作者机构：
[Tian, Xuefei; Ma, Jing; Hu, Jiawen] Hunan Univ Chinese Med, Sch Clin Med, Changsha, Peoples R China.;[Zheng, Qiongjuan; Wang, Dongxin; Liu, Xuejun; Hu, Jiawen] Econd Peoples Hosp Hunan Prov, Brain Hosp Hunan Prov, Changsha, Peoples R China.;[Zhang, Yun] Northwest Minzu Univ, Lanzhou, Peoples R China.;[Liu, Chunyu] SUNY Upstate Med Univ, Dept Psychiat, Dept Neurosci & Physiol, Syracuse, NY USA.
通讯机构：
[Ma, Jing] H;[Wang, Dongxin] E;Hunan Univ Chinese Med, Sch Clin Med, Changsha, Peoples R China.;Econd Peoples Hosp Hunan Prov, Brain Hosp Hunan Prov, Changsha, Peoples R China.
摘要：
This study aims to know the seeking help behavior of individuals with SZ (Schizophrenia) in Hunan province of China. Individuals (age > 15) with schizophrenia were recruited in the study after a two-stage diagnosis procedure (including questionnaire screening and face-to-face SCID interview by psychiatrists) in Hunan province. A self-designed questionnaire was used to investigate their help-seeking behavior. (1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n = 163) pursued professional psychiatric services and 30.8% (n = 78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. (2) Family history of mental disorders is significantly related to whether or not the individual with SZ seeks help, and the first choice of help is significantly related to education level. (P < 0.05). (3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). About one-third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospitals and relatives as their first choice. Among the factors we investigated, family history of mental disorders is the most influential factor associated with help-seeking behavior. Individuals with more education tend to seek professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etc.
期刊：
Evidence-Based Complementary and Alternative Medicine,2021年2021 ISSN：1741-427X
作者机构：
[Liu, Yu] Cent South Univ, Postdoctoral Res Stn Clin Med, Xiangya Hosp 3, Changsha 410013, Peoples R China.;[Liu, Yu] Cent South Univ, Xiangya Hosp 3, Dept Plast Surg, Changsha 410013, Peoples R China.;[Liu, Yu; Shi, Jian-Ping; Jiao, Yu-Qi] Inner Mongolia Med Univ, Hohhot 010000, Peoples R China.;[Xiong, Wu] Hunan Univ Chinese Med, Affiliated Hosp 1, Changsha 410007, Peoples R China.;[Yan, Yu; Zhou, Jian-Da; Liu, Yang; Yin, Chao-Qi] Cent South Univ, Third Xiangya Hosp, Dept Plast Surg, Changsha 410013, Peoples R China.
摘要：
Background. To create an animal model for diabetic ulcers with semi-Yin and semi-Yang (SYSY) syndrome and to study the pathological and metabolic features of SYSY syndrome. Methods. Firstly, based on the clinical characteristics of the SYSY syndrome of diabetic ulcer, an animal model of diabetic ulcers with SYSY syndrome being full-thickness skin defects was created by injecting streptozotocin (STZ) intraperitoneally, infecting with Staphylococcus aureus, and gastrically administering senna. Secondly, the content and distribution patterns of collagen fibers, the expression of neutrophils and macrophage markers, angiogenesis, and the expression of IL-1 beta and IL-10 in the rats with Yang syndrome, Yin syndrome, and SYSY syndrome of diabetic ulcers at different time points were detected. Representative traditional Chinese medicine (TCM) ointment of Yang syndrome, Yin syndrome, and SYSY syndrome was used to treat this animal model. The above indexes in each treatment group were detected. Finally, metabonomics was used to detect and analyze the changes of differential metabolites related to macrophage metabolism in Yang, Yin, and SYSY syndromes at different time points. Results. An animal model of diabetic ulcers with SYSY syndrome was established. The pathological features of the SYSY syndrome group were chronic low-grade inflammatory reactions. On the third day, the SYSY syndrome group displayed lower expression of CD16, CD68, CD163, IL-1 beta, and metabolites related to M1-type macrophages compared with other groups. On the seventh day, the SYSY syndrome group showed lower expression of CD31, IL-10, myeloperoxidase, and metabolites related to M2-type macrophages. Treatment with Chong He Ointment, a representative TCM ointment for SYSY syndrome, reversed the expression levels of these indexes and promoted wound healing in the SYSY group. Conclusion. SYSY syndrome presents a persistent pathological state of low inflammation, which may be caused by an insufficient activation of the M1-type metabolic pathway in macrophages in the early acute inflammatory stage, resulting in the incomplete clearance of pathogens and debris and continuous stimulation of macrophages to initiate the M1-type metabolic pathway. CD163, CD31, IL-10, and citric acid can be used as potential specific markers for the recovery and progression of SYSY syndrome.
