To retrospectively analyze the clinical data of 42 patients at our department with bulbar myasthenia gravis.They underwent video-assisted thoracoscopic extended thymectomy (VATET) from May 2003 to August 2010.Another 42 patients treated with medications alone were selected as controls.Compared with the control group (4.32 ± 0.23),postoperative dysphagia scores improved significantly in patients undergoing VATET(9.21 ±0.41).And so did the dysphagia assessment classification (P ＜0.05).Thus VATET could effectively and definitely relieve dysphagia in patients with bulbar myasthenia gravis.

AIM: To study the clinical efficacy and safety of intravenous immunoglobulin (IVIG) for infant with severe pneumonia.　METHODS: Seventy patients of infant with severe pneumonia were divided into 2 groups. Patinets (n=50) of the trea- tment group (M 30, F 20; age 6 mo± s 5 mo) were treated with IVIG and conventional drugs, IVIG 400 mg*kg-1*d-1 for 3 d. Patinets (n=20) of the control group (M 12, F 8; age 7 mo±7 mo) were treated with conventional drugs.　RESULTS: The duration of fever, tachypnea, high heart rate shortened. The gasp and rales disappeared earlier. The cardiac failure recovered faster than the control group. There was significantly diffference statistically (P<0.05). The level of IgG, IgA raised after treatment. There was significantly difference statistically (P<0.01). The level of CD+3, CD+4, CD+8 after treatment also raised significantly compared with that before treatment (P<0.05). IL-6 and IL-8 after treatment reduced. There was significantly difference statistically (P<0.05).　CONCLUSION: IVIG is safe and effective drug in adjuvant treating severe pneumonia of infant, specially RSV pneumonia.

Objective To investigate the application effects of quantitative and qualitative fecal occult blood (FOB) reagent in colorectal cancer screening.Methods With the platform of colorectal cancer screening for early diagnosis and treatment,the original screening methods and process were not changed,individuals underwent colorectal cancer screening,aged from 40 to 74 years old,from four villages of Haining City in Zhejiang Province were selected as study objects.Initial screening included medical history questionnaire and FOB test.The first stool samples were examined both with quantitative and qualitative FOB test,one week later the second samples were detected with qualitative FOB test.History positive or once of any type of reagent positive was considered as initial screening positive.The individuals with initial screening positive received fine screening (colon endoscope examination).The effects evaluation included the positive rate of FOB,intestinal lesion detection rate,sensitivity,specificity and Youden index.The health economic analysis was calculated.Chi-square test was performed for comparisons between the two groups.Results A total of 8 427 history survey were completed,the positive rate of history was 8.48％(715/8 427) ; 6 644 underwent quantitative detection of FOB and the positive rate was 4.44 ％ (295/6 644) ; qulitative test was conducted in 12 633 samples were conducted and the positive rate was 2.56 ％ (324/12 633),the difference was statistically significant (x2 =49.27,P＜ 0.01).A total of 854 individuals with initial screening positive underwent electronic colonoscopy examination,the total intestinal lesion detection rate was 22.72％ (194/854),of which the intestinal lesion detection rate of quantitative group was 34.55％ (66/191),and that of qualitative group was 17.73％ (36/203),the difference was statistically significant (x2 =14.53,P＜0.01).The detection rate of both quantitative and qualitative test positive was 43.75 ％ (14/32).The colorectal cancer detection rates of quantitative and qualitative FOB test were 3.66％ (7/191) and 0.99％ (2/203),advanced adenoma detection rates were 8.38 ％ (16/191) and 5.91％,there were no significant differences (x2 =2.08 and 0.96,both P＞0.05).The sensitivity of quantitative and qualitative FOB test in advanced adenoma and cancer detection rate was 45.10％ and 27.45％,respectively.The average cost of quantitative and qualitative FOB test in intestinal lesions detection was 5 874.50 and 1 432.14 yuan.Conclusion The effects of quantitative FOB test in colorectal cancer screening was better than that of qualitative reagent,however on the cost of screening,the former was 4.10 times of the latter.

