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.

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

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

Objective To evaluate the clinical practical value of the heart rate viability test in the patients with malignant tumor during their therapies. Methods Totally 187 cases were analyzed and were divided into three different groups, which included 90 malignant tumor patients before therapy, 45 patients with chemotherapy and 52 non-malignant tumor cases (control group). We compared four HRV indexes(ASDNN5,SDANNS, SDNN and RMSSD) of the patients between the different groups as well as inside each group. Results There were statistical significances in the indexes of ASDNN5, SDANN5 and SDNN of patients at different stages before therapy, the three indexes of the stage Ⅲ group were lower than those of the stage Ⅰ group and the control group as well. The three indexes of the stage Ⅳ group compared with the stage Ⅰ group or the control group (P<0.05) were lower either. There was also statistical significances in SDNN between the stage Ⅲ and the stage Ⅱ of the before-therapy group (P< 0. 05). The indexes of SDANN5 and SDNN of the stage Ⅳ in the chemotherapy group were lower than those of the same stage in the before-therapy group(P<0.05). Conclusions The later the stage of malignant tumor patients is, the more the index of HRV declines. Chemotherapy may affect autonomic nerve function of stage Ⅳ patients with malignant tumor and decrease their HRV.

[Objective] We summarizes the professor Shao Changrong's experience in treating COPD by using invigorating spleen and draining dampnessmethod. [Method] This paper analyzes the etiology, pathology, therapeutic principle and relevant case revealing about the COPD patients with insufficien-cy of the spleen and phlegmatic hygrosis. And we explain the Pro. Shao's empirical prescription cal ed Ping-Ke-Hua-Tan decoction. [Results] In his view, COPD attack and aggravation are related with phlegmatic hygrosis. The fundamental reason is the insufficiency of the spleen and the external reason is phlegmatic hygrosis. Its mechanism is mostly the blending of excessiveness and deficiency. [Conclusion] Theinvigorating spleen and draining dampnessmethod is effective in treating COPD. Pro. Shao Changrong's diagnosing and treating of COPD is worthy widely clinical reference and promotion.

Objective To summarize perioperative points for nursing patients with extramammary Paget’s disease undergoing resection of tumor of vulva expansion and flap repair.Method Eleven patients with extramammary Paget’s disease were managed with resection of tumor of vulva expansion and flap repair,and with perioperative care as well.Results The tumors in all of the patients were removed completely and the flaps survived.All patients were discharged for hospitalization of(4.5±0.7)days.No flap infection or necrosis occurred.Conclusion The measures for nursing the patients with extramammary Paget’s disease undergoing resection of tumor of vulva expansion and flap repair may include preoperative preparation,mental care,postoperative observation of flaps, prevention of complications,health education,instruction on nutrition and formation of proper life style,which may be beneficial for the smooth manipulation of resection as well as for the postoperative rehabilitation.

Positive psychology focuses on enhancing individual positive emotion and promoting the development of individual positive personality.Introducing positive psychology into the first stage of internal medical resident standardized training will improve the resident ability to solve clinical problems.It's helpful for resident doctors to improve their clinical thinking ability,doctor education innovation ability and lifelong self-education ability.It inspires their creative thinking by motivating their positive emotions It would help them to avoid occupational tiredness.Using the idea of positive psychology could improve the comprehensive quality of residents.