Objective To evaluate the methods of postoperative respiratory management and complications prevention of patients with myasthenia gravis who received thymectomy. Methods According to the accumulated scores of myasthenic crisis prediction, the patients with myasthenia gravis who underwent thymectomy in the past 5 years were divided into 2 groups: high risk group(12, n=11). The time of mechanical ventilation, restoration of muscle strength and spontaneously breathing during extubation, results of arterial blood gas analysis, body temperature, chest X-ray examination and sputum culture of each patient were analyzed. Results The time of mechanical ventilation in high risk group (18~30 h, 26 h in average) was longer than that in control group(4~28 h, 14 h in average)(P

Objective To explore the effects of electro-acupuncture combined with surface gastric pacing on gastrointestinal dysfunction for patients with spinal cord injury (SCI).Methods Seventy-five SCI patients with gastrointestinal dysfunction were divided randomly into an electro-acupuncture group (group A),a gastric pacing treatment group (group B) and a group for which electro-acupuncture was combined with gastric pacing (group C).There were 25 cases in each group.Members of group A were given 30 minutes of electro-acupuncture per day ; those of group B had 30 minutes of gastric pacing treatment twice per day ; group C was provided with both 30 minutes of electro-acupuncture and one 30-minute gastric pacing treatment per day.All of the interventions lasted ten days.Before and after the treatment,all patients were assessed using a clinical symptoms score and with electrogastrograms,and any adverse effects were observed.Results There was a significant improvement in upper abdominal pain and epigastric discomfort,bloating and early satiety,nausea,vomiting,as well as belching and loss of appetite in each group after treatment.Before treatment there was no significant difference in the average clinical symptom scores of the three groups.After treatment the values had decreased,and those of group C were significantly lower than group A or B.The average scores of groups B and A were not significantly different.The electrogastrogram results showed than after treatment there was significant improvement in N％ and T％ in groups A and B,and also significant improvement in N％,B％ and T％ in group C compared to before treatment.Group C's improvements were all significantly greater than those observed in groups A and B.Conclusion Electro-acupuncture or gastric pacing alone can give some improvement in gastrointestinal function and its electrophysiological indicators,but their combined effects are better than when either is used alone.

OBJECTIVE To analyze impulsive-like behaviors of SD rats induced by pramipexole in Y-maze avoidance tasks. METHODS Behaviors of SD rats in Y-maze avoidance tasks were recorded with a camera and analyzed by Noldus Etho Vision XT8 software after acute subcutaneous injection of pramipexole(0.1,1 and 10 mg · kg-1),including right reaction numbers of 20 consecutive avoidance tasks,shuttle number of times between the three arms of Y-maze, distance covered in Y-maze and time spent in safe arms during 20 consecutive avoidance tasks. Then,the prepulse inhibition(PPI)of the startle reflex test was used to assess the effect of pramipexole on sensorimotor gating (SG). Effects of pramipexole on the dialyzed content of monoamine neurotransmitter and its metabolites in the striatum and amygdala of SD rats were measured by microdialysis in vivo. RESULTS Compared with normal control group,the rats of pramipexole group showed a significant increase in the shuttle number of times and distance covered in Y-maze between Y-maze avoidance tasks(P<0.01),but a statistically significant decrease in the time spent in safe arms(P<0.01),while the number of right reactions in Y-maze avoidance tasks was not changed. Such premature responses were quite similar to certain impulsive-compulsive behaviors in rodent models,such as five-choice serial reaction time tasks. In the PPI test,pramipexole displayed an impairing effect on SG(P<0.01). The microdialysis results showed that there was an increase of dopamine and 5-hydroxytryptamine in the striatum of pramipexole group, but not statistically significant. Monoamine neurotransmitters and their metabolites were not significantly changed in the amygdala. CONCLUSION Pramipexole can induce impulsive-compulsive behaviors in Y-maze avoidance tasks,which might be attributed to impaired SG.

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

· AlM: To study the effect of bone mesenchymal stem cells ( BMSCs ) and chondroitinaseABC ( ChABC ) on photoreceptor apoptosis in the retina of sodium iodate-induced rats.
·METHODS:Forty Sprague Dawley rats ( SD rats) were intraperitoneally injected with NalO3 (30g/L, 100mg/kg) to establish the retinal degeneration models ( postnatal 28d).These rats were devided into 4 groups.Group A was not injected, group B was injected with BMSCs, group C was injected with BMSCs and ChABC, and group D was injected with phosphate buffer saline ( PBS).After 28d, subretinal injection were applied. Hematoxyln - eosinstaining ( HE ) , tunel and immunohistochemistry were performed at 21d after subretinal injection.
· RESULTS: Photoreceptor number and photoreceptor apoptosis rate of B and C groups were more than those of A and D groups, and there was significant difference statistically ( P <0.05 ) . Photoreceptor number and photoreceptor apoptosis rate of group B were compared with those of group C, and there was no statistical significance between B and C groups ( P>0.05 ) .Glial fibrillary acidic protein ( GFAP) was expressed by BMSCs after intraocular injection.
· CONCLUSlON: BMSCs and ChABC injected into subretinal space may alleviate photoreceptor apoptosis so as to protect retinal photoreceptor cells in degenerated rats.

