Objective To compare and analyze differences in clinical characteristics, auxiliary examination and im?munotherapy between children with anti-N-methyl-D-aspartate(NMDA) receptor encephalitis and adults. Methods Clinical data was retrospectively collected from 34 cases anti-NMDA receptor encephalitis. All people were divided into the child group and the adult according to the age of onset and the inpatient department. Score of Modified Rankin Scale (mRS) before and after treatment and follow-up period (6 months~24 months) were compared to estimate the neurologi?cal outcomes. Results Data from 34 patients including 19 children and 15 adults was analyzed. Hypoventilation, epilep?sy and status epilepticus were more common in the adult group than in the child. The positive rate of EEG delta brush was higher in child group than in adult group. Two women were complicated by suspicious ovarian teratoma. Intravenous immune globulin was used commonly in the child group, while the plasma exchange or immunosuppressant used common?ly in the adult group. Time of onset to hospital admission and final diagnosis were shorter in the child group than in the adult. Patients requiring ICU were fewer in the child group than in the adult. The scores of mRS were significantly lower in the child group than in the adult at hospital discharge (P<0.05). Conclusion Clinical characteristics is more compli?cated in adults with anti-NMDA receptor encephalitis compared with children including a worse disease severity and a poorer short-term outcome.

Objective To analyze tissue vascular endothelial growth factor receptor 1 (VEGFR-1)and VEGFR-2 and their soluble form (sVEFGR-1 and sVEGFR-2) in the plasma in patients with preeclampsia,and to explore its clinical significance.Methods sVEGFR-1 and sVEGFR-2 expressions in plasma of normal pregnancy women and preeclampsia patients were detected by enzyme-linked immunosorbnent assay (ELISA) ; VEGFR-1,VEGFR-2,sVEGFR-1 and sVEGFR-2 mRNA expressions of normal pregnancy women and preeclampsia patients in placenta were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results ELISA results showed that the level of sVEGFR-1 in plasma of normal control group before and after delivery was (12.33 ± 1.52) ng/ml and (4.55 ± 0.31) ng/ml,respectively,while that of preeclampsia group was (77.25 ± 9.47) ng/ml and (8.13 ± 0.74) ng/ml,respectively; the differences between before and after delivery in the two groups were of statistical significance.The level of sVEGFR 2 in plasma of normal control group before and after delivery was (8.74 ± 1.24) ng/ml and (6.43± 0.55) ng/ml,respectively,while that of preeclampsia group was (5.69 ± 0.75) ng/ml and (4.96 ±0.67) ng/ml,respectively.RT-PCR results were consistent with ELISA results.Conclusions Rapid decrease of plasma sVEGFR-1 and continuously low-level expression of plasma sVEGFR-2 indicated that VEGFR-1 might be closely related to preeclampsia,and decrease of plasma sVEGFR-2 in preeclampsia women might be taken as a marker of endothelial cell function disorder.

Objective To study the effect of combining recombinet interferon α -2b gel and loop electrosurgical excision procedure (LEEP) to treat cervical intraepithehal neoplasia (CIN). Methods Prospective, randomly and control study was progressed in 80 patients with CIN Ⅱ-Ⅲ. Before carrying out LEEP, all women were performed high-risk HPV DNA detection by the method of HC2. Among them, forty women were. assigned to be the study group, in which the patients were added to use recombinet interferon α -2b gel for three courses of treatment before and after LEEP, the other forty women who carried out LEEP simply were assigned to be the control group. All patients were examined by hquid-based thinprep cytology test (TCT) and colposcopic site-specific biopsies to doubtful focus of infection in the 3rd, 6th, 9th and 12th month after treatment, and judged the effect by using HC2 in the 6th and 12th month after treatment. Results Eighty patients were not detected residue and recidivafion of CIN diagnosed by coiposcopic site-specific biopsies to doubtful focus of infection. In the study group, 3 women were abnormal detected by TCT, 37 women were negative detected by HC2, the negative rate was 92.5% when LEEP ended 6 months. The cure rate was 100.0% when LEEP ended 12 months. In the control group, 21 women were abnormal detected by TCT, 19 women were negative detected by HC2, the negative rate was 47.5% when LEEP ended 6 months, 8 women were negative detected by TCT, 25 women were negative detected by HC2, the cure rate was 62.5% when LEEP ended 12 months.In the 6th and 12th month after LEEP, the difference was distinguished in the cure rate between two groups. Conclusions There is double interrupted effects by combining recombinets interferon α -2b gel and LEEP to treat CIN. It can raise the one-time cure rate of the patients with CIN.

OBJECTIVE:To explore the reasons,occurrence mechanisms,as well as prevention methods for complications following cerebrovascular stent implantation.METHODS:A computer-based online search was performed by the first author.The databases of Medline and CNKI were searched with year's limitation of 1989-2009.According to the inclusive and exclusive criteria,the documents were screened,collected and evaluated from the following aspects:treating progress of cerebrovascular stent implantation;category and biocompatibility of cerebrovascular stent;as well as occurrence and prevention methods for complication following cerebrovascular stent implantation.RESULTS:A series of complications,such as carotid sinus response,hyper-perfusion syndrome,cerebral anglo spasm,bleeding at puncture locus,thrombosis,restenosis,as well as cerebral ischemia,would occur following cerebrovascular stent implantation.The complications were difficult to eliminate,but should be avoided by selecting correct implanting cases,elevating operator's proficiency,enhancing understanding of complications,obeying perioperative management,as well as correctly and in-time treatment.Polymer stent,coating stent,and drug eluting stent presented superior biocompatibility to metal stent,which could prevent restenosis following implantation.CONCLUSION:Cerebrovascular stent implantation is one of the main treatments for cerebrovascular disease.Polymer stent,coating stent,and drug eluting stent exhibit excellent biocompatibility.The complications associate to stent implantation are preventable and remediable via sufficient preoperatively preparation,exactly operation and perioperative management.

