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.

Objective: To analyze the risk factors for peri-procedural myocardial infarction (PMI) in patients with percutaneous coronary intervention (PCI) and to study the impact of CYP2C19 genotypes on PMI. Methods: A total of 283 coronary artery disease (CAD) patients received elective PCI were enrolled, the patients were with normal level of cTnI prior PCI, without adverse reaction post PCI and cTnI levels were re-examined at 24 hours after PCI. The patients were divided into 2 groups: PMI group,n=83 and Non-PMI group,n=200. CYP2C19 genotypes were detected by DNA microarray chip method and based on its result, the patients were classiifed into 3 genotypes: Extensive metabolism type, Intermediate metabolism type and Poor metabolism type. The patients with ADP inhibition rate ≤ 20% was deifned as heightened platelet reactivity (HPR) which was measured by thrombelastograph. Baseline clinical condition was compared between 2 groups and the impact of CYP2C19 genotypes with other risk factors for PMI occurrence were studied. Results: The occurrence rate of PMI was 29.3% (83/283); the age, gender, BMI, smoking, blood levels of TG, LDL-C and uric acid, history of hypertension and diabetes were similar between 2 groups,P>0.05. Compared with Non-PMI group, PMI group had more implanted stents (2.1 ± 0.9) vs (1.5 ± 0.6) and longer total length of stents 56 (36-71) mm vs 33 (23-51) mm, bothP<0.05; lower ADP inhibition rate (36.0 ± 29.8) % vs (43.9 ± 26.4) %,P=0.02 and higher HPR occurrence rate 39.8% vs 22.0%,P=0.01. The ratios of CYP2C19 genotypes of Extensive metabolism, Intermediate metabolism and Poor metabolism were 37.5%, 45.2% and 17.3% respectively, while PMI patients in each genotype were 21.7%, 29.7% and 44.9% respectively. Logistic regression analysis indicated that HPR (OR=2.18, 95% CI 1.19-4.01,P=0.02), total length of stents (OR=1.03, 95% CI 1.00-1.06,P=0.007) and CYP2C19 Poor metabolism genotype (OR=2.8, 95% CI 1.24-6.28,P=0.01) were the risk factors for PMI occurrence. Conclusion: HPR, total length of stents and CYP2C19 poor metabolism genotype were the risk factors of PMI occurrence, while poor metabolism genotype might be the most important endogenous reason for PMI occurrence.

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.

Objective To classify all the plant pollen allergens, each allergen sequence available was compared with protein family database. After that, the appearance and taxonomic distribution of each protein family could be known. When made reference to evolutionary analysis, a regular rule of the distribu-tion of all plant pollen allergens could be concluded. Methods Protein family memberships of each allergen were assigned by comparing the sequences with the Pfam database. Representative members of the most a-bundant pollen allergen families were compared with the Uniprot database using the BLAST server. Acces-sion number of all the interesting homologous could be obtained and all the sequence information could be ac-quired by Batch Entrez. Finally, the evolutionary trees were drawn with the help of MEGA4.0 software. Re-sults One hundred and sixty-eight pollen allergens were classified into 26 protein families. Profilins, pollen _allerg_1 and EF hands constituted the most abundant pollen allergen families. Profilins and EF hands oc-curred in almost all allergenic plant families, whereas allergenic Expansins, FAD_binding proteins, Amb_V allergens and Thaumatins were confined to single taxon. Conclusion It is concluded that the highly con-served sequences of allergens families such as Profilin may be one of the most important reasons of the cross reactivities in allergic diseases. The classification of pollen allergens may be helpful to clinical practice and basic research.

Objevtive To evaluate the efficacy and safety of intensive pulse light (IPL) on treating the telangiectasis and dermal atrophy due to corticosteroid-dependent dermatitis.Methods We applied the IPL on 13 patients who had telangiectasis and dermal atrophy caused by corticosteroid-dependent dermatitis every three to four weeks.The treatment lasted three to eight times.The patients's skin types were Fitzpatrick Ⅲ-V and they had had corticosteroid therapy from 15 months to 13 years.Results To telangiectasis,3 patients had excellent effect afterwards;7 patients achieved fair good effect;Another patients also achieved improvement;2 cases had no positive effect;The total effective rate reached 76.92%.10 patients of dermal atrophy among the total 13 had improvement of the thickness of dermis.Conclusion Intensive pulse light can improve the telangiectasis and dermal atrophy of corticosteroid-dependent dermatitis.It needs less recovery time with fewer side effects and therefore IPL is an effective method for the Iesions.

Objective　To evaluate the effects of cold provocation on optic dise blood flow and retinal light sensitivity of primary open-angle glaucoma (POAG) patients,and explore the relationship between the changes of optic disc blood flow and retinal light sensitivity.　Methods　A total 33 POAG patients　(33　eyes) and 13 normal controls　(13　eyes)　were tested by using the Heidelberg retinal flowmetry (HRF) and Topcon automatic perimeter,and the optic disc blood flow and retinal light sensitivity of POAG patients and normal controls were measured at normal conditions and after cold provocation.　Results　The mean optic disc blood flow,volume and the mean retinal light sensitivity of POAG patients decreased significantly (P＜0.05)　after cold provocation.There was a linear and significant relationship between the decrease of mean optic disc blood flow and mean retinal light sensitivity of POAG patients (r=0.615,P＜0.001).The optic disc blood flow of POAG patients with a history of migraine were more likely to reduce in response to cold provocation and reduced much more than those without such history (P＜0.05).　Conclusion　Cold provocation can significantly reduce both the optic disc blood flow and retinal light sensitivity in POAG patients.A close correlation was found between the amount of mean optic disc blood flow decrease and the volume of mean retinal light sensitivity decline.

Objective To probe into the related factors and nursing of nosocomial infection for infectious diseases ward. Methods 2198 cases of patients in infectious diseases ward of our hospital were selected from February 2008 to December 2009, prospective monitoring and retrospective analysis were simultaneously adopted. Results In cases of nosocomial infection, mainly respiratory tract was the infection site, where the upper respiratory tract infection rate was 30.52%, lower respiratory tract infection rate was 28.57%, higher than other parts, there were significant differences. At the same time, nosocomial infection due to indwelling catheter and the irrational use of antibiotics led to higher rates of infection, 19.23%and 17.69%, there were significant differences. In addition, we could see from the age of nosocomial infection, ≤ 3-year-old children and elderly patients ≥ 60 years old had higher infection rate, 9.43% and 9.71%, there were significant differences. Conclusions According to elements features of infectious disease outbreak in hospital ward, to take effective care and prevention measures to reduce the infectious diseases room of the hospital infection will be of great clinical significance.