Objective: To have a profound understanding of anti-N-methyl-D-aspartic receptor (anti-NMDAR) encephalitis, through the clinical analysis of 5 cases of anti-NMDAR encephalitis, and literature review. Methods: This is a retrospective analysis. Five cases of anti-NMDA receptor encephalitis treated from May 2010 to June 2015, in the Department of Neurology, Beijing Friendship Hospital affiliated to Capital Medical University, were included in this study. The clinical data, including clinical manifestation, past history, radiological features, serum and cerebral spinal fluid examinations, treatment and prognosis, were analyzed. Results: Among the 5 cases, 3 young female and 2 middle-to old-aged male. The clinical features of the onset was mental and behavior disorder, as well as seizure and extrapyramidal features, like facial and limbic involuntary movements or tremor. Coma and hypopnea was severe in 3 young female cases, needing assistance of mechanical ventilator, while the manifestation of 2 male patients was much mild, need not assisted respiration. 1 case had teratoma of ovary, 1 case had Vogt-Koyanagi-Harada syndrome. The anti-NMDA receptor antibody was positive in cerebraospinal fluid of all 5 cases, but in serum of 3 cases, serum and CSF Epstein-Barr virus (EBV) IgM antibody was positive in 1 case, while herpes simplex I virus (HSV-1) IgM antibody positive in another case, and anti-myelin oligodendrocyte glycoprotein (MOG) antibody was seen in serum and CSF in 1 case. The time interval from the onset to treatment was 10-37 d (18.8±9.8 d). IVIG was used in all of the 5 cases, glucocoticoid in 4 cases, and plasma exchange in 3 cases. One case with Vogt-Koyanagi-Harada syndrome, having a long time before diagnosis and treatment, died, while the other 4 cases had good prognosis, and had no relapse. Conclusions Mental and behavior disturbance is common at onset of anti-NMDAR encephalitis. The radiological and lab examination may be normal. It may be accompanied with HSV-1 or EBV infection, anti-MOG antibody may be positive in this disease. Active treatment is important.

Objective To investigate the prevalence and risk factors of restless leg syndrome (RLS) in hemodialysis patients after kidney transplantation failure.Methods Patients of hemodialysis after kidney transplantation failure were investigated by face-to-face interviews,from March to July,2015,at four dialysis units in Beijing.RLS was diagnosed according to the International RLS Study Group (IRLSSG) criteria.The severity of RLS was assessed using International RLS Rating scale.Besides,three validated sleep disorder questionnaires (Hamilton anxiety and depression scale,Epworth sleepiness scale and Pittsburgh sleep quality index) were completed by the patients at the same time.Results Ninety-four hemodialysis patients after kidney transplantation failure were enrolled;46 patients (48.94％) met the diagnosis of RLS,the average age was 53.44±l 1.89 years,and the median time of RLS onset after kidney transplantation failure was 46 months.The International RLS Rating scale scores of the patients were 17.26±7.81;76.0％ patients were above moderate.As compared with the non-RLS patients,patients with RLS used more erythropoietin (44/48 vs.46/46),less ferrila (30/48 vs.19/46),and few hypnotic medicine (10/48 vs.3/46),with significant differences (P＜0.05).The serum ion,serum ferritin and serum Vitamin B12 of patients with RLS were significantly lower as compared with non-RLS patients (P＜0.05);and poorer sleep quality and higher depression scale scores in the patients with RLS were noted as compared with those in the non-RLS patients (P＜0.05).Conclusion The prevalence of RLS in hemodialysis patients after kidney transplantation failure is high,low iron protein content,low serum iron content and low vitamin B12 levels may be risk factors for RLS.

Objective: To investigate the role of peroxisome proliferator-activated-receptor-γ coactivator-1α (PGC-1α) in carotid atherosclerosis due to human cytomegalovirus (HCMV) infection. Methods: Thirty-three samples of carotid arterial sclerosis plaques after carotid endarterectomy (CEA) were collected in the experiment group, and 12 pieces of normal intracranial arteries were collected in the control group. The plaques of carotid artery were studied using in situ hybridization (ISH) and immunohistochemistry (IHC) for the role of PGC-1α in HCMV related atherosclerosis. HCMV immediate early (IE) gene of two groups was detected using ISH, and the expression of PGC-1α using IHC. Results: HCMV IE gene was positive 72.7% in the atherosclerotic plague group, while 16.6% in the control group, there was significant difference between the two groups (P<0.05). As to PGC-1α expression, in the atherosclerosis group, 8/33(24.2%) were strongly positive (+ + + ), 9/33(27.2%) were positive (+ + ), 6/33(18.2%) were weakly positive (+ ), and 10/33(30.3%) were negative (-). While in the control group, 1/12(8.3%) was strongly positive (+ + + ), 2/12(16.7%) were positive (+ + ), and 1/12 (8.3%) was weakly positive (+ ), and 8/12 (66.7%) were negative (-). The differences between the two groups were statistically significant (P<0.05). Conclusions HCMV immediate early gene and PGC-1α were both related to athersclerotic plaque formation, suggesting that PGC-1α may play an important role in as the plaque formation due to HCMV infection.

Objective: To investigate the role of lectin-like Ox-LDL receptor-1( LOX-1) in the activation and oxidative stress of cultured human umbilical vein endothelial cell(HUVEC) after human cytomegalovirus(HCMV) infection. Methods: HUVEC were divided into four groups: HCMV, Control, Carrageenan, and HCMV+ Carrageenan. After HCMV AD169 infection, the supernatant of the culture was extracted, and cells were lysed. The levels of LOX-1 mRNA, intercellular adhesion molecule-1(ICAM-1) mRNA and vascular cellular adhesion molecule-1(VCAM-1) in HUVEC were measured by real-time PCR. And the content of nitrogen monoxidum(NO) of the supernatant was detected by nitrate reductase method accordingly. Results: 24 h after infection, the mRNA expression of LOX-1, ICAM-1 and VCAM-1 in HUVEC of HCMV infected group increased obviously compared to control, and NO quantity increased accordingly. The mRNA expression of LOX-1, ICAM-1 and VCAM-1 and the quantity of NO decreased after adding the LOX-1 inhibitor carrageenan. There was significant difference between groups(P<0.05). Conclusions HCMV may increase the mRNA expression of ICAM-1 and VCAM-1 and quantity of NO by upregulating the mRNA expresion of LOX-1, which may contribute to the formation of a therosclerosis(AS).

Objective: To investigate the role of the activation and oxidative stress of cultured human umbilical vein endothelial cells (HUVEC) after HCMV infection. Methods: HUVECs were divided into four groups: control, HCMV(+ ), after HCMV AD169 infection, and the supernatant of the culture was extracted, and the cells were lysed. The levels of vascular cellular adhesion molecule-1 (VCAM-1) in HUVEC were measured by real-time PCR. And the content of nitrogen monoxide (NO) of the supernatant was detected by nitrate reductasemethod accordingly. Results: Twenty-four hours after infection, the mRNA expression of VCAM-1 in HUVECs of HCMV infected group increased obviously compared to control, and NO quantity increased accordingly and time-dependently. There was significant difference between groups(P<0.01). Conclusions HCMV increases the mRNA expression of VCAM-1 and quantity of NO, which may contribute to the formation of AS.