There is continuous debate regarding the effectiveness of thymectomy in the treatment of non-thymomatous myasthenia gravis(MG). This systematic review was undertaken to determine whether thymectomy was effective in non-thymomatous MG. We retrieved articles published between January 1980 and September 2013. Sixteen cohort studies were included. Given the considerable heterogeneity, we used a descriptive method instead of statistical synthesis. The median relative rates(RRs) and their interquartile ranges were used to estimate the magnitude of benefit. Compared to conservatively treated MG patients, thymectomized patients had higher survival, clinical remission, pharmacologic remission and improvement rates, and RRs were 1.07(1.01–1.17), 1.83(0.82–2.99), 1.55(1.22–1.95) and 1(1.00–1.09), respectively. Subgroup analyses showed that patients with moderate to severe generalized MG benefited more from thymectomy, with RRs of survival and pharmacologic remission increasing to 1.35(1.24–1.49) and 2.68(1.73–4.17), respectively. These results suggested that thymectomy might be an effective procedure in non-thymomatous MG patients. The patients with moderate to severe generalized MG might benefit more. Taking into account the poor methodological quality of present studies, more well-designed prospective randomized controlled trials(RCTs) are still required to reach unequivocal conclusion.
Adult-born neurons undergo a transient period of plasticity during their integration into the neural circuit.This transient plasticity may involve NMDA receptors containing NR2B,the major subunit expressed at early developmental stages.The main objective of the present study was to investigate the effects of NR2B gene knockdown on the functional integration of the adult-born granule cells generated from the subgranule zone (SGZ) in the hippocampus.The small interfering RNA (siRNA) was used to knock down the NR2B gene in the adult-born hippocampal neurons.In the functional integration test,the mice were exposed to a novel environment (open field arena),and the expression of c-fos was immunohistochemically detected in the hippocampus.After exposure to the novel environment,siRNA-NR2B mice were significantly different from control mice in either the number of squares or the number of rears they crossed,showing decreased horizontal and vertical activity (P<0.05).Moreover,the c-fos expression was increased in both control and siRNA-NR2B mice after open field test.But,it was significantly lower in siRNA-NR2B neurons than in control neurons.It was concluded that the neural activity of newborn neurons is regulated by their own NR2B-containing NMDA glutamate receptors during a short,critical period after neuronal birth.
