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.

Verification of scientific literature novelty assessment is the final step in writing the literature novelty assessment report and is closely related with its academic level.The key points in verifying novelty assessment of medical literature were thus analyzed with examples in this paper, including the scientific and technical points, literature novelty assessment points, retrieval terms, retrieval strategies, and conclusion of literature novelty assessment.

Objective: To explore influence of coping style on sleep quality and blood pressure in community male population with high normal value blood pressure. Methods: The Pittsburgh sleep quality index (PSQI) and coping style questionnaire (CSQ) were used to assess 120 men with high normal blood pressure in community. With PSQI>7 scores as criterion for judging sleep quality disorders, the subjects were divided into sleep disorder group (n=51) and normal sleep group (n=69), and sleep disorder group received psychological intervention. Results: Sleep disorders existed in 42.5% male population with high normal blood pressure. Compared with normal sleep group, there was significant increase in PSQI [（6.43±2.59）scores vs. (8.33±3.14）scores] and diastolic blood pressure [(81.00±8.91) mmHg vs. (88.00±5.69) mmHg] and significant decrease in factor scores of “problem solving” [(0.76±0.21) scores vs. (0.61±0.18) scores] and “asking for help” [(0.52±0.26) scores vs. (0.41±0.11) scores] in sleep disorder group, P<0.05 all; Compared with before intervention there were significant increase in scores of “problem solving” [(0.61±0.18) scores vs. (0.71±0.12) scores]and “asking for help” [(0.41±0.11) scores vs. ( 0.51±0.13) scores]and significant decrease in PSQI score [(8.33±3.14) scores vs. (7.41±2.37) scores] and diastolic blood pressure [(88±5.69)mmHg vs. (80± 4.17)mmHg] after psychological intervention 12 weeks in sleep disorder group, P<0.05 all. Conclusion: Psychological intervention may improve sleep quality and reduce blood pressure in community male population with high normal value blood pressure.

Aim To observe the neuron nitric oxide synthase(nNOS) expression in the distal cerebrospinal fluid contacting neurons(CSF-CNs) of rat brain parenchyma, and investigate the role of CSF-CNs in the development of morphine dependence and withdrawal.Methods Male adult Sprague-Dawley rats, weighed 260?20 g,were experimented with A 3 ?l volume of 30% cholera toxin subunit B with horseradish peroxidase(CB-HRP) was injected into one of the rats′lateral ventricles to trace and locate the distal CSF-CNs of rat brain parenchyma 48 hours before the animals were killed. All animals were perfused and the relative tissue of rats′brain was removed.Frozen serial coronal sections (40 ?m) were cut. Then TMB-ST reaction procedure was used to stain the CB-HRP positive neurons,followed by immunohistochemistry double-labeling of the nNOS with CB-HRP positive neurons. The withdrawal symptoms were observed and scored. The numbers of the CB-HRP, and CB-HRP/nNOS positive neurons on the same segmental brain sections were counted.Results The withdrawal symptoms of the withdrawal group were significant, scores of all signs were significantly higher than those of the dependence groups and control group(P

Objective The ultrastructure of the distal CSF-contacting neurons in the dorsal raphe and the relationships with their surrounding tissues were observed and a new morphological evidence for their functional significance was offered. Methods We combined CB-HRP tracing with electron microscopic techniques and observed the ultrastructure of the distal CSF-contacting neurons in the dorsal raphe and the relationships with their surrounding tissues. Results 1.The CSF-contacting neurons have the general cytological structure of neurons; 2.CB-HRP mainly is localized in the trans face of the Golgi apparatus and lysosomes;3.There are two kinds of contrary direction synaptic relationships between the distal CSF-contacting neurons and the non-CSF-contacting neurons.Conclusions 1.There are no obvious differences between the CSF-contacting neurons and other neurons in ultrastructure;2.The Golgi apparatus and the lysosomes may exist the special function in take and transport the material from CSF;3.The CSF-contacting neurons can not only transport the material or deliver the information from the dorsal raphe to CSF,but also from CSF to the dorsal raphe.

It was found that the training targets, offered courses and training levels differed greatly in China and foreign countries by comparing the domestic and foreign education of health information management and the offered courses for undergraduates in 8 foreign and 11 domestic medical universities , indicating thateducation of healthin -formation management should be internationalized and standardized with the IMIA international recommendations as its guidance , its training target defined, and its course system rationalized .

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.

Animals ; Brain Injuries ; blood ; cerebrospinal fluid ; chemically induced ; Endotoxins ; toxicity ; Female ; Male ; Natriuretic Peptide, C-Type ; analysis ; Neurotensin ; analysis ; Rabbits

Growth year is one of the important factors for the quality of Polygala tenufolia. In this study, primary metabolites and secondary metabolites were compared in 1, 2 and 3 years old P. tenufolia cultivated in Shaanxi Heyang. The samples were subjected to ultra-high performance liquid chromatography (UPLC)-quadrupole time-of-flight mass spectrometry (Q-TOF MS) and nuclear magnetic resonance (NMR) analysis, and the obtained data were analyzed using principal component analysis (PCA) and other statistical analysis methods. In addition, content and correlation of different metabolites were also calculated. The results showed no significance between main component contents in 2 year-old and 3 year-old P. Tenufolia, but 1 year-old was statistically different. The contents of primary metabolites, such as fructose, sucrose, and choline increased as time goes on, while glycine and raffinose decreased. The contents of secondary metabolites, such as onjisaponin Fg, polygalasaponin XXVIII, polygalasaponin XXXII increased, while polygalaxanthone III and parts of oligosaccharide multi-ester including tenuifoliose A, tenuifoliose C, tenuifoliose C2 and tenuifoliose H decreased with the extension of the growth years. Growth years has important impact on the quality of P. tenuifolia and the existing growing years of commodity P. tenuifolia have its scientific evidence. This study supplied a new method for the quality evaluation of Chinese medicinal materials.

OBJECTIVE: To optimize the formula of retinoid self-emulsifying preparation. METHODS: The formula of retinoid self-emulsifying drug delivery system was optimized with the solubility of retinoid in different kinds/proportions of oil phases and surfactants as index through solubility test and drawing of ternary phase diagrams. RESULTS: The optimized formula ratio of retinoid self-emulsifying preparation was 0.01∶0.938∶0.402∶0.15 (retinoid / IPM/ Tween-85/ isopropanol, g∶g∶g∶mL). CONCLUSION: The retinoid self-emulsifying preparation prepared in accordance with the above-mentioned ratio is up to the related standard.