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.

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