Objective To investigate the clinical manifestations and prognosis of patients with anti-leucine rich glioma inactivated 1（LGI1）antibody encephalitis. Methods A retrospective analysis was performed for the data of patients with anti-LGI1 antibody encephalitis who were hospitalized in Department of Neurology，Xuanwu Hospital，Capital Medical University，from September 2019 to December 2023，including clinical features，treatment，and prognosis. Results A total of 80 patients were enrolled，including 48 male patients and 32 female patients. Of all 80 patients，51（63.8%）had the initial symptom of epilepsy，13（16.3%）had the initial symptom of faciobrachial dystonic seizures，26（32.5%）had the initial symptom of cognitive impairment，and 12（15%）had the initial symptom of mental and behavioral disorders. As for comorbidities，there were 28 patients（35%）with hyponatremia，22（27.5%）with Hashimoto's thyroiditis，and 5（6.25%）with tumor. All 80 patients tested positive for serum LGI1 antibody，and 69（86.3%）tested positive for LGI1 antibody in cerebrospinal fluid. Among the 80 patients，37（46.25%）had abnormalities on magnetic resonance imaging，and 30 had abnormalities on 18F-FDG PET/CT. There were 50 patients with abnormalities on video electroencephalography. A total of 77 patients received first-line immunotherapy，and after follow-up for 1 year，19.4% of the patients had the sequela of seizure，59.7% of the patients had deterioration of the memory，and 48.6% of the patients had mental and behavioral disorders. Conclusion Epilepsy，cognitive impairment，and mental and behavior disorders are the most common manifestations of anti-LGI1 antibody encephalitis. There is generally a good prognosis after immunotherapy，with the sequelae of cognitive impairment and mental and behavioral disorders.

Catheter associated urinary tract infection (CAUTI) refer to urinary system infections that occur after the insertion of a urinary catheter or within 48 hours after its removal. CAUTI exacerbate patient conditions, prolong hospital stays, increase medical costs and economic burdens on patients, and can be life-threatening in severe cases. The Asia Pacific Society of Infection Control (APSIC) convened a working group of infection prevention and control experts from the Asia-Pacific region to publish the APSIC guideline for prevention of catheter associated urinary tract infections (CAUTIs) (referred to as the "APSIC Guideline"). This guideline encompasses the prevention and management of CAUTI in patients with indwelling catheters, covering the entire process from catheter insertion, maintenance, to removal, and are characterized by their practicability and directive nature. This article interprets the APSIC Guideline from aspects such as risk factors of CAUTI, diagnosis, development of prevention strategies, monitoring, and implementation of prevention plans, aiming to provide scientific guidance for clinical healthcare professionals in preventing CAUTI.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

New Delhi metallo-β-lactamase-1 (NDM-1) is capable of hydrolyzing nearly all β-lactam antibiotics, posing an emerging threat to public health. There are currently less effective treatment options for treating NDM-1 positive “superbug”, and no promising NDM-1 inhibitors were used in clinical practice. In this study, structure–activity relationship based on thiosemicarbazone derivatives was systematically characterized and their potential activities combined with meropenem (MEM) were evaluated. Compounds 19bg and 19bh exhibited excellent activity against 10 NDM-positive isolate clinical isolates in reversing MEM resistance. Further studies demonstrated compounds 19bg and 19bh were uncompetitive NDM-1 inhibitors with Ki = 0.63 and 0.44 μmol/L, respectively. Molecular docking speculated that compounds 19bg and 19bh were most likely to bind in the allosteric pocket which would affect the catalytic effect of NDM-1 on the substrate meropenem. Toxicity evaluation experiment showed that no hemolysis activities even at concentrations of 1000 mg/mL against red blood cells. In vivo experimental results showed combination of MEM and compound 19bh was markedly effective in treating infections caused by NDM-1 positive strain and prolonging the survival time of sepsis mice. Our finding showed that compound 19bh might be a promising lead in developing new inhibitor to treat NDM-1 producing superbug.

As the largest hospital group,performance payment distribution system directly affects the work enthusiasm of nurses.It analyzed and summarized the current 8 deficiencies and defects existing in the wage distribution.It proposed 5 measures and methods to focus on the performance payment so as to improve the enthusiasm of nurses work and promote the medical service quality and the comprehensive performance of hospitals.

Objective:To establish the quality standard system of Gui Erbai gel based on a method ofa system to multiple evalu-ation and discuss the feasibility of the method used for the quality standard for traditional Chinese medicine. Methods:TLC identifi-cation of Gui Erbai gel was established by one thin layer system. An HPLC method was used to detect 6 active components in Gui Erbai gel. Results:Five active components in the gel could be identified by one thin layers system simultaneously with clear spots and good separation. Six active components in the gel could be determined by the same HPLC system with high accuracy. The average content of podophylotoxin,quercetin,kaempferol,imperatorin,dictamnine and rutin is as follows 0. 154,0. 052,0. 138,0. 051,0. 060,0. 048 mg· g-1 . RSD<3％. Conclusion:The established method based on a system to multiple evaluation can be used for the quality standard establishment for Gui Erbai gel with the properties of promising feasibility, simple operation, low cost, high accuracy and good stabili-ty.

