Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome of central nervous system.The main clinical manifestations include psychiatric symptoms,movement disorders and seizures.It is often misdiagnosed as viral encephalitis.Tumors,especially the ovarian teratoma,play an important role in the disease.The prevalence in children is beyond imagination.Anti-NMDAR antibodies are specific diagnostic tests.Immune suppression is the main treatment.The first-line treatments include corticosteroids,intravenous immunoglobulin,and plasmapheresis.The second-line treatments include biological agents and cytotoxic drugs.Early diagnosis and treatment are essential for neurologic recovery.Overall prognosis is good.

Objective To investigate the effect of Tongxinluo capsule combined with metoprolol on elderly patients with coronary heart disease and angina pectoris and its influence on hemorheology and inflammatory factors.Methods 135 elderly patients with angina pectoris of coronary heart disease were selected,and they were randomly divided into treatment group (68 cases) and control group (67 cases).The treatment group was treated with Tongxinluo capsule combined with metoprolol,while the control group was treated with metoprolol.The two groups were treated for 8 weeks.The curative effect of the two groups was compared,the number and duration of angina pectoris,the changes of hemorheology and inflammatory factors before and after treatment were compared.Results The total effective rate of the treatment group (94.12％) was higher than 76.12％ of the control group (P ＜ 0.05).After treatment,the frequency and duration of angina pectoris in the treatment group were (6.03 ± 1.21) times/week and (3.02 ± 0.76) min/time,respectively,which were significantly lower than those in the control group [(9.87 ± 1.46) times/week and (4.86 ± 0.98) min/time] (t =16.649,12.201,all P ＜ 0.05).After treatment,the whole blood viscosity at high shear rate [(3.76 ± 0.41) mPa/s],whole blood viscosity in low shear [(8.13 ± 0.76) mPa/s],plasma viscosity [(1.23 ± 0.08) mPa/s],erythrocyte aggregation index [(2.06 ± 0.27)],fibrinogen [(2.46 ± 0.41) g/L] in the treatment group were lower than those in the control group[(4.53 ± 0.52) mPa/s,(9.61 ± 0.89) mPa/s,(2.09 ± 0.27) mPa/s,(2.63 ± 0.35),(3.53 ± 0.62) g/L] (t =9.562,10.396,25.170,10.604,11.844,all P ＜ 0.05).After treatment,the interleukin-6 (IL-6) [(8.49 ± 1.76) pg/mL],intercellular adhesion molecule-1 (ICAM-1)[(85.25 ± 8.92) pg/mL],C reactive protein (CRP) [(8.74 ± 1.76) mg/L] in the treatment group were lower than those in the control group[IL-6 (11.32 ± 2.10) pg/mL,ICAM-1 (103.42 ± 10.72) pg/mL,CRP (14.98 ± 2.24)mg/L] (t =8.491,10.712,18.012,all P＜0.05).Conclusion Tongxinluo capsule combined with metoprolol in the treatment of elderly patients with coronary heart disease angina pectoris has obvious curative effect,and can improve the patients'blood rheology and inflammatory reaction.

ObjectiveTo investigate the relationship between carotid atherosclerosis and progressing stroke.Methods103 patients with acute cerebral infarction within the first 24 hours from onset were tested with carotid color doppler ultrasonography during the first week from admission. Univariate and multiple logistic regression analyses were performed to examine the relationship between carotid intima media thickness (IMT), plaque structure, the degree of artery stenosis and the early deterioration of cerebral infarction.ResultsPrevalence of carotid plaque and thickness of IMT in patients with progressing stroke were higher than that in non progressing patients. In logistic regression, presence of carotid plaque was independent predictors of progressing stroke. Plaque size, extent of artery stenosis and IMT were not included in the regression model.ConclusionPlaque structure and its chemical feature may be the cause of progressing stroke.

As the most popular simplified model of the optical imaging system, the acquisition of the Gaussian point spread function (PSF) parameter is one of the hotspots and key points on which people do research in the field of image restoration. Based on the idea by which there exists deterministic mathematical relationship between Gaussian OTF feature points as well as its parameter and the frequency representation of the image in an existed literature, we proposed an automatic, accurate, stable, and improved approach. This method is able to give prominence to the related calculation feature by a Gaussian convolution and degeneration operation and finally realize the automatic esti mation of PSF parameter of a microscopic image. Experiments have proved that a good restoration result can be achieved utilizing the estimated PSF by the present method, which is of considerable application and reference value in restoration of other sorts with Gaussian approximate PSF model or 3D microscopic image restoration.
Algorithms ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; Microscopy ; Models, Theoretical ; Normal Distribution

