Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

Objective:To explore the therapeutic effect of Bupiqiangli compound on experimental myasthenia gravis with sub-clinical hypothyroidism in rats and the influence of hypothalamus-pituitary-thyroid-thymus(HPTT)axis.Methods:SPF Lewis rats were randomly divided into normal group,model group,Bupiqiangli compound low-dose,medium-dose and high-dose groups.Model rats were immunized with AchR-α subunit 97-116 peptide sequence to construct an experimental myasthenia gravis model,and then methimazole was used to prepare an experimental myasthenia gravis with subclinical hypothyroidism model.Bupiqiangli compound low-dose,medium-dose and high-dose groups were given 4.57 g/kg,7.12 g/kg and 9.49 g/kg of Bupiqiangli compound by gavage,nor-mal group and model group were given an equal volume of normal saline by gavage,once a day,for 4 weeks.After the last gavage,Lennon scores of rats in each group were recorded;HE staining was used to detect pathological changes of thymus and thyroid;ELISA was used to detect expression levels of acetylcholine receptor antibody(AchRab),thyroid stimulating hormone(TSH),thyrotropin releasing hormone(TRH),free thyroxine(FT4)and thyroxine(T4)in serum;mRNA level of TRH in hypothalamus and TSH in pituitary tissue were detected by qPCR;Western blot detected changes of protein expressions of Cleaved Caspase3,Bcl2 associated X protein(Bax)and B-cell lymphoma-2(Bcl2)in thymus.Results:Compared with normal group,model group showed obvious symp-toms of muscle weakness,Lennon score increased significantly(P<0.05),obvious pathological changes in thymus and thyroid tissues,while no significant changes in expressions of FT4 and T4 in serum(P>0.05),expressions of AchRab,TSH and TRH in serum were significantly increased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly increased(P<0.05),protein expressions of Cleaved Caspase3 and Bax in thymus were significantly decreased(P<0.05),while expression of Bcl2 protein in thymus increased significantly(P<0.05).Compared with model group,myasthenia symptoms of compound high-dose group were im-proved,Lennon score was significantly decreased(P<0.05),pathological changes of thymus and thyroid tissues were improved,ex-pressions of FT4 and T4 in serum had no significant changes(P>0.05),expressions of AchRab,TSH and TRH in serum were signifi-cantly decreased(P<0.05),expressions of TRH in hypothalamus and TSH in pituitary were significantly decreased(P<0.05),expres-sions of Cleaved Caspase3 and Bax in thymus were significantly increased(P<0.05),while expression of Bcl2 in thymus was signifi-cantly decreased(P<0.05).Conclusion:Bupiqiang compound can improve clinical symptoms of experimental myasthenia gravis with subclinical hypothyroidism in rats,and its mechanism may be related to the regulation of HPTT axis.

Objective: To discuss the surgical technique of lateral unicondylar knee replacement (UKR) for patients with lateral compartment osteoarthritis and evaluate its recent clinical efficacy. Methods: A retrospective analysis was conducted on 22 cases of lateral compartment osteoarthritis patients receiving lateral UKR at Orthopedic Department, Beijing Chao Yang Hospital, Capital Medical University from January 2016 to January 2019.There were 8 males (8 knees) and 14 females (14 knees), aged 65.7 years(range: 54 to 83 years).All patients completed preoperative imaging examination and excluded extra-articular deformity.Lateral parapelatellar approach was used for the operation and the tibial osteotomy was performed by extramedullary positioning.The residual cartilage of the external condyle was removed by pendulum saw to subchondral bone.Appropriate prosthesis were selected, and the tightness of the gap and the stability of the joints were repeatedly confirmed during the operation.The postoperative complications and the results of physical and imaging examinations were collected.The preoperative and postoperative Oxford knee Score (OKS) and knee society score (KSS) of patients were recorded and compared by paired t test. Results: All patients were followed up for 24.6 months (range: 8 to 40 months).No complications such as incision exudation, skin necrosis and deep venous thrombosis of lower limbs were found after the operation.No cases of prosthesis loosening, excessive wear of pads, dislocation and postoperative infection were found at the last follow-up.The OKS decreased from 46.5±3.1 preoperative to 22.4±3.3 postoperative(t=13.4, P=0.00) and KSS improved from 69.5±8.7 preoperative to 90.2±7.4 postoperative (t=16.9, P=0.00) . Conclusions For the treatment of lateral compartment osteoarthritis, UKR has the advantages of rapid recovery of knee function, less complications and less trauma.The short-term efficacy is satisfactory, but the long-term efficacy remains to be observed.

