Objective:To modify amino in the neurotoxin,learn about modified neurotoxin′s activity.Methods:We made rat models that were suffered from spinal injury and had marked muscular hypertonia.We separated neurotoxin from agkistrodon in ZheJiang,modified amino in the neurotoxin by using acetic anhydride,then applied the modified neurotoxin to rats in order to know about its effects,and used the physiological recorder to authenticate its effects.Results:The modified neurotoxin was applied to the rats by injecting to the abdominal cavity.These rats 'muscular hypertonia was improved,and their survival time was much longer.Conclusion:Amino in the neurotoxin is an important radical.

Objective:To separate neurotoxin from the snake venom.Methods:The neurotoxin was separated by using DEAE-Sephadex A-50 chromatography and Sephadex G-50 gel filtration,then identified by the physiological recorder and so on.Results:The neurotoxin was not only separated effectively,but also had good biological activities.Conclusion:This experimental method can be applied.

Objective To apply doctor-patient communication model to improve students doctor-patient communication, and to raise medical quality. Methods 200 patients were allocated to observation group and control group randomly. In the observation group, we applied doctor-patient communication model,the other with common education schema. In order to appraise clinic effect,60 students were allocated to observation group and control group randomly. We applied doctor-patient communication model based on common medical education to the observation group, the other with common medical education. Results Patients in treatment group had more apparent clinic effect than control group.Students in treatment group. had more apparent capability than control group. Conclusion Application of doctor-patient communication in department of Neurology can improve stu-dents'clinic study and improve their clinic quality,and it can also completely cultivate the ability .of new type of medical talents.

Objective To observe the effects of dual antiplatelet therapy at different time after cervical artery stenting and to investigate the reasonable time for dual antiplatelet therapy. Methods Sixty-six patients with symptomatic cervical artery artery stenosis ＞50% or asymptomatic stenosis ＞70% performed stenting under local anesthesia. They were randomly allocated into dual antiplatelet therapy (aspirin + clopidogrel) for 1 month and for 3-month groups after procedure, and then they began to take aspirin for a long time. The complications, vascular events, and the incidence of restenosis were observed respectively. Results There were no vascular events and death in both groups from 6 to 36 months after procedure. There was no significant difference in the incidence of complication and restenosis (9% vs. 6%, P = 0. 642). Conclusions There was no significant difference in the efficacy of aspirin + clopidogrel treatment after cervical artery stenting between 1 month and 3 months. One month dual antiplatelet therapy may be appropriate, but large-scale randomized controlled trials are needed to confirm it.

Objective To investigate the clinical symptoms and MRI imaging findings in patients with autoim-mune encephalitis and to improve clinician's understanding about the clinical and imaging characteristics of autoim-mune encephalitis. Methods We analyzed the clinical features and MRI findings of 33 patients with autoimmune en-cephalitis in our department. Results Of these 33 patients, 27 (81.8%) had psychiatric symptoms, 26 (78.8%) had seizure, 18 (54.5%) had involuntary movement, 11 (33.3%) had fever and 9 (27.3%) patients presented with cen-tral hypoventilation, the present of involuntary movement and fever was lower in group LE than in group NMDA. A total of 10 patients had positive MRI finding. Of these 10 patients, 8 had brain parenchyma lesions, 3 had meningeal involvement. The most likely affected parenchymal lesions are occipital lobe, bilateral hippocampus, frontal lobe, pari-etal lobe, temporal lobe, thalamus and cerebellum. Conclusion Psychiatric symptoms and seizure are the most com-mon neurological symptoms of autoimmune encephalitis. MRI may show abnormal signals in the limbic system. FLAIR is the most sensitive MR imaging sequence for detection of autoimmune encephalitis lesions.

Objective To explore the unique relationship between Willis circle and cerebral watershed infarction in a Chinese population. Methods A retrospective analysis of cerebral CT angiography was conducted in 471 non-cere?bral watershed infarctions and 93 MRI-diagnosed cerebral watershed infarctions (CWI)(including External CWI and In?ternal CWI)in Department of Neurology of our hospital and compare the related variations and types of Willis circle be?tween these groups. Results Compared with non-cerebral watershed infarctions, the prevalence of Uni-FTP (short for“fetal type of the Posterior cerebral artery”) in E-CWI (36.4%, P<0.05) and Bi-FTP in I-CWI (0%, P<0.05) was signifi?cantly higher in cerebral watershed infarctions. Conclusion FTP is probably an unique risk factor in Chinese patients with CWI.

Objective:To investigate the effect of ultrasound-guided midline catheter placement on the incidence of catheter-related bloodstream infection (CRBSI) in severe emergency patients.Methods:Five hundred and twenty-nine patients were chosen as the research objects from March 2018 to December 2019 at Emergency Intensive Care Unit, which was divided into the experimental group ( n=278) and the control group ( n=251). In the experimental group, ultrasound-guided midline catheter was used as central venous catheter (CVC) removal method of sequential, and in the control group, peripheral venous indwelling needle was used as sequential method after removal of CVC. CVC, midline catheter and the indwelling time of indwelling needle were counted. The utilization rate of CVC was compared between the two groups. Kaplan-Meier survival curve was plotted to describe the CVC indwelling time of the two groups and log-rank test was performed. Cox regression analysis was performed to analyze the influencing factors of CVC indwelling time and compare the incidence of CRBSI and other catheter-related complications. Results:The CVC indwelling time of the experimental group was significantly shorter than that of the control group (8 d vs. 13 d, P=0.000). The CVC utilization rate of the experimental group was significantly lower than that of the control group (49.83% vs. 80.45%, P=0.000). Multivariate Cox regression analysis showed that difficult intravenous access, length of ICU stay, the site of catheter placement, and midline catheter implantation without ultrasound-guidance were independent risk factors for prolonged CVC indwelling time ( P=0.000). The CRBSI rate of the experimental group was significantly lower than that of the control group (0.571‰ vs. 3.802‰, P=0.038). There was no significant difference in the incidence of other catheter-related complications between the two groups ( P=0.403). Conclusions:Ultrasound-guided midline catheter implantation can shorten the indwelling time of CVC, reduce the utilization rate of CVC, and reduce the incidence of CRBSI, which is worthy of clinical promotion.

Parkinson's disease (PD) is a common degenerative neurological disease in middle-aged and elderly people,which is characterized by typical motor symptoms.The accompanying non-motor symptoms are also getting increasingly attention.Among them,psychosis associated with Parkinson's disease accounted for 30％-80％ of patients with Parkinson~ disease,mainly in PD patients treated for 10 years or more,and the severity of mental symptoms have a greater impact on the quality of life of patients.This article provides a brief review of the current state of drug treatment for psychosis associated with Parkinson's disease (PDPs).