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 explore the operation al skills of laparoscopic appendectomy(LA) and to improve its proficiency.Methods The clinical data of 121 patients under went LA during February 2013 to May 2014 were summarized retrospectively.Results All the 121 cases were completed successfully with no complication.Conclusion With the development of laparoscope and accumulation of experiences LA can be safe and complications can be minimized if the this operation skill being obtained.

The development and progress of gastric mucosal diseases is a complex process associated with multiple factors and underlying mechanisms,and individuals may present different genetic susceptibilities to gastric mucosal diseases. Various studies have demonstrated a strong link between Toll-like receptors( TLRs),as pattern recognition receptors,and the development and progress of gastric mucosal diseases. The gene polymorphisms of TLRs may change its encoded proteins or related signaling pathways,which results in different susceptibilities to gastric mucosal diseases;this might affect the development,progress and clinical outcome of the disease. In this review article,the advances in study on TLRs and its gene polymorphisms in gastric mucosal diseases were summarized.

Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.

Objective:To analyze different age group elderly’s financial burden and risk due to non-communicable chronic diseases (NCDs). Methods:Based on CHARLS baseline investigation data, disease economic burden, disease economic risk for family and disease relative risk are used to analyze the economic risk and economic burden of the different age groups of urban and rural NCDs elderly. Results: The diseases financial burdens of urban NCDs elderly are greater than rural; for diseases family risk and relative risk, NCDs elderly are greater than non-NCDs elderly, urban NCDs elderly are greater than rural, high-age group NCDs elderly are greater than low-age group NCDs elderly. Conclusion: It is needed to improve the NCDs elderly’s medical security ability with basic health insurance, especially to improve medical security ability of the high-age group for rural elderly.

OBJECTIVE:To provide reference for the standardization of the instruction of levonorgestrel emergency contraception. METHODS:Instruction of levonorgestrel emergency contraception in the market was compared with the national regulations and foreign instruction of the same kind of productions in order to discover the problems in domestic specification. RESULTS:The major problems of domestic instruction of levonorgestrel emergency contraception included instructions without population limits, unclear frequency and interval of drug use,without attention to ADR of levonorgestrel emergency contraception,lack of pharmacy research data. CONCLUSIONS:The problems existing in domestic instruction of levonorgestrel emergency contraception are shortage of items and warnings of drug safety. Related administration departments and enterprises are suggested to modify and perfect the instruction of levonorgestrel emergency contraception.

Objective To explore the relationship between the family conditions and internet addiction of medical college students with limb disabled. Methods 400 medical college students were investigated by the University Student Going-online Investigation table, EMBU and Chinese Internet Addiction Scale. Results There was significant correlation between parental occupations and internet addiction total score of medical college students with limb disabled( r= 0.195, P < 0.01 ; r = 0.163, P < 0.05 ). There was significant correlation and prediction between negative parental rearing patterns such as the parents' punishment-severity and rejection-denying and dimensions of interpersonal relations, health, forced going-online behaviors, time management( P < 0.05, P< 0.01 ), but there was no significant correlation and prediction between parents' warmth-comprehension and all dimensions. Conclusion Family conditions play a important role in influencing internet addiction of medical college students with limb disabled.

To investigate the relationship of the expressions of matrix metalloproteinases(MMPs) and tissue inhibitor of metalloproteinase (TIMP) with metastasis and prognosis in colorectal cancer. Using S P immunohistochemistry method to detect the expressions of MMPs and TIMP in 41 cases of colorectal cancer. The expression levels were analyzed quantitatively by computer image analysis system. The results showed that the expression of MMP 2,MMp 9 and TIMP 1 was higher than those in normal epithelial mucosa. In the cases with metastasis to lymph node, the expressions of MMP 2 and MMP 9 TIMP 1 were significantly higher than that of cases without metastasis.The high expressions of the three factors are closely correlated with the progression and poor prognosis of colorectal cancer. It suggested that expressions of MMPs and TIMP are closely related with metastasis and prognosis in colorectal cancer.

Objective To Describe the queuing mathematical model and analyze the reasonable hospital application pattern of electronics voluntary system.Methods By scientifically arranging medical care personnel and equipment,patients queuing process was optimized.Results We successfully applied the outpatient real-time computer information management system of electronics voluntary based on this mathematical model.Conclusion It is a possible way to optimize the queuing process and improve the efficiency in electronic triage system based on queuing theory.

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.