Objective: To evaluate clinical treatment efficacy of double-row fixation with bridging suture anchors for chronic, severe patellar tendinopathy. Methods: A retrospective study of 18 patients suffered from severe patellar tendinopathy and underwent surgical treatment during January 2009 and June 2014 at Department of Orthopedic, Beijing Chao Yang Hospital, Capital Medical University was conducted. All patients had received conservative therapy for more than 6 months(range: 6-30 months) but the effect was unsatisfactory. There were 10 males (12 knees) and 8 females (12 knees)with age of 47.2 years(range: 32-63 years). Seven cases on the left and 17 cases on the right. The surgical treatment included a midline incision at patellar tendon, complete debridement, and double-row fixation with bridging suture anchors. Visual analogue scale(VAS), Lysholm score were collected preoperatively and postoperatively, and compared by paired-t test. The postoperative complications was recorded. Results: All patients were followed up for 35.7 months (range:24-64 months) without any dropout.VAS decreased from 7.5±1.6 preoperative to 1.4±1.0 (t=4.45, P=0.00) postoperative, Lysholm score increased from 48.3±5.2 to 89.6±5.4 (t=-4.88,P=0.00).The Lysholm score was excellent in 3 cases and good in 15 cases.No patellar tendon rupture or suture fixation failure was recorded during the follow-up period. Conclusions The effect of double-row fixation with bridging suture anchors is satisfactory with few postoperative complications.It can not only improve clinical symptoms of patients, but also restore knee joint function.

Objective To evaluate clinical treatment efficacy of double?row fixation with bridging suture anchors for chronic, severe patellar tendinopathy. Methods A retrospective study of 18 patients suffered from severe patellar tendinopathy and underwent surgical treatment during January 2009 and June 2014 at Department of Orthopedic, Beijing Chao Yang Hospital, Capital Medical University was conducted.All patients had received conservative therapy for more than 6 months(range:6-30 months) but the effect was unsatisfactory. There were 10 males(12 knees) and 8 females(12 knees)with age of 47.2 years(range: 32-63 years). Seven cases on the left and 17 cases on the right. The surgical treatment included a midline incision at patellar tendon,complete debridement,and double?row fixation with bridging suture anchors. Visual analogue scale(VAS),Lysholm score were collected preoperatively and postoperatively, and compared by paired?t test. The postoperative complications was recorded. Results All patients were followed up for 35.7 months (range:24-64 months) without any dropout.VAS decreased from 7.5± 1.6 preoperative to 1.4±1.0(t=4.45,P=0.00) postoperative, Lysholm score increased from 48.3±5.2 to 89.6± 5.4 (t=-4.88,P=0.00).The Lysholm score was excellent in 3 cases and good in 15 cases.No patellar tendon rupture or suture fixation failure was recorded during the follow?up period. Conclusions The effect of double?row fixation with bridging suture anchors is satisfactory with few postoperative complications.It can not only improve clinical symptoms of patients,but also restore knee joint function.

Objective To evaluate clinical treatment efficacy of double?row fixation with bridging suture anchors for chronic, severe patellar tendinopathy. Methods A retrospective study of 18 patients suffered from severe patellar tendinopathy and underwent surgical treatment during January 2009 and June 2014 at Department of Orthopedic, Beijing Chao Yang Hospital, Capital Medical University was conducted.All patients had received conservative therapy for more than 6 months(range:6-30 months) but the effect was unsatisfactory. There were 10 males(12 knees) and 8 females(12 knees)with age of 47.2 years(range: 32-63 years). Seven cases on the left and 17 cases on the right. The surgical treatment included a midline incision at patellar tendon,complete debridement,and double?row fixation with bridging suture anchors. Visual analogue scale(VAS),Lysholm score were collected preoperatively and postoperatively, and compared by paired?t test. The postoperative complications was recorded. Results All patients were followed up for 35.7 months (range:24-64 months) without any dropout.VAS decreased from 7.5± 1.6 preoperative to 1.4±1.0(t=4.45,P=0.00) postoperative, Lysholm score increased from 48.3±5.2 to 89.6± 5.4 (t=-4.88,P=0.00).The Lysholm score was excellent in 3 cases and good in 15 cases.No patellar tendon rupture or suture fixation failure was recorded during the follow?up period. Conclusions The effect of double?row fixation with bridging suture anchors is satisfactory with few postoperative complications.It can not only improve clinical symptoms of patients,but also restore knee joint function.

