Objective To analyze the improvement of clinical symptoms,relapse and neurological functional recovery and the prognostic factors of anti-N-methyl-D-aspatate receptor (NMDAR) encephalitis.Methods Follow-up was conducted for 51 hospitalized patients with anti-NMDAR encephalitis at the Department of Neurology,Xuanwu Hospital,Capital Medical University from June 2012 to April 2015.The neurological functional recovery was evaluated through modified Ranking Scale (mRS),and the prognostic factors were analyzed.Results Among the 51 patients with anti-NMDAR encephalitis,89％ (45/51) were completely recovered or remained mild neurological dysfunction (mRS score ≤ 2).The prognosis of main clinical symptoms was as follows:78％ (35/44) of the mental and behavior disorders were fully recovered,94％ (32/34) of the seizures were controlled and 65％ (21/31) of the cognitive deficiency were completely recovered;25％ (13/51) of the patients relapsed.Comparison of clinical data of initial on-set among complete recovery patients group (mRS score =0),partial recovery patients group (mRS score =1 or 2) and poor prognosis patients group (mRS score ≥ 3) showed that initial clinical manifestation with memory deficiency (17,9,6 cases respectively;x2 =6.664,P=0.036),involuntary movements(19,4,5 cases respectively;x2 =7.976,P =0.019) and central hypoventilation (5,0,2 cases respectively;x2 =6.124,P =0.047) had statistically significant difference.Conclusions The majority of anti-NMDAR patients have favorable prognosis,but some of the patients may remain various degrees of neurological deficiency,including mental and behavior disorders,cognitive deficiency and seizures.Initial clinical manifestation with memory deficiency,involuntary movements and central hypoventilation may indicate a poorer prognosis.

Objective To investigate the expression of spleen tyrosine kinase (Syk) in endometrial cancer ( EC ) and its relationship with the clinic and pathological factors , as well as the diagnostic value for EC . Methods Through real-time PCR and immunohistochemistry, the expression level of Sky mRNA and protein in normal endometrial tissues, atypical hyperplasia of endometrial tissues and endometrial cancer tissues were examined. Results The expression of Syk in EC were lower than that in endometrial atypical hyperplasia and normal endometrium (P < 0.05). The expression of Syk was related to histological grade, invasive depth, lymphatic metastasis and clinical stages (P<0.05). Conclusion Syk contributes to tumorigenesis and metastasis of EC. The detection of Syk can provide evidence to evaluate the malignancy grade of EC.

Objective To analyze the clinical characteristics of leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis.Methods Fourteen patients diagnosed as leucine-rich gliomainactivated protein 1 antibody-associated encephalitis in Capital Medical University Xuanwu Hospital from January 2012 to January 2015 were recruited.The clinical manifestation,brain magnetic resonance imaging,cerebrospinal fluid findings and biochemical examination of these patients were analyzed.Results The case series of 14 patients had an average age of (48.93 ± 15.60) years (range 27-67 years) with a male to female ratio of 2.5∶ 1.All patients presented with short-term memory loss.Nine patients experienced dementia.Additionally,among the 14 patients,12 experienced seizures,8 experienced faciobrachial dystonic seizures,10 had psychiatric symptoms,and 8 showed sleep dysfunction.Two patients were transferred into intensive care unit because of deteriorating symptoms and were provided operated mechanical ventilation.Thirteen of 14 patients exhibited abnormalities in their brain magnetic resonance imaging,with lesions in temporal lobe and hippocampus.Six patients had abnormal cerebrospinal fluid findings,8 patients showed hyponatremia (serum Na+ ＜ 135 mmol/L),while 5 patients co-existed with other autoantibodies.Screening for malignant tumors revealed normal findings.During 2 years follow-up,3 patients relapsed.Conclusions Leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis is an autoimmune encephalitis characterized by short-term memory loss,faciobrachial dystonic seizures and hyponatremia.Lesions in brain MRI always involve in temporal lobe and hippocampus.This disease can relapse and is seldom associated with tumor.

