Objective: To study the clinical therapeutic characteristics of myasthenia gravis (MG) with hyperthyroidism and the effects of surgical procedures for the patients. Methods:Subtotal thyroidectomy,thymectomy,and simultaneous subtotal thyroidectomy and thymectomywere performed on eleven patients with MG and hyperthyroidism. These patients were followedup after the operation. Results :The neck incisions were infected in two of seven type Ⅱ b patientsdue to trachestomy and the infected incisions were surgically healed. The MG symptoms of threecases (1 cases in type Ⅱ. and 2 cases in type Ⅱ b) relapsed in 3 to 6 months after subtotal thy-roidectomy. The MG symptoms of 2 cases (1 case in type Ⅱa and 1 case in type Ⅱ b) relapsed in 8to 12 months after thymectomy. Among six patients treated by simultaneous subtotal thyroidecto-my and thymectomy,the MG symptoms relapsed in a type I case 3 months after the operation,remitted in three case (1 case in type Ⅱ, and 2 cases in type Ⅱb) and improved in two type Ⅱ bcases since the operations. Conclusion:The simultaneous subtotal thymectomy and thyroidectomyfor patients with MG and hyperthyroidism might have better effects,although infective opportuni-ty of the neck incisions increased owing to trachestomy. However,the prognostic effects were notvery satisfactory whether simple subtotal thyroidectomy or thymectomy for the patients with MGand hyperthyroidism was performed.

Objective:To establish an HPLC-MS/MS method for the determination of lamotrigine ( LTG) in human plasma to be applied in the clinical therapeutic drug monitoring. Methods:LTG was analyzed on a Kromasil C8 (50 mm × 2. 1 mm,5μm) column. Methanol and water (both containing 0. 1% formic acid) was used as the mobile phase with gradient elution. The flow rate was 0. 6 ml ·min-1 at the column temperature of 40℃. The ion transitions under an ESI positive model were performed at m/z 256. 0>211. 0 and m/z 264. 1>154. 0 for LTG and ticlopidine (internal standard, IS), respectively. Results: The calibration curve of LTG was linear within the range of 0. 02-2 μg · ml-1 . The recoveries of LTG at three quality control levels were within the range of 91. 94%-100. 28%. LTG was stable under all tested conditions and the dilution (the dilution factor was 10) had no influence on the accuracy and precision of LTG determination. Conclusion:The HPLC-MS/MS method for the determination of LTG developed in the study is accuracy, stable and convenient, and is applicable in the clinical therapeutic drug monitoring of LTG.

Objective To examine the biomechanical properties of three-dimensional(3D) printed electron beam melting(EBM) Ti-6AI-4V mesh as scaffold for mandibular repairment.Methods We fabricated Ti-6Al-4V samples of different structures with strut,sheet and 3D mesh scaffolds(a controllable diameter 0.35,0.50,0.70 mm,distribution density:intensive sparse) by EBM process.The mechanical properties of these structures were examined by X-ray energy dispersive spectrum(EDS),uniaxial tensile test,three-point bending test,under compression load and compared with their different microstructure and mechanical properties.Results Compressive deformation behavior of these cellular structures exhibited brittle character that had a typical irregular plateau region in the stress-strain curves.The mesh of larger diameter(d=0.70 mm) showed higher specific strength than the meshs of small diameter(d=0.35 mm) did,and the other 3D mesh under the same condition showed identical specific stiffness.Conclusions EBM was successfully used to fabricate novel 3D mesh Ti-6Al-4V structures for applications.By optimizing the buckling and bending deformation,Ti-6Al-4V cellular solids with high strength,low modulus.Furthermore,the results of mechanical property and chemistry composition showed that the scaffold could completely satisfy the requirement of hard tissue repairment.

Objective To evaluate the surface characteristics and cytocompatibility of Ti-6Al-4V alloy fabricated using select laser melting (SLM) and electron beam melting (EBM) technique.Methods Ti-6Al-4V alloy specimens were fabricated with SLM and EBM.A wrought form of Ti-6Al-4V alloy was used as a control.Its properties were evaluated using component analysis,contact angle test,surface roughness,surface topography,cell ultrastructure,cell attachment and proliferation observation,metal ion precipitation examination.Results The roughness of SLM and EBM specimens was suitable for cell attachment but not the best.The character of SLM and EBM specimens was hydrophobic (＞65°).The surface topography of EBM and SLM specimens were similar,but were not the best type for cell attachment.The components of Ti-alloy oxide film were detected in all the specimens.The content of Ti,A1,V ions of EBM,SLM and wrought specimens were very low and did not affect the cell attachment and proliferation.The ultrastructure of cell was normal,and the cytomembrane was intact.The number of cells was similar to each other among the three kinds of specimens and increased obviously with the culture time.Conclusions The results of the study suggested that EBM and SLM Ti-6A1-4V specimens possessed good surface characteristics.However,the surface modification are needed further.

