关键词： 医学教育   改革   神经病学   网络教学   多元化   大健康  

摘要： 随着移动互联网、云计算、大数据、人工智能以及5G时代的来临,信息技术在教育、医疗、贸易等多个领域中得到了广泛的应用。翻转课堂和精品资源网络共享等信息技术与传统高等教育教学相融合的网络教学模式已逐步取代传统的“填鸭式”教学,并成为现代教育技术发展的方向和教育改革的重点。文章通过对神经病学网络教学模式的探索进行归类总结,根据神经病学的教学特点指出现阶段教学模式中存在的不足,分析并提出神经病学全网络教学模式面临的挑战,并构建“以学生为中心”的神经病学多元化全网络教学模式,旨在通过改革,提升神经病学教学质量,实现网络、科研与教学的紧密结合。

关键词： 办刊宗旨   中国医师协会   神经疾病   神经解剖学   普及与提高   神经病学   专业期刊   神经内外科  

摘要： 《中国现代神经疾病杂志》为国家卫生健康委员会主管、中国医师协会主办的神经病学类专业期刊。办刊宗旨为:理论与实践相结合、普及与提高相结合,充分反映我国神经内外科临床科研工作重大进展,促进国内外学术交流。所设栏目包括述评、专论、论著、临床病理报告、应用神经解剖学、神经影像学、循证神经病学、流行病学调查研究、基础研究、临床研究、综述、临床医学图像、病例报告、临床病理(例)讨论、新技术新方法等。

关键词： Hepatitis E virus   Acute hepatitis E   Extrahepatic manifestations   Neurological manifestations   Neuralgic amyotrophy   Guillain-Barrésyndrome  

摘要： Hepatitis E virus(HEV)is an important cause of repeated waterborne outbreaks of acute ***,several extrahepatic manifestations(EHMs)have been described in patients with HEV *** these,neurological disorders are the most common EHM associated with *** involvement of both the peripheral nervous system and central nervous system can occur together or in *** can present with normal liver function tests,which can often be misleading for *** is a paucity of data on HEV-related neurological manifestations;and these data are mostly described as case reports and case *** this review,we analyzed data of 163 reported cases of HEV-related neurological *** mechanisms of pathogenesis,clinico-demographic profile,and outcomes of the HEV-related neurological disorders are described in this *** root and plexus disorder were found to be the most commonly reported disease,followed by meningoencephalitis.

关键词： anesthesia   acute   intravascular  

摘要： Dear Editor,Emergency intravascular thrombectomy is the best treatment for acute ischemic stroke [1]. However, it is controversial whether the use of general anesthesia during emergency intravascular thrombectomy affects patient recovery.

关键词： intraoperative monitoring   osmotic demyelination syndrome   post‐   transplant encephalopathy   post‐   transplant outcomes   sodium  

摘要： Rapid changes in serum sodium (Delta SNa) peri-liver transplant (LT) predispose to post-LT neurological complications (NC). We aimed to assess whether implementation of a protocol directed at limiting peri-LT Delta SNa reduced post-LT NC. A retrospective single-center review of adult LT recipients from 1/2016 to 10/2017 was performed. Patients with hyponatremia (SNa < 135 mEq/L) within 7 days of LT were analyzed in two eras: pre-protocol (1/2016-9/2016) and post-protocol (10/2016-10/2017). The primary outcome was the development of NC within 1 month of LT. Perioperative Delta SNa (Delta SNaPost-LT) was assessed as a secondary outcome. Among 85 and 107 patients who underwent LT pre- and post-protocol, 39 (46%) and 42 (39%) were hyponatremic within 7 days of LT, respectively. Significantly fewer patients in the post-protocol era developed NC vs. pre-protocol (7.1% vs. 25.6%, p = .02). Additionally, fewer LT recipients in the post-protocol era developed Delta SNaPost-LT >= 10 mEq/L (9.5% vs. 30.7%, p = .02). Intraoperatively, more patients post-protocol received hypotonic saline (33.3% vs. 2.6%, p < .01). Multivariable logistic regression revealed that transplantation in the post-protocol era was associated with significantly reduced odds (odds ratio 0.11, 95% confidence interval 0.01-0.50) of developing NC. In conclusion, the implementation of a multidisciplinary protocol aimed at reducing Delta SNa peri-LT was independently associated with a reduction in post-LT NC.

关键词： Children   Emergency   Acute strabismus   Squint   Red flags  

摘要： Objectives: Acute strabismus (AS) is the most common ocular motility disorder in children. In the emergency setting evaluation, the primary concern is to exclude a potentially dangerous underlying condition, requiring immediate intervention. Our first aim was to describe the epidemiology, clinical features, and underlying causes of AS in a cohort of children presenting to the emergency department (ED). Our second aim was to identify clinical features associated with a significant risk of underlying neurological emergencies (NEs). Design and setting: Clinical records of all patients under 18 years presenting for AS to the ED of the Bambino Gesu Children's Hospital over a 10-year period were retrospectively reviewed. A logistic regression model was applied to detect predictive variables associated with a higher risk of NEs. Results: 208 patients (M:F 1/4 1.19) were identified (0.35 cases per 1000 admission). Commonly associated symptoms included diplopia (18.3%), headache (23.1%), nausea or vomit (8.6%). Other ocular or neurological abnormalities were associated in 47.6% of patients. NEs accounted for 24.03% of all cases, mostly represented by brain tumours (8.65%). Ptosis, optic disk blurring, vomit, gait abnormalities and consciousness disorders were found to confer a significantly greater risk of an underlying NE. Conclusions: Potentially severe neurological conditions may affect almost one in four children presenting to the ED for AS. Brain malignancies are the most common dangerous cause. Presence of ptosis, papilledema, vomit, gait disorders, consciousness impairment, pupillary defects and multiple cranial nerves involvement should be considered as red flags.

