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01 November 2012, Volume 32 Issue 11 Previous Issue    Next Issue

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New techniques for early diagnosis of deep vein thrombosis and thromboembolism in small pulmonary arteries ZHONG Na-Shan 2012, 32(11): 817-819.  Abstract ( )   PDF (2253KB) ( )   Early detection and management are important for patients with thromboenbolism.Based on recent research at Guangzhou Institute of Respiratory Diseases，this paper introduces the use of infrared thermal imaging (IRTI) in detecting deep vein thrombosis (DVT) and optical coherence tomography (OCT) in detecting peripheral pulmonary thromboembolism (PTE).The author suggested that IRTI can be a simple，effective and affordable tool for diagnosis of DVT，and that OCT can be more sensitive than selective angiography in identifying peripheral PTE，and can also help guide personalized treatment of this condition.

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The application of epinephrine in cardiopulmonary resuscitation：an update study HANG Chen-Chen, LI Chun-Cheng 2012, 32(11): 820-823.  Abstract ( )   PDF (2553KB) ( )   Epinephrine，the catecholamine naturally in human body，possesses adrenergic activities of α and β，which can increase the resistance of peripheral vessels，improve the perfusion pressures of coronary artery and cerebral vessels，and promote the recovery of circulation.In recent decades，epinephrine has always been a drug of choice for the emergency treatment of cardiac arrest (CA) during cardiopulmonary resuscitation (CPR).However，the efficacy of epinephrine remains uncertain due to the lack of massive clinical random control trials under the limitation of ethics.In recent years，epinephrine has been controversial in application in CPR due to its possible damage of heart and brain and the adverse longterm prognosis.In this study，the application of epinephrine and the prognosis after emergency treatment for CA in these years were primarily investigated.

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The modern concept and classification of autoimmune encephalitis WANG De-Xin, LIU Lei 2012, 32(11): 824-825.  Abstract ( )   Encephalitis is one of the common emergencies of neurology.The early diagnosis and the appropriate treatment are very important.Autoimmune encephalitis (AE) refers to a major category of diseases resulting from a reaction of the immune system against antigens of central nervous system and has been gradually considered as an important nonspecific factor to cause reversible encephalitis.According to the differences in etiology and therapy，AE may be divided into specific antigen (or antibody) associated AE and nonspecific antigen (antibody) associated AE.Knowing more about AE is of major significance in finding new diseases and deepening the understanding of immune pathological mechanism of central nerve system.

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Encephalitis associated with antibodies against neuronal cell surface antigens WANG Jia-Wei, SONG Zhao-Hui 2012, 32(11): 826-829.  Abstract ( )   Since encephalitis associated with antibodies against neuronal cell surface antigens hasnt been known enough by people，it has always been delayed diagnosis and treatment，which results in an adverse effect on its prognosis.The target antigens of encephalitis associated with antibodies against neuronal cell surface antigens play an important role in synaptic transmission，plasticity and nerve excitability，including NMDAR，AMPAR，GABABR and other receptors such as LGI1 and Caspr2This kind of disease mainly occurs in children and young people and has relatively severe disease degree and longer disease course，with or without tumor，which has a relatively good prognosis after treatment but has a trend of recurrence.In this study，the introduction of clinical characteristics and the update of diagnosis and treatment were highlighted so as to cause the concerns of clinicians.

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Encephalitis associated with antibodies against the intracellular antigens AN Zhong-Beng, ZHOU Guan-En 2012, 32(11): 830-832.  Abstract ( )   Paraneoplastic neurological syndromes，such as limbic encephalitis，are associated with many specific antibodies which can easily recognize the tumor and nerve tissues，with expressive antigens.These intracellular antigens include Hu，Yo，Ma2，CRMP5，amphiphysin and glutamic acid decarboxylase，etc.The main clinical syndrome of intracellular antigen and antibody associated encephalitis are limbic encephalitis，cerebellar ataxia and epilepsy.Most patients usually have a adverse prognosis.

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Hashimotos encephalopathy DIAO Wei-Qin 2012, 32(11): 833-834.  Abstract ( )   Hashimoto’s encephalopathy (HE) is a controversial neurological disorder that includes a group of heterogeneous neurological symptoms and the increased level of antithyroid antibodies.The clinical manifestations of HE may include encephalopathic features such as convulsion，behavioral and psychiatric abnormality，movement disorders and coma.Although HE has been believed to be correlated with Hashimotos thyroiditis or thyroid dysfunction，the most common immunological abnormality of HE is the presence of increased antibodies of antithyroglobulin or antimicrosomal.At present，it is still unclear as to whether the increased antithyroid antibodies is abiogenetic dysimmunity secondary to encephalopathy or it does cause the occurrence of disease.The effective reaction of HE to hormone or plasmapheresis also supported the hypothesis that this belonged to the immune pathogenic mechanism.

