Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome of central nervous system.The main clinical manifestations include psychiatric symptoms,movement disorders and seizures.It is often misdiagnosed as viral encephalitis.Tumors,especially the ovarian teratoma,play an important role in the disease.The prevalence in children is beyond imagination.Anti-NMDAR antibodies are specific diagnostic tests.Immune suppression is the main treatment.The first-line treatments include corticosteroids,intravenous immunoglobulin,and plasmapheresis.The second-line treatments include biological agents and cytotoxic drugs.Early diagnosis and treatment are essential for neurologic recovery.Overall prognosis is good.

Objective To investigate the effect of Tongxinluo capsule combined with metoprolol on elderly patients with coronary heart disease and angina pectoris and its influence on hemorheology and inflammatory factors.Methods 135 elderly patients with angina pectoris of coronary heart disease were selected,and they were randomly divided into treatment group (68 cases) and control group (67 cases).The treatment group was treated with Tongxinluo capsule combined with metoprolol,while the control group was treated with metoprolol.The two groups were treated for 8 weeks.The curative effect of the two groups was compared,the number and duration of angina pectoris,the changes of hemorheology and inflammatory factors before and after treatment were compared.Results The total effective rate of the treatment group (94.12％) was higher than 76.12％ of the control group (P ＜ 0.05).After treatment,the frequency and duration of angina pectoris in the treatment group were (6.03 ± 1.21) times/week and (3.02 ± 0.76) min/time,respectively,which were significantly lower than those in the control group [(9.87 ± 1.46) times/week and (4.86 ± 0.98) min/time] (t =16.649,12.201,all P ＜ 0.05).After treatment,the whole blood viscosity at high shear rate [(3.76 ± 0.41) mPa/s],whole blood viscosity in low shear [(8.13 ± 0.76) mPa/s],plasma viscosity [(1.23 ± 0.08) mPa/s],erythrocyte aggregation index [(2.06 ± 0.27)],fibrinogen [(2.46 ± 0.41) g/L] in the treatment group were lower than those in the control group[(4.53 ± 0.52) mPa/s,(9.61 ± 0.89) mPa/s,(2.09 ± 0.27) mPa/s,(2.63 ± 0.35),(3.53 ± 0.62) g/L] (t =9.562,10.396,25.170,10.604,11.844,all P ＜ 0.05).After treatment,the interleukin-6 (IL-6) [(8.49 ± 1.76) pg/mL],intercellular adhesion molecule-1 (ICAM-1)[(85.25 ± 8.92) pg/mL],C reactive protein (CRP) [(8.74 ± 1.76) mg/L] in the treatment group were lower than those in the control group[IL-6 (11.32 ± 2.10) pg/mL,ICAM-1 (103.42 ± 10.72) pg/mL,CRP (14.98 ± 2.24)mg/L] (t =8.491,10.712,18.012,all P＜0.05).Conclusion Tongxinluo capsule combined with metoprolol in the treatment of elderly patients with coronary heart disease angina pectoris has obvious curative effect,and can improve the patients'blood rheology and inflammatory reaction.

ObjectiveTo investigate the relationship between carotid atherosclerosis and progressing stroke.Methods103 patients with acute cerebral infarction within the first 24 hours from onset were tested with carotid color doppler ultrasonography during the first week from admission. Univariate and multiple logistic regression analyses were performed to examine the relationship between carotid intima media thickness (IMT), plaque structure, the degree of artery stenosis and the early deterioration of cerebral infarction.ResultsPrevalence of carotid plaque and thickness of IMT in patients with progressing stroke were higher than that in non progressing patients. In logistic regression, presence of carotid plaque was independent predictors of progressing stroke. Plaque size, extent of artery stenosis and IMT were not included in the regression model.ConclusionPlaque structure and its chemical feature may be the cause of progressing stroke.

0.05).The incidence of upper limb edema and dysfunction was 4.2%(2/48) in PALD group and 16.0%(8/50) in TALD group(P0.05).Conclusion PALD may reduce upper limb dysfunction after operation in patients with stage Ⅰ and Ⅱ breast cancer,and does not increase prognostic risk.

The pathomechanism of hip pain and hip osteoarthritis is multi-factorial.Recently,abnormal impingement between proximal femur and the acetabular rim,femoroacetabular impingement(FAI),has been recognized as a relatively common and possibly prearthritic cause of these symptoms.Accurate diagnosis of the impingement disease pattern is the basis of successful surgical care.The article summarizes the pathomechanism of three types of femoroacetabular impingement and important diagnosis criteria.In addition,this paper further explores requirements for a diagnostic pelvis radiograph and multiple-parameters in pelvic imaging concerning femoroacetabular impingement,such as acetabular retroversion alpha angle,offset,the offset ratio.It will improve the diagnostic rate of FAI and formulating a reasonable treatment plan,so that the therapeutic effect of hip joint disease is improved.

