The neurotoxicity related to immune checkpoint inhibitors (ICI) is rare, and the clinical experience remains limited. This paper reported an elderly male patient with advanced small cell lung cancer (SCLC). Following two circles of chemotherapy combined with immunotherapy (serplulimab, 200 mg), the patient developed fatigue, cognitive impairment, motor apraxia, and ataxia. Based on the examination of blood neurotransmitters and brain magnetic resonance imaging, the patient was diagnosed with ICI-associated encephalitis, and his symptoms improved after hormone treatment.

Objective:To observe the changes of peripapillary vessel density and retinal nerve fiber layer parameters (RNFL) in diabetic mellitus (DM) patients with early diabetic retinopathy (DR).Methods:A retrospective clinical study. From January to December 2018, twenty-eight DM patients (47 eyes, DM group) and 20 normal subjects (40 eyes, control group) in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. There was no significant difference between the two groups in age ( t=-1.397, P=0.169) and sex composition ratio ( χ2=0.039, P=0.843). The optic nerve head was scanned by OCT angiography (OCTA) with HD 4.5 mm ×4.5 mm imaging scanning mode for all subjects. The peripapillary radial peripapillary capillaries vessel density (ppVD) and peripapillary retinal nerve fiber layer (pRNFL) thickness were measured. The changes of ppVD and pRNFL thickness between the two groups were observed. Pearson correlation analysis was used to analyze the correlation between ppVD and pRNFL in each quadrant. Results:Compared with the control group, the mean ppVD and superior-hemi part, inferior-hemi part, superior, nasal, inferior and temporal quadrant ppVDs of DM group were all significantly lower than those of control group ( t=5.107, 4.360, 3.713, 4.007, 2.806, 4.046, 2.214; P<0.05). The mean and all quadrants pRNFL thickness were lower in eyes of DM group compared with the control, and the superior and inferior quadrant pRNFL thickness were statistically significant ( t=2.117, 2.349; P<0.05), while the mean pRNFL and superior-hemi, inferior-hemi part, nasal and temporal quadrant were not statistically significant ( t=1.867, 1.717, 1.869, 0.720, 0.303; P>0.05). Pearson correlation analysis showed that the significant high-positive correlation was found between ppVD and pRNFL thickness in the nasal quadrant ( r=0.734, P<0.001). Conclusion:In early DR patients, ppVD decreased and pRNFL thinned.

OBJECTIVE To observe the clinical characteristics and risk factors of the hospital-acquired infection among uremia patients.METHODS The clinical data of 187 cases of uremia were retrospectivety analyzed during from Apr 2003 to Dec 2006.RESULTS There were 61 cases with hospital-acquired infection.The infection rate was 32.6%.The repiratory(54.1%) and urinary(21.3%) systems were the main infection sites.The main pathogens were Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis,S.aureus and fungi.The related factors were renal function,serum albumin,hemoglobin,duration in hospital,age and invasive medical procedures.CONCLUSIONS The hospital-acquired infection with uremia is with higher rate in respiratory system.The risk factors are renal failure,decrease in serum albumin and hemoglobin,abuse use of antibiotics and invasive medical procedures and deserve corresponding nursing strategy.

0 05) CONCL_USION:The adsorption of infusion set will not result in obvious changes of drug concentration