Autoimmune encephalitis is a kind of inflammatory disease of central nervous system caused by abnormal immune response of body immune system to neuronal antigen,and is generally considered to be reversible encephalitis caused by noninfectious factors.Its characteristic manifestations include acute and subacute onset of cognitive dysfunction,epilepsy and mental disorder.With the discovery of related antibodies,summaries of clinical syndrome and application of new functional imaging instruments,the diagnosis of autoimmune encephalitis is increasingly standardized.The priority treatment of autoimmune encephalitis is immunomodulatory therapy,including glucocorticoid,immunoglobulin,plasma exchange and immunosuppressant.The other treatments could be the related tumor resection,electroshock therapy,etc.The symptoms in most patients can get substantial relief with active treatment.The present paper would focus on the research progress in treatment of autoimmune encephalitis.

Objective To analyze the sensitivity of auxiliary examinations in different periods of sporadic Creutzfeldt-Jakob disease (sCJD).Methods The clinical data of 53 sCJD patients were retrospectively analyzed including the different stages of skull diffusion-weighted magnetic resonance imaging (DWI),24-hour ambulatory electroencephalogram (EEG),18F-FDG PET/CT (PET-CT)and cerebrospinal fluid 14-3-3 protein.When calculating the sensitivity of an auxiliary examination,the diagnostic criteria were defined by combining the specific clinical manifestations with two or more positive results of other auxiliary examinations.Results There were 24,53 and 22 sCJD patients,respectively,met the criterion of early (E),middle (M) and later (L) stage of disease (some patients fit 2 or 3 stages).The sensitivity ofDWl (E:58.3％ M:85.4％,L:94.7％),EEG (E:45.8％,M:62.7％,L:77.8％),14-3-3 protein in cerebrospinal fluid (E:11.1％,M:52.9％) and PET-CT (E:80％,M:100％) increased gradually with disease progression,The sensitivity of PET-CT was higher than the other auxiliary examinations for E and M stages;no PET-CT was conducted in L stage.High signal regions mainly distributed in the cortex in E and M stages,but in L stage,no significant difference was found on the distribution of high signal regions between cortex and basal ganglia.Conclusions The sensitivities of the auxiliary examinations were different for sCJD patients in different stages.Reexaminations in different periods may improve the sensitivity for sCJD diagnosis.The sensitivity of PET-CT was high,and the combination of PET-CT and other auxiliary examinations may play a key role in the diagnosis of sCJD.

BACKGROUND:Light-cured composite resin is used for dental crown defective repair in terms of both function and morphology.
OBJECTIVE:To investigate the therapeutic effects of light-cured composite resins on crown defects.
METHODS:Relevant literatures concerning light-cured composite resins for repair of crown defects were retrieved. Literatures which met the study standard were deeply analyzed. Meanwhile, fol ow-up results and literature results were compared for patients receiving light-cured composite resins for repair of crown defects to identify the feasibility of light-cured composite resins for repair of crown defects.
RESULTS AND CONCLUSION:Based on the included data, the successful rate of light-cured composite resins for repair of crown defects was over 90%. Clinical fol ow-up of 12 patients undergoing light-cured composite resin showed that the repaired crowns were stable and fixed, and exhibited a symmetrical appearance with the contralateral namesake tooth of the adjacent tooth, and there was a normal bite relationship. During the fol ow-up study, 19 teeth repaired from 12 patients had no loosing, no shedding, no percussion pain and normal bite relationship. X-ray films showed no apical shadows. Light-cured effects were limited to the upper and middle parts but not to the apical part. Therefore, a better therapeutic effect can be obtained.

Objective This study aims to investigate the effect of rehabilitation skills training on suicide and relapse prevention of patients with depression.Methods Eighty patients were randomly divided into two groups.One group accepted depression rehabilitation skills training and the other group accepted general health education for 4 weeks.Both groups were followed up by 12 months,and the number of relapse and suicide and the score of Health-related quality of life made by Word Health Organization (WHOQOL-BREF) were recorded.Results The rate of relapse (10.0％ vs.42.5％) and hospitalization (5.0％ vs.20.0％) were lower in skills training group than in control group (P＜0.05).Rate of seeking help of suicide was higher in skills training group than in control group (25.5％ vs.7.5％) (P＜0.05).The suicide mortality was insignificantly different between two groups (0.0％ vs.2.5％) (P＞0.05).The scores of WHOQOL-BREF were significantly higher in skills training group than in control group in follow-up (P＜0.05).Conclusions Rehabilitation skills training program can not only reduce the rate of relapse and suicide but also improve the quality of life of patients with depression.

