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.

This article introduces the proteomic study of the cell lines,tissue,pancreatic juice and serum from well-diagnosed patients of pancreatic cancer,benign pancreatic disease,normal control,etc.The highly specific and sensitive biomarkers and their significant roles in the mechanism of development and progress of pancreatic cancer,early diagnosis,therapy monitoring,prognosis,follow-up,and so on,are presented and discussed.

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.

MicroRNA(miRNA)is a kind of 22 nt endogenous small non-coding single strand RNA and is universally present in animals and plants.It can suppress the expression of target genes at post-transcription al level by complementary biding to the 3'UTR of target mRNAs.Recent studies indicate that microRNA is closely associated with tumorigenesis,differentiation,metastasis and relapse.MicroRNA might act as a new biomarker of tumor diagnosis and a new target of tumor gene therapy.

Transient ischemic attack (TIA) is an independent risk factor of stroke. About two-thirds patients with TIA will reoccur TIA or stroke. To predict the risk of stroke after the onset of TIA may identify the prognosis of patients, so as to have an intervention for the high-risk patients as early as possible. This article reviews the various risk assessment tools for stroke after TIA, in order to provide ideas for the prognostic assessment of TIA.

Objective To evaluate the clinical practical value of the heart rate viability test in the patients with malignant tumor during their therapies. Methods Totally 187 cases were analyzed and were divided into three different groups, which included 90 malignant tumor patients before therapy, 45 patients with chemotherapy and 52 non-malignant tumor cases (control group). We compared four HRV indexes(ASDNN5,SDANNS, SDNN and RMSSD) of the patients between the different groups as well as inside each group. Results There were statistical significances in the indexes of ASDNN5, SDANN5 and SDNN of patients at different stages before therapy, the three indexes of the stage Ⅲ group were lower than those of the stage Ⅰ group and the control group as well. The three indexes of the stage Ⅳ group compared with the stage Ⅰ group or the control group (P<0.05) were lower either. There was also statistical significances in SDNN between the stage Ⅲ and the stage Ⅱ of the before-therapy group (P< 0. 05). The indexes of SDANN5 and SDNN of the stage Ⅳ in the chemotherapy group were lower than those of the same stage in the before-therapy group(P<0.05). Conclusions The later the stage of malignant tumor patients is, the more the index of HRV declines. Chemotherapy may affect autonomic nerve function of stage Ⅳ patients with malignant tumor and decrease their HRV.

[Objective] We summarizes the professor Shao Changrong's experience in treating COPD by using invigorating spleen and draining dampnessmethod. [Method] This paper analyzes the etiology, pathology, therapeutic principle and relevant case revealing about the COPD patients with insufficien-cy of the spleen and phlegmatic hygrosis. And we explain the Pro. Shao's empirical prescription cal ed Ping-Ke-Hua-Tan decoction. [Results] In his view, COPD attack and aggravation are related with phlegmatic hygrosis. The fundamental reason is the insufficiency of the spleen and the external reason is phlegmatic hygrosis. Its mechanism is mostly the blending of excessiveness and deficiency. [Conclusion] Theinvigorating spleen and draining dampnessmethod is effective in treating COPD. Pro. Shao Changrong's diagnosing and treating of COPD is worthy widely clinical reference and promotion.