The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated r...The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated region of展开更多
Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading...Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading to acute and chronic forms of adverse reactions (ADRs).After oral administration,TAC is predominantly absorbed in the duodenum and jejunum and has highly variable pharmacokinetics,particularly when diarrhea occurs.^([2,3]) Few data has been published on TAC overexposure following mild diarrhea.Mild diarrhea is relatively common and often unreported,which can easily be overlooked by physicians,especially in the emergency department.Here,we report the occurrence of serious ADRs to TAC after mild diarrhea in a MG patient with community-acquired pneumonia(CAP),including nephrotoxicity,metabolic abnormalities and severe immunosuppression.展开更多
重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sl...重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sleep-disordered breathing,SDB）及嗅觉、听觉、认知等非运动症状。MG自身免疫性抗体是目前临床研究的热点,MG的临床分型也倾向于与不同抗体类型有关。展开更多
Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14...Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14）, Bǎihuì （百会 GV 20）, Shàngxīng （上星 GV 23） of Governor Vessel, and its crossing points with Yinqiao and Yangqiao Meridian, such as Jīngmíng （睛明 BL 1）, shēnmài （申脉 BL 62）, Dìcāng （地仓 ST 4）, Jūliáo （巨髎 ST 3）, Chéngqì （承泣 ST 1 ）, etc. Besides, ginger-partition moxibustion was applied at Yángbái （阳白 GB 14） and Sìbái （四白 ST 2）. The plum-blossom needle was applied at upper limb distribution of lung channel of hand taiyin, heart channel of hand shaoyin and pericardium channel of hand jueyin. The patients’ clinical symptoms, potential degradation percentages of repetitive nerve stimulation （RNS） in low frequency were observed. Results 8 cases were clinically cured, 20 cases were basically cured, 12 cases were remarkably effective, 15 cases were effective and 5 cases were failed. The total effective rate was 91.7%. Compared with before the treatment, the potential degradation percentages of repetitive nerve stimulation in low frequency were lowered [（19.44±6.28）% vs （8.78±3.12）%, （P0.05）]. Conclusion Acupuncture and moxibustion at extra-meridian and collateral for ocular myasthenia gravis could achieve positive efficacy.展开更多
Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from ...Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from 1980-2004 using WHO classification （1999）, the statistical software was used to analyze the relationship among the WHO classification, MG and clinical stages. Results： （1） Two cases of type A, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type C were classified. Type B2 more likely accompanied MG （P〈0.05）, while none with MG occurred for type C. （2） One patient was in stage Ⅰ, 30 were in stage Ⅱ, 38 were in stage Ⅲ, and 5 were in stage Ⅳ. The latest histologic classification was significantly correlated with Masaoka stages （P〈0.01）. Conclusion： The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. It can also evaluate the prognosis of patients.展开更多
ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many mor...ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many more. It gets activated in response of various stimuli like growth factors, cytokines, virus, second messengers, transforming agents and carcinogens. While transferring signals from cell surface receptors to cell nucleus, ERK interacts with a numbers of proteins. Physiochemical and functional characterization of these proteins is little known. Thus, we attempted to study physiochemical and functional properties of ERK interacting proteins using bio-computational tools. ExPASy and SOSUI server suggested 22 ERK interacting proteins. Physical and chemical parameters of these ERK interacting partners indicated higher percentage of hydrophobic amino acid and leucine as major constituent. Moreover, the instability index indicated that four proteins are stable in over wide range temperature in vitro, and remaining eighteen proteins were found unstable. In addition, SOSUI server showed that fifteen proteins were soluble and six are trans-membrane in nature.展开更多
Myasthenia gravis （MG） is an autoimmune neuromuscular junction disease mediated by antibodies against the acetylcholine receptor （AChR）. The etiology and immunopathogenesis of MG remain unclear. Recent research ha...Myasthenia gravis （MG） is an autoimmune neuromuscular junction disease mediated by antibodies against the acetylcholine receptor （AChR）. The etiology and immunopathogenesis of MG remain unclear. Recent research has shown the involvement of autoantibodies, lymphocytes, cytokines and chemokines, in the pathogenesis of MG. Systematic factors are also demonstrated, such as inheritance and endocrine. This review indicates the research development in immunopathogenesis of MG.展开更多
Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage I and II thymoma us- ing the trans-sternal technique. Whether this is appropriate for minimally invasive approach is not yet...Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage I and II thymoma us- ing the trans-sternal technique. Whether this is appropriate for minimally invasive approach is not yet clear. We evalu- ated the feasibility of complete video-assisted thoracoscopic surgery （VATS） thymectomy for the treatment of Ma- saoka stage I and Ⅱ thymoma-associated myasthenia gravis, compared to conventional trans-sternal thymectomy. We summarized 33 patients with Masaoka stage I and II thymoma-associated myasthenia gravis between April 2006 and September 2011. Of these, 15 patients underwent right-sided complete VATS （the VATS group） by us- ing adjuvant pneuomomediastinum, comparing with 18 patients using the trans-sternal approach （the T3b group）. No intraoperative death was found and no VATS case required conversion to median sternotomy. Significant differences between the two groups regarding duration of surgery and volume of intraoperative blood loss （P = 0.001 and P 〈 0.001, respectively） were observed. Postoperative morbidities were 26.7% and 33.3% for the VATS and T3b groups, respectively. All 33 patients were followed up for 12 to 61 months in the study. The cumulative probabilities of reaching complete stable remission and effective rate were 26.7% （4/15） and 93.3% （14/15） in the VATS group, which had a significantly higher complete stable remission and effective rate than those in the T3b group （P = 0.026 and P = 0.000, respectively）. We conclude that VATS thymectomy utilizing adjuvant pneuomo- mediastinum for the treatment of stage I and II thymoma-associated myasthenia gravis is technically feasible but deserves further investigation in a large series with long-term follow-up.展开更多
Myasthenia gravis is an acquired,humoral immunity-mediated autoimmune disease characterized by the production of autoantibodies that impair synaptic transmission at the neuromuscular junction.The intervention-mediated...Myasthenia gravis is an acquired,humoral immunity-mediated autoimmune disease characterized by the production of autoantibodies that impair synaptic transmission at the neuromuscular junction.The intervention-mediated clearance of immunoglobulin G(IgG)was shown to be effective in controlling the progression of the disease.The neonatal Fc receptor(FcRn)plays a key role in prolonging the serum half-life of IgG.Antagonizing FcRn to prevent its binding to IgG can accelerate the catabolism of the latter,resulting in decreased levels of IgG,including pathogenic autoantibodies,thereby achieving a therapeutic effect.In this review,we detail the substantial research progress,both basic and clinical,relating to the use of FcRn inhibitors in the treatment of myasthenia gravis.展开更多
文摘The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated region of
基金supported by the Clinical Research Foundation of Zhejiang Provincial Medical Association (2020ZYC-A113)。
文摘Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading to acute and chronic forms of adverse reactions (ADRs).After oral administration,TAC is predominantly absorbed in the duodenum and jejunum and has highly variable pharmacokinetics,particularly when diarrhea occurs.^([2,3]) Few data has been published on TAC overexposure following mild diarrhea.Mild diarrhea is relatively common and often unreported,which can easily be overlooked by physicians,especially in the emergency department.Here,we report the occurrence of serious ADRs to TAC after mild diarrhea in a MG patient with community-acquired pneumonia(CAP),including nephrotoxicity,metabolic abnormalities and severe immunosuppression.
文摘重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sleep-disordered breathing,SDB）及嗅觉、听觉、认知等非运动症状。MG自身免疫性抗体是目前临床研究的热点,MG的临床分型也倾向于与不同抗体类型有关。
文摘Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14）, Bǎihuì （百会 GV 20）, Shàngxīng （上星 GV 23） of Governor Vessel, and its crossing points with Yinqiao and Yangqiao Meridian, such as Jīngmíng （睛明 BL 1）, shēnmài （申脉 BL 62）, Dìcāng （地仓 ST 4）, Jūliáo （巨髎 ST 3）, Chéngqì （承泣 ST 1 ）, etc. Besides, ginger-partition moxibustion was applied at Yángbái （阳白 GB 14） and Sìbái （四白 ST 2）. The plum-blossom needle was applied at upper limb distribution of lung channel of hand taiyin, heart channel of hand shaoyin and pericardium channel of hand jueyin. The patients’ clinical symptoms, potential degradation percentages of repetitive nerve stimulation （RNS） in low frequency were observed. Results 8 cases were clinically cured, 20 cases were basically cured, 12 cases were remarkably effective, 15 cases were effective and 5 cases were failed. The total effective rate was 91.7%. Compared with before the treatment, the potential degradation percentages of repetitive nerve stimulation in low frequency were lowered [（19.44±6.28）% vs （8.78±3.12）%, （P0.05）]. Conclusion Acupuncture and moxibustion at extra-meridian and collateral for ocular myasthenia gravis could achieve positive efficacy.