Objective To study the convenient, safe and effective surgical intervention methods for correcting prominent wide lower face. Methods According to the wideness of mandibular angles, single or combined surgical treatments were performed by an intraoral approach under nerve block and local infiltration anesthesia, such as grinding mandibular angles, curved osteotomy of the angles and osteotomy of ascending ramus outer layer, partial masseter muscle resection, partial buccal fat pad removal and liposuction of cheek to reconstruct the whole lower face contour. Resnlts In the 71 cases followed up for 4 to 24 months, 60 cases were excellent, 9 were acceptable and 2 were unsatisfactory. The total satisfactory rate was 97 %. Conclusion According to the characteristics of prominent wide lower face, single or combined surgical treatments are performed to reconstruct the bone and soft tissue of lower face. This operative method is simple, safe and consistent with cosmetic surgery principle with little complications.

Alemtuzumab ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antibodies, Neoplasm ; therapeutic use ; Antigens, CD ; metabolism ; Antigens, CD7 ; metabolism ; Antigens, Neoplasm ; metabolism ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; CD52 Antigen ; Chromosome Aberrations ; Chromosome Deletion ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Glycoproteins ; metabolism ; Hodgkin Disease ; metabolism ; pathology ; Humans ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Lymphoma, T-Cell, Peripheral ; drug therapy ; genetics ; metabolism ; pathology ; Neoplasm Recurrence, Local ; Prednisone ; therapeutic use ; Receptors, CXCR3 ; metabolism ; Survival Rate ; Vincristine ; therapeutic use

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

Objective: To investigate the cause of an incident of occupational contact dermatitis in a farm in Tianjin Prefecture, so as to provide insights into occupational safety. Methods: The disinfection process, use of disinfectants and individual protective measures in this farm were collected, and a field epidemiological investigation was conducted to collect the demographic characteristics, history of occupational contact, clinical symptoms, diagnosis and treatment data, and onset of disease among individuals with the same type of job. The cause of this incident was analyzed. Results: There were ten interns exposed to potassium hydrogen sulfate compounds simultaneously in this farm, and then, nine interns developed skin flushing across the body, and swelling and itching of the skin. Among these ten interns, five individuals were admitted to hospitals because of severe symptoms and were then clinically diagnosed as systemic contact dermatitis. All five individuals were cured following treatments. Epidemiological survey showed that all cases had a definite history of occupational contact with potassium hydrogen sulfate compounds but without use of any protective agents. In addition, there were thirty-five individuals with the same type of job in this farm that developed similar symptoms when they joined in the disinfection for the first time, and these individuals were self-cured following cessation to contact; however, recurrence of symptoms was found following contacts again. Conclusion This is a cluster of occupational contact dermatitis caused by exposure to potassium hydrogen sulfate compound.

Objective To explore the long-term efficacy of botulinum toxin type A injections on facial beauty and its long-term safety.Methods A total of 33 beauty-seekers with botulinum toxin type A treatment for more than five years were reviewed as observation group,using digital muscle palpation meter (Myoton PRO) for the determination of the orbicularis oculi muscle and masseter muscle tension (F),the muscle characteristic parameters,such as muscle hardness (S) using a homemade facial questionnaire test for satisfactory rate of beauty from both beauty-seekers and physicians.At sametime,33 normal adults that never accepted botulinum toxin injection with matched age and gender were collected as control group.The same-sex indicators were dtermined and compared with using statistic analysis t test.Results The pairwised parameters of the same sex and site were comparied between the two groups;average F and S values in the observation group were lower than those of the control group,but no statistically significant difference were observed between the two groups (P＞0.05);in the observation group,average appearance age was 7.3 years younger than the control group,and the facial shape improved significantly.Conclusions Long-term and repeated application of botulinum toxin A is able to remove crow's feet and decrease the masseter and so the injection is safe with high satisfaction to beauty-seekers.

Objective To establish a neonatal transport network in order to improve the diagnosis and treatment levels of the basic medical unit and to decrease medical disputes and fatality rate of the new born Methods The first neonatal transport network in the Southwest of China, covering Chongqing and the adjacent areas, was established During the process of transport, warm keeping, unobstructed respiratory tracts, oxygen treatment, establishment of venous passage and placement of gastric canal were included Meanwhile, the vital signs, colors of the skin and mucosa and consciousness should be closely observed Corresponding measures could be taken at any time when needed Results Satisfactory results were achieved by means of the neonatal transport network Conclusion The neonatal transport network can play a very important role in strengthening the treatment of the newborn, decreasing the fatality rate and sequela and improving the diagnosis and treatment levels of the basic medical unit