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.

With the development of society, eating disorders(EDs) have attracted people's attention because of their chronicity, high fatality rate and heavy social burden. However, the current treatment mainly includes psychotherapy and drug therapy, but the therapeutic effect is not satisfactory. Studies suggest that patients with EDs have brain abnormalities related to the prefrontal cortex. In recent years, the neuromodulation therapies, especially the non-invasive neuromodulation therapies, have become a research hotspot because of their few side effects and easy to use. At present, they have been used in mental disorders such as depression, obsessive-compulsive disorder, substance addiction and so on. A small number of studies on EDs have also been carried out. This paper reviews the related studies on anorexia nervosa and bulimia nervosa, and introduces the working principles of deep brain stimulation, transcranial magnetic stimulation and direct current stimulation and their efficacy in the treatment of EDs. Previous studies have shown that neuromodulation therapies are effective in the treatment of EDs. However, the existing research results are not exactly same, and the best parameters need to be clarified. In the future study, it is necessary to integrate cognitive, neuroimaging and biomarker data to identify different endophenotypes in EDs, so as to help clarify the disease mechanism, help patients with EDs to formulate individual treatment plans, improve clinical symptoms, and put forward suggestions and prospects for future research and application.

Objective:To investigate the clinical characteristics and genetic mechanism of a patient with gout and hyperlipidemia.Methods:Clinical data of patient and his parents were collected in details, including their medical histories, physical examination results, and laboratory tests. DNA was extracted from the peripheral blood of the patient and their parents for whole exome sequencing. Protein function was predicted for new mutations.Results:The patient was a 22-year-old male with typical clinical manifestations of hypoglycemia, hyperuricemia, gout, and hyperlipidemia. c. 260delG(p.V88Ffs*13)frameshift mutation was detected in the second exon of the patient′s glucose-6-phosphatase(G6PC) gene, and c. 532C>G(p.P178A)missense mutation was detected in the fourth exon. The father and mother of the patient were heterozygotes carrying c. 260delG(p.V88Ffs*13)and c. 532C>G(p.P178A)mutations, respectively. Protein structure prediction showed that mutations were able to cause protein structure changes. The patient was diagnosed as glycogen storage disease type Ⅰa(GSD-Ⅰa)with secondary gout.Conclusions:The compound heterozygous mutation of G6PC gene is the pathogenic basis of this gout patient. The discovery of the new pathogenic mutation c. 260delG(p.V88Ffs*13)of the G6PC gene broadened the spectrum of pathogenic genes of GSD-Ⅰa and gout in Chinese patients.

10 units allows identification of patients a high risk factors in development ARDS.The high risk fac- tors providing the greatest contribution to improve therapy in acute lung injury and prevent ARDS to occur.

For inquiring into reflection factors of a-fetoprotein(AFP)reduction af- ter treatment by transcatheter arterial chemoembolization(TACE),40 cases of primary hepatocellular cancer(HCC)were concentration investigated.The results showed that the levels of AFP conditions difficult to reduce under following conditions such as nodular type cancer,no regression of even enlargement of tumor mass,tumor metastasis,increase of serum iron-protein and disease aggrevation.After TACE the above labels showed significa- tion difference between AFP level more than 400?g/ml and less than 250ng/ml(P

Objective:To prepare Pingwei dispersible tablets and establish a method for the determination of atractylodin. Meth-ods:HPLC was performed on a Kromasil C18 column(250 mm × 4. 6 mm,5 μm)using methanol-water(75:25)as the mobile phase at a flow rate of 1 ml·min-1 . The detection wavelength was at 340nm. The column temperature was 30℃ and the injection volume was 10 μl. Results:The optimized formula of the tablets was as follows:the proportion of inner disintegrant microcrystalline cellulose,out-side disintegrant carboxymethyl cellulose sodium and HPMC was 40%,9% and 2%,respectively. The adhesive was 2% HPMC in 70% ethanol,and 1. 5% magnesium stearate was used as the lubricant. The linear range of atractylodin was 0. 100 6-0. 503 0 μg(r=0. 999 9),and the average recovery was 99. 3%(RSD=0. 9%,n=6). Conclusion:The formula and the preparation process of the tablets are reasonable and the content determination method is simple,accurate and specific,which can be used in the quality control of Pingwei dispersible tablets.

Objective: To investigate the trend in incidence of stroke in Yongkang City, Zhejiang Province from 2015 to 2022, so as to provide the evidence for improving stroke prevention and treatment strategies. Methods: The incidence of stroke in Yongkang City from 2015 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The incidence of stroke in gender-, age- and subtype-specific was analyzed, and the incidence trend of stroke was analyzed by average annual percentage change (AAPC). Results: A total of 22 408 stroke cases were reported in Yongkang City from 2015 to 2022, with crude incidence of 457.97/105 and standardized incidence of 379.55/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=6.447%, P<0.05). The crude incidence of stroke was higher among males than females (495.97/105 vs. 417.58/105, P<0.05), and the standardized incidence of stroke was higher among males than females (425.29/105 vs. 332.49/105, P<0.05). The average age of stroke cases was (70.74±12.64) years. The crude incidence of stroke appeared a tendency towards a rise with age (P<0.05), and which in residents aged 30 to 44 years showed an increasing trend (AAPC=6.142%,P<0.05). There were 18 040 cases of ischemic stroke (80.51%), 4 121 cases of hemorrhagic stroke (18.39%) and 247 cases of unclassified stroke (1.10%) reported from 2015 to 2022. The crude incidence of ischemic stroke was higher than which of hemorrhagic stroke (368.70/105 vs. 84.22/105, P<0.05). The crude incidence of ischemic stroke appeared a tendency towards a rise (AAPC=7.851%, P<0.05). Conclusions The crude incidence of stroke appeared a tendency towards a rise in Yongkang City from 2015 to 2022, with ischemic stroke as the predominant subtype. Male and the elderly should be given a high priority for stroke control.