Objective:To observe the effect of combining transcranial direct current stimulation (tDCS) with functional electrical stimulation-assisted cycling (FES-cycling) on lower limb motor function early after a stroke.Methods:Thirty-seven survivors of a recent stroke were divided into a tDCS treatment group ( n=18) and a pseudo-stimulation group ( n=19). While receiving routine rehabilitation training and clinical drug treatment, the tDCS treatment group also cycled in response to functional electrical stimulation while simultaneously receiving tDCS anode stimulation of the motor cortex M1 area. The pseudo-stimulation group followed the same protocol but with the tDCS stimulation inactivated. Both groups were treated for 20min daily, 5 days weekly for 4 weeks. Before and after the 4 weeks of treatment, the lower limb motor function, walking ability and ability in the activities of daily living of both groups were evaluated using the Fugl-Meyer assessment scale for the lower extremities (FMA-LE), the timed up and go test (TUGT) and the modified Barthel index (MBI) respectively. Transcranial magnetic stimulation was used to detect each subject′s cerebral cortex motor threshold (CMT) , cortical latency (CL) and central motor conduction time (CMCT) as well as the amplitude (Amp) of the motor evoked potential of the lower limb primary motor cortex (M1 area). Results:After 4 weeks of treatment, the average FMA-LE and MBI scores and TUGT times of the two groups had improved significantly compared with those before treatment. The average FMA-LE score and TUGT time of the tDCS group were significantly better than those of the pseudo-stimulation group. The average CMT, CL and CMCT in both groups were significantly lower than those before the intervention, while the average Amp had increased significantly, but there were significant differences in the average CMT, Amp, CL and CMCT between the two groups after the 4 weeks of treatment.Conclusions:Transcranial direct current stimulation combined with cycling assisted by functional electrical stimulation can effectively stimulate excitability in the motor cortex soon after a stroke. That should promote the recovery of nerve activity and lower limb function.

Myricetin(MYR)was cocrystallized with caffeine(CAF)by suspension and the single crystal of MYR-CAF cocrystal was cultured by slow solvent evaporation. Cocrystals obtained by two different methods were the same in crystal form after characterization with X-ray diffraction. Structural analysis of single crystal of MYR-CAF showed that its crystal system and the space group were monoclinic and P21/n, respectively. In MYR-CAF cocrystal, 4′-OH in ring B and 7-OH in ring A of MYR interacted with CAF at(8)C=N and(2)C=O through hydrogen bonds. In comparison to the original MYR crystal, the intrinsic dissolution rate of MYR was significantly enhanced for about 17-fold after cocrystallization with CAF.

Objective To study radiographic classification of tarsometatarsal joint dislocation and postoperative imaging evaluation.Methods 74 patients with tarsometatarsal joint dislocation were included in this study.Tarsometatarsal joint dislocations were classified by the Myerson fracture displacements classification.All patients were evaluated according to the American Orthopedics Foot & Ankle Society (AOFAS)clinical rating systems.Results There were 19 patients with Myerson A,46 patients with Myerson B and 9 patients with Myerson C tarsometatarsal joint dislocation.39 distal tarsal bone fractures and 156 metatarsal fractures,with simultaneous scaphoid fractures in 10 patients were showed.All patients who were followed up and no infection.The AOFAS scale was categorized as excellent,good,fair or poor,and 22 patients were considered as excellent,29 patients as good,17 patients as fair and 6 patients as poor.Postoperative imaging evaluation required anatomical reduction of tarsometatarsal joint.On the anteroanterior radiogragh,the base medial edge of the second metatarsal bone and the medial edge of intermediate cuneiform were combined to form a straight line.The shortest distance between the base of the first metatarsal bone and the second metatarsal bone should be less than 2 mm.On the medial oblique radiogragh,a smooth line connecting the medial edge of the fourth metatarsal bone with the medial edge of cuboid bone always appeared.On the lateral radiogragh,the dorsal edge of the second metatarsal bone and intermediate cuneiform formed a smooth line.The height of metatarsus should not exceed the dorsal edge of corresponding cuneiform.The longitudinal arch angle was restored within normal limits.Conclusion The type-B tarsometatarsal joint dislocation is the most common type and frequently accompanies by multiple fractures.Intraoperative and postoperative multidirectional observation of anatomical reduction of tarsometatarsal joint dislocation can reduce incidence of posttraumatic arthritis.