作者机构：
[Zhu, Zhongshan; Yang, Zhou; Tang, Sanyuan; Zhou, Ting; Li, Xiaobing] Brain Hosp Hunan Prov, Dept Oncol, Changsha 410007, Hunan, Peoples R China.;[Tian, Xuefei; Zhou, Ting] Hunan Univ Chinese Med, Coll Integrated Chinese & Western Med, Dept Internal Med, Changsha 410208, Hunan, Peoples R China.;[Yang, Ping] Hunan Univ Chinese Med, Brain Hosp Hunan Prov, Dept Psychiat, Clin Med Coll, Changsha 410007, Peoples R China.;[Wu, Ruoxia] Hunan Univ Chinese Med, Hunan Key Lab TCM Prescript & Syndromes Translat, Changsha 410208, Hunan, Peoples R China.;[Li, Liang] Hunan Univ Chinese Med, Prov Key Lab TCM Diagnost, Changsha 410208, Hunan, Peoples R China.
摘要：
Aims. Lung adenocarcinoma (LUAD) cells could escape from the monitoring of immune cells and metastasize rapidly through immune escape. Therefore, we aimed to develop a method to predict the prognosis of LUAD patients based on immune checkpoints and their associated genes, thus providing guidance for LUAD treatment. Methods. Gene sequencing data were downloaded from the Cancer Genome Atlas (TCGA) and analyzed by R software and R Bioconductor software package. Based on immune checkpoint genes, kmdist clustering in ConsensusClusterPlus R software package was utilized to classify LUAD. CIBERSORT was used to quantify the abundance of immune cells in LUAD samples. LM22 signature was performed to distinguish 22 phenotypes of human infiltrating immune cells. Gene set variation analysis (GSVA) was performed on immune checkpoint cluster and immune checkpoint score using GSVA R software package. The risk score was calculated by LASSO regression coefficient. Gene Ontology (GO), Hallmark, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed. PROC was performed to generate the ROC curve and calculate the area under the curve (AUC). Results. According to the immune checkpoint, LUAD was classified into clusters 1 and 2. Survival rate, immune infiltration patterns, TMB, and immune score were significantly different between the two clusters. Functional prediction showed that the functions of cluster 1 focused on apoptosis, JAK/STAT signaling pathway, TNF-alpha/NF kappa B signaling pathway, and STAT5 signaling pathway. The risk score model was constructed based on nine genes associated with immune checkpoints. Survival analysis and ROC analysis showed that patients with high-risk score had poor prognosis. The risk score was significantly correlated with cancer status (with tumor), male proportion, status, tobacco intake, and cancer stage. With the increase of the risk score, the enrichment of 22 biological functions increased, such as p53 signaling pathway. The signature was verified in IMvigor immunotherapy dataset with excellent diagnostic accuracy. Conclusion. We established a nine-gene signature based on immune checkpoints, which may contribute to the diagnosis, prognosis, and clinical treatment of LUAD.
摘要：
Actin is the structural protein of microfilaments, and it usually exists in two forms: monomer and polymer. Among them, monomer actin is a spherical molecule composed of a polypeptide chain, also known as spherical actin. The function of actin polymers is to produce actin filaments, so it is also called fibroactin. The actin cytoskeleton is considered to be an important subcellular filament system. It interacts with numerous relevant proteins and regulatory cells, regulating basic functions, from cell division and muscle contraction to cell movement and ensuring tissue integrity. The dynamic reorganization of the actin cytoskeleton has immense influence on the progression and metastasis of cancer as well. This paper explores the significance of the microfilament network, the dynamic changes of its structure and function in the presence of a tumor, the formation process around the actin system, and the relevant proteins that may be target molecules for anticancer drugs so as to provide support and reference for interlinked cancer treatment research in the future.
