The main content of the 2019 Myasthenia Gravis Foundation of America Scientific Session is summarized, and the main conclusions are presented as follows: Muscle-specific receptor tyrosine kinases antibody positive myasthenia gravis (MuSK-MG) is still the research hot spot in MG research fields, including the clinical researches, the clinical pharmaceutical researches and the fundamental experiment researches. Thymectomy shows safety and effectiveness for acetycholine receptor antibody positive MG (AChR-MG). However, thymectomy needs further discussion about the safety and effectiveness for other types of MG. AChR-MG patients with or without thymoma can benefit from thymectomy. Now there are still no special effective drugs to cure MG, and monoclonal antibody drugs are the hopes for MG patients. With the emergence of different kinds of monoclonal antibodies, MG will be more likely to be conquered. More attention has been paid to the role of B cells′ origin and apoptosis abnormality in the pathogenesis of MG in MG researches.

OBJECTIVETo investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention.

METHODSA total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed.

RESULTSThe effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (P<0.05). The SSRS scores of patients with anxiety disorder were lower than those of patients without anxiety disorder (P<0.05). Multiple regression analysis showed that gender and social support were predictive factors of the occurrence of anxiety disorder (R=0.318).

CONCLUSIONA high anxiety disorder rate occurred in adolescent patients with cleft lip and palate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

Adolescent ; Anxiety ; Anxiety Disorders ; epidemiology ; Child ; Cleft Lip ; epidemiology ; psychology ; Cleft Palate ; epidemiology ; psychology ; Humans ; Mental Health ; Parents ; Social Support ; Surveys and Questionnaires

Adolescent ; Child ; Female ; Humans ; Hypertension ; blood ; Insulin ; blood ; Insulin Resistance ; Male

OBJECTIVETo observe the effect of total flavones of Epimedium leptorrhizum (YYH-C) on osteoporosis in ovariectomized rats.

METHODOvariectomized female rats were randomly divided into the model group, YYH-C lower, middle and high dose (0.7, 1.4, 2.8 g x kg(-1)) groups, the positive drug Bujiale (0.15 mg x kg(-1)) group, and the sham group. The rats were orally ad-ministrated with drugs for three months. Parathyroid hormone (PTH), procollagen I N-terminal peptide (PINP), alkaline phosphatase (ALP), calcium (Ca) and phosphrous (P) in serum were detected. Femur bones and vertebrae bones of left side were collected to determined bone metrological indexes, including bone mineral density (BMD), bone Ca, and bone ash weight/dry weight percentage. Femur bones of right side were collected to for a morphological observation of bone.

RESULTCompared with the sham group, the model group showed significantly higher PTH and ALP content but obviously lower PINP and Ca content. The three YYH-C 3 groups could resist the decrease of PINP. Specifically, low and middle dose groups could remarkably inhibit the increase of PTH, and the high dose group could increase the Ca content in serum, but without significant effect on the rise in ALP. There was no significant difference in P content in serum in each group. BMD, ash weight/dry weight percentage, Ca and P content of the model group were significantly lower than those in the sham group. The high dose YYH-C group could significantly increase BMD. All of the three YYH-C groups could notably increase ash weight/dry weight percentage and Ca, P content in femur bones and vertebrae bones. YYH-C could significantly increase average thickness, area, area percentage of bony trabeculae, cortical bone area percentage of femoral shaft and the number of osteoblasts on the surface of bony trabeculae, and decrease the number of osteoclasts.

CONCLUSIONYYH-C can effectively control the bone mass loss of rats with ovariectomy-induced osteoporosis, prevent the changes in bone microstructure, and inhibit bone absorption, so as to resist high turn-over osteoporosis after ovariectomy. [Key words] total flavones of Epimedium leptorrhizum; ovariectomized rat; osteoporosis

