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.

Microbiology is an important,fundamental and obligatory course in contemporary life science.This article introduces that teaching group of microbiology in Nankai University realizes transformation of teaching center,fully embodies the modernization of teaching notion and gives full play to students' main effect practically by adhering to teaching reform as center,optimizing teaching method as measure,communicating in and after class and using multi-media and teaching web.Therefore,teaching system is established to adapt to modern teaching notion and eventually microbiology course becomes a cultivation platform to foster elites with both solid fundamental theory and innovating mind.

BACKGROUNDThe cochlear hydrops analysis masking procedure (CHAMP) is a new diagnostic technique for Meniere's disease (MD). But its value has not been well proven. This study aimed to evaluate the diagnostic value of CHAMP for MD.

METHODSCHAMP test was taken in three populations using the Auditory Evoked Potential system delivered by Bio-logic Systems Corporation: (1) otologically normal subjects; (2) patients clinically diagnosed with definite MD; (3) patients clinically diagnosed with probable and possible MD.

RESULTSAccording to the comparison between the normal and definite MD group, if the abnormal criterion of CHAMP was defined as latency delay less than 0.3 ms, then the corresponding sensitivity was only 52%. However, if the abnormal criterion was defined as latency delay between 0.6 and 3.8 ms, then a sensitivity of 93% and a specificity of 100% can be achieved. The complex amplitude ratio showed a significant overlap between normal and definite MD group. If the abnormal criterion was defined as a complex amplitude ratio less than 0.95, the corresponding specificity was only 50%. However, if the abnormal criterion was defined as less than 0.80, the corresponding sensitivity was 60%, and the specificity was 97%. If the abnormal criterion of CHAMP was defined as latency delay less than 0.6 ms or the complex amplitude ratio less than 0.80, CHAMP result can be obtained in all subjects with good sensitivity and specificity.

CONCLUSIONSCHAMP can differentiate patients with Meniere's disease from otologically normal subjects with high sensitivity and specificity. The recommended criterion of abnormal CHAMP was a latency delay less than 0.6 ms or a complex amplitude ratio less than 0.80.

Adolescent ; Adult ; Aged ; Audiometry, Evoked Response ; Endolymphatic Hydrops ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Meniere Disease ; diagnosis ; physiopathology ; Middle Aged ; Young Adult

Objective To analysis the etiology and molecular classification of brucella strains isolated in Guangdong province in 2010.Methods The strains of 19 brucella were verified and identified by some methods including traditional biology phenotype confirmation,PCR amplification and pulsed field gel electrophoresis (PFGE).Results On phenotype level,4 strains were brucella melitensis biovar 1,2 strains were brucella suis biovar 3,and the rest were brucella melitensis biovar 3,which were specific B genes positive strains,and the PFGE typing similar values ranging from 67.9％ to 100％.In addition to the four strains from Zhuhai for the outbreak,the homology was 100％,and the rest were sporadic cases.Conclusions Brucella cases,in Guangdong province,are highly sporadic and dispersed outbreaks.Compared with a few years ago,it shows species diversification,and brucella melitensis biovar 3 is still the dominant serotype.PFGE can be used to distinguish the three species of brucella,but it can't effectively distinguish the allotypes.

This study explored three molecular typing methods for Vibrio parahaemolyticus(VP)in Liaoning Province in 2020,to assess the correlation among the three methods and the genetic relationships among between strains;analyze the epi-demic trends and distribution patterns of VPin Liaoning Province;and provide reliable technical support for the prevention and control of foodborne diseases.Serum typing,PFGE,REP-PCR,and ERIC-PCR molecular typing and cluster analysis were performed on 44 VP isolates from Liaoning Province in 2020.A total of 44 isolated strains were divided into 15 serotypes,and 8 isolated strains could not be classified.The serotypes were primarily O3 group,O1 group,and O2 group.Clinical isolates had high molecular similarity,whereas food isolates had low molecular similarity.The resolution(DI)of PFGE was 0.986,that of REP-PCR was 0.947,and that of ERIC-PCR was 0.935.The molecular similarity between serotype O3 and O1 group strains was high.The epidemic serotypes of isolated VP strains in Liaoning Province in 2020 were consistent with those from the past 5 years.The resolution of the PFGE typing method was better than that of REP-PCR and ERIC-PCR;moreover,REP-PCR had better resolution than ERIC-PCR.These three typing methods showed good intercorrelation.The O3 group strains are likely to originate from the O1 group strains.When a foodborne disease outbreak is caused by VP,laboratories with conditions can apply these three methods to trace the source of the pathogenic bacteriaquickly and effectively.

Objective Todeterminetherelationshipbetweenthetumorvolumeoftheperipherallungadenocarcinomawith maximum diameter≤3cmandlymphnodemetastasis(LNM).Methods TheMSCTmanifestationsof235subjectswhowerediagnosedasperipheral lungadenocarcinomawithmaximumdiameter≤3cm wereretrospectivelyanalyzed.Thesepatientsweregroupedaccordingtodifferent parametersincludingsmokinghistory,differentiation,tumorconsistencyandavailabilityoftumornecrosis.Tumorvolumeandratesof LNMamongthesegroupswerecompared.ROCanalysiswasusedtocalculatethecut-offvalueanddiagnosticaccuracy.Results (1) ThetumorvolumeofLNMgroupwaslargerthanthatofnoLNMgroup,cut-offvaluewas5.5cm3,andAUCwas0.76;(2)Therates ofLNMofthewell,moderate-well,moderate,moderate-poorandpoordifferentiationgroupswere0%,8.7%,17.7%,45.6%and46.7%respectively.Theratesofpuregroundglassopacity(p-GGO),mixedandsolidtumorwere0%,8.3%and29.3%respectively.The ratesofthetumorpresentandabsentofnecrosiswere47.8%,22.0%respectively(P＜0.05).Conclusion Usingthevolumeoftumor on MSCTtopredictLNMisanewnon-invasivewayofassessingLNM,withhighsensitivityandspecificity,whichcouldsupplymore imaginginformationforsurgeonstochoosethewayoflymphnodedissection.