摘要：
Introduction: Workplace violence (WPV) against healthcare providers has severe consequences and is underreported worldwide. The aim of this study was to present the features, causes, and outcomes of serious WPV against healthcare providers in China. Method: We searched for serious WPV events reported online and analyzed information about time, location, people, methods, motivations, and outcomes related to the incident. Result: Serious WPV reported online in China (n = 379) were mainly physical (97%) and often involved the use of weapons (34.5%). Doctors were victims in most instances (81.1%). Serious WPV mostly happened in cities (90.2%), teaching hospitals (87.4%), and tertiary hospitals (67.9%) and frequently in Emergency Department (ED), Obstetrics and Gynecology Department (OB-GYN), and pediatric departments; it was most prevalent in the months of June, May, and February. Rates of serious WPV increased dramatically in 2014 and decreased after 2015, with death (12.8%), severe injury (6%), and hospitalization (24.2%) being the major outcomes. A law protecting healthcare providers implemented in 2015 may have helped curb the violence. Conclusion: Serious WPV in China may stem from poor patient-doctor relationships, overly stressed health providers in highly demanding hospitals, poorly educated/informed patients, insufficient legal protection, and poor communication. Furthering knowledge about WPV and working toward curtailing its presence in healthcare settings are crucial to increasing the safety and well-being of healthcare workers.
关键词：
Chaihu-Longgu-Muli decoction;Hippocampal neurons;Pyroptosis;Temporal lobe epilepsy;Traditional Chinese medicine
摘要：
Ethnopharmacological relevance: Chaihu-Longgu-Muli Decoction (CLMD) is a classic prescription created by Zhong-jing Zhang, a famous ancient Chinese medical scientist, to harmonize uncontrollable body activities and calm the minds. Now Traditional Chinese Medicine (TCM) physicians often apply it to treat psychiatric diseases such as epilepsy. Aim of the study: This study investigated the mechanism of the effect of Chaihu-Longgu-Muli Decoction (CLMD) on hippocampal neurons pyroptosis in rats with Temporal Lobe Epilepsy (TLE). Materials and methods: The lithium chloride-pilocarpine-induced TLE rat model was established. The behavioral testing was performed and, the expression of IL-1 beta and TNF-alpha in serum was detected by ELISA, qRT-PCR was used to detect the mRNA expression of NLRP3, Caspase-1, IL-1 beta and TNF-alpha in hippocampus. The expression of NLRP3 and Caspase-1 in hippocampal dentate gyrus was detected by immunofluorescence assay. Results: CLMD could significantly suppress the frequency and duration time of epileptic seizures, reduce the expression of NLRP3, Caspase-1 TNF-alpha and IL-1 beta. Conclusions: CLMD exerted an obvious antiepileptic effect by improving pyroptosis in hippocampal neurons of TLE rats.
摘要：
Background Alcohol dependence (AD) patients have a high prevalence of aggressive behavior (AB). The frontal cortex and amygdala contains various neurotransmitter systems and plays an important role in AB, which is also associated with cognitive deficits. However, to date, no study has addressed the association of metabolites in the frontal cortex and amygdala with cognitive deficits in Chinese aggressive behavior-alcohol dependent patients(AB-ADs). Methods We recruited 80 male AD and 40 male healthy controls (HCs), who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Modified Overt Aggression Scale (MOAS), and the proton magnetic resonance spectroscopy (H-1 MRS) scan using 3.0T Siemens. The H-1 MRS data were automatically fitted with a linear combination model for quantification of metabolite levels of n-acetyl-aspartate (NAA), glutamate (Glu), Choline (Cho) and creatine (Cr). Metabolite levels were reported as ratios to Cr. Results The AB-ADs group scored significantly lower than the non-aggression-alcohol dependent patients (NA-ADs) on these two RBANS subscales (immediate memory and attention function indices). The AB-ADs group showed a significant reduction in NAA/CR ratio in the left frontal cortex and Cho/Cr ratio in the left amygdala, and elevation in Glu/Cr ratio in the bilateral amygdala, compared with the NA-ADs group. The NAA/Cr ratio in the left frontal cortex was positively associated with immediate memory (r=0.60, P<0.05), and the Glu/Cr ratio in the right amygdala was negatively associated with delayed memory (r=-0.44,P<0.05) in AB-ADs group. Conclusions Metabolite alterations in the frontal cortex and amygdala may be involved in the pathophysiology of AB in AD and its associated cognitive impairment, especially immediate memory and delayed memory.