Objective To investigate the risk factors for NAFLD patients with mild cognitive impairment ( MCI) in elderly through comparing the clinical features among elderly NAFLD patients with MCI. Methods A total of one hundred and sixteen elderly patients with NAFLD were enrolled in this study and were divided into MCI group (37 cases) and non-MCI group (79 cases). The clinical data including medical history of myocardial infarction,diabetes mellitus,hypertension,medications,blood pressure,BMI,liver function, kidney parameters,glucose metabolism, serum lipid profile, vitamin D, NAFLD fibrosis score, HOMA-IR and carotid plaques were analyzed and compared. Results Compared with non-MCI group,the age,AST/ALT ratio, serum creatinine,NAFLD fibrosis score,serum uric acid of MCI group were significantly higher ((80. 5±7. 4) years vs.(72.5±8.0)years,t＝5.87,P＜0.001; (1.33±0.51) vs. (1.09±0.30),t＝2.599, P＝0.012;(100.86±78.02) μmol/L vs. (78.12±22.12) μmol/L,t＝2.402, P＝0.018; (0.73±1.01) vs. (0.03 ±1. 17),t＝3. 132,P＝0. 002; (382. 95±79. 61) μmol/L vs (349. 99±79. 18) μmol/L,t＝2. 086,P＝0. 039), while serum γ-glutamyl transpeptidase (γ-GT),diastolic blood pressure (DBP),estimated glomerular filtration rate (eGFR) of MCI group were significantly lower than those in the non-MCI group (22. 00(17. 00,26. 00) U/L vs. 28. 00(19. 00,39. 50) U/L,Z＝－3. 038,P＝0. 002;(69. 30±6. 78) mmHg vs. (74. 30±9. 45)mmHg,t＝－3.252, P＝0.002; (62.60±17.78)(ml/min×1.73 m2) vs. (79.41±16.95)(ml/min×1.73 m2),t＝－4. 900,P＜0. 001). Detection rates of carotid unstable plaques and high BMI in MCI group were higher than those in the non-MCI group (83. 78%(31/37) vs. 64. 56%(51/79),χ2＝4. 496, P＝0. 034)(83. 78%(31/37) vs. 60. 76%(48/79),χ2＝6. 149, P＝0. 013) . There were no significantly differences between the two groups in history of myocardial infarction,diabetes mellitus,hypertension,usage rates of antiplatelet drugs and statins. Logistic regression showed that age (regression coefficient＝0. 166,OR＝1. 181,95%CI 1. 078－1. 293,P＜0. 001), high BMI (regression coefficient＝1. 942,OR＝6. 974,95%CI 1. 466－33. 176,P＝0. 015),diastolic blood pressure ( regression coefficient＝ －0. 099, OR＝ 0. 905, 95%CI 0. 828－0. 990, P＝ 0. 029 ), γ-GT (regression coefficient＝－0. 094,OR＝0. 910,95%CI 0. 852－0. 972,P＝0. 005), serum uric acid (regression coefficient＝－0. 009,OR＝1. 009,95%CI 1. 000－1. 017,P＝0. 039) and low density lipoprotein cholesterol ( LDL-C) (regression coefficient＝0. 898,OR＝2. 454,95%CI 1. 029－5. 854,P＝0. 043) were related to elderly NAFLD patients with MCI. Conclusion The high BMI,diastolic blood pressure,serum uric acid,low density lipoprotein are related to MCI in elderly patients with NAFLD. For elderly patients with NAFLD,these indicators may be used to assess the risk of MCI and to locate high-risk groups at an early stage.

Objective:To investigate the association between nonalcoholic fatty liver disease(NAFLD)and mild cognitive impairment(MCI)in the elderly.Methods:Three hundred ninety-two study subjects aged 60 years and above visiting the geriatric department of Peking University People's Hospital for chronic disease management between July 2016 and January 2018 were enrolled, and population-based clinical data of the study subjects were collected.Participants' cognitive function was assessed, and the correlation between NAFLD and MCI was analyzed.Results:The detection rate of MCI in the NAFLD group(n=191)was significantly higher than that in the non-NAFLD group(n=201)[38(19.9%) vs.21(10.4%) χ2=6.837, P=0.009]. Multivariate analysis revealed that NAFLD was closely correlated with and was an independent risk factor for MCI( OR=2.625, 95% CI: 1.250-5.512, P=0.011)after adjusting confounding variables such as age, sex, education level, components of metabolic syndrome, medication, and conditions affecting biochemical and metabolic processes.In addition, the female sex( OR=2.775, 95% CI: 1.363-5.651, P=0.005), unstable carotid plaques( OR=2.736, 95% CI: 1.131-6.620, P=0.026), serum albumin( OR=0.908, 95% CI: 0.840-0.982, P=0.015), fasting serum glucose( OR=1.268, 95% CI: 1.076-1.493, P=0.004), and the serum AST/ALT ratio( OR=2.984, 95% CI: 1.370-6.500, P=0.006)were also independently associated with MCI, of which, the female sex, unstable carotid plaques, increased levels of fasting serum glucose and the AST/ALT ratio were independent risk factors for MCI. Conclusions:NAFLD is associated with and is an independent risk factor for MCI in the elderly.Assessment of cognitive function in elderly patients with NAFLD should be emphasized.

Objective To construct the recombinant plasmid of coxsackievirus group A type 16 (CA16)VP1,express in E.coli and identify expressed product. Methods The CA16 VP1 gene was amplified by PCR,The constructed recombi-nant plasmid pET21b-CA16 VP1 was transformed into E.coli BL21(DE3) for expession and purification,expressed and purified product was identified by SDS-PAGE,Indirect ELISA tested Antigenicity and validity of recombinant proteins CA16 VP1. Results The coxsackievirus group A type 16 VP1 protein was expressed in peokaryotic cells and purified, which showed specific reaction with mice antiserum against CA16 virus,high reactivity with part serums of the elderly population in Taiyuan city. Conclusion CA16 VP1 protein was successfully expressed, had good Antigenicity and va-lidity,which will lay a foundation for study on the CA16 diagnostic kits.