OBJECTIVE:To investigate the protective effects of insulin-glucose on myocardium in patients receiving cardiac valve replacement under cardiopulmonary bypass. METHODS:Totally 120 patients receiving combined cardiac valve replacement under cardiopulmonary bypass were divided into control group and observation group according to random number table,with 60 cases in each group. All patients were given routine operation. Control group was given Thomas cardioplegia and oxygenated blood with a ratio of 1:4(V:V)to protect myocardium at 4 ℃. Besides that,the observation group was additionally given Insulin injec-tion 10 IU/L and Glucose injection 10 g/L added into Thomas cardioplegia at 4 ℃ to protect myocardium. The levels of plasma brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnⅠ)before anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after surgery,the rate of recovery of automatic heartbeat after opening aor-ta,the application of vasoactive agent(dopamine)at T1 and the occurrence of postoperative complications were observed and com-pared between 2 groups. RESULTS:At T0,there was no statistical significance in the levels of plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P<0.05);the levels of cTnⅠ began to decrease at T4 and cTnⅠbegan to decrease at T5. However,the levels of BNP and cTnⅠwere significantly lower in observation group than in control group at T1-5,with statistical significance(P<0.05). After open-ing aorta,there was no statistical significance in the rate of recovery of automatic heartbeat between 2 groups(P>0.05). The dos-age of dopamine (at T1) and the incidence of complications in observation group were statistically lower than control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after surgery. CONCLUSIONS:Insulin-glucose can alleviate myocardial damage, reduce the dosage of vasoactive agent and the incidence of postoperative complications in pa-tients receiving combined cardiac valve replacement under cardiopulmonary bypass with significant protective effect on myocardium with good safety.

The paper aims to analyze the flaws of new medical reform policies of cost accounting and bonus based on performance by introducing encouraging mechanism in bonus of the front two wheels: workload efficiency management and cost control management and the refraining mechanism by the two wheels: daily flaws management and key KPI checking.This efficiency-oriented four-wheel driven management mode reflects the reality of work-performance-based distribution, avoidsNine Forbiddingand reflect the public welfare.

Objective To investigate the clinical characteristics and related factors of diagnosis and treatment of patients with hypertensive cerebral hemorrhage,and provide basis for clinical treatment and prognosis.Methods The clinical diagnosis and treatment data of 96 patients with hypertensive cerebral hemorrhage,admitted to our hospital from February 2010 to February 2013,were analyzed.Results In all the 96 patients,improvement was noted in 76 accounting for 79.17％,limb paralysis in 74 accounting for 77.08％ and death in 17 accounting for 17.71％; death within 24 hours of onset was noted in 11 accounting for 11.46％ and within 24-72 hours in 6 accounting for 6.25％.Automatic discharge was observed in 3,accounting for 3.13％.Conclusion Choosing corresponding treatments according to the hematoma sizes in patients with hypertensive cerebral hemorrhage plays important role in improving the prognosis.

Objective To investigate the correlation between asymmetric dimethylarginine (AD-MA) and endothelial dysfunction in patients with uremia.Methods Uremic patients who did not receive hemodialysis were defined as A group (n =40) ; uremic patients who had received hemodialysis were divided into B group (n =45) ;healthy people were defined as C group (n =20) ;and chronic kidney disease (stage 2 ～ 4) patients were defined as D group (n =20).The diameter of intima-media thickness,and endothelium-dependent or independent dilation (EDD or EID) of radial artery in right forearm were detected with diasonography.The levels of ADMA were determined by high-performance liquid chromatography.Results Compared to C group,the levels of ADMA in A,B and D groups were significantly increased [C:(0.78 ±0.19) μmol/L,A:(1.51 ±0.16) μ mol/L,B:(1.13 ±0.14) μmol/L,D:(0.92 ±0.11) μmol/L; P ＜0.05].Compared to A group,the levels of ADMA were significantly decreased in B group (P ＜0.05).EDD and EID were decreased significantly in A,B and D groups compared to C group [EDD:C:(13.52±1.73)％ vs A:(7.32 ±0.54)％,B:(9.02 ±0.86)％,D:(10.13 ±1.25)％,P ＜0.05;EID:C:(14.45±1.85)％ vsA:(10.37 ±1.51)％,B:(9.54±1.39)％,D:(11.17±1.56)％,P ＜0.05].EDD in B group was significantly lower than A group (P ＜0.05).In group A,a negative correlation was found between EDD and the level of ADMA (r =-0.81,P =0.020).Conclusions ADMA level was significantly increased in uremic patients.A close correlation existed between ADMA and endothelial dysfunction of radial artery.