Objective Explore the value of video-assisted thoracoscopic extended thymectomy in the treatment of myasthenia gravis.Methods This is a prospective randomized control study.Fifty-four patients who were confirmed to be MG preoperatively from 2005 to 2008 were divided into VATS group(27 cases)and thoracotomy group(27cases).Thymectomy and dissection of all faity tissue anterior to pericardium were performed in both groups.Results When compared with thoacotomy group,VATS group had less blood loss,shorter postoperative hospital stay and time of postoperative chest drainge tube left.One patient was converted to open surgery because of the injury to the brachiocephalic vein.During a period of followed-up 624 months,symptom was improved in 81% of the patients in VATS group and 85% in thoractomy group(P>0.05).Conclusion Extened thymectomy with VATS is safe and feasible with the advantage of less invasion,less surgical trauma and pain,lower rate of complication and good curative effect.

Objective To report a rare case of M3r subtype of acute promyelocytic leukemia (APL)with 3'-end of RARα (3'RARα) submicroscopic deletion, and the characters of morphologic, cytogenetic,molecular genetic and molecular biology studies. Methods Chromosomes of bone marrow (BM) cells were prepared with direct method and short-term culture method, and R-banding technique was used for karyotypic analysis. Fluorescence in situ hybridization (FISH) assays were performed on fixed BM cells using the following specific DNA probes: CEP X/Y alpha satellite DNA probe, LSI PML-RARα dual-color dual-fusion and LSI RARα dual-color break apart probes. A quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR) was performed to detect the PML-RARα transcript. A multiplex nested RT-PCR was also performed, which may simultaneously detect the fusion genes derived from 29 chromosomal aberrations in acute leukemia including PML-RARα, PLZF-RARα and NPM-RARα fusion transcripts. Results R-banding analysis revealed a karyotype of 45,X,-Y[6]/46,XY[8], FISH using CEP X/Y probe further confirmed Y-chromosome loss. FISH analysis with RARα dual-color break apart probe demonstrated a deletion of the entire 3'-end of one allele of RARα gene. Cytogenetic, FISH and RT-PCR analyses showed no PML-RARα,PLZF-RARα, NPM-RARα, NuMA-RARα and STAT5b-RARα rearrangements. Conclusion A new RARαrearrangement involving 3'RARα submicroscopic deletion in APL without X-RARα fusion has been identified.FISH analysis with RARα dual-color break apart probe is a useful method for characterization of this abnormality, but its molecular consequences remain to be elucidated.

Peroxisome proliferative-activated receptor (PPAR) γ coactivator-1α (PGC-1α) is a transcriptional coactivator of PPARγ.PGC-1α can bind with many different transcription factors.It plays a number of functions in the different tissues and the process of biological reaction.Recent studies have shown that PGC-1α signaling pathway has a neuroprotective effect.This article reviews the neuroprotective effect of PGC-1α in cerebral ischernia and its possible mechanisms.

Objective To study the application of VATS and gasless laparoscopy to the treatment of portal hepertension Methods 12 operations of the splenectomy combined with ligation of pericardial vein and lower part of lung covered by omentum majus were performed throngh the thoracoscopy and laparascopy Results All of the 12 operations were successful. The procedures lasted (2.5～5.2) hours with mean time being 3.3 hours. Gastrointestinal function recovered in (48-72) hours after operation. The duration of hospitalization was (9～11)days. No postoperative thoracic and abdominal cavity complications were found. The average duration of hospitalization after operation was 10.3 days.12 cases were followed up for 2 month to 4 years and no rebleeding was found. Conclusions The procedures including ligation of pericardial vein under VATS combined with gasless laparoscopy assisted splenectomy and lower part of lung covered by omentum majus for the treatment of portal hypertension is passable.

[Summary] A single-incision video-assisted thoracoscopic sublobular limited resection was performed for a 2-cm pulmonary nodule at the right lower lobe of the lung in August 2014.The post-operative pathological diagnosis was inflammatory myofibroblastic tumor of the lung.No recurrence and metastasis was found after one year’s follow-up.

