Background::The scale assessment was helpful in predicting the presence of antibodies to autoimmune encephalitis. This study aimed to evaluate the application of antibody prevalence in Chinese patients with epilepsy and encephalopathy (APE2-CHN) and response to immunotherapy in Chinese patients with epilepsy and encephalopathy (RITE2-CHN) for patients with different neuronal surface antibodies.Methods::A total of 1365 patients with epileptic seizures as the prominent feature in Xuanwu Hospital, Capital Medical University, from June 2016 to June 2020 were enrolled in our study. Of these, 915 patients with epilepsy of unknown etiology whose serum and/or cerebrospinal fluid samples were examined for autoimmune antibodies were selected. All patients were scored with antibody prevalence in patients with epilepsy and encephalopathy (APE2), response to immunotherapy with epilepsy and encephalopathy (RITE2), APE2-CHN, and RITE2-CHN scores.Results::Of the 915 patients, 191 patients were positive for neural-surface specific antibodies (115 N-methyl-D-aspartate receptor (NMDAR) Ab, 47 leucine-rich glioma-inactivated protein 1 (LGI1) Ab, 8 contactin-associated protein 2 (CASPR2) Ab, 4 AMPA2RAb, and 11 GABAR-B-Ab; 3 CASPR2-Ab and LGI1-Ab, 2 NMDAR-Ab and CASPR2-Ab, and 1 NMDAR-Ab and myelinoligodendrocyte glycoprotein [MOG] Ab). The sensitivity and specificity of APE2 ≥4 in predicting the presence of neural-surface specific antibodies in our study were 74.35% and 81.77%, respectively, and the sensitivity and specificity of APE2-CHN ≥4 were 75.92% and 84.53%, respectively. Eight cases had an APE2 score <4 and APE2-CHN score ≥5; all these patients had memory decline as the prominent manifestation. We divided the patients into six groups according to the different antibodies. APE2-CHN scores showed higher sensitivity for the prediction of NMDAR-Ab, but lower sensitivity for LGI1-Ab. A total of 187/191 (97.91%) patients received immunotherapy and 142/191 (74.35%) patients benefited from the treatments. The patients who were positive for LGI1-Ab with RITE2-CHN ≥8 responded well to immunotherapy.Conclusions::APE2-CHN had the highest value for predicting the positivity of NMDAR-Ab and RITE2-CHN evaluated the response of immunotherapy for anti-LGI1 encephalitis appropriately. However, RITE2 and RITE2-CHN do not appear to be good predictors of immunotherapy outcomes for patients with specific neuronal-surface antibodies and high APE2-CHN scores are often indicative of a poor response to immunotherapy.

背景:小儿股骨头坏死又称为Perthes病,自从被发现以来受到人们的广泛关注,对该病的研究与探索也在不断深入.目的:旨在探讨Perthes病在全球的研究现状与发展趋势.方法:通过Wed of Science核心合集的科学引文索引扩展数据库检索1994年至2018年7月30日关于Perthes病的相关文献出版物,用文献计量学的方法对所收集数据进行数据统计及研究.使用Vos viewer软件进行文献耦合分析及共现分析等,分析Perthes病在全球范围内的研究现状及发展趋势.结果与结论:①共纳入1106篇研究,全球的研究发表物呈波动式逐年递增,而其中美国在该领域的研究保持领先地位,研究文献被引用次数及H指数均远超排名第2位的国家;②《JOURNAL OF PEDIATRIC ORTHOPAEDICS》杂志的出版物发表量排名榜首,达到125篇;③"TEXAS SCOTTISH RITE HOSP CHILDREN"是文献发表物数量贡献最大的机构;④而研究方向可以分为5大集群:"治疗方法、疾病特征、临床诊断、发病机制和骨代谢疾病",其中"评分"的研究是近年来新提出的关注点;⑤由目前的全球趋势可以预测,关于Perthes病的研究还有很大的探索空间,对应的文献出版物数量将不断增加,其中美国在这一领域保持着明显的领先地位.目前的研究集中于Perthes病中的"疾病特征",而"评分"是该领领域新的关注点.

