Anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis is a common autoimmune encephalitis.It is recognized gradually in neurological field in recent years.This disease has relatively consistent clinical manifestations.There is a specific anti-NMDAR antibody in cerebrospinal fluid,and a good response to immune therapy.Anti-NMDAR encephalitis is closely associated with viral encephalitis.It is often misdiagnosed as viral encephalitis before it is well understood.Recently,a number of studies have found that virus infection is an important inducing factor of anti-NMDAR encephalitis.The recurrence of the viral encephalitis,especially herpes simplex virus encephalitis,is partially caused by immunological reaction of the central nervous system secondary to virus infection,and the immunological therapy is necessary.The recognition of anti-NMDAR encephalitis and its relationship with viral encephalitis,is very important for the proper treatment and improving the outcome of the patients.

Objective To detect human papilloma virus (HPV) and to determine its genotype in children with condyloma acuminatum (CA) in Weifang city,Shandong province.Methods Swab specimens were collected from the surface of lesions of 24 children with CA.PCR/flow-through hybridization assay was performed to detect HPV and determine its genotypes in these specimens.Results Among the 24 specimens,95.8％ (23/24) were positive for HPV.Of the HPV-positive specimens,87.0％ (20/23) harbored single type of HPV,and 13.0％ (3/23) multiple types of HPV.The most common genotype was HPV6(9/23),followed by HPV16 (6/23),HPV11 (5/23),HPV58 (3/23),HPV18 (2/23),and HPV53 (1/23).Conclusions HPV 6,16,11,58 and 18 prevail in children patients with CA in Weifang city,Shandong province.Additionally,the HPV genotypes in children patients are similar to those in their close contacts.

Organic anion transporting polypeptides (OATP), a member of solute carrier (SLC) superfamily, is considered as an important transmembrane uptake transporters. OATP is involved in the transport of a variety of endo- and xenobiotics (bile acids, bilirubin, prostaglandin, thyroid hormones, steroid hormone conjugates), drugs and toxins in a Na+ and ATP independent manner. Multiple factors (eg. hormones, proinflammatory cytokines, drugs) can affect the distribution, expression and activity of OATPs, leading to an altered accumulation of OATP substrates and related food-drug and drug-drug interactions. Changes in the distribution and expression of OATPs in malignant tissues may be related to the pathological process of cancer, while the modulation epigenetic mechanism also contributes to its distribution patterns. This review describes the factors that can affect the expression or function of OATPs, which may provide a valuable reference for drug development and the clarification of pathogenesis.

SUMMARY To demonstrate the clinical manifestation, diagnosis and treatment of myoclonus epilepsy with ragged-red-fibers ( MERRF) , a case of MERRF was presented with review of the literature. A 4-year-7-month-old girl was diagnosed with MERRF. She had tremor, fatigue and developmental delay for more than 2 years. Laboratory tests showed that the serum and urine lactic acid and pyruvic acid increased significantly. Electroencephalogram showed diffuse and focal spike slow wave and slow wave in right central and parietal regions. Electromyogram showed neurological damage. Gene mutational analysis showed mtDNA 8344 A>G mutation. The mutational rate was 78%. Mitochondrial disease MERRF syndrome was diagnosed. Cocktails therapy with vitamins B1, B6, B12, L-carnitine, and coenzyme Q10 was administra-ted to the patient. MERRF is a rare disease. The diagnosis can be made by gene mutational analysis. Cocktail therapy may slow down the deterioration of the disease. Gene therapy is still experimental.