·AlM:To evaluate the visual and anatomic outcomes of intravitreal ranibizu mab injections for myopic choroidal neovascular ization ( mCNV) in Chinese patient s.
·METHOD S: This study is ar etrospective case.Thri ty-five p atients treated for mC NV were included in this study.Their eyes were treated with a single intravitreal injection of 0.5 mg ranibizumab following a pro re nata ( PRN) regimen indicated by persistent or recurrent CNV. Best correc te d visual acuity ( BCVA ) , CNV findings on fundus fluorescen t angio graphy ( FFA ) , central retinal thickness ( CRT ) on optical coherence tomography ( OCT ) , total number of treatments, and complications were evaluated.
· RESULTS:The mean follow-up duration was 20mo (range 16-24mo).Twenty-eight patients (80%) were followed up for more 22mo.The mean baseline BCVA was 0.74 logarithm of the minimum angle of resolution (logMAR) [standard deviation (SD) 0.23] and improved significantly to 0.49 logMAR ( SD 0.31 ) ( P<0.001, Wilcoxon signed-rank test) after treatment.At the final months of follow-up, 21 of the 35 eyes (60%) showed an improvement of 2 lines or more in BCVA, 13 eyes ( 37%) remained unchanged, and 1 ey e (3%) had a deterioration of 2 lines or more.Mean CRT decreased from 297 μm ( SD , 72 ) at baseil ne to 228 μm ( SD, 61 ) at the final follow-up (P<0.001, paired t-t est). During follow-up, the mean number of repeat injections was 3.2 ( SD, 0.94;range, 1-7 injections).No drug-related complications were observed after treatment.
· CONCLUSlON:The long-term outcomes observed in this study suggest that intravitreal ranibizumab is safe and effective for treating mCNV.

Objective To investigate the diagnostic value of combination of echocardiography with electrocardiography for coronary artery lesions(CAL) in Kawasaki disease(KD).Methods Seventy eight children with KD received echocardiographic and electrocardiographic examination.Seventy eight cases were divided into 3 groups according to the results of echocardiogram.Results CAL was discovered in 45 cases and 32 cases with coronary artery dilation,the other 13 cases with coronary artery aneurysm among them.Abnormal electrocardiogram was found in 16 cases.ratio of abnormal electrocardiogram was higher in CAL group than that in normal coronary artery group(P

To evaluate multi-slice computer tomography (MSCT) in mediastinal lymph node metastasis of T1 and T2 non-small cell lung cancer (NSCLC). Methods:A total of 32 patients with T1 and T2 NSCLC from February 2004 to October 2012 were selected. Preoperative MSCT assessment of mediastinal lymph nodes was performed on basis of the pathological results. Results:Lymph nodes with diameters of≥10 mm were evaluated, and the sensitivity and specificity of the MSCT mediastinal lymph node me-tastases were 82.4%and 92.4%, respectively. Lymph node size, primary tumor location, and visceral pleural invasion showed statistical significance in forecasting mediastinal lymph node metastases (P<0.05). Conclusion:MSCT can be used for the effective evaluation of mediastinal lymph node metastasis, lymph node size, and position of primary tumor. and visceral pleural invasion of the tumor had a higher risk of mediastinal lymph node metastasis.

Adult ; Aged ; Cartilage Diseases ; diagnosis ; therapy ; Humans ; Laryngeal Cartilages ; Laryngeal Diseases ; diagnosis ; therapy ; Male ; Middle Aged

Objective To understand occupational stress and burnout status of nurses working for general or cancer hospitals of Xinjiang so as to provide a theoretical basis for the prevention and reduction of occupational stress and burnout of nurses.Methods A total of 497 nurses from a general hospital or a tertiary-level cancer hospital were recruited by using random sampling to learn their occupational stress and burnout.Results Of 497 participants,247 were working for comprehensive hospitals and 250 for cancer hospitals.In comparison with the norm,the nurses of general hospitals showed higher scores in occupational task dimension (t=14.316,P＜0.05) and personal strain dimension (t=25.416,P＜0.05),but lower scores in personal resource dimension (t=7.389,P＜0.05).Meanwhile,the nurses of cancer hospitals were found to have higher scores in occupational task dimension (t=15.840,P＜0.05) and personal strain dimension (t=15.694,P＜0.05),but lower scores in personal resource dimension (t=7.488,P＜0.05) when compared to the norm.Those working in general hospitals had higher scores in emotional exhaustion dimension (t=13.109,P＜0.05) and passive burnout dimension (t=13.198,P＜0.05) than the norm,while lower scores in professional sense dimension (t=17.716,P＜0.05).The nurses of cancer hospitals were observed to show higher scores in emotional exhaustion dimension (t=8.044,P＜0.05) and negative burnout dimension (t=1 1.111,P＜0.05) than the norm,while lower scores in professional sense dimension (t=20.820,P＜0.05).Conclusions Hospital managers should take efforts to control nurses' occupational stress and burnout-related factors so as to enhance their work initiative.