Autoimmune neurological diseases have a high morbidity and mortality,but are treatable if diagnosed earlier.Many auto-antibodies may become important laboratory biomarkers for the diagnosis,evaluating severity,prognosis,and even reflecting treatment response,of these diseases.With the development of new knowledge and diagnostic technology,there is a pending need for discovering new pathogenesis-based biomarkers with high sensitivity and specificity on autoimmune diseases of the nervous system.To fulfill this goal,the pathogenesis as well as translational studies in autoimmune diseases of the nervous system are highly warranted.Multi-center randomized double-blinded clinical trials are also necessary to appropriately evaluate the clinical value of these auto-antibodies.W henever possible,these validated autoantibody assays are readily encouraged to perform and popularize these methods in clinical practice.

Objective To investigate the role of mifepristone in endometriosis after laparoscopic surgery. Methods One hundred and forty-three women diagnosed with endometriosis after laparoscopic surgery were divided into two groups: one group with 78 cases were given mifepristone at 10 mg once daily (mifepristone group),and the other group with 65 cases were given gestrinone at 2.5 mg,twice every week (gestrinone group). All patients were followed-up 1 to 2 years and observed curative effect, compared the therapy effect on endometriosis as well as the side effects of two drugs. Results The clinical symptom and sign were improved at 3, 6, 12 months in two groups (P< 0.01). The rate of efficiency was 85.9%(67/78) in mifepristone group,and 84.6%(55/65) in gestrinone group, there was no significant difference between two groups (P > 0.05). The rates of acne, weight gain, joint ache, aminotransferase increase was lower in mifepristone group than those in gestrinone group (P <0.01 or <0.05). The recovery time of ovulation or menstruation was shorter in mifepristone group [(12.0 ± 2.9), (26.8 ± 3.9) d]than those in gestrinone group [(25.3 ±3.7), (35.0±4.1) d](P<0.05). Conclusions Mifepristone seems to be an effective,safe,and convenient treatment for endometriosis with low-cost and few side effects. Therefore,it can be used as first choice for treatment of endometriosis after laparoscopic surgery.

Objective To investigate the clinical features of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the significance of anti-NMDAR antibody assay in clinical diagnosis.Methods Sixty-two patients were divided into 3 groups of encephalitis,encephalopathy and other central nervous system diseases based on their affliction. Anti-NMDAR antibody was detected by transfected cell-based indirect immunofluorescence assay in the serum and cerebrospinal fluid. The clinical features,laboratory tests,treatment and prognosis of NMDAR encephalitis were analyzed.ResultsAnti-NMDAR antibody was positive in serum and (or) cerebrospinal fluid of 9 patients (9/32,28％ ) from encephalitis group.The positive rate of anti-NMDAR antibody in cerebrospinal fluid was higher than that in serum of these patients.Among them,5 patients with higher antibody titer had impaired blood-brain barrier.No tumor was detected in these 9 patients.The most predominant symptoms of anti-NMDAR encephalitis include fever,psychiatric disturbances,seizures,dystonia and autonomic dysfunction.Brain MRI and electroencephalography were also abnormal. Patients were responsive to early immunotherapy. Conclusion Detection of the anti-NMDAR antibody may be important for early diagnosis and treatment of autoimmune encephalitis.

Objective To evaluate the applicability and reliability of optical coherence tomography (OCT) technical in detecting the thickness changes of ganglion cell complex (GCC) and outer retinal layers (ORL) in Alzheimer's disease.Method 28 AD patients and 30 healthy control subjects were recruited.SD-OCT was used to measure the macular ganglion cell complex thickness and outer retinal thickness.Cognitive function was evaluated by Mini-Mental State examination (MMSE).Intra-ocular tension and axis length were measured at the same time.Results OCT data shows statistic difference of ganglion cell complex thickness between AD group and control group,while there is no significant difference of outer retinal layers thickness between the two groups.Significant correlations between GCC thickness and MMSE scores were observed.There was no significant correlation between the MMSE scores and the ocular tension.Conclusions Retinal thickness reduction of AD patients can be detected by OTC,and could be related with disease progression.OCT can be used to screen the early stage AD patient.

Objective To study the therapeutic effect of pingyangmycin local injection under suspension microlaryngoscopy for treatment of laryngopharyngeal and laryngeal hemangioma. Methods The total of 44 cases of patients with laryngopharyngeal or laryngeal hemangioma were randomly divided into the experimental group ( n=22 ) and the control group (n=22). They were treated with bleomycin 5 mg or pingyangmycin 4-8 mg injection under suspension microlaryngoscopy in the hemangioma, respectively. If the treatments were not curative, repeated one more times in intermittent 15 d, but not more than 3 times. Therapeutic effect and adverse effect were recorded and analyzed. Results The total effective rate (95. 4%)in the experimental group was significantly better than that (59. 1%) in the control group (P<0. 05),and side reaction in two groups showed no significant variation. Conclusion Pingyangmycin local injection for treating laryngopharyngeal and laryngeal hemangioma is effective, less adverse reaction.

Objective To evaluate the efficacy of ventricle septal defect(VSD) occluder through lower ministernotomy for patients with perimembranous VSD. Methods From January 2007 to August 2008,41 patients with perimembranous VSD(14 male,27 female,weighed 9.0 to 71 kg with a mean of 46.3?16.1) underwent a closure of perimembranous VSD through lower ministernotomy using Amplatzer occluder.Before the operation,all the cases had been confirmed as having a 3-to 8.5-cm perimembranous VSD by transthoracic echocardiography(TTE).Under general anaesthesia,a small incision was made at the lower sternum to expose the right ventricle,and then occluder was placed in the right ventricle.TEE,electrocardiography and chest X-ray were performed before discharge and 1 month after the operation.Results The procedure was completed successfully in all the patients with a mean operation time of(6.2?3.3) hours(ranged from 2.5 to 17 hours).The ICU stay was(15.1?4.3) in average(8-21 hours).The mean drainage volume after the surgery was(80?33) ml(35-210 ml).Follow-up was available in all the cases for(7.9?4.1) months(range,3-15 months).During the period,no A-V block,new AI,occluder displacement,embolization,tricuspid incompetence or residual occurred. Conclusions VSD occluder is feasible and safe for closure of perimembranous ventricular septal defects through lower ministernotomy.

