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.

As the most popular simplified model of the optical imaging system, the acquisition of the Gaussian point spread function (PSF) parameter is one of the hotspots and key points on which people do research in the field of image restoration. Based on the idea by which there exists deterministic mathematical relationship between Gaussian OTF feature points as well as its parameter and the frequency representation of the image in an existed literature, we proposed an automatic, accurate, stable, and improved approach. This method is able to give prominence to the related calculation feature by a Gaussian convolution and degeneration operation and finally realize the automatic esti mation of PSF parameter of a microscopic image. Experiments have proved that a good restoration result can be achieved utilizing the estimated PSF by the present method, which is of considerable application and reference value in restoration of other sorts with Gaussian approximate PSF model or 3D microscopic image restoration.
Algorithms ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; Microscopy ; Models, Theoretical ; Normal Distribution

Coronal restoration of endodontically treated teeth may be viewed as one of the main parameters that influence the outcome of endodontic treatment. The purposes of restoring endodontically-treated teeth include preventing recontamination of the root canal system and periapical area, replacing the compromised dental hard tissue, restoring the coronal morphology and function, providing necessary strength for the restoration/tooth complex for functional stress, and avoiding crown and/or root fracture. This article reviewed recent researches on the restoration of endodontically treated teeth, provided evidence for clinical practice on topics as when to restore them, basic principles to be considered during treatment planning, and specific restoration options for both anterior and posterior teeth under different functional occulsal load conditions. Several issues should be taken into account during the decision making process, such as remaining tooth tissue, functional masticatory forces, comprehensive oral rehabilitation, and esthetic requirements.
Decision Making ; Dental Restoration, Permanent ; Humans ; Root Canal Therapy ; Tooth Crown ; Tooth, Nonvital

Objective To discuss MSCT assessment of pulmonary arterial hypertension (PAH) in patients with IPF before lung transplantation.Methods Between Sep.2002 and Aug.2010,lung transplantation (LTX) was performed on 96 patients with end-stage lung disease.Thirty patients with IPF were found to have PAH,as defined by mean pulmonary artery pressure (mPAP) ≥25 mm Hg by cardiac catheterization.Fifteen control patients (mPAP ＜25 mm Hg) were also identified.The diameter of the principal pulmonary artery (PPA) and ratio of main pulmonary artery to aortic diameter (rPA) were assessed by MSCT.Results MSCT-determined PPA and rPA were (34.4 ±4.4) mm and 1.03 ± 0.09 in patients with PAH,and (25.3 ± 3.3) mm (P＜0.01) and 0.77 ± 0.12(P＜0.01) in controls.In our group of patients,PPA (28.5 mm) had a sensitivity of 86.7％ and specificity of 80％ for predicting PAH,and rPA 0.935 had a sensitivity of 96.7％ and specificity of 93.3％ for predicting PAH.There was a correlation between the degree of PAH and PPA (r =861,P ＜0.01 ),and between the degree of PAH and rPA (r =0.887,P＜ 0.01 ) in patients with IPF associated with PAH.Conclusion MSCT is useful for the detection of IPF with PAH,and CT determined rPA has an excellent diagnostic value.

Objective In this research we established rapid atrial pacing rabbit models, to investigate the effects of simvastatin on changes of early atrial effective refractory period (AERP) and protein expression of atrial α1c sub-unit of L-type calcium channel on atrial remodeling. Methods 42 rabbits were randomly divided into 3 groups:control group,rapid pacing group and simvastatin group,simvastatin 5 mg/( kg·d) was given intragastrically daily for two weeks before electrophysiology study in simvastatin group, normal saline was given intragastrically in control and rapid pacing group instead. Control group with no pacing, in simvastatin group and rapid pacing group, right atrium was paced at 800 beats/min for 8 hours to establish acute atrial fibrillation models, right atrial effective re-fractory period(AERP)was measured at the basic cycle length of 200 ms and 150 ms before pacing and 1,2,4,6, and 8 hours after the onset of the pacing, the changes of rate adaptation of AERP (AERP200-AERP150) were ana-lyzed . Right atrium tissue was obtained for measurement of protein expression of atrialα1 c subunit of L-type calcium channel by Western blot. Simultaneously,lipid levels in each group was examined. Results No significant differ-ence in lipid levels among three groups was observed. The AERP was shortened and the rate adaptation of AERP (AERP200-AERP150) disappeared during pacing compared with those before pacing(P<0.05). The shortening of AERP was reversed and AERP200-AERP150 was maintained in simvastatin group. Compared with the control group,the protein expression levels of atrial α1c subunit of L-type calcium channel decreased significantly after 8 hours pacing in rapid pacing group(P<0.01). The protein expression levels of simvastatin group decreased insig-nificantly . Conclusion Atrial rapid pacing can induce the shortening of the AERP and the losing of adaptability to the frequency of AERP,pretreatment with simvastatin can improve the degree significantly and maintain the adapta-bility to frequence basically. The protein expression levels of atrial α1c subunit of L-type calcium channel de-creased significantly after 8 hours pacing,pretreatment with simvastatin can prevent this change without lowering the lipid levels,thus contributing to the ionic mechanism of simvastatin for antiarrhythmia.

In the scientific,systematic,practical and feasible principles,the quality control needs and management needs of health authorities and medical institutions were analyzed.The study probed into the real-time monitoring functions of existing hospital information systems and information products of IT technology firms,and the feasibility of setting up key monitoring points during medical service processes.685 real-time monitoring indicators have been set up for real-time monitoring of medical process quality.

Objective To explore the best plan of perioperative individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery.Methods Eighty elderly patients with coronary heart disease undergoing gastrointestinal surgery were divided into experimental group and control group by random digits table method with 40 cases each.Conventional capcity treatment was given during surgery and postoperative period in control group.Individualized fluid therapy was used during surgery and postoperative period in intensive care unit of 24 h in experimental group,which was determined based on target controlled fluid therapy according to the cardiac index,stroke volume,and stroke volume variation.Traditional fluid therapy was used in control group in the intraoperative and postoperative period.The two groups were compared in terms of postoperative hemodynamic parameters,total fluid volume,incidence of adverse cardiac events,and recovery of gastrointestinal function.Results The mean arterial pressure at the beginning of the operation,the cardiac index at operation begining 1 h and at the end of operation were (80.4 ± 6.4) mmHg (1 mmHg =0.133 kPa),(4.0 ± 0.6) L/(min ·m2),(4.1 ± 0.8) L/(min ·m2) in experimental group and (76.9 ± 8.0) mmHg,(3.5 ± 0.4) L/(min· m2),(3.6 ± 0.3) L/(min · mè) in control group,and there were significant differences between two groups (P ＜ 0.05).During surgery and 24±hour stay in intensive care unit,the total fluid volume,crystal usage,urine and colloid usage were (2 915 ± 650),(2 715 ± 415),(1 515 ± 315),(1 225 ± 385),(419 ± 233),(619 ± 285),(1 015 ± 220),(1 535 ± 455) ml in experimental group and (3 645 ±770),(3 355 ±750),(2 315 ±320),(1 855 ±325),(602 ±31),(875 ±423),(805 ±250),(1 135 ± 205) ml in control group,and there were significant differences between two groups (P ＜ 0.05).The perioperative adverse cardiac events rate was 30％ (12/40) in experimental group,lower than 45％ (18/40) in control group,but the difference was no statistically significance (P ＞ 0.05).Conclusion In the elderly patients with coronary artery disease undergoing gastrointestinal surgery,individualized fluid therapy can effectively decrease adverse cardiac events,improve postoperative gastrointestinal function,and reduce length of hospital stay.