Alkaline Phosphatase ; metabolism ; Animals ; Bone Density ; drug effects ; Calcium ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Epimedium ; chemistry ; Female ; Flavones ; administration & dosage ; Humans ; Osteoporosis, Postmenopausal ; drug therapy ; metabolism ; physiopathology ; Ovariectomy ; Parathyroid Hormone ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To research and prepare the individualized knee in vitro guided plate by 3D printing technique and to investigate the feasibility of its application in 8-plate epiphysiodesis.Methods Twelve children patients with knee varus or valgum in our hospital from January 2014 and November 2016,7 boys and 5 girls,average age of 8.2 years old,were performed the lower extremity continuous spiral CT scanning in the knee straight position.The Dicom format stored CT data were imported into software Mimics 15.0 for reconstructing the knee joint 3D model.The knee joint data after reconstruction were guided into software Geomagic1 1.0 with the.stl format.According to the demand that screws without perforating epiphyseal and joint surface,paralle ling to the epiphyseal and locating in the anterior-posterior median line of epiphyseal,the 8-plate placing screw navigation template was designed and printed by using the 3D printing technique;the 8-plate plate and screw internal fixation was conducted by intraoperative template location.The placed screw position was evaluated by postoperative CT.Results The imaging identification showed that 8-plate epiphysiodesis by using 3D printing individualized in vitro guided plate had accurate screw placement.The cases were followed from 6 months to 2 years,the satisfactory orthopedic effect was obtained in all cases.Conclusion Preparing the individualized knee in vitro guided plate by applying 3D printing technique in assisted 8-plate epiphysiodesis for treating child knee varus or valgum has accurate screw position and satisfactory effect.

Objective To establish a method of PKH26 labeled bone marrow-derived endothelial progenitor cells (EPCs) into rats with liver fibrosis and observe cell immigration and differentiation in the liver after transplantation.Methods Bone marrow-derived EPCs were isolated and cultured from rats with liver fibrosis,and then labeled with PKH26 in vitro.Under the scanning confocal microscopy and flow cytometry,PKH26 fluorescent labeling rate and cell survival rate were measured.EPCs of PKH26 fluorescent labeling were transplanted into rats with liver fibrosis via the tail vein,and the migration situation was observed in the liver.Endothelial cell markers CD31 and von willebrand factor (vWF) were detected by using immunofluorescence.Results The PKH26-labeled EPCs appeared red fluorescence and the labeling rate was 96.65 ％.As compared with unlabeled cells,the labeled cells grew well,and had no significant changes in the growth curve.After transplantation into the liver of rats,the PKH26 labeled cells were mainly distributed in blood vessel endothelium along fibers and hepatic sinusoids in hepatic lobule.Endothelial cell-specific antigens such as CD31 and vWF could be detected along the vascular walls.Conclusion PKH26 could be used to label and track EPCs in the liver of rats with liver fibrosis in vitro.The PKH26-labeled cells may migrate to the surrounding of the hepatic vessels and differentiate into mature endothelial cells.

OBJECTIVE Study the role of estrogen receptor (ER)in the inhibition of cell viability and differentiation induced by bisphenol A (BPA)in micro mass culture of rat e mbryonic midbrain(MB) cells.METHODS Micro mass cultures of MB were prepared fro m rat e mbryonic midbrain on gestation day 13.MB cells were exposed to BPA (10 -4 ,10 -6 ,10 -8 ,10 -10 ,10 -12 mol·L -1 )for 5 d.Cell viability was assessed by neutral red uptake test.MB differentiation was detected by he matoxylin staining and i mage analysis.In order to observe the role of ER pathway in the toxicity induced by BPA,cell cultures were co-treated with ICI182780 0.1 n mol·L -1 ,ta moxifen 1 n mol·L -1 and BPA 0.1 mmol·L -1 for 5 d, the cell viability and foci differentiation were detected.Moreover,the protein expression levels of ER in normal e mbryonic brain of gestation day 18,testis tissue fro m adult rats and midbrain cells untreated with BPA were investigated by Western blot.The mRNA expression levels of ER in normal e mbryonic brain of gestation day 13 and gestation day 18,ovary and testis tissue fro m adult rats,and midbrain cells un-treated with BPA were investigated by real-ti me PCR.The mRNA expression levels of Notch1 and Hes1 in MB cells treated with BPA 0.1 mmol·L -1 were also detected by real-ti me PCR.RESULTS BPA 0.1 mmol·L -1 could inhibited MB cell viability and foci differentiation.However,this effect could not be reversed by ER antagonist.The protein and mRNA expression levels of ER in e mbryonic brain and MB cells untreated with BPA were found to be extre mly low.In addition,BPA 0.1 mmol·L -1 could inhibited the mRNA expression levels of Notch1 and Hes1 .CONCLUSION BPA could inhibited MB cell viability and foci differentiation.ER pathway might be not involved in this effect.Instead,Notch-Hes pathway might be involved for this effect.

OBJECTIVETo observe the effect of Huannao Yicong capsule (HYC) on senile mild cognitive impairment.