Objective To observe expression of autophagy-related proteins LC-3 and Beclin-1 in alveolar macrophages in the silicosis model of rats , and to investigate the molecular mechanisms of silicosis formation from cells autophagy perspective .Methods Fifty adult male SD rats were randomly divided into control and model groups , 25 rats for each group .The silicosis model was made by one-time infusion of silica dust suspension through the trachea without exposed.The rats were sacrificed on the 1st, 3rd, 7th, 14th or 28th day after the modeling .Alveolar macrophages were obtained from bronchoalveolar lavage and used for subsequent research after culture and purification .Morphological characteristics of alveolar macrophages were observed by HE staining and transmission electron microscope ;The expression of LC-3 and Beclin-1 was detected by means of immunocytochemistry and Western blotting in each group .Results Compared with the control group , alveolar macrophages of the model group had larger volume and abundant cytoplasm , the phagocytic silica dust particles were observed in some cells , and autophagosomes were detected by transmission electron microscope .The expressions of LC-3 and Beclin-1 were increased at all time points in the model group ( P<0.05 ) .Both LC-3 and Beclin-1 began to increase at the 1st day.As the extension of time the expression gradually enhanced , peaked at the 14th day(P<0.05), and decreased at the 28th day, but higher than the basal expression .Conclusion Autophagy is activated in alveolar macrophages of the silicosis model , and alveolar macrophages autophagy is involved in the pathological process of silicosis in the rat .

Objective:To explore the effect of bone marrow mesenchymal stem cell transplantation on silicosis fibrosis in different time windows in rats.Methods:BMSCs were isolated and cultured from male 3-week-old SD rats in vitro.Fifty healthy female SD rats were randomly divided into 5 groups:control group,silicosis model group,early treatment group,middle treatment group,late treatment group(n=10).The silicosis model was made by one-time infusion of silica dust suspension using the non-exposed tracheal in-tubation(50 μg/ml),and 1 d,14 d,28 d of BMSCs were given for intervention therapy (1 ×106 ml-1 ).Rats in each group were sacrificed 14 days after treatment.The BMSCs identified by flow cytometry;the morphological changes of the lung tissues were observed by HE staining;the expression of MMP-9,collagen type Ⅰ and collagen type Ⅲ were detected by immunocytochemistry and Western blot analysis.Results: BMSCs in early silicosis ( 1 d ) and the middle silicosis ( 14 d ) compared to silicosis model group can significantly alleviate the pathological process of silicosis fibrosis (P<0.05),BMSCs in late silicosis (28 d) treatment had no significant effect(P>0.05).Conclusion:Exogenous BMSCs transplantation on rat silicosis early pathological processes play a role in delaying , late treatment effect is not obvious.

Objective To explore the abnormally functional brain regions of female patients with depression by resting state functional magnetic resonance imaging (fMRI),and analyze the correlation with the severity of depressive symptoms.Methods 32 female patients diagnosed with depressive disorder and 40 matched healthy controls completed resting state fMRI scans.The whole brain's regional homogeneity (ReHo) and amplitude of low-frequency fluctuation(ALFF) were calculated,and the correlation analysis be tween ReHo and ALFF of brain regions with significant difference and the severity of depressive symptoms was conducted.Results Compared with control group,the left precuneus/left cuneus (MNI:-18,-81,45),bilateral precentral gyrus (MNI:-58,-5,35 and 57,-6,33),left inferior parietal lobule (MNI:-42,-36,45) and right inferior temporal gyrus(MN1:60,-45,-18) (P＜0.05,corrected by AlphaSim)in the case group showed significantly decreased ReHo,with statistical significance.Compared with control group,the left cuneus(MNI:-3,-87,30),right inferior temporal gyrus(MNI:60,-48,-18) and left precentral gyrus(MNI:-63,-3,26) (P＜0.05,corrected by AlphasSim)in the case group showed significantly decreased ALFF.The ReHo in the right inferior temporal gyrus was negative correlated with the HAMD-17 total score and retarda tion factor(r=-0.484,P=0.017;r=-0.408,P=0.048),the ALFF in the right inferior temporal gyrus was positively correlated with weight factor(r=0.574,P=0.003),and negative correlated with the number of depressive episodes(r=-0.416,P=0.043).Conclusion Female with depression in resting state have several abnormally functional brain regions and the extent of damage is correlated with the severity of depressive symptoms.Combination of the two parameters may yield a more comprehensive pathophy-siological mechanism for depressive disorder.