Tumor metastasis, the main characteristic of malignance tumor, is the primary cause of death for most cancer patients.The initiation of tumor metastasis involves complex signaling pathway within tumor cell and microenvironment, mediating primary tumor metastasis, invasion, survival and arrest in the blood circulation, and progressive growth at the distant site.The most research on the mechanism of tumor metastais will help understand the metastasis process, and identify promising molecular targets for cancer clinical diagnosis and treatment.

Objective To investigate the effects of comprehensive pelvic floor rehabilitation program on pelvic floor muscle strength, female sexual function index (FSFI) score and sexual satisfaction scale for women (SSS-W) score in patients with perimenopausal female sexual dysfunction. Methods The clinical data of 120 patients with perimenopausal female sexual dysfunction were retrospectively analyzed, and all the patients were treated with estrogen and progesterone replacement therapy. Among the patients, 80 patients were treated with Kegel training program (control group), and 80 patients were treated with Kegel training program combined with comprehensive pelvic floor rehabilitation program (treatment group). The pelvic floor muscle strength, FSFI score, SSS-W score, incidence of algopareunia and sexual life frequency were compared between 2 groups. Results The pelvic floor muscle strength after treatment in treatment group was significantly better than that in control group. The Ⅲ,ⅣandⅤgrade of pelvic floor muscle strength in treatment group was in 5, 42 and 33 cases, and that in control group was in 21, 47 and 12 cases, and there was statistical difference (P<0.05). The FSFI scores and SSS-W scores after treatment in treatment group were significantly higher than those in control group:(32.24 ± 3.70) scores vs. (28.51 ± 2.95) scores and (139.80 ± 16.17) scores vs. (122.33 ± 13.75) scores, and there were statistical differences (P<0.05). The incidence of algopareunia after treatment in treatment group was significantly lower than that in control group:10.00%(8/80) vs. 55.00%(44/80), and there was statistical difference (P<0.05). The sexual life frequency after treatment in treatment group was significantly better than that in control group, the 0, 1, 2 and≥3 times/month of sexual life frequency in treatment group was in 0, 8, 20 and 52 cases, and that in control group was in 5, 34, 24 and 17 cases, and there was statistical difference (P<0.05). Conclusions Comprehensive pelvic floor rehabilitation program in patients with perimenopausal female sexual dysfunction can efficiently promote the recovery process of pelvic floor muscle strength, improve FSFI score and SSS-W score, and increase the degree of sexual satisfaction.

Objective Three-dimensional(3D) automated ultrasonic volume measurement is becoming favorable in clinical application and turns to be an important direction .The article was to evaluate the consistency of two-dimensional (2D) and three-di-mensional ultrasonography in the diameter measurement of single follicle . Methods 438 single folliculars were respectively meas-ured by the same sonographer in 2D and 3D ultrasonic measurement.2D diameter, 3D mean diameter and 3D virtual ball diameter of every single follicle were recorded , and Bland-Altman method were used to evaluate the consistency of the results by these two meth-ods. Results In the consistency analysis on the diameter measurement of single follicle by 2D and 3D mean diameter measurment methods, d equaled -1.06 mm, and 95% LoA range covered the range of -4.82 mm to 2.70 mm.95% CI of 95% LoA range,-5.21 mm to 3.08 mm, was beyond the settings of clinical acceptable error limit range , -3.56 mm to 1.44 mm, showing poor consis-tency.Likewise, in the research of the consistency in the measurement of 2D diameter and 3D virtual ball diameter in the diameter measurement of single follicle , d equaled -0.07 mm , and 95%LoA range covered the range of -3.11 mm to 2.98 mm.95%CI of 95%LoA range, -3.43 mm to 3.29 mm, was beyond the settings of clinical acceptable error limit range , -2.57 mm to 2.43 mm, showing poor consistency . Conclusion 2D and 3D ultrasound measurements in the diameter measurement of single follicle are not consistent.However, considering the objectivity and accuracy of the results , 3D ultrasonography still has an advantage over 2D ultra-sonography , which can provide more acurate aid for assisted reproductive technology .

