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　To investigate the incidence， clinical characters and pathogenesis of hyponatremia following acute stroke in the elderly patients.Methods　The clinical,serum natrium and CT data of 41 cases with hyponatremia following acute stroke in the elderly patients were retrospectively analysed.Results The incidence of hyponatremia following acute stroke in the elderly patients was 16.02% (taking hemorrhagic stroke),the occurrence of the patients' coma induced by hyponatremia and the fatality rate were higher than the controls (P＜0.05);Hyponatremia correlated closely with the localization of lesions in CT, the focus in brain ganglion (induding thalamus) and hematocele in the ventricles of brain caused easily hyponatremia.Conclusion　Dysfunction of hypothalamus-pituitarium was one of the risk factors in causing hyponatremia following acute stoke in the elderly patients.

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.

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.