The genetically modified mice , as a helpful model , have been widely used in life scientific research . However, several new issues appeared subsequently with the wide application of the genetically modified mice .Here, we mainly discussed and analyzed the problems in the management and usage of genetically modified mice , which underlies the foundation for establishing management practice of the genetically modified mice .

The vehicle-mouted medical PSA oxygen generation system for driver on plateau is developed independently,according to the environment characteristics of high altitude and low air pressure on the Qinghai-Tibet Plateau,aiming at the actual vehicles support work of plateau troops,through two years' research and experiment again and again.By system workflow design,tests under various conditions,and applicability analysis,especially,the tests conducted on the simulation plateau artificial environment and the vehicle loading tests under five typical environments of Qinghai-Tibet Route at different altitudes,the system is proved to be reliable,satisfied and can meet the requirements of national standard for medical oxygen.

Objective To examine the effectiveness and safty of intraperitoneal injection of rapamycin on epileptogenesis in a rat model of pentylenetetrazole-induced kindling epilepsy. Method The Sprague Dawley rats at 6-8 weeks old were randomly divided into group PTZ+RAPA and group PTZ+NS. The body weight, mortality and seizures were recorded at 1, 4 and 6 weeks after treatment. Mossy fiber sprouting in the hippocampal CA3 area and DG area was examined by Tim staining. Results 1.The rats mortality was 22.9% in PTZ+RAPA and 10.4% in PTZ+NS. Weight alteration was statistically significant between PTZ+RAPA and PTZ+NS at the corresponding time points (P< 0.001); 3. The kindling rate was 66.7% in PTZ+RAPA and 58.3% in PTZ+NS at 6 weeks and the difference was statistical significant between these two groups (P>0.05). There was no statistical significance in the seizure scores be-tween PTZ+RAPA and PTZ+NS (P> 0.05). 4.The scores of mossy fiber sprouting in hippocampal CA3 and DG areas was higher in PTZ+NS than in PTZ+RAPA (P<0.05). Conclusion Rapamycin cannot reduce or curb epileptic seizures in young rats. It can obviously reduce the weight of the young SD rats which may be associated with its side effects.

Objective To investigate the effect of Tongqiao Yinao decoction ( TYD) on postoperative cogni-tive dysfunction in elderly patients and its underlying mechanisms .Methods 100 anesthetic patients for orthopedic surgery were randomly divided into the TYD-treated group and control group ,50 patients in each group .In TYD-trea-ted group,patients received 150mL TYD orally,twice daily for constitutive 15 days,beginning from the day of admis-sion in addition to conventional symptomatic and supportive treatment .While patients in control group received no TYD.Mini-mental state examination ( MMSE) was used to evaluate the patients′cognitive function before and after anesthesia.Meanwhile,blood samples of patients were also collected to test the expression levels of IL -6.Results There was no significant difference between the two groups before operation .However ,TYD-treated patients had signif-icantly lower incidence rate of POCD than the controls ( 20% in the control group , and 12% in the TYD-treated group;χ2 =4.332,P=0.037) 7 days after operation.The incidence rates of POCD in the TYD-treated group and control group were 30%and 38%1 day after operation ( P>0.05),28% and 20% 3 days after operation ( P>0.05),respectively.Compared with that before operation ,the blood levels of IL-6 in the two groups significantly increased 3 days after operation (control group,t=2.412,P=0.009;TYD-treated group,t=1.429,P=0.039).In contrast to the control group,the level of IL-6 in TYD-treated group declined to the baseline (the control group,t=0.851,P=0.049;TYD-treated group,P=0.404).Interestingly,compared with the controls,the TYD-treated patients had a significant lower level of IL-6 after operation (t=1.198,P=0.035).Furthermore,Pearson correlation analysis showed that change of IL-6 level in blood was negatively correlated with MMSE score (r=-0.782,P=0.022). Conclusion TYD can improve postoperative cognitive dysfunction in elderly patients ,presumably through decreasing the level of IL-6 in blood.