Objective To analyze the clinical manifestations and the features of brain MRI and cerebrospinal fluid (CSF) findings in adult Chinese patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods We reviewed the clinical manifestations,brain MRI and CSF examinations of 29 patients who were diagnosed as anti-NMDAR encephalitis.Results The major clinical features of anti-NMDAR encephalitis patients included psychiatric symptoms (86％,25/29),seizures (83％,24/29),decreased consciousness (55％,16/29),involuntary movements (55％,16/29),central hypoventilation (34％,10/29),and hypersalivation (17％,5/29).Some patients also experienced autonomic instability,hemiplegia and aphasia.Underlying ovarian teratoma was identified in 14％ of affected patients(4/29).Brain MRI was found abnormal in up to 62％ patients (18/29),located in the temporal lobes,hippocampus,thalamus,brain stem,cingulate gyrus,frontal and parietal cortex,corpus callosum,internal capsule,basal ganglia and periventricular area.CSF findings were abnormal in 83％ of patients with anti-NMDAR encephalitis.Oligoclonal banding in CSF was positive in 95％ patients (19/20).The recurrence rate during 3 years was 31％ (9/29).Conclusions Anti-NMDAR encephalitis is a treatable disease,yet with high recurrence rate.Its predominant clinical features are psychiatric symptoms and seizures,while involuntary movements,central hypoventilation and hypersalivation are its characteristic manifestations.Lesions in MRI are widespread,not only restricted to limbic lobe.

Objective To evaluate the application value of non-invasive hemodynamic monitoring by thoracic electrical bioimpedance (TEB) in elderly non-cardiac surgery patients after general anaesthesia.Methods Fifty-six elderly non-cardiac surgery patients after general anaesthesia were divided into control group and TEB group with 28 patients in each group by random digits table. All patients received standardized care including central venous pressure (VAP). Besides these monitoring, hemodynamic monitoring by TEB was used to evaluate the hemodynamic state of patients in TEB group. Diuretics, inotropic agents, vasoactive drugs or intravenous fluid therapy were used according to monitoring guidance. The heart rate (HR), mean arterial pressure (MAP), VAP, urine output (UO) were recorded in different time. The length of mechanical ventilation and ICU stay were also recorded. The difference in HR, MAP, VAP, UO, the length of mechanical ventilation and ICU stay between two groups were analyzed. Results The differences between two groups had no significance in HR, MAP, VAP, UO at the same time (P ＞ 0.05 ). The length of mechanical ventilation of TEB group [ (19.5±15.9)h] was shorter as compared to that of control group [ (25.5 ± 16.5) h ], but the difference was not significant (P =0.173). The ICU stay of TEB group [(2.8 ± 1.0) d ] was shorter as compared to that of control group[(3.6±1.6)d] and the difference was significant (P=0.032). Conclusion Non-invasive hemodynamic monitoring by TEB can monitor the changes of hemodynamics and direct treatment in elderly non-cardiac surgery patients after general anaesthesia.

The pancreatic tissues from patients with islet cell hyperplasia,insulinoma,and pancreatic adenocarcinoma,as well as normal pancreatic tissues were embedded with paraffin,serial sections were cut and mounted on glass slides.Immunohistochemical staining was carried out with N-myc down-stream regulated gene 2 (Ndrg2) monoclonal antibody by means of ABC method,and Western blotting was carried out to detect the expression and distribution of Ndrg2.The results showed that Ndrg2 positive immunoreactivity was mainly localized in the cytoplasm of islet cell,being similar to the localization of insulin positive immunoreactivity.The number and volume of pancreatic islets were increased in the patients with islet cell hyperplasia,and Ndrg2 expression was also increased.Western blotting results showed that the expression of Ndrg2 in the pancreas of patients with islet cell hyperplasia was increased compared with normal group.The above results suggest that Ndrg2 may play an important role in performing physiological function of islet cells.

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.