Objective:To explore the clinical characteristics of patients with antibodies against contactin-associated protein-like 2 (CASPR2).Methods:The clinical data of 24 patients with anti-CASPR2 encephalitis diagnosed at the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2022 were retrospectively analyzed. According to the age of first onset, the patients were divided into early onset group (10 cases, onset age<45 years) and late onset group (14 cases, onset age≥45 years). The clinical data including clinical manifestations, auxiliary examinations, and treatment response between these 2 groups were compared.Results:Among the 24 patients, there were 13 cases with epilepsy, 13 cases with cognitive decline, 13 cases with mental disorders, 14 cases with autonomic dysfunction, 8 cases with peripheral nerve hyperexcitability, 5 cases with Morvan syndrome, 5 cases with unstable walking, and 8 cases with sleep disorders. Among the 10 cases of the early onset group, 7 cases are females, and 8 cases showed epilepsy. The incidence rate of epilepsy in the early onset group was higher than that in the late onset group (5/14, Fisher exact probability, P=0.047). Among the 14 cases of the late onset group, 6 cases are females, 9 cases showed cognitive impairment and 8 cases presented with mental disorders. There were 6 cases with abnormal brain magnetic resonance imaging (MRI). The cerebrospinal fluid protein of the late onset group [0.37 (0.29, 0.58) g/L] was higher than that in the early onset group [0.22 (0.16, 0.30) g/L; Z=-2.667, P=0.008]. The modified Rankin Scale (mRS) scores before and after treatment were 3.29±0.83 and 1.50 (0.75, 2.25), which were higher than those in the early onset group [mRS scores before and after treatment were 2.10±0.99 and 0 (0, 1.00), t=-3.188, P=0.004; Z=-2.335, P=0.020]. Conclusions:There are various symptoms in patients with anti-CASPR2 encephalitis. The early onset patients are common in women, with a higher incidence of epilepsy. The late onset patients are common in males, with prominent manifestations of cognitive impairment and mental disorders, which have a greater impact on daily living abilities. And abnormal MRI findings are common, and the cerebrospinal fluid protein is higher in late onset patients. Anti-CASPR2 antibody may cause more severe immune damage to the nervous system in elderly patients.

Objective:To explore the effect of mindfulness-based stress reduction combined with knowledge, attitude and practice nursing in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) .Methods:From January 2019 to January 2020, convenience sampling was used to select 80 patients with OSAHS admitted to the Department of Sleep Medicine, Second Hospital of Shanxi Medical University as the research object. The control group received routine nursing, and the observation group conducted mindfulness-based stress reduction combined with knowledge, attitude and practice nursing on the basis of the control group, and the intervention period was 1 month. The daytime sleepiness, psychological resilience and quality of life were compared between the two groups before and after the intervention.Results:After the intervention, the Simplified Chinese version of the Epworth Sleepiness Scale score in the observation group was lower than that in the control group, and the total score and all dimension scores of the Connor-Davidson Resilience Scale and the score of each dimension of the Calgary Sleep Apnea Quality of Life Index were higher than those in the control group, with statistical differences ( P<0.05) . Conclusions:Mindfulness-based stress reduction combined with knowledge, attitude and practice nursing can reduce daytime sleepiness in patients with OSAHS, and improve their psychological resilience and quality of life.

Objective To measure quantitatively and analysis the differences in the anterior segment biological parameters between the normal subject and patients suffering primary angle closure glaucoma (PACG),as well as the distinction among different stages of PACG by using anterior segment optical coherence tomography (OCT).Methods A retrospective case series study was designed.Medical records of 217 cases (217 eyes) from The Second Hospital of Hebei Medical University from December 2013 to December 2014 were recruited,including 5 groups as follows:35 cases (35 eyes) with pre-clinical stage acute primary angle closure glaucoma (APACG),32 cases (32 eyes) with remission period of APACG,35 cases (35 eyes) with early stage of chronic primary angle closure glaucoma (CPACG),35 cases (35 eyes) with progress period of CPACG and 80 cases (80 eyes) coming for regular eye health examination in general clinic.The anterior segment biological parameters of each group was measured by Heidelberg Spectralis OCT,including the anterior chamber width (ACW),angle opening distance (AOD),trabecular iris area (TISA),iris thickness (IT) and crystalline lens rise (CLR).Results The IT and CLR of APACG and CPACG were significantly greater than normal control group,while other anterior segment parameters were significantly smaller,with significant differences between them (all at P＜0.01).The IT and CLR of APACG was bigger than those of CPACG,with significant differences between them (both at P＜0.05),the ACW,AOD,TISA of the two gruops showed no significant differences.The AOD and TISA of remission period of APACG were significantly decreased than those of pre-clinical stage (all at P＜O.01).The IT and CLR of remission period APACG was significantly greater than pre-clinical stage (both at P＜0.01).The difference in ACW of the two group was not statistically significant (P＞0.05).Compared with progress period of CPACG,the IT of the early stage of CPACG was thicker,while the CLR was smaller (both at P＜0.01).There was no significant difference in ACW,AOD and TISA between the two groups.The IT2000 and ITmax of pre-clinical stage of APACG were significantly smaller than those of early stage of CPACG (both at P＜0.01).There was no significant difference in other parameters between the two groups (P＞0.05).The IT750,IT2 000 and ITmax of the pre-clinical stage of APACG were significantly thicker than those of progress period of CPACG (all at P＜0.05).There was no significant difference in other parameters between the two groups (P＞0.05).Conclusions Compared with normal people,the PACG patients have a more crowding anterior segment structure,smaller AOD,smaller TISA,thicker IT and more anterior located lens.The APACG patient at remission period has a more crowding anterior segment structure,smaller AOD,smaller TISA,thicker IT and more anterior located lens than APACG patient at per-clinic stage.The CPACG patient at progress period has a higher CLR,but thinner IT than patient at early stage.The APACG patients at per-clinic stage has thicker IT and a more crowding anterior segment structure than the CPACG patient at early stage,and the APACG patient at remission period has thicker IT than CPACG patient at progress period.