关键词：
Acute ischemic stroke;D-dimer;D-dimer to fibrinogen ratio;Fibrinogen
摘要：
Introduction and Objective: At present, there is no hematology marker with high specificity to the diagnosis and differential diagnosis of acute ischemic stroke (AIS). How to use the existing test items to improve the diagnosis efficiency worthy of discussion. D-Dimer (DD) and fibrinogen (FIB) were the common indicators in thrombotic diseases, but D-dimer to fibrinogen ratio (D/F) in AIS has not been used in clinical practice. In this work, we focus on the evaluation of D/F. Methods: 90 AIS patients were selected as the observation group and 65 other patients without coagulation function disorder as the control group. Meanwhile, a total of 33 patients with other diseases with impaired consciousness in the same period were collected. Based on the AIS patients with or without consciousness disorder divided it into consciousness disorder group and unconsciousness disorder group. Then based on the patients with or without consciousness disorder divided it into other diseases with unconsciousness disorder group and Other diseases with lacunar cerebral infarction (LCI)and disturbance of consciousness group. then compare the differences of plasma DD, FIB and D/F between groups. Results: All plasma DD, FIB and D/F ratio in AIS patients were significantly higher than in other disease group (P = 0.000, P = 0.001, P = 0.000), but DD, D/F in disorders of consciousness group was significantly higher than in unconsciousness disorders group (P = 0.007, P = 0.005). The DD of the AIS with consciousness disorder group were significantly higher than that of the other disease with consciousness disorder group (P = 0.042), and the DD, D/F ratio of Other diseases with lacunar cerebral infarction and disturbance of consciousness group were significantly higher than one(P = 0.000, P = 0.003). All others are undifferentiated. Conclusions: When DD, D/F ratio is high, other diseases caused by consciousness disorders are likely to be combined with infarcts, which can be used for the diagnosis and differential diagnosis of patients with different types of consciousness disorders, especially hospitalized patients. (c) 2020 Elsevier Inc. All rights reserved.
摘要：
Sperm-associated antigen 9 (SPAG9) is a biomarker and potential therapeutic target for several cancers; however, its involvement in liver cancer progression is not clear. The aim of the present study was to determine whether SPAG9 regulates proliferation of liver cancer. Immunohistochemistry and cell immunofluorescence were used to confirm the expression and the localization of SPAG9 in human liver cancer tissues and the liver cancer-derived HepG2 cells. A small interfering RNA (siRNA) designed to target SPAG9 was transiently transfected into HepG2 cells using Lipofectamine (TM) 2000, and proliferation, apoptosis and cell cycle progression were analyzed using CCK-8 assay and flow cytometry; western blotting was used to detect the expression of SPAG9, JNK, p38, MKK3 and MKK6, and co-immunoprecipitation was used to assess the interaction between SPAG9 and JNK. SPAG9 was overexpressed in 16 out of 20 (80%) patients with liver cancer. The protein was localized in both the cytoplasm and nucleus of liver cancer cells obtained from patients and in HepG2 cells. Depletion of SPAG9 inhibited the proliferation of HepG2 cells, promoted apoptosis and arrested the cell cycle at the S phase. Moreover, cells deficient in SPAG9 had decreased expression of JNK, p38 and MKK3 compared to HepG2 cells not treated with an siRNA targeting SPAG9. In the present study, SPAG9 was revealed to regulate cell proliferation, apoptosis and cell cycle progression in liver cancer cells through the SPAG9/MKK3/p38 axis. This axis is a novel therapeutic target for liver cancer.
摘要：
Hemangioblastomas (HBs) are classified as grade I tumors with uncertain origin according to the World Health Organization's classification system. HBs are characterized by rich mesenchymal cells and abundant capillaries. It has been shown that tumorigenesis of HBs depends on mutational inactivation of Von Hippel-Lindau (VHL) tumor suppressor gene. Therefore, the majority of patients will undergo VHL single gene test, and sequencing scheme is rarely used in clinic. In this study, we described a girl and her father successively found to have HBs within half a year. The results of next-generation sequencing (NGS) and Sanger sequencing analysis showed that both of them carried heterozygous mutation of RNF139 p.Q650R. This mutation was interpreted as Pathogenic variation based on the American College of Medical Genetics and Genomics (ACMG) guideline. Sanger sequencing was performed with other family members. No mutation on rs118184842 locus of RNF139 gene was found in the samples from the girl's mother, uncle and aunt. This report supports that the novel mutation of RNF139 p.Q650R probably serve as a key role in HBs progression.