Ackerman's pattern analysis is an epoch-making leap in the diagnosis of dermatopathology,which embodies a profound understanding of the whole dermatovenereology.To improve the teaching quality of Dermatovenereology for five year clinical medical students,pattern analysis is introduced into course educational practice,and the diseases that scattered throughout the whole textbook and listed in various chapters or sections are reclassified according to its pathological features.Thus the organic connection of related knowledge points and the lateral contrast network between different diseases is constructed by the central tache of dermatopathology,and therefore makes the course more logical and be more beneficial for the undergraduate students to learn and to remember.By the way,the thinking method of pattern analysis will also be an implicit teaching content and imperceptibly instilled to the undergraduate students,and inspired potential and motivation and aroused learning interest,expanded thought train ability to pursue advanced and further studies.

Objective To explore clinical effect of compound danshen dropping pills,aspirin enteric-coated tablets combined with small dose of estrogen on treatment of patients with thin endometrium.Methods A total of 69 patients with thin endometrium were collected and divided into 3 groups.Group Ⅰ was treated with estrogen at 3 to 5 days after menstrual period,group Ⅱ was treated with aspirin and compound danshen dropping pills,and group Ⅲ was treated with estrogen,aspirin and compound danshen dropping pills.General condition,ovulation,drug use,endometrial growth before and after the use of drugs and pregnancy rate were compared.Results There were no significant differences in general situations and ovulation results before treatment among three groups (P ＞0.05).After medication,the endometrial thickness of the 3 groups improved significantly,and the endometrial thickness of group Ⅲ was significantly better than group Ⅰ and Ⅱ (P =0.005,0.012).In group Ⅰ,Ⅱ and Ⅲ,the proportion of endometrium more than 7 mm after treatment was 38.1％,16.7％ and 60％ respectively,and the success rate of group Ⅲwas significantly higher than that of group Ⅰ and Ⅱ (P =0.008).The clinical pregnancy rate in group Ⅲ was significantly higher than that in group Ⅰ and Ⅱ (P =0.049).Conclusion Compound danshen dropping pills,aspirin entericcoated metformin combined with small dose of estrogen can significantly improve endometrium and pregnancy rate in patients with thin endometrium,with less estrogen dosage.

Objective To explore clinical effect of compound danshen dropping pills,aspirin enteric-coated tablets combined with small dose of estrogen on treatment of patients with thin endometrium.Methods A total of 69 patients with thin endometrium were collected and divided into 3 groups.Group Ⅰ was treated with estrogen at 3 to 5 days after menstrual period,group Ⅱ was treated with aspirin and compound danshen dropping pills,and group Ⅲ was treated with estrogen,aspirin and compound danshen dropping pills.General condition,ovulation,drug use,endometrial growth before and after the use of drugs and pregnancy rate were compared.Results There were no significant differences in general situations and ovulation results before treatment among three groups (P ＞0.05).After medication,the endometrial thickness of the 3 groups improved significantly,and the endometrial thickness of group Ⅲ was significantly better than group Ⅰ and Ⅱ (P =0.005,0.012).In group Ⅰ,Ⅱ and Ⅲ,the proportion of endometrium more than 7 mm after treatment was 38.1％,16.7％ and 60％ respectively,and the success rate of group Ⅲwas significantly higher than that of group Ⅰ and Ⅱ (P =0.008).The clinical pregnancy rate in group Ⅲ was significantly higher than that in group Ⅰ and Ⅱ (P =0.049).Conclusion Compound danshen dropping pills,aspirin entericcoated metformin combined with small dose of estrogen can significantly improve endometrium and pregnancy rate in patients with thin endometrium,with less estrogen dosage.