Objective To investigate the perioperative management and video-assisted thoraco-scopic (VATS) extended thymectomy for myasthenia gravis ( MG ). Methods A total of 102 patients who received extended thymectomy for MG from June 2000 to August 2007 were divided into 2 groups by operative approach: 51 in the VATS group and 51 in the full median sternotomy group. The clinical features, including operation time, operation blood loss, post-operative drainage, inci-dence of crisis, hospital stay, and the 1-year total effective rate after the operation were compared. Complications were treated exactly and cholinesterase inhibitors were applied to control the symptom of MG before the operation. The whole thoracic gland and fat in the anterior mediastinum were removed. Steroid, cholinesterase inhibitors and plasmapheresis were used to prevent and cure masthemic crisis after the operation. Results No patients died in the operation and hospitalization. There was no sig-nificant difference in the operation time [(128.14±34.82) min vs. (130.46±28.71) min] and the 1-year total effective rate after the operation (85.8% vs. 87.2% )in the 2 groups(P>0.05).The operation blood loss, postoperative drainage, incidence of crisis, and postoperative hospital stay in the median sternotomy group were higher or longer than those in the VATS group [(93.77±21.64) mL vs. (45.42±10.96)mL,P<0.05; (174.65±21.64)mL vs. (101.33±28.76) mL,P <0.01;7.84% vs. 1.96%, P<0.05;(14.23±3.17)d vs. (8.37±1.18)d, P<0.05)]. Conclusion VATS extended thymectomy for myasthenia gravis is safe, less invasive and effective. Preoperative preparation and the perioperative managemant can decrease the incidence of crisis. The plasmapheresis is the key of curing masthemic crisis.

BACKGROUND: In many parts of the body, muscle diastolic and contractive activities can promote the body's energy metabolism. Furthermore, the muscles also play an irreplaceable role in maintaining body posture and joint stability. OBJECTIVE: To summarize the rules of muscle function and aging changes, to search for research related to the trainability of old muscle function, and to provide references for muscular anti-aging research in field of sports medicine. METHODS: Taking senescence, aging, muscle function, exercise, training in English as the search terms, Pubmed database from January 2000 to May 2009 was retrieved; Taking aging, muscle function, training in Chinese as the search terms, CNKI database from January 2000 to May 2009 was searched. Literatures were limited to English and Chinese languages. Inclusive criteria: research closely related to the trainability of motor function and muscle metabolic function in the elderly; Exclusive criteria: obsolete and lack of credibility of the literature. RESULTS AND CONCLUSION: Totally 67 literatures were screened out by computer, according to inclusion and exclusion criteria, 31 documents of which were involved in the analysis. Based on the recent research On muscle function, the muscle function can be summarized into three aspects: motor function, metabolic function and maintenance function. The elderly muscle aging is mainly showed in these 3 aspects. How to reconstruct these functions through resistance training? The concerning data were summarized in this paper, to verify the trainability of ageing's muscle motor and metabolism functions, but no study indicates that the maintenance function can be reconstructed, and deserves further studies of sports science.

Objective To study the quantitative method of determination of Fas ligand (FasL) and T-cell intracellular antigen-1 (TIA-1) in renal allografts and to evaluate its clinical significance. Methods The magnitude of intragraft FasL and TIA-1 mRNA was quantified by competitive PCR in 42 samples obtained to diagnose the etiology of graft dysfunction, and the results were expressed as the ratio of picograms of target gene to picograms of ?-actin, and were compared with the histopathogical diagnosis based on Banff criteria. Results Of all 42 samples, the transcripts were detectable in 11 for FasL and 27 for TIA-1. Intragraft expression of FasL and TIA-1 was significantly up-regulated in acute rejection group compared with chronic rejection group (P

Objective To explore the treatment of complications associated with non-functioning renal allografts using embolism of renal artery.Methods Six patients with non-functioning renal allografts were treated with renal artery embolism,morphous,blood flow of allografts and symptoms were observed.Results Hematuria disappeared in 3 days after embolism;blood pressure levels controlled by drugs were in a normal region.Using color Doppler sonography,we found no blood flow in 4 cases,discontinuous blood flow in 2 cases.Blood flow disappeared in all 6 allografts 3 months later,and the allografts had atrophied.Conclusion Embolism of renal artery may be an effective and safe method for the treatment of complications associated with non-functioning renal allografts,especially for some severe patients;it could avoid the risks of operation.