METHODSSixty-two patients were randomly divided into two groups, the 31 patients in the treated group were treated with HYC 3 capsules, 3 times daily, and the 31 in the control group with Hydergin 3 tablets, 3 times daily. Treatment for two successive months was a therapeutic course. The changes of cognitive effect index (CEI), integral of measuring scale (CCSE, FQA and MMSE), TCM Syndrome scoring, quality of life (QOL), cerebral arterial blood flow (CBF) and hemorrheologic parameters in the two groups were observed.

RESULTSThe total effective rate of treatment in improving cognition in the 30 patients of the treated group (with one case lost) was 83.33%, while that in the 29 patients of the control group (with two cases lost) was 48.28%, the difference between them was significant (u = 2.36, P < 0.05). Intent-to-treat analysis, namely, the case lost in the treated marked as ineffective and those in the control group as effective, showed the total effective rate in the two groups was 80.65% and 51.61% respectively, which also showed significant difference (u = 2.02, P < 0.05). In the treated group after treatment, the integrals of CCSE, FAQ and MMSE significantly increased (P < 0.05 or P < 0.01), the TCM Syndrome scoring decreased (P < 0.01), the scoring of QOL significantly improved, the mean BBF increased (P < 0.05 or P < 0.01), and the cerebral arterial resistance index improved significantly. All these improvements in the treated group were significantly higher than those in the control group respectively (P < 0.05). Besides, the hemorrheologic parameters in the treated group were improved, most of them were better than those in the control group (P < 0.05 or P < 0.01).

CONCLUSIONHYC has good therapeutic effect on senile mild cognitive impairment, it is safe without any adverse reaction.

Aged ; Aged, 80 and over ; Capsules ; Cognition ; drug effects ; Dementia ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Intelligence Tests ; Male ; Middle Aged ; Phytotherapy ; Quality of Life

Objectives To investigate the impact of ischemic preconditioning (IPC) on dynamics of homing of endothelial progenitor cells (EPCs) after renal ischemia reperfusion injury (IR).Methods Sixty male Sprague-Dawley rats were randomly divided into three groups after right-side kidney nephrectomy:for sham-operated rats,lumbotomy without vascular clamping was performed; IR rats were clamped renal blood vessels for 40 minutes while IPC rats were pre-treated with 15 min ischemia and 10 min reperfusion.At 3,12,24 h,and 3 days after reperfusion,the pool of circulating,kidneys,lungs and spleens were harvested.The extent of renal injury was assessed by biochemical and histological examination.The dynamics of homing of EPCs was observed by flow cytometry.Results The rats in IPC group exhibited significant improvements in renal function and morphology.Compared with IR group and sham group,the number of EPCs in blood was increased in the IPC group at 12 h and 24 h after reperfusion (P ＜ 0.05).The number of EPCs in kidney was increased at all times pointin the IPC group and IR group as compared to the sham group (P ＜ 0.05.In addition,EPCs number was increased in IPC group compared with the IR group at 12 h and 24 h [(11.36±0.66)％ vs (6.37±0.69)％,(6.31±0.70)％ vs (4.40±0.60)％,all P＜ 0.05].Compared with IR group and sham group,the number of EPCs in the lung was increased in the IPC groups at 12 h after reperfusion [(2.95±0.66)％ vs (1.78±0.59)％,(1.66±0.61)％,all P ＜ 0.05].The number of EPCs in spleen was increased in the IPC group at 72 h as compared with the IR group and sham group [(0.55±0.06)％ vs (0.34±0.07)％,(0.31±0.06)％,all P ＜ 0.05].Conclusions Endogenous EPCs may home to injured kidney after IPC.EPCs can also gather in the lungs and spleen.

The authors introduced the hotspots and forefront of 2018 Myasthenia Gravis Foundation of America′s Scientific Session, including the research forefront and trend of the following:International research hotspots in the myasthenia gravis (MG) had been changed from the most common acetylcholine receptor antibody positive MG (AChR?MG) into other subtypes, particularly muscle specific tyrosine kinase receptor antibody positive MG; The efficacy of thymectomy was effective in the whole AChR?MG group, but not in other MG subgroups; Existing drugs in MG treatment can not achieve the expected effect, so endless new drug development had become a hot field of MG research; In terms of basic research, more attention had been paid to exploring the specific mechanisms involved in MG pathogenesis, including the study of antigen specific B cells and even antigen specific T cells.