This study was aimed to investigate the chemical constituents from the leaves of Vitex negundovar. cannabifolia. Column chromatography including silica gel, Sephadex LH-20, ODS, and semi-preparative HPLC were used to separate and purify the chemical constituents, and the structures were elucidated on the basis of physicochemical properties, MS and NMR spectroscopic data. As a result, 11 compounds were isolated from the ethyl acetate extract of V. negundo var. cannabifolia, and identified as apigenin (1), penduletin (2), chrysosplenol-D (3), quercetin (4), 1,4-dihydroxy-3R,5R-dicaffeoyloxy cyclohexane carboxylic acid (5), maeranthoin F (6), capsidiol (7), caryolandiol (8), β-sitosterol (9), p-hydroxybenzonic acid (10), and β-daucosterin (11). It was concluded that compounds 5 8were firstly isolated from the plants of Vitex genus, and compounds 1 and 4 were isolated from V. negundovar. cannabifolia for the first time.

Objective To investigate the feasibility and safety of surgical device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary.Methods A total of 45 patients diagnosed as doubly committed sub-arterial ventricular septal defect (dcVSD) with transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) were enrolled from June 2014 to August 2016 in Henan Children Heart Center,Henan Provincial People's Hospital.There were 39 males and 6 females,with the mean age of (2.2 ±2.1) years old(0.5-8.0 years),the body weight (13.8 ± 7.1) kg(7.0-34.1 kg),the defect size (4.5 ± 1.0) mm (3.0-8.0 mm).After general anesthesia,the patients were in supine and evaluated by TEE which indicated whether they were fit to closure.Then,they were turned to the right lateral position while this technique was determined.A vertical incision of 2-3 cm was made between the third and the fifth intercostal space and invasion in thoracic space via fourth intercostal space.Puncture was done at the anterior surface of right ventricular outlet tract to build a delivery tract.The occluder was released and the VSD was occluded under transesophageal echocardiography guidance.Results Forty-one patients had a successful surgical dcVSD closure with asymmetric occluders sized (6.0 ± 1.5) mm(4-10 mm).Among 4 failure cases,2 cases (4.4％) were switched to open-heart surgical repair,1 case (2.2％) due to device related aortic regurgitation,the rest 1 case (2.2％) experienced a dislocation of occluder into pulmonary artery and was converted to surgical repair after retrieve of occluder.Trivial residual shunt was detected in 2 cases (4.4％) postoperatively,a spontaneous closure was observed by 1 month follow-up and 3 months follow-ups,respectively.All the patients were discharged 5 to 8 days after the operation.With a follow-up of (10.4 ±5.0) months [3-24 months],there were no complications such as pericardial effusion,displacement of device,atrioventricular block or new valvular dysfunction.Conclusions Minimally invasive device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary is a feasible and safe treatment for closure of dcVSD.This technique has advantages of minor wound,less exudation,covert incision,however,long term follow-up is necessary.

Objective To systematically review the effects of different delivery routes of oxytocin in preventing hemorrhage after cesarean section.Methods Databases including PubMed,Medline,Embase,Cochrane library,Wanfang Medical Database,China National Knowledge Internet (CNKI),VIP Database for Chinese Technical Periodicals were searched by computers and Conference papers were manually searched.The randomized,controlled clinical trials of oxytocin given by intramuscular injection,intravenous injection or intravenous infusion were included in elective cesarean section under spinal anesthesia.The quality of included literatures was evaluated by Cochrane systematic evaluation.The primary outcome measure was intraoperative amount of blood loss or change in Hb before and after operation.The secondary outcome measures were changes in blood pressure and heart rate,electrocardiogram,uterine contraction and other adverse reactions after using oxytocin.Results Seven studies involving 2 325 patients were included in this meta-analysis.Among the 2 325 patients,oxytocin was given through intramuscular injection in 79 cases,by intravenous injection in 1 147 cases and in the way of intravenous infusion in 1 099 cases.Compared with intramuscular injection group or intravenous infusion group,no significant change was found in the amount of blood loss during operation in intravenous injection group (P＞0.05).There was no statistically significant difference in the amount of blood loss during operation between intravenous injection group and intravenous infusion group (P＞0.05).Intravenously infusing oxytocin produced less effect on the mean arterial pressure and heart rate than intravenously injecting oxytocin (P＜0.01).Conclusion Intravenous infusion is a suitable route for oxytocin delivery in cesarean section with spinal anesthesia.