目的：探讨视锐V超声直视下前置局麻方法在PICC置管中的止痛效果，为PICC置管患者提供超前镇痛，实现置管全程的无痛护理。方法选择行视锐V超声引导下结合改良塞丁格技术行PICC置管的患者60例，采用随机数字表法随机分为观察组和对照组，每组各30例。观察组穿刺前利用视锐Ⅴ血管超声仪直视靶血管使用0．2％利多卡因0．3 ml行皮下局部浸润麻醉，对照组经皮穿刺后扩皮前再行0．2％利多卡因0．3 ml皮下局部浸润麻醉。比较两种麻醉方式下患者疼痛指数、置管过程中的患者感受程度和患者满意度。结果观察组患者置管全程疼痛评分平均为（5．29±2．89）分，对照组为（5.77±2．34）分，两组比较差异有统计学意义（t＝-0．710，P＜0．05）。观察组患者静脉穿刺感受评估级别低于对照组，穿刺部位短暂的刺痛感受患者20例，对照组3例，两组比较差异有统计学意义（ Z＝-4．743，P＜0．05）。观察组患者满意度为73．3％，对照组为53．3％，两组比较差异有统计学意义（χ2＝199．000，P＜0．01）。结论视锐V超声直视下超前镇痛局麻方法在PICC置管中能准确有效的对穿刺局部进行麻醉，缓解置管过程中的疼痛，改善置管过程患者舒适度，提高患者置管满意度。

目的 探讨在超声引导下辅助改良塞丁格技术在PICC置管中应用的效果.方法 选取2009年10月至2010年2月经我院PICC专科护士会诊后认为无法在直视下穿刺置入PICC管的60例患者,经Site-Rite 5超声引导下辅助改良塞丁格技术置入三向瓣膜PICC管,分析其置管效果.结果 60例患者均成功置入PICC管,成功率100%,无并发症发生.结论 经超声引导下配合改良塞丁格置入PICC管是一种实用、安全、成功率高的置管方法,对局部血管条件差的患者更突显其优势.

目的:探讨对二氧化钛纳米粒子(TiO2NPs)进行锌(Zn)和氮(N)共掺杂时最适掺杂浓度及Zn和N共掺杂TiO2NPs(Zn-N-TiO2 NPs)对口腔变异链球菌的抑制作用,阐明其作用机制.方法:采用钛酸丁酯、硝酸锌和氨水分别作为钛(Ti)源、Zn源和N源,利用溶胶-水热法合成TiO2 NPs和不同掺杂浓度的Zn-N-TiO2 NPs,通过X射线衍射(XRD)、拉曼光谱、扫描电子显微镜(SEM)和紫外-可见光吸收光谱分析(UV-vis)对纳米粒子进行表征,采用Cure Rite辐射仪对牙科发光二极管(LED)光固化灯进行表征.变异链球菌分为空白对照组、单独LED光照组、TiO2NPs组、1％Zn-3％N-TiO2NPs(Zn1)组、3％Zn-3％N-TiO2NPs(Zn3)组、5％Zn-3％N-TiO2NPs(Zn5)组和7％Zn-3％N-TiO2NPs(Zn7)组.将各组纳米粒子与变异链球菌菌液混合(终浓度为2 g·L-1)摇匀.除空白对照组,其他各组采用牙科LED光分别照射1、3和5 min,空白对照组仅用培养基处理,采用平板菌落计数法记录各组平板菌落数.选取抗菌效果最佳组(Zn3组),利用1,3-二苯基异苯并呋喃(DPBF)探针检测活性氧(ROS)释放量,分为0 min组、1 min组、3 min组和5 min组,每组取2 g·L-1的Zn3-DPBF溶液100μL分别采用牙科LED光照0、1、3和5 min,观察各组溶液在波长410 nm处吸收峰值,即代表ROS释放量.变异链球菌分为对照组、N-乙酰半胱氨酸(NAC)组、Zn3组和NAC+Zn3组,LED光照射5 min后避光培养24 h,采用平板菌落计数法计数各组平板菌落数.结果:成功合成Zn-N-TiO2NPs,晶体结构为锐钛矿型,TiO2NPs组、Zn1组、Zn3组、Zn5组和Zn7组纳米粒子平均晶粒尺寸分别为15.6、11.3、9.8、9.4和7.3 nm;SEM观察纳米粒子为分布均匀的球形颗粒;UV-vis显示Zn3在400～500 nm波长范围内吸光度(A)值明显升高.与空白对照组比较,LED光照射5 min时Zn3组菌落数最少(P<0.05).与0 min组比较,1 min组、3 min组和5 min组Zn3-DPBF溶液在波长410 nm处吸收峰值依次下降,表明各组纳米粒子溶液ROS释放量随光照时间延长而逐渐增加.与Zn3组比较,NAC+Zn3组菌落数明显增加(P<0.05).结论:Zn和N掺杂浓度均为3％的TiO2 NPs(3％Zn-3％N-TiO2NPs)联合LED光照射通过光催化作用能有效抑制口腔变异链球菌的生长.