OBJECTIVE To investigate the bacterial distribution and antibiotic resistance of main pathogens from urinary tract infection (UTI) in our hospital for the guidance of rational use of antibiotics. METHODS The antibiotic resistance of clinical pathogen isolates from urinary tract infection by routine bacterium culture from Jan 2006 to Dec 2007 were studied retrospectively. The extended spectrum ?-lactamases (ESBLs) were detected out to the Gram-negative bacilli. RESULTS There were 722 strains of pathogens in the whole 2773 urinary samples with the isolating rate 26.0%. Most of the Urinary tract infections of patients were caused by Gram-negative bacilli (69.4%),then by Gram-positive cocci (16.3%) and fungi (14.3%). The most common pathogens in urinary tract infection were Escherichia coli (47.9%),Enterococcus faecais (7.9%),E. faecium (4.0%),Proteus mirabilis (3.9%),and Pseudomonas aeruginosa (3.5%). The Gram-negative bacilli were found to be sensitive to imipenem and meropenem,but highly resistant to the most other antibiotics,while P. mirabilis was susceptive to amikacin and cephalosporins. The Gram-positive cocci were more sensitive to nitrofuvantoin and vancomycin,but highly resistant to penicillin,oxacillin and SMT. CONCLUSIONS E. coli is still the primary urinary pathogen among patients,and highly resistant to a lot of antibiotics,We should carry out cultivation,isolation,and antimicrobial susceptibility testing as soon as possible to guide reasonable clinical drug therapy.

Objective To explore the application of auto-regressive integrated moving average (ARIMA) product season model in predicting number of inpatient and hospitalized expense of malignant tumor,and to provide scientific basis for hospital business management.Methods We collected inpatient data of malignant tumor from January 2007 to December 2015 in one hospital for model fitting,and used monthly data 2016 to verify the effect of model prediction.We predicted the number of inpatient and hospitalized expense of malignant tumor in 2017.Results ARIMA (0,1,1) (1,1,0) 12 was the best model for number of inpatient and hospitalized expense of malignant tumor,with prediction fitting errors of 1.1％ and 1.47 ％,respectively.The number of inpatient and hospitalized expense of malignant tumor in 2017 were predicted to be 7631 and 0.336 billion.Conclusion ARIMA product season model can better applied in the predicting of hospital business management.

Objective To investigate the frequency of autoimmune encephalitis (AE) in limbic encephalitis (LE) syndrome and compare its clinical features with viral encephalitis.Methods Patients diagnosed with LE syndrome who admitted to Huashan Hospital between December 2015 and June 2016 were enrolled and screened for autoantibodies associated with AE (anti-N-methyl-D-aspartate receptor, anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, anti-gamma-amino-butyric acid B-receptor, anti-leucine-rich glioma inactivated 1 and anti-contactin-associated protein-like 2 antibodies) in cerebrospinal fluid (CSF) and serum. Their clinical features and auxiliary examinations were also collected and analyzed retrospectively. Results Fifty-four patients were diagnosed with LE syndrome, including 35 males and 19 females. The age of these patients was (38.98±17.29) (15-75) years. Twenty patients (37.0%) were identified as AE, 17 patients (31.5%) as viral encephalitis. Other cases included three (5.5%) with neurosyphilis, one (1.9%) with glioma and 13 (24.1%) of unknown cause. Young patients(15-29 years old)and patients older than 45 years accounted for 46.0% (17/37) and 37.8% (14/37) of all AE and viral encephalitis cases respectively. Patients with AE had longer disease progression time than patients with viral encephalitis ((22.45±11.62) d vs (6.24±2.95) d, t=6.015, P<0.01).Emergency hospitalization of patients with AE was less frequent than that of patients with viral encephalitis (3/20 vs 12/17, P=0.001). Patients with AE were less common to present with fever at disease onset than patients with viral encephalitis (8/20 vs 15/17, P=0.006). Seizures as the first neurological symptom were less common in AE than in viral encephalitis (2/20 vs 8/17, P=0.023). White blood cell counts in CSF were less frequently elevated in AE than in viral encephalitis (7/17 vs 12/15, P=0.036). The differences of age, gender, disease severity as well as abnormal rates of brain MRI, electroencephalogram and CSF protein were not statistically significant between the two groups. Tumors were discovered in 6 (6/19) patients with AE. Conclusions The frequency of AE in LE syndrome is not low. It is worthwhile to screen for autoantibodies associated with AE in patients diagnosed with LE syndrome. AE and viral encephalitis have their own characteristics, which could offer help in differential diagnosis between them and application of effective treatment.

Objective To investigate the clinical significance of titin antibody(titinab) in myasthenia gravis(MG) Methods Recombinant MGT-30 peptide was synthesized by genetic engineering technique We had examined titinab in the sera of 141 MG patients with different thymic pathology(MG group),265 normal controls(NC group) and 36 diseased controls without MG(NMG group) using recombinant MGT-30 as antigen of ELISA Acetylcholine receptor antibody(AChRab) and presynaptic membrane receptor antibody(PrsmRab) were parallelly examined in MG patients Results The titer of titinab in the sera of MG patients was significantly higher than those of NC group and NMG group( P