Objective:To investigate the efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis.Methods:60 patients with myasthenia gravis were selected and randomly divided into two groups.The observation group(32 cases) received video assisted thoracic surgery.The control group(28 cases) received thoracic surgery.The efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis was evaluated by perioperative indexes,QMG scores before operation,after 3 months,6 months operation and complications during 6 months follow-up.Results:During the perioperative period,there was no statistical significance in the operation time between two groups(P＞0.05).The bleeding volume of observation group was less than that of the control group (P＜0.05).The drainage time,hospitalization and incision length of observation group were shorter than those of the control group (P＜0.05).Before operation,there was no statistical significance in the QMG scores.At 3 months,6 months after operation,the QMG scores were decreased in both groups.The QMG score of observation group was lower than that of the control group (P＜0.05).During 6 months' follow-up,complications were observed in 7 cases of the observation group and 17 cases of the control group,the major complication was pulmonary infection.The incidence of complications in the control group was higher than that of the observation group (P＜0.05).Conclusion:Video assisted thoracic surgery had advantages of smaller surgical incision,faster recovery and higher safety in the treatment of myasthenia gravis.

Objective To explore the efficacy of thoracoscopic treatment of giant pulmonary bulla with complex conditions. Methods Video-assisted thoracoscopic surgery (VATS) was performed in 32 cases of giant pulmonary bulla with complex conditions in our department from September 2011 to November 2015. According to the dyspnea index of the American medical research council, there were 22 cases with distress index Ⅳ and 10 cases with distress index Ⅴ. Results All the patients underwent thoracoscopic surgery smoothly. The drainage tube was retained for 4-7 d in 17 cases, 8-14 d in 14 cases and 48 d in 1 case. The follow-up after operation was 12-18 months (mean, 16. 0 ± 3. 2 months). The dyspnea index was maintained at gradeⅠin 10 cases and gradeⅡin 22. All the patients were able to take care of themselves in daily life. Conclusion Giant pulmonary bulla with complex conditions can be treated under thoracoscopy with good surgical outcomes.

This study conducted a bibliometric analysis of the literature related to the field of hemodialysis arteriovenous fistula from the Web of Science database. The current and future research hotspots and development trends in this field were visualized by sorting and interpreting the research data and drawing a visualization chart. This study suggests that there are certain academic barriers between China and developed countries, and international multicenter clinical trials should be conducted in the future with early identification of arteriovenous fistula dysfunction and emerging diagnostic tools as the academic development direction.