摘要：
There are different views of how the immune system participates in the reaction to cancer. Here, we evaluated expression of DAMP proteins HSP70 and cancer-testis antigen SPAG9 in patients with hepatocellular carcinoma（HCC） and lung cancer to explore tumor immunity. Our analysis showed that levels of HSP70 and SPAG9 antibody were significantly higher in serum of lung cancer and HCC patients than in serum from healthy subjects（P < 0.001）, but there were no differences in levels of HSP70 antibody in patients and controls. Levels of serum SPAG9 antibody in newly diagnosed lung cancer patients were significantly higher than in treated lung cancer patients（P < 0.05）, but there were no differences in levels of HSP70 or HSP70 antibody. Levels of serum HSP70 and SPAG9 antibody, but not HSP70 antibody, were also higher in hepatitis/cirrhosis patients than in healthy subjects（P = 0.005, P < 0.001）. Levels of serum SPAG9 antibody were significantly higher in HCC patients than in hepatitis/cirrhosis patients, but there were no differences in HSP70 or HSP70 antibody levels. Finally, levels of serum HSP70 and SPAG9 antibody were significantly higher in HCC patients than in lung cancer patients（P < 0.05, P < 0.001）. These results indicate that cancer-testis antigen SPAG9 induces a strong humoral immune response in cancer patients but HSP70 does not. These results show that SPAG9 has potential as a tumor-specific biomarker.
作者机构：
[Yuan, Ning; Liu, Chunyu] Cent South Univ, Xiangya Hosp 2, Dept Psychiat, Changsha, Hunan, Peoples R China.;[Yuan, Ning; Liu, Chunyu] Cent South Univ, Xiangya Hosp 2, Mental Hlth Inst, Changsha, Hunan, Peoples R China.;[Yuan, Ning; Liu, Chunyu] Cent South Univ, Natl Clin Res Ctr Mental Disorders, Changsha, Hunan, Peoples R China.;[Yuan, Ning; Liu, Chunyu] Cent South Univ, Natl Technol Inst Mental Disorders, Changsha, Hunan, Peoples R China.;[Yuan, Ning; Liu, Chunyu] Hunan Univ Chinese Med, Sch Clin Med, Hunan Prov Brain Hosp, Dept Psychiat, Changsha, Hunan, Peoples R China.
通讯机构：
[Liu, Chunyu] C;[Liu, Chunyu] H;Cent South Univ, Xiangya Hosp 2, Dept Psychiat, Changsha, Hunan, Peoples R China.;Cent South Univ, Xiangya Hosp 2, Mental Hlth Inst, Changsha, Hunan, Peoples R China.;Cent South Univ, Natl Clin Res Ctr Mental Disorders, Changsha, Hunan, Peoples R China.
摘要：
Inflammation is a natural defence response of the immune system against environmental insult, stress and injury, but hyper- and hypo-inflammatory responses can trigger diseases. Accumulating evidence suggests that inflammation is involved in multiple psychiatric disorders. Using inflammation-related factors as biomarkers of psychiatric disorders requires the proof of reproducibility and specificity of the changes in different disorders, which remains to be established. We performed a cross-disorder study by systematically evaluating the meta-analysis results of inflammation-related factors in eight major psychiatric disorders, including schizophrenia (SCZ), bipolar disorder (BD), autism spectrum disorder (ASD), major depression disorder (MDD), post-trauma stress disorder (PTSD), sleeping disorder (SD), obsessive-compulsive disorder (OCD) and suicide. A total of 43 meta-analyses involving 704 publications on 44 inflammation-related factors were included in the study. We calculated the effect size and statistical power for every inflammation-related factor in each disorder. Our analyses showed that well-powered case-control studies provided more consistent results than underpowered studies when one factor was meta-analysed by different researchers. After removing underpowered studies, 30 of the 44 inflammation-related factors showed significant alterations in at least one disorder based on well-powered meta-analyses. Eleven of them changed in patients of more than two disorders when compared with the controls. A few inflammation-related factors showed unique changes in specific disorders (e.g., IL-4 increased in BD, decreased in suicide, but had no change in MDD, ASD, PTSD and SCZ). MDD had the largest number of changes while SD has the least. Clustering analysis showed that closely related disorders share similar patterns of inflammatory changes, as genome-wide genetic studies have found. According to the effect size obtained from the meta-analyses, 13 inflammation-related factors would need <50 cases and 50 controls to achieve 80% power to show significant differences (p < 0.0016) between patients and controls. Changes in different states of MDD, SCZ or BD were also observed in various comparisons. Studies comparing first-episode SCZ to controls may have more reproducible findings than those comparing pre- and post-treatment results. Longitudinal, system-wide studies of inflammation regulation that can differentiate trait- and state-specific changes will be needed to establish valuable biomarkers.
