular proteinases,Cathepsin is a key member.In this review,the relationships between Cathepsins and many diseases associated with extracellular matrix remodeling is discussed.

Objective To investigate the treatment of inverted nipple by continual extension with S tractors made of Kirschner wires on the base of preliminary clinical obervation.Methods Under local anesthesia,with the inverted nipples being dragged out by a presutured thread or a pair of towel clips,a Kirschner wire of 10 cm long and 0.5-1.0 mm in diameter was transversly penetrated through the base of inverted nipple.Then the Kirschner wire was bended at both points of 1.5 cm distantly from the nipple center in clockwise cemicircularly.Two cemicircular Kirschner wires were folded downward hingelikely and the center axis was supported by two cemicircles.This folded S tractor pushed and supported the inverted nipple forwardly and constantly.The hinge angle was adjusted during the treatment according to the traction requirment.It was nessessary for wearing these S tractors for at least 6 months before the Kirschner wires were being taken out.During referrals,the hinge angle was revised for mentaining the extension efforts.Results We treated 32 cases of inverted nipple,total 58 moderate and severe lesions,with this method effectively.No infection was observed during the treatment.The nipple form was naturally and stably outstanding after Kirschner wires taken out.No relapses were observed during a mean 6 monthe following up.Conclusions This procedure is simple and convenient without the need of complicated surgical procedures or perplexed equipments.The nipple shaps are observed natural and stable after Kirschner wire is removed.No recurrences are observed.There are no damages to breastfeeding function.The obvious drawback of this method is its reqairing of long continuously wearing and its inconvenience.

AIM: To study the chemical components in Compound Kushen Injection(Radix Sophorae Flavescentis),and to develop a method to identify the composition contained Radix Sophorae Flavescentis. METHODS: The sample was analysed with gradient elution by HPLC.Agilent MS TRAP equipped with ESI source was used as detector and operated in positive ion mode. RESULTS: 11 components were identified in Compound Kushen Injection. CONCLUSION: This method is simple,rapid and can be used for the analysis of components in Compound Kusen Injection.

Objective To compare the influence of regular intermittent bolus of different con-centrations of ropivacaine for epidural labor analgesia on maternal intrapartum fever.Methods One hundred parturients aged from 20 to 35 years,of ASA Ⅰ or Ⅱ,singleton pregnancy,head presenta-tion,were randomly divided into two groups:Group H with 0.1% ropivacaine and 0.4 μg/ml sufen-tanil,Group L with 0.08% ropivacaine and 0.4 μg/ml sufentanil,50 cases in each group.Both groups were given epidural analgesic solution of 8 ml every 60 minutes respectively.Maternal tympanic membrane temperature,pain visual analogue scale (VAS),and modified Bromage score were recorded at the beginning of analgesia,1,2,3,4,5 h post analgesia,delivery,and 1 h post de-livery.And the anesthetics consumptions,labor duration,and neonatal Apgar score of 1,and 5 min were also observed.Results Compared with the beginning of analgesia,maternal tympanic membrane temperature significantly rose at 4,5 h post analgesia,delivery,and 1 h post delivery in both groups (P <0.05).Compared with group L,maternal tympanic membrane temperature significantly rose at 4,and 5 h post analgesia in group H (P <0.05).There was no significant difference in the incidence of intrapartum fever between the two groups.Compared with the beginning of analgesia,maternal VAS significantly decreased from 1 h post analgesia to 1 h post delivery in both groups (P <0.05);but there was no statistically significant difference between the two groups.Conclusion Regular inter-mittent epidural bolus of 0.08% or 0.1% ropivacaine combined with 0.4 μg/ml sufentanil can provide satisfactory labor analgesia,and body temperature rises more dramatically in women receiving higher concentration of local anesthetic than those receiving lower concentration.

Objective To evaluate the efficacy and toxicity of Taxol-based chemotherapy in patients with advanced gastric cancer. Methods Thirty-one patients with advanced gastric cancer were treated with two kinds of Taxol-based chemotherapy schedule. The treatment schedule were composed of paclitaxel and fluorouracil(TF) or cisplatin(TP). The patients who had had chemotherapy with fluorouracil were arranged to TP group,others to TF group. A treatment cycle lasted 21 days. The efficacy was evaluated after two cycles of the chemotherapy. Results total efficiency rate of two groups was 45.2 %; the efficiency rate of TF was 47.4 %; the rate of TP was 41.7 %; CBR was 80.6 %. The main side effect of toxicity were neutropenia and nausea as well as vomiting. Conclusion Taxol-based combination chemotherapy is a high response protocol with mild toxicity. TP schedule has a high efficiency for advanced gastric cancer.