文摘Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from 1980-2004 using WHO classification （1999）, the statistical software was used to analyze the relationship among the WHO classification, MG and clinical stages. Results： （1） Two cases of type A, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type C were classified. Type B2 more likely accompanied MG （P〈0.05）, while none with MG occurred for type C. （2） One patient was in stage Ⅰ, 30 were in stage Ⅱ, 38 were in stage Ⅲ, and 5 were in stage Ⅳ. The latest histologic classification was significantly correlated with Masaoka stages （P〈0.01）. Conclusion： The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. It can also evaluate the prognosis of patients.
文摘ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many more. It gets activated in response of various stimuli like growth factors, cytokines, virus, second messengers, transforming agents and carcinogens. While transferring signals from cell surface receptors to cell nucleus, ERK interacts with a numbers of proteins. Physiochemical and functional characterization of these proteins is little known. Thus, we attempted to study physiochemical and functional properties of ERK interacting proteins using bio-computational tools. ExPASy and SOSUI server suggested 22 ERK interacting proteins. Physical and chemical parameters of these ERK interacting partners indicated higher percentage of hydrophobic amino acid and leucine as major constituent. Moreover, the instability index indicated that four proteins are stable in over wide range temperature in vitro, and remaining eighteen proteins were found unstable. In addition, SOSUI server showed that fifteen proteins were soluble and six are trans-membrane in nature.
文摘Myasthenia gravis （MG） is an autoimmune neuromuscular junction disease mediated by antibodies against the acetylcholine receptor （AChR）. The etiology and immunopathogenesis of MG remain unclear. Recent research has shown the involvement of autoantibodies, lymphocytes, cytokines and chemokines, in the pathogenesis of MG. Systematic factors are also demonstrated, such as inheritance and endocrine. This review indicates the research development in immunopathogenesis of MG.
文摘Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage I and II thymoma us- ing the trans-sternal technique. Whether this is appropriate for minimally invasive approach is not yet clear. We evalu- ated the feasibility of complete video-assisted thoracoscopic surgery （VATS） thymectomy for the treatment of Ma- saoka stage I and Ⅱ thymoma-associated myasthenia gravis, compared to conventional trans-sternal thymectomy. We summarized 33 patients with Masaoka stage I and II thymoma-associated myasthenia gravis between April 2006 and September 2011. Of these, 15 patients underwent right-sided complete VATS （the VATS group） by us- ing adjuvant pneuomomediastinum, comparing with 18 patients using the trans-sternal approach （the T3b group）. No intraoperative death was found and no VATS case required conversion to median sternotomy. Significant differences between the two groups regarding duration of surgery and volume of intraoperative blood loss （P = 0.001 and P 〈 0.001, respectively） were observed. Postoperative morbidities were 26.7% and 33.3% for the VATS and T3b groups, respectively. All 33 patients were followed up for 12 to 61 months in the study. The cumulative probabilities of reaching complete stable remission and effective rate were 26.7% （4/15） and 93.3% （14/15） in the VATS group, which had a significantly higher complete stable remission and effective rate than those in the T3b group （P = 0.026 and P = 0.000, respectively）. We conclude that VATS thymectomy utilizing adjuvant pneuomo- mediastinum for the treatment of stage I and II thymoma-associated myasthenia gravis is technically feasible but deserves further investigation in a large series with long-term follow-up.
基金supported by the National Natural Science Foundation of China,No.U1604181the Joint Project of Medical Science and Technology Research Program of Henon Province,No.LHGJ20190078+1 种基金Henan Medical Education Research Project,No.Wjlx2020531Henan Province Key R&D and Promotion Special Project(Science and Technology Tackle),No.212102310834(all to JW)。
文摘Myasthenia gravis is an acquired,humoral immunity-mediated autoimmune disease characterized by the production of autoantibodies that impair synaptic transmission at the neuromuscular junction.The intervention-mediated clearance of immunoglobulin G(IgG)was shown to be effective in controlling the progression of the disease.The neonatal Fc receptor(FcRn)plays a key role in prolonging the serum half-life of IgG.Antagonizing FcRn to prevent its binding to IgG can accelerate the catabolism of the latter,resulting in decreased levels of IgG,including pathogenic autoantibodies,thereby achieving a therapeutic effect.In this review,we detail the substantial research progress,both basic and clinical,relating to the use of FcRn inhibitors in the treatment of myasthenia gravis.