Objective:To analyze the effect of birth parity on life expectancy (LE) and healthy life expectancy (HLE) among rural women.Method:A total of 15 304 women aged 40 to 79 years who participated in baseline and follow-up surveys were selected from a rural cohort in Henan province. The LE and HLE of women with different birth parity were calculated by using multi-state life table.Results:There were 1 195 (7.8%), 7 782 (50.8%), 3 867 (25.3%) and 2 460 (16.1%) women with 1, 2, 3 and 4 birth parities, respectively, and the M ( Q1 and Q3) of age were 50.3 (47.3, 53.4) and 53.3 (48.8, 60.7), 62.6 (55.4, 66.9) and 69.5 (64.7, 73.4) years old, respectively. LE at 40 years old was 44.5, 44.8, 45.1 and 45.4 years old, and HLE was 17.7, 18.3, 18.8 and 19.3 years old, respectively. LE at age 40 increased by 0.3, 0.6, and 0.9 years in women with 2, 3, and 4 birth parities or more and HLE increased by 0.5, 1.1, and 1.6 years, respectively, compared with women with 1 birth parity. For women with higher and lower socioeconomic status who had 4 birth parities or more, the LE at age 40 was 47.1 and 43.9 years, respectively, an increase of 0.2 and 0.1 years over women with 1 birth parity, respectively; and the HLE was 20.4 and 18.7 years, respectively, an increase of 1.4 and 1.3 years over women with 1 birth parity, respectively. Conclusion:LE and HLE show an upward trend with the increase of birth parity among rural women.

Objective:To analyze the effect of birth parity on life expectancy (LE) and healthy life expectancy (HLE) among rural women.Method:A total of 15 304 women aged 40 to 79 years who participated in baseline and follow-up surveys were selected from a rural cohort in Henan province. The LE and HLE of women with different birth parity were calculated by using multi-state life table.Results:There were 1 195 (7.8%), 7 782 (50.8%), 3 867 (25.3%) and 2 460 (16.1%) women with 1, 2, 3 and 4 birth parities, respectively, and the M ( Q1 and Q3) of age were 50.3 (47.3, 53.4) and 53.3 (48.8, 60.7), 62.6 (55.4, 66.9) and 69.5 (64.7, 73.4) years old, respectively. LE at 40 years old was 44.5, 44.8, 45.1 and 45.4 years old, and HLE was 17.7, 18.3, 18.8 and 19.3 years old, respectively. LE at age 40 increased by 0.3, 0.6, and 0.9 years in women with 2, 3, and 4 birth parities or more and HLE increased by 0.5, 1.1, and 1.6 years, respectively, compared with women with 1 birth parity. For women with higher and lower socioeconomic status who had 4 birth parities or more, the LE at age 40 was 47.1 and 43.9 years, respectively, an increase of 0.2 and 0.1 years over women with 1 birth parity, respectively; and the HLE was 20.4 and 18.7 years, respectively, an increase of 1.4 and 1.3 years over women with 1 birth parity, respectively. Conclusion:LE and HLE show an upward trend with the increase of birth parity among rural women.

OBJECTIVETo investigate an ideal modeling method of designing 3D mesh scaffold substitutes based on tissue engineering to restore mandibular bone defects. By analyzing the theoretical model from titanium scaffolds fabricated by 3D printing, the feasibility and effectiveness of the proposed methodology were verified.

METHODSBased on the CT scanned data of a subject, the Mimics 15.0 and Geomagic studio 12.0 reverse engineering software were adopted to generate surface model of mandibular bone and the defect area was separated from the 3D model of bone. Then prosthesis was designed via mirror algorithm, in which outer shape was used as the external shape of scaffold. Unigraphics software NX 8.5 was applied on Boolean calculation of subtraction between prosthesis and regular microstructure structure and ANSYS 14.0 software was used to design the inner construction of 3D mesh scaffolds. The topological structure and the geometrical parameters of 3D mesh titanium scaffolds were adjusted according to the aim of optimized structure and maximal strength with minimal weight. The 3D mesh scaffolds solid model through two kinds of computer-aided methods was input into 3D printing equipment to fabricate titanium scaffolds.

RESULTSIndividual scaffolds were designed successfully by two modeling methods. The finite element optimization made 10% decrease of the stress peak and volume decrease of 43%, and the porosity increased to 76.32%. This modeling method was validated by 3D printing titanium scaffold to be feasible and effective.

CONCLUSIONS3D printing technology combined with finite element topology optimization to obtain the ideal mandibular 3D mesh scaffold is feasible and effective.

Feasibility Studies ; Humans ; Mandible ; anatomy & histology ; Porosity ; Printing, Three-Dimensional ; Tissue Engineering ; methods ; Tissue Scaffolds ; Titanium