Objective To study the relation between hyperglycaemia and the prognosis in patients with type 2 diabetes mellitus undergoing coronary revascularization. Methods Study retrospectively 334 type 2 diabetes mellitus patients underwent coronary revascularization, we compare the incidence of hyperglycaemia between patients with good prognosis and patients with bad prognosis undergoing coronary artery bypass graft and percutaneous transluminal coronary angioplasty. We identify by logistic regression analysis the extent of hyperglycaemia as risk factor in the prognosis individually. Results In patients undergoing coronary artery bypass graft and percutaneous transluminal coronary angioplasty, the incidence of hyperglycaemia is higher in patients with bad prognosis than in patients with good prognosis. It is identified by logistic regression analysis that hyperglycaemia deteriorates the prognosis of patients undergoing coronary artery bypass graft (OR=2.033, P=0.008) and patients undergoing percutaneous transluminal coronary angioplasty (OR=2.476, P=0.006). Conclusion To control hyperglycaemia efficiently following coronary revascularization in patients with type 2 diabetes mellitus is mandatory.

Point-of-care pulmonary ultrasound is a widely used tool for rapid diagnosis and monitoring treatment in emergency departments and intensive care units.Pulmonary ultrasound has high sensitivity,specificity and diagnostic accuracy in identification of pneumonia,pneumothorax,pulmonary-embolism,pleural effusion,alveolar interstitial syndrome,etc.Besides,it can assess the lung aeration from interstitial syndrome to lung consolidation.Additionally,it provides real-time information of treatment response.Lung ulrasound applications in pulmonary disease were reviewed in this article.

Important papers representing the advances in AIDS vaccine research were retrieved from Web of Sci-ence using HistCite.The citation chronological chart was plotted by analyzing the relation between their citation fre-quency and cited frequency , and analyzing their citation sequences , which shows the development rules and histori-cal development path in AIDS vaccine research , and provides a certain reference value for the researchers in related fields at home and abroad.

Objective To define the relationship between genes expression of 5 immune effector molecules and acute rejection of renal allografts. Methods The magnitude of intragraft Fas, Fas ligand (FasL), granzyme B(GB) , perforin(P) and T cell intracellular antigen-1 (TIA-1) mRNA were quantified by competitive PCR in 42 samples. Results were expressed as the ratio of picograms of target gene to picograms of ?-actin, and were compared with the histological diagnosis based upon Banff criteria. Results Of all 42 tissues, the transcripts were detectable in 41 for Fas, 11 for FasL, 19 for GB, 33 for P and 27 for TIA-1. Intragraft expression of FasL, GB, P and TIA-1 but not Fas was significantly elevated in acute rejection group as compared with chronic rejection group ( P

BACKGROUND:There is always a controversy about nonsurgical and surgical repair of acute Achiles tendon rupture. Except retrospective analysis, there is a lack of high-level evidence-based medicine data.
OBJECTIVE:To systemicaly evaluate the clinical effectiveness of the nonsurgical versus surgical treatment for acute closed rupture of the Achiles tendon.
METHODS:The randomized controled trials about the nonsurgical versus surgical treatment for acute Achiles tendon rupture were searched in PubMed, EMbase, CBM, CNKI, Ovid, and WanFang Data by computer as wel as in relevant journals by hand, which were reported before February 2014. The Cochrane Library (Issue 1, 2014) was also retrieved. Two reviewers independently screened studies, extracted data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Then Meta-analysis was conducted using RevMan 5.2 Software.
RESULTS AND CONCLUSION:Nine randomized controled trials were included, and totaly 874 patients were involved, 441 cases in the nonsurgical group and 433 in the surgical group. The results of Meta-analysis showed that compared with the surgical group, the incidence of complications was lower [OR=0.41, 95%CI(0.26, 0.63), P< 0.000 1], but the rate of tendon re-rupture [OR=2.86, 95%CI(1.62, 5.02),P=0.000 2] and incidence of cicatricial adhesion [OR=0.07, 95%CI(0.03, 0.19),P < 0.000 1] were higher in the nonsurgical group. However, there were no significant differences between the two groups in patient satisfaction, superficial infection, motion recovery, and deep infection. Compared with the surgical treatment, the nonsurgical treatment can reduce the incidence of complications, but has a higher incidence of re-rupture. Because of sample-size and methodological quality restrictions, this conclusion needs further verification of large-sample, multicenter, and high-quality randomized controled trials.

Objective To develop a portable medical drop speed monitoring equipment which can conveniently control the drop speed in infusion.Methods Taking the monolithic integrated circuit of 89C51 as a core,such units were designed as the master control unit,keyboard input system,drop speed detection,drop speed control,digital display,acousto-optics alarm circuit and electromotor drive.All circuit module units were connected in monolithic integrated circuit.The gathering data were transferred to monolithic integrated circuit in the form of electrical signals.After the operation,analysis and processing,monolithic integrated circuit transferred the data to demonstration module,electrical machinery and acousto-optics alarm circuit through the outlet.Results Automatically controlling the drop speed according to the difference of drop speed,this equipment can reach the required drop speed in 5~10s and maintain this speed with an error of 12 drops per minutes.Conclusion Portable medical drop speed monitoring equipment achieves the goal of the task and meets the clinical requirement.This equipment is worthy of popularizing.