Coronal restoration of endodontically treated teeth may be viewed as one of the main parameters that influence the outcome of endodontic treatment. The purposes of restoring endodontically-treated teeth include preventing recontamination of the root canal system and periapical area, replacing the compromised dental hard tissue, restoring the coronal morphology and function, providing necessary strength for the restoration/tooth complex for functional stress, and avoiding crown and/or root fracture. This article reviewed recent researches on the restoration of endodontically treated teeth, provided evidence for clinical practice on topics as when to restore them, basic principles to be considered during treatment planning, and specific restoration options for both anterior and posterior teeth under different functional occulsal load conditions. Several issues should be taken into account during the decision making process, such as remaining tooth tissue, functional masticatory forces, comprehensive oral rehabilitation, and esthetic requirements.
Decision Making ; Dental Restoration, Permanent ; Humans ; Root Canal Therapy ; Tooth Crown ; Tooth, Nonvital

ObjectiveTo explore the factors related to infections of intravenous catheter as well as preventive measures.MethodsIn 598 cases of patients with central venous catheterization,indwelling time,location,bacteriology were monitored among 130 patients with suspected venous catheter infection.ResultsIndwelling catheter lasts for 3 days at least,70 days at most.For 77 out of toual cases,microbiology culture of catheter tip and blood culture were positive,accounting for 12.88％.Detected pathogens were 151 in total.Gram-negative bacteria were 48(31.79％),gram-positive bacteria were 78(50.65％),fungal were 25 (16.56％).Among these,the most common pathogens were Staphylococcus epidermidis,Staphylococcus aureus,Candida and Acinetobacter,most of the bacteria had a high degree of drug resistance.The choice of position:infection rate of subclavian vein and basilic vein was lower than that of the superclavian vein and internal jugular vein,infection rate of catheterization time ≤ 13d was lower than that of ≥ 14d.ConclusionsThe choice of subclavian vein and basilic vein,standardization of puncture technical,strict catheter care,shortening of catheterization time and improvement of the general condition of patients can reduce catheter-reiated infections.The rational use of antibiotics is a critical measure to reduce vascular catheter infections of patients.

Objective To explore the multidisciplinary treatment for acute massive gastrointestinal (GI) bleeding caused by Dieulafoy's lesion.Methods The clinical data of 48 patients with Dieulafoy's lesions treated at our hospital from April 2007 to April 2012 were retrospectively analyzed.Of the 48 patients,40 were males and 8 were females,with a mean age of 46.7 years (range 21 -52 years).Accurate diagnosis was established by emergency upper gastrointestinal endoscopy, angiography and emergency laparotomy.Results The most common location of the bleeding Dieulafoy's lesion was at the body of stomach (40 cases),followed by the cardia (4 cases),the duodenum (2 cases) and the jejunum (2 cases ),with most lesions being located in the upper part of the stomach within 6 cm of the gastroesophageal junction.Correct diagnosis was made by endoscopy in 46 patients and by emergency laparotomy in 2 cases.Of the 18 patients initially treated endoscopically epinephrine injection and endoscopic hemoclips,2 cases needed angiography to identify the source of bleeding and were cured by transcatheter arterial embolization.23 patients underwent surgical therapy.In this series,47 cases were cured,1 patient died of hypovolaemic shock and multi-organ failure during the hospital stay.Average length hospital stay was (10.8 ± 2.5 ) d.Conclusions Dieulafoy' s lesion is less common cause of gastrointestinal bleeding.Endoscopy plays a key role in the diagnosis and treatment.Topical epinephrine injection and haemoclipping may cure the patients,if it fails angiography and embolization provides a therapy.Most patients may need a laparotomy and surgery as a decisive measure.

Objective To understand the total score of health management knowledge demand and self evaluation score of known health management knowledge,in order for hospitals to take more reasonable and effective health management education for patients after discharge.Methods From March to May of 2012,700 patients in a certain three level of first-class general hospital were selected before their discharge,using self-made health management questionnaire for investigation.The total score of health management knowledge demand and score of known health management knowledge among 700 patients with different demographic characteristics underwent statistics.Results After investigation,the results showed that patients with different nationalities,payment method,the average monthly income,family history,residence and intend demonstrated statistical significance in total score of health management knowledge requirement.Patients with different occupation,culture degree and accept frequency showed statistical significance in known health management knowledge.Conclusions According to the current investigation of total score of different health management knowledge demand and known health management knowledge in patients with different demographic characteristics,the hospital should take corresponding adjustment for health management mission to ensure the health management quality of patients after discharge,and improve the health management level of patients after discharge.

Mercury is one of the ubiquitous environmental neurotoxins which causes adverse effects on the development of children's neural system.Considering the severe neurotoxicity of mercury,finding and minimizing the sources of mercury exposure is essential for children's health.Amongst the mercury compounds,the toxicity of organic mercury is the most severe.Methyl mercury (MeHg) is the most detrimental and represents a major source of human exposure of mercury.Recent studies on molecular mechanisms of MeHg neurotoxicity points out that MeHg mainly mediates its toxic effects through the impairment of intraceilular calcium homeostasis,alteration of glutamate homeostasis,and oxidative stress.These concepts provide the biochemical interpreting of MeHg neurotoxicity.This review provides the current information on mercury,including environmental sources,neurotoxicity,and molecular mechanisms of MeHg-induced neurotoxicity.It will be helpful to find some effective ways of interfering children mercury exposure.