Objective To analyze the clinical and imaging features of subependymal giant cell astrocytomas in patients with tuberous sclerosis.Methods The clinical data of 48 patients with tuberous sclerosis,admitted to our hospital from July 2007 to August 2009,were collected.According to the patients' history,sign and MRI results,the clinical features and imaging characteristics of subependymal giant cell astrocytomas were analyzed.Results Four patients with tuberous sclerosis were diagnosed as having subependymal giant cell astrocytomas and 2 of them were also diagnosed as having obstructive hydrocephalus;these 4 patients were male with an average onset age of five years (ranged from 1 to 12 years old).Seizure and skin lesions were found in these 4 patients with 3 presenting cognitive dysfunction.CT scanning showed iso-density or slightly low density in subependymal giant cell astrocytornas and some of these tumors were calcified with high density.MRI showed TIWI iso-signal or low signal and T2WI iso-signai or high signal; FLAIR high signal was presented and asymmetrical signal was also shown when calcification happened;enhanced MRI showed significant intensification on the tumors.Conclusion Some patients with tuberous sclerosis can have subependymal giant cell astrocytomas,the slow-growing tumors,which are often adjacent to the foramen of Monro and lead to obstructive hydrocephalus.Long-term follow-up needs to be conducted to find tumors at an early stage in patients with tuberous sclerosis.

Objective Auditory brainstem responses (ABR) evoked by tone burst is an important method of hearing assessment in referral infants after hearing screening. The present study was to compare the thresholds of tone burst ABR with filter settings of 30 - 1500 Hz and 30 - 3000 Hz at each frequency,figure out the characteristics of ABR thresholds with the two filter settings and the effect of the waveform judgement, so as to select a more optimal frequency specific ABR test parameter. Methods Thresholds with filter settings of 30 - 1500 Hz and 30 -3000 Hz in children aged 2 -33 months were recorded by click,tone burst ABR. A total of 18 patients ( 8 male / 10 female), 22 ears were included. Results The thresholds of tone burst ABR with filter settings of 30 - 3000 Hz were higher than that with filter settings of 30 - 1500 Hz. Significant difference was detected for that at 0. 5 kHz and 2.0 kHz ( t values were 2.238 and 2. 217, P ＜ 0. 05 ), no significant difference between the two filter settings was detected at the rest frequencies tone evoked ABR thresholds. The waveform of ABR with filter settings of 30 - 1500 Hz was smoother than that with filter settings of 30 - 3000 Hz at the same stimulus intensity. Response curve of the latter appeared jagged small interfering wave. Conclusions The filter setting of 30 - 1500 Hz may be a more optimal parameter of frequency specific ABR to improve the accuracy of frequency specificity ABR for infants' hearing assessment.

Objective To study the characteristic of the cochlear hydrops analysis masking procedure ( CHAMP) in normal adults, and to evaluate the diagnostic values of its parameters for logic auditory evoked potential system: clicks presented alone (unmasked condition) and clicks presented with ipsilateral pink noise high-pass filtered at 8 , 4, 2, 1, and 0. 5 kHz respectively. Results The wave V latency of ABR to the high-pass masking pink noise clicks were longer than ABR to clicks alone. The latency delays of wave V for clicks presented with ipsilateral pink noise high-pass filtered at 8 , 4, 2, 1, and 0.5 kHz compared to clicks alone were (0.30 ±0.18), (0.97 ±0.43), (1.65 ±0.64), (3.21 ±0.56),(4. 66 ± 0. 37 ) ms respectively. The complex amplitude ratio between ABR to click + 0. 5 kHz high-pass noise and click alone was 0.95 ±0.11. Conclusions CHAMP is a promising diagnostic method for membranous labyrinth hydrops, and the latency delay of wave V might be used as the normal criterion. The specificity of the complex amplitude ratio need furthur evaluation in clinical work.

Objective The objective of this study was to estimate the current status of prevalence, awareness, treatment and control rate of hypertension in adult residents living in rural area of Liaoning Province, North China. Methods The screening was finished in 2008, probability proportional to size sampling method was used to select the representative sample. Blood pressure was measured in 153 481 adults (aged >35yr) , information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Results Overall, hypertension prevalence rate was 40. 6% , the age-specific hypertension prevalence rate was 23. 9% , 36. 6% , 49. 0% , and 63. 8% in men and 20. 7% ,40. 0% ,55. 0% , and 68. 9% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and above 65 years, respectively. Among hypertensive patients, awareness rate was only 56.9%, 39.7% patients received antihypertensive medication and blood pressure control rate [ < 140/90 mm Hg (1 mm Hg = 0.133 kPa)] was 3.9% in all participants and 9.8% in treated hypertensive patients. Conclusions Our results indicates that hypertension prevalence is high while awareness, treatment and control rate of hypertension was low in rural areas of northeast China. These results underscore the urgent need to develop comprehensive strategies to improve prevention, detection, and treatment of hypertension in rural population of Liaoning province.