关键词： 住院医师规范化培训   神经病学   临床学习   解决方案  

摘要： 随着人民对就医需求的增加,住院医师规范化培训作为国家卫生部门深化医疗体制改变的重要部分,对改善人民的就医环境起着重要的作用。我们进一步调研了参与神经病学住院医师规范化培训的学员,了解他们的日常生活和工作安排。就住院医师规范化培训学生学习的重点、难点进行了分析和总结,同时就难点提出了相关的解决方法。进一步反映了神经病学住院医师规范化培训学员在临床学习中遇到的困难,对临床学习难度的掌握提出了一定的解决方案。

摘要： 《临床神经病学杂志》系国家级神经病学专业性学术刊物,由南京医科大学附属脑科医院主办。刊登内容以临床神经病学为主,兼及有关边缘学科。读者对象以从事临床神经病学专业的高、中级人员为主,也可供内科、儿科、眼科、五官科医师参阅。本刊的办刊宗旨是:面向临床,面向基层,注重实用,鼎力于提高我国临床神经科医师的专业理论及诊疗水平。

摘要： We present the case of a young woman with an Emotionally Unstable Personality Disorder (EUPD) diagnosis suffering from high-risk self-injurious behaviour. She was also diagnosed with Ehlers-Danlos Syndrome and Functional Neurological Disorder, manifesting as nonepileptic seizures and immobility. Our patient, "A,"endured traumatic childhood abuse and became highly dependent on services in her late teens. Recurrent suicide attempts resulted in twenty to thirty acute psychiatric admissions, Intensive Care Unit stays, and multiple failed trials of psychological therapy. Nonepileptic seizures and wheelchair dependency made her "too complex"for many specialist services. She was eventually admitted to Springbank ward in Fulbourn Hospital, Cambridge. The EUPD specialist unit prides itself on evidence-based treatments, shared values, and a least restrictive approach. At discharge, our