Objective To explore the value of video-assisted thoracoscopic thymectomy in the treatment of myasthenia gravis. Methods A prospective randomized controlled study,fifty-four patients who were preoperatively confirmed to be MG from 2005 to 2008 were divided into VATS group (27 cases) and conventional thoracotomy group (27 cases). Thymectomy and dissection of all fatty tissue anterior to the pericardium were performed in both the groups. The operation time,blood loss,chest drainage time,hospital stay and outcomes of the two groups were recorded and compared. Results In the VATS group,one patient was converted to open surgery because of electrocoagulation injury and brachiocephalic vein. Compared with the conventional group,the patients in the VATS group had fewer blood loss [(43.0?5.2) ml vs (117.6?17.2) ml,t=-21.196,P=0.000],shorter operation and postoperative drainage time [(89.4?15.0) min vs (98.4?12.5) min,t=-2.377,P=0.021;and (2.2?1.6) d vs (4.2?1.3) d,t=-5.003,P=0.000,respectively],and shorter postoperative hospital stay [(7.0?1.2) d vs (11.0?2.5) d,t=-7.379,P=0.000].In the conventional group,3 patients developed MG crisis and 9 had lung infection,while none of the VATS group developed the crisis,and 2 showed lung infection (P=0.236; ?2=5.295,P=0.021). The 54 patients were followed up for 6 to 24 months with a mean of 18.6 months,during the period,the MG symptoms were improved in 80.8%(21/26)of the patients in VATS group and 85.2% (23/27)in conventional group (Z=-0.126,P=0.899). Conclusions Extended thymectomy by 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 analyze and compare the effect of early minimally invasive surgical treatment and conventional treatment for patients with severe acute pancreatitis.Methods According to the including criteria,eight randomized-controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed and analyzed by using Revman 4.2 software.Results Compared with conventional treatment,early minimally invasive surgical treatment was associated with a significantly lower incidence of mortality(RR=0.35,95%CI:0.20～0.63,P

By use of Bayes probability analysis,a computer aided diagnosis(CAD)system has been established for the diagnosis of ovarian tumor by ultrasound.The capabilities of Bayes method were (1)improving the diagnostic accuracy:(2)facilitating the diagnosis.The results obtained by this method in easily misdiagnosed cases correlated with the pathological findings.It is a good complement for the diagnosis of ovarian tumors by ultrasound and thus raises the ultrsonud diagnostic level for clinical application.

Four cases of abdominal vascular lesions were diagnosed with color Doppler flow imaging (CDFI). These cases include aneurysm of portal vein, splenic aneurysm intrahepatic pseudoaneurysm and carvenous trasformation of portal vein, Above cases were misdiagnosed by B-mode ultrasonogram, but well detected by CDFI. Therefore, we consider that CDFI combined with B-mode ultrasonography, is a noninvasive and accurate method for the diagnosis of abdominal vascular lesion and its differential diagnosis with abnormal, but non-vascular, duct or chamber structure.

AIM:To determine whether apoptosis is involved in the development of vascular remodeling in renovascular hypertension rats and whether the inhibitory effect of tetrandrine on proliferation is mediated by apoptosis.METHODS:Apoptosis was detected in histologic sections of aorta and tail arteries with in situ end-labeling.The apoptosis ratio in cultured cells was measured by [3H]-TdR incorporation and flow cytometer analysis method.RESULTS:Compared with the sham group,the apoptosis rate of renal hypertension rat(RHR)increased.Tetrandrine(Tet)directly induced apoptosis in cultured AVSMCs(from RHR)and increased apoptosis induced by TGF?,TGF?1 and deficient FCS.CONCLUSION:Tet induces and sensitizes vascular smooth muscle cells of RHR to apoptosis,which at least partly related to the regression of vascular remodeling.

Brain ischemic tolerance refers to endogenous brain protective mechanism during severe ischemic injury of the body. Ischemia preconditioning is an effective mean to induce brain ischemic tolerance. However, the invasive and ethical limitation made the application of ischemic preconditioning difficult in the clinical practice. Studies found that extracellular signal regulated kinase (ERK) signaling pathway played an important role in the formation of brain ischemic tolerance. Meanwhile, brain ischemic tolerance induced by traditional Chinese medicine (TCM) had its unique advantages. This article reviewed effects of ERK signaling pathway in the inducing of brain ischemic tolerance and TCM intervention in recent years.

Objective To study the feasibility and efficacy of operative method of maximal thymectomy by video-assisted thoracoscopic surgery(VATS)for myasthenia gravis(MG).Methods From August 2005 to June 2007,27 patients with MG received maximal thymectomy by VATS(VATS group).The thymus and fat tissues in the anterior and upper mediastinum were resected.Patients who received transsternal thymectomy from May 2004 to July 2005 served as a control(conventional group).Results In the VATS group,the maximal thymectomy by VATS was completed in 26 patients,one patient was converted to open surgery because of the injury to the brachiocephalic vein.Compared with the conventional group,the patients in the VATS group had fewer blood loss [(46.0?5.7)ml vs(120.0?18.8)ml,t=-19.231,P=0.000],lower level of analgesic requirement(3 vs 12,?2=7.068,P=0.008),and shorter postoperative hospital stay [(7.0?1.2)d vs(11.0?2.5)d,t=-7.379,P=0.000].There was no significant difference in the operation time,myasthenia gravis crisis,and surgical outcomes between the two groups.Conclusions Maximal thymectomy by VATS is feasible and safe for patients with MG.Patients have shorter hospitalization,less surgical trauma and pain,lower rate of complication,and quicker recovery after the treatment.Further studies are needed to investigate its long-term efficacy

Objective To investigate the Tiaogan Yunpi Decoction on the region of interest regional encephalic activation MR signal intensity variation among diarrhea type irritable bowel syndrome(IBS) patients.Method Adopting self-paired collated method,functional fMRI was used to observe the regional interest MR signal variation of anterior cingulate cortex(ACC),island cortex(IC),prefrontal cortex(PFC),hypothalamus(THAL) before and after the treatment,as well as after the controlled treatment using placebo among 18 diarrhea dominant IBS patients when they were rectum stimulated.Results After the treatment,when the injected gas reached 90 mL,the change of MR signal variation of IC was signifycantly decreased compared with that before the treatment(P