As a depot drug delivery system, injectable polylactide-polyglycolide (PLGA) sustained-release microspheres have been successfully used to treat many diseases since the first microsphere product Lupron depot was approved for marketing in the United States in 1989. It has the ability of long-term release in the body for several days to several months, which can not only reduce the times of administration, but also reduce the drug blood concentration fluctuations, significantly improve the safety and patient compliance. In vitro-in vivo correlation (IVIVC) makes the development of microspheres more possible. It can describe the dynamic information of drug release in vivo through the in vitro release behavior of microspheres, and can reduce the workload of each stage and shorten the time span while characterizing the performance of microspheres. IVIVC can provide guidance or support for drug development, production changes, supervision and management. This article summarizes the release mechanism of injectable PLGA sustained-release microspheres, common measurement methods and theories of in vitro and in vivo release. And we also focus on the establishment and application of IVIVC, especially A level IVIVC in the field of microsphere preparations, to provide a reference for further study on in vitro-in vivo correlation of microspheres.

Objective To evaluate the frequency and morphological characteristics of the posterolateral articular fracture in tibial plateau fractures.Methods A retrospective analysis of CT images and clinical data was taken among 309 cases of tibial plateau fractures from 2008 May to 2013 January.There are total 264 patients were recorded excluding 45 cases with which the CT image is missing or not compatible with the medical Picture Archiving and Communication Systems (PACS).To determine the occurrence rate of the posterolateral articular fracture in tibial plateau fractures and measure morphological parameters such as the axial angle of fracture line,articular surface area,sagittal fracture angle,fracture height,and amount of displacement.Results 39 cases of posterolateral articular fragments were found in 264 cases of tibial plateau fractures with the 14.8％ incidence (39/264).There were 18 males and 21 females,aged from 31-70 years (mean,52 years).17 left cases and 22 right cases.The mechanism of injury were traffic accident in 22 patients,blow by a heavy object in 2 patients,a fall in 11 patients,and other causes (unknown) in 4 patients.The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment and the major articular fragment angle was 22° (range,-43°-62°),and an average accounted for 14.1％ of the articular surface of the total tibial plateau (range,8％-32％).The posterolateral fragment exhibits a vertical fracture pattern and an average sagittal fracture angle was 76° (range,58°-97°),suggestive of shear instability and vertical displacement.Maximum posterior cortical height was 28 mm (range,18-42 mm),and average size of the displacement was 10.48 mm (range,2-19 mm).Conclusion The posterolateral plateau articular fracture fragment has morphological characteristics of a conical shape fragment,relative small articular surface area and sagittal fracture angle.

Cell Membrane ; metabolism ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Proto-Oncogene Proteins c-kit ; analysis

Objective Explore the change of IL-1β and IL-18 expression in pulmonary hypertension induced by monocrotaline.Methods Divide the mouses into two groups, control group and experimental group (n=10).Establish rats pulmonary hypertension model induced by monocrotaline.Detect the model by ultrasound, myocardial cells HE dyeing and tunnel test;ELISA was used to detect the serum biological markers NF-κB, COX2, IL-6, IL-1β, TNF-α and NO;Immunohistochemical was used to detect the expression level of IL-1β and IL-18 in the lung tissue;the protein change of NLRP3 in the lung tissue was detected by Western blot.Results Serum biological markers of NF-κB, COX2, IL-6, IL-1β, TNF-α and NO are significantly increased in PAH rats(P<0.05);The expression of IL-1β, IL-18 in the lung tissue increased obviously(P<0.05);The NLRP3 protein expression was significantly higher in experimental group.Conclusions Changes of NLRP3 effect increase expression of IL-1β and IL-18and which may play an important role in pulmonary hypertension induced by monocrotaline.

Objective To report surgical outcomes of managing comminuted fractures of the inferior patellar pole with separate vertical wiring plus anchor suture fixation.Methods From January 2010 to January 2015,37 patients with comminuted fractures of the inferior patellar pole were treated with separate vertical wiring and anchor suture fixation.They were 15 men and 22 women,from 32 to 76 years of age (average,55.1 years).The intervals from fracture to surgery ranged from 2 to 3 days (average,2.1 days).According to the AO classification,all the fractures were type 34-A1.The visual analogue scale (VAS) scores,ranges of motion (ROM) of the knee,Bostman scores and postoperative complications were recorded at 6 weeks,3,6 and 12 months and the final follow-up postoperatively.Results The follow-up time for the 37 patients averaged 16 months (range,from 12 to 23 months).The fracture union time averaged 10 weeks after surgery (range,from 8 to 13 weeks).At postoperative 6 weeks,3,6 and 12 months and the final follow-up,respectively,the average VAS scores were 2.5,1.1,0.3,0.2 and 0.2 points,the average ranges of motion 109.5°,123.7°,128.6°,129.1° and 132.5°,and the average Bostman scores 23.7,26.9,29.1,29.4 and 29.6 points.No patient reported delayed union,nonunion,loss of reduction,wire breakage,wound problem or irritation from the implant.Conclusion Separate vertical wiring combined with anchor suture fixation is a useful technique for comminuted fractures of the inferior patellar pole,for it is easy to perform,allows early functional exercise and leads to fine curative outcomes.