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The clinical diagnosis of auto immune encephalopathies ZHANG Hua, MU Yan-Lei 2012, 32(11): 835-838.  Abstract ( )   The auto immune encephalopathies refer to a group of diseases caused by the interaction of some autoantibodies with active cells or correlation factors with the protein on neuron surface of central nervous system.In this group of diseases，the typical clinical features of each disease may be associated with a known specific antibody.The disease conditions are usually correlated with the levels of antibodies but a few cases may be with potential tumor.At present，the commonly known autoimmune encephalopathy are limbic encephalitis (LE)，Movans syndrome (MOS)，Hashimotos encephalitis and NMDAR encephalitis，etc.Broadly speaking，it also includes the encephalopathy manifestations of immunological diseases.The classification of these diseases is complex and their diagnosis is mainly dependent on the clinical manifestations and the relative specific examinations (immune marker and imagining).In this study，the diagnosis and identification of this group of diseases were summarized.

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The treatment and prognosis of autoimmune encephalo myelitis after infection LI Hai-Feng 2012, 32(11): 839-841.  Abstract ( )   The nonspecific infection can cause autoimmune encephalo (mye) litis which mainly include acute disseminated encephalomyelitis (ADEM)，acute haemorrhagic leucoencephalopathy (AHLE) and Bickerstaffs brainstem encephalitis (BBE).In the present study，the clinical manifestation，treatment and prognosis of autoimmune encephalo (mye) litis were introduced.

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The clinical symptoms and treatment of connective tissue disease involving the nervous system CU Xiao-Hun, DONG Qin-Wen 2012, 32(11): 842-845.  Abstract ( )   Connective tissue disease (CTD)，subordinated to the rheumatic diseases，belongs to the nonorgan specific autoimmune disease which can involve single or multiple systems hence the presence of different clinical manifestations.So far，the mechanism of CTD is still uncertain.Many studies showed that CTD was correlated with its antibodies and Tcell mediated lesions，with the pathological basis of chronic inflammation in vessels and connective tissues.CTD can involve the brain，meninges，spinal cord，cranial and peripheral nerves，with various clinical manifestations.Efficacy could be found in many CTDs after treatment of corticosteroids and immunosuppressive agents.Nevertheless，many symptoms couldnt be totally relieved hence the further study for the new treatment.

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Standardized blood pressure measurementInterpretation of Chinese Guidelines for Blood Pressure Measurement WANG Wen, DUO Hui 2012, 32(11): 846-849.  Abstract ( )   Blood pressure(BP)measurement is an important method in the diagnosis，evaluation，treatment and scientific research of hypertension.At present，the methods of BPM are office blood pressure measurement (OBPM)，ambulatory blood pressure measurement (ABPM) and home blood pressure measurement (HBPM).In the present study，the main points of application and precautions of these three methods were compared.The suitable BPM should be chose according to the clinical situation.Eligible upperarm blood pressure monitor accredited by the international standard should be recommended for HBPM，which might improve the compliance and blood pressure control of patients.In the conditional areas，ABPM can be promoted and used，which might be helpful for understanding 24 h BP and its rhythm.

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Electrodiagnosis of amyotrophic lateral sclerosis LIU Meng-Sheng, CUI Li-Yang 2012, 32(11): 850-852.  Abstract ( )   Amyotrophic lateral sclerosis (ALS) refers to a progressive neurodegenerative disorder involving upper and lower motor neurons.Electrodiagnosis played a key role in the early diagnosis of ALS.Notably，Needle electromyography was most critical and the major method to confirm the lower motor neuron degeneration，which could show the extended neurogenic changes.The Motor nerve conduction velocity was mainly used to differentiate ALS from other diseases.While，electrodiagnosis and its interpretation must be combined with clinic results，only in which could it effectively avoid missed diagnosis and misdiagnosis.

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Necrotizing sarcoid granulomatosis HUANG Hai-Dong, BAI Chong, LI Jiang 2012, 32(11): 853-855.  Abstract ( )   Necrotizing sarcoid granulomatosis (NSG) is a seldom seen pulmonary guanulomatous disease，with no specificity of clinical manifestation.The typical pathological characteristics of NSG include noncaseous epithelial granulomatosis，granulomatous angiitis and coagulation necrosis.The differential diagnosis of NSG mainly include sarcoidosis，wegener granulomatosis and other guanulomatous diseases caused by infectious diseases.This disease is sensitive to the glucocorticoid treatment.The followingup should be enhanced among those patients with relapse of NSG.