Objective To evaluate the clinical results from different endoscopic treatments of patients with chronic pancreatitis. Methods Thirty-seven cases of chronic pancreatitis had accepted endoscop-ie treatments were analvzed retrospectively. Results All cases were diagnosed clearly by ERCP showing different degree of pancreatic duct dilatation. Among them 21 cases had pancreatic duct stricture, 9 cases pancreatie duet ealeification. EPS in 18 cases and EST in 37 cases, basket extraction pancreatic duct stones in 6 eases, PDSD in 17 cases, NPD in 5 cases were conducted. The abdominal pain in 34 cases disappeared or markedly relieved alter treatment. Conclusion Endoseopie treatments have the advantages of safe, less-trauma and effectiveness. The combination of different endoscopic treatments improved evidently the current state of chronic pancreatitis treatment, thereby the therapeutic results.

Objective To evaluate the effect of propofol postconditioning on the activities of proapoptotic proteins Bid,Bim and Puma in rat cortical neurons subjected to oxygen-glucose deprivation/restoration (OGD/R) and the relationship with p38 mitogen-activated protein kinase (p38MAPK) signaling pathway.Methods The cortical neurons obtained from Sprague-Dawley rats (＜24 h after birth) were cultured in vitro and seeded in 6-well culture palate (2 ml/well).The cortical neurons were randomly divided into 4 groups (n =42 each) using a random number table:control group (group C),OGD/R group,propofol postconditioning group (group P),and propofol postconditioning + p38MAPK inhibitor SB202190 group (group PS).The neurons were subjected to O2-glucose deprivation for 90 min followed by restoration of O2-glucose supply for 24 h.In P and PS groups,propofol with the final concentration of 50 μmol/L was added to the culture medium immediately after restoration of O2-glucose supply,and the neurons were cultured for 2 h.SB202190 with the final concentration of 50 μmol/L was added to the culture medium at 1 h before O2-glucose deprivation,and the neurons were cultured for 2 h.The neuronal apoptosis was detected using Annexin V-FITC/PI double staining combined with flow cytometry,the number of viable neurons was evaluated by methyl thiazolyl tetrazolium assay,and the amount of lactic dehydrogenase (LDH) released was measured using colorimetric method.Mitochondrial membrane potential (MMP) was assessed by JC-1 fluorescence assay.The expression of Bid,Bim and Puma proteins was determined by Western blot.Results Compared with group C,the apoptosis rate and amount of LDH released were significantly increased,the neuronal survival rate and MMP were significantly decreased,and the expression of Bid,Bim and Puma was significantly up-regulated in group OGD/R (P＜0.05).Compared with group OGD/R,the apoptosis rate and amount of LDH released were significantly decreased,the neuronal survival rate and MMP were significantly increased,and the expression of Bid,Bim and Puma was significantly down-regulated in P and PS groups (P＜0.05).Compared with group P,the apoptosis rate and amount of LDH released were significantly increased,the neuronal survival rate and MMP were significantly decreased,and the expression of Bid,Bim and Puma was significantly up-regulated in group PS (P＜0.05).Conclusion Propofol postconditioning reduces OGD/R-induced injury to rat cortical neurons through activating p38MAPK signaling pathway and inhibiting activities of pro-apoptotic proteins Bid,Bim and Puma.

Objective To evaluate the clinical value of endoscopic palliative stents drainage in patients with unresectable carcinoma at pancreas head.Methods Endoscopic stents placement was Derformed in 197 patients with unresectable pancreas head carcinoma,from August 2003 to August 2007,and the clinieal data was studied retrospectively.Results Bile duct obstruction was present in all patients.in which 126 were accompanied with dilation of distal pancreatic duct,91 with atrophy of pancrea body and tail. Stent placement in pancreatic duct Was performed in 108 patients with a Success rate of 96.4%,and placement in bile duct was performed in all patients with a success rate of 99.0%.In 195 patients with successful stent placement,jaundice dissolved after the procedure.Of 101 patients who had abdominal pain,complete pain alleviation Was achieved in 98,partially alleviation achieved in 3. Serum amylase level increased after the operation in 24 cases,which resumed tO normal value after corresponding managements.All Datients received a lifelong follow-up at mean duration of 373.57±157.35 days,with a longest survival time of 842 days.Conclusion Endoscopic palliative stents drainage is safe and effective in patients with unresectable Dancre.atie carcer,which miight increase survival rate and improve life quality.