Objective To investigate the relationship of serum Th1/Th2 cytokine levels with liver function and their clinical significance in patients with alcoholic liver cirrhosis (ALC).Methods Thirty-four ALC patients,13 patients with viral liver cirrhosis (VLC),and 17 healthy controls were included in the study.Serum levels of Th1 cytokines (tumor necrosis factor (TNF)α,interferon (IFN)γ,and inter-leukin (IL)-12)and Th2 cytokines (IL-10,IL-4,IL-6,and IL-13)were measured by cytometric bead array,and their correlations with Child-Pugh classification,model of end-stage liver disease (MELD)score,and biochemical parameters of liver function were ana-lyzed.Comparison between multiple groups was made by Kruskal-Wallis H test,and comparison between two groups was made by Mann-Whitney U test.Correlation analysis was performed by Spearman rank test.Results The Th1 (TNFαand IFNγ)/Th2 (IL-10,IL-4, and IL-13)cytokine levels in ALC group were significantly lower than those in healthy control group (P<0.05),and these indices de-creased nonsignificantly as the Child-Pugh class increased.Compared with VLC patients,ALC patients had significantly increased Th1/Th2 cytokine levels except IL-4 level (P<0.05).In ALC patients,TNFα,IL-10,and IL-13 levels were positively correlated with pro-thrombin time activity (P<0.05)but negatively correlated with total bilirubin and MELD score (P<0.05);especially,the levels of IL-10,IL-13,IL-4,TNFα,and IFNγwere negatively correlated with daily alcohol consumption (P<0.05).Conclusion The expression of Th1/Th2 cytokines is significantly reduced in ALC patients and is correlated with alcohol intake and liver function damage.Monitoring se-rum Th1/Th2 cytokine levels in ALC patients is helpful for clinical treatment and prognostic evaluation.

AIM:To investigate the effects of tanshinone IIA ( Tan) on cardiac action potential in rats with a-cute cerebral ischemia (ACI).METHODS:ACI was established in rats accordingly .Animals were divided into 3 groups:sham group, ACI group, and ACI with Tan treatment group .The defect of neural function in each group was graded , elec-trocardiogram was measured , monophasic action potential was recorded , and the levels of cardiac troponin I ( cTnI ) and creatine kinase-MB ( CK-MB) were examined by commercially available kits .RESULTS:Compared with ACI group , Tan significantly decreased the scores of the defect of neural function , reduced the incidence and duration of the abnormalities in electrocardiogram , prolonged the effective refractory period , action potential duration at 50%repolarization and action po-tential duration at 90%repolarization, and inhibited the elevation of cTnI and CK-MB levels.CONCLUSION:Tan main-tains a stable heart rhythm in ACI rats , which may be related to its protective effect on ischemic myocardium .

Objective To investigate the effect of unilateral basal ganglia hemorrhage on long -term behavio-ral development of neonatal SD rats.Methods Forty -eight neonatal SD rats (1 0 days after birth)were equally divided into cerebral hemorrhage (CH)group,sham operation (SH)group and normal control (NC)group randomly, 1 6 cases for each group.Stereotaxic apparatus was used to inject autologous blood 25 μL into rats′brain caudate nu-cleus to establish basal ganglia hemorrhage model,while SH group was injected with nothing,and NC group received no treatment.Berderson scoring method was used to test rats′neurological functions on the first day,the third day,the seventh day,and the fourteenth day after operation,respectively.The open -field environment test and the Lat maze were used to assess behavior of the rats on the fourteenth day after operation,lasting for 3 days continuously.Results (1 )After being modeled rats appeared with different degrees of neurological function damage.SH group rats′neurologi-cal function damage was slight,which was completely restored in the 72 hours after surgery.CH group rats appeared hemiplegia and muscle tension change.CH rats neurological scores′on the first and third day after modeling scores were separate (3.40 ±0.83)scores and (1 .1 3 ±0.92)scores respectively,and the scores were statistically higher than SH group [(0.73 ±0.59)scores and (0.1 3 ±0.35)scores]and NC group (all P <0.05).And then Bederson score de-creased,and on the seventh and fourteenth day after modeling,the Bederson scores′difference was not statistically sig-nificant among the 3 groups(P >0.05).(2)On the fourteenth day after modeling,in open -field test and the Lat maze,the number of passed panels,straightening(times)and grooming(times)in CH group were more than those in SH group and NC group respectively (all P <0.05).The difference in the number of passed panels,straightening (times)and grooming (times)between SH group and NC group was not statistically significant (P >0.05 ). Conclusions Neonatal rats focal hemorrhage in unilateral basal ganglia is strongly repairable and compensatory,which leaves no severe neurological dysfunction.The neurological function damage which is caused by unilateral basal ganglia hemorrhage can lead to the increase of autonomic activities,the decrease of non -selective attention level,attention defi-cit and other long -term behavioral abnormalities.

ObjectiveTo investigate the outcomes of mother a nd baby smaller than 37 gestational age caused by preeclampsia. Method sThe data for 122 preterm birth that was single pregnancy with preecla mpsia in our hospital from January 1993 to December 2002 were collected. The pri nciple of diagnosis and treatment, the outcomes were analyzed retrospectively. T he 122 pregnant women were divided into 3 groups according to their gestational age, more than 28 weeks and smaller than 31 +6 weeks was the first group (28 cases), more than 32 weeks and smaller than 33 +6 weeks was the second grou p (26 cases), more than 34 weeks and smaller than 36 +6 weeks was the thir d group (68 cases). The data were statisted with SAS software.Results The earlier the pregnancy-induced hypertension happened, the earlier the preeclampsia occured, the mean time was 14 03 d, 16 85 d,22 22 d, respect ively, (P0.05), the outcomes of mothers were good. Increasing the gestational age under the cond ition that the occurrene of comptications was not increased, 60 64% pregnant wo men accepted the treatment of improving the maturity of fetal lung. There were n o differences among the three groups at the morbidity of perinatal SGA, intracra nial hemorrhage (P 0.05) .ConclusionWe could improve the outcomes of pret erm birth caused by preeclampsia by enhancing the perinatal care, treating and t erminating pregnancy activey Increasing the gestational age, improving the matur ity of fetal lung would decrease the morbidity of severe RDS and improve the pe rinatal outcome effectively.