摘要：
Neurons undergo degeneration, apoptosis and death due to ischaemic stroke. The present study investigated the effect of Sijunzi decoction (SJZD), a type of traditional Chinese medicine known as invigorating spleen therapy, on anoikis (a type of apoptosis) in rat brains following cerebral ischaemia-reperfusion. Rats were randomly divided into sham, model, nimodipine and SJZD low/medium/high dose groups. A middle cerebral artery occlusion model was established. Neurobehavioural scores were evaluated after administration for 14 days using a five-grade scale. Blood-brain barrier permeability and apoptotic rate were detected using Evans blue (EB) extravasation and TUNEL staining, respectively. Tissue inhibitor of metalloproteinase 1 (TIMP-1), matrix metalloproteinase 9 (MMP-9) and collagen IV (COL IV) were determined using immunohistochemistry. Neurobehavioural scores decreased remarkably in all SJZD and nimodipine groups compared to the model group (P<0.05). Compared with the sham group, EB extravasation was higher in the model group (P<0.01). The amount of EB extravasation decreased in the SJZD high dose and nimodipine groups compared to the model group (P<0.01), and extravasation in the SJZD high dose group was lower than the SJZD low and medium dose groups (P<0.01). TIMP-1 and MMP-9 expression and apoptotic rate increased, but COL IV decreased significantly in the hippocampus of the model group compared to the sham group (P<0.01). TIMP-1 and COL IV expression increased significantly and MMP-9 and apoptotic rate decreased remarkably in all SJZD and nimodipine groups compared to the model group (P<0.01). TIMP-1 and COL IV expression decreased, but MMP-9 expression and apoptotic rate increased in the SJZD low and medium dose groups compared to the SJZD high dose group (P<0.01). SJZD rescued neurons and improved neurobehavioural function in rats following cerebral ischaemia-reperfusion, especially when used at a high dose. The mechanism may be related to protection of the extracellular matrix followed by anti-apoptotic effects.
摘要：
The main clinical manifestations of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis are acute or subacute seizures, cognition impairment, and psychiatric symptoms. Nowadays, the scheme of antipsychotic therapy for this disease has not been established. This study reports three cases of anti-NMDAR encephalitis with psychiatric symptoms. The anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum were positive. The psychiatric symptoms still existed after intravenous immunoglobulin (IVIG) treatment; thus, clozapine was used for antipsychotic therapy. Case 1 was a 37-year-old man who suffered from bad mood and suicide behaviors for 1 month. Hallucination and delusion still existed after IVIG treatment and hormone therapy, and the symptoms were relieved when given clozapine for 12 months. Case 2 was a 28-year-old man who was admitted to our hospital due to injuring other people and destructive behaviors for 2 days. He showed irritability, bad temper, declined cognition, and severe delusion of persecution after IVIG treatment and hormone therapy, but the psychiatric symptoms disappeared when given clozapine for 3 months. Case 3 was a 23-year-old man who suffered from headache and babbing for 7 days. Symptoms such as irritability, bad temper, babbing, and injuring other people still existed after IVIG treatment and hormone therapy, but they disappeared when given clozapine for 2 months. Therefore, we suggest that during the treatment of anti-NMDAR encephalitis with psychiatric symptoms, if the anti-NMDAR antibodies in CSF and serum were positive, and psychiatric symptoms could not be controlled after IVIG and hormone therapy, clozapine may work.