关键词： Acute encephalopathy with biphasic seizures and late reduced diffusion   Children   Clinical prediction rule   Convulsion   Pediatrics   Prognosis   Seizure  

摘要： Objective: The clinical prediction rule (CPR) for acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was developed with an area under the receiver operating characteristic curve (AUC) of 0.95 ? 0.96. Our objective was to verify the AESD CPR in a new cohort and compare the utilities of three CPRs of acute encephalopathy: the Tada, Yokochi, and Nagase criteria. Methods: We reviewed the clinical data and medical charts of 580 consecutive patients (aged < 18 years) with febrile convulsive status epilepticus lasting for > 30 min in 2002 ? 2017 and measured the performance of the CPRs in predicting AESD and sequelae. Results: The CPRs predicted AESD with an AUC of 0.84 ? 0.88. The Tada criteria predicted AESD with a positive predictive value (PPV) of 0.25 and a negative predictive value (NPV) of 0.99. The Yokochi criteria predicted AESD with a PPV and NPV of 0.20 and 0.95, respectively, after 12 h. The Nagase criteria predicted AESD with a PPV and NPV of 0.14 and 1.00, respectively, after 6 h. The PPVs of the Tada, Yokochi, and Nagase criteria for sequelae were 0.28, 0.28, and 0.17, respectively;the corresponding NPVs were 0.97, 0.95, and 0.98, respectively. Conclusions: The effectiveness of the AESD CPR in a new cohort was lower than that in the derivation study. CPRs are not sufficient as diagnostic tests, but they are useful as screening tests. The Nagase criteria are the most effective for screening among the three CPRs due to their high NPV and swiftness. ? 2021 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

关键词： Neurological disorders   Pediatric emergency department   Epileptic disorder   Seizures   Epilepsy  

摘要： Aim: Neurological disorders are one of the reasons for admission in pediatric emergency departments (PEDs). We aimed to evaluate the frequency of neurological disorders seen in a large tertiary PED. Methods: We conducted a one-year retrospective study that included 1471 medical records. Inclusion was based on the main complaint recorded by nurses at triage. We also retrieved the final diagnoses and the investigations performed in the PED. Results: About 3.4% of the yearly admissions was based on a neurologic complaint on arrival. The final diagnosis was of a neurologic disorder in 1237 children, 2% of which were admitted to the pediatric intensive care unit. An opinion from a child neurologist was requested for 33% of the children. Seizures were the most frequent reason for admission, followed by headaches. A previous visit to the PED in the past six months was a frequent finding (40%), and about one third of the patients with a neurologic diagnosis (except headaches) was already being followed by a child neurologist. Interpretation: Neurological disorders are frequent in our PED and are mainly represented by seizures and headaches. Appropriate training in epileptology might be helpful for healthcare professional working in PEDs . (c) 2021 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

摘要： Background: The NIH Helping to End Addiction Long-term (HEAL) Initiative aims to focus efforts on advancing scientific solutions to stem the opioid crisis, improving prevention and treatment of opioid misuse/addiction, and enhancing pain management. Goal: NINDS is charged with accelerating the discovery and development of new non-addictive pharmacologic and non-pharmacologic pain therapeutics as part of the HEAL Initiative. NINDS established the Preclinical Screening Platform for Pain (PSPP) to accelerate and enhance testing of novel, non-addictive pain therapeutics. This program will evaluate new, as well as repurposed, small molecules, biologics, devices, and natural products across a range of pain conditions. PSPP is accepting assets from academic and industry sponsors, worldwide. Here we describe efforts within the PSPP program. The overall goal of the PSPP program is to provide an efficient, rigorous, one-stop in vivo screening resource to accelerate identification and efficacy profiling of non-opioid therapeutics for the treatment of pain. Under NINDS direction, preclinical testing of submitted agents is performed by contract facilities on a blinded and confidential basis at no cost to the PSPP participants. Test candidates are evaluated in a suite of in vivo pain-related endpoints and models, following in vitro receptor profiling, pharmacokinetic and safety assessment. Importantly, test candidates are also evaluated in models of abuse liability. We will describe the advances made to date towards establishing program goals of evaluating assets in a rigorous and reproducible manner.

关键词： rehabilitation   inertial measurement unit   force sensors   biofeedback   postural balance   gait   stroke   Parkinson's disease   mild cognitive impairment  

摘要： Wearable devices are used in rehabilitation to provide biofeedback about biomechanical or physiological body parameters to improve outcomes in people with neurological diseases. This is a promising approach that influences motor learning and patients' engagement. Nevertheless, it is not yet clear what the most commonly used sensor configurations are, and it is also not clear which biofeedback components are used for which pathology. To explore these aspects and estimate the effectiveness of wearable device biofeedback rehabilitation on balance and gait, we conducted a systematic review by electronic search on MEDLINE, PubMed, Web of Science, PEDro, and the Cochrane CENTRAL from inception to January 2020. Nineteen randomized controlled trials were included (Parkinson's n = 6;stroke n = 13;mild cognitive impairment n = 1). Wearable devices mostly provided real-time biofeedback during exercise, using biomechanical sensors and a positive reinforcement feedback strategy through auditory or visual modes. Some notable points that could be improved were identified in the included studies;these were helpful in providing practical design rules to maximize the prospective of wearable device biofeedback rehabilitation. Due to the current quality of the literature, it was not possible to achieve firm conclusions about the effectiveness of wearable device biofeedback rehabilitation. However, wearable device biofeedback rehabilitation seems to provide positive effects on dynamic balance and gait for PwND, but higher-quality RCTs with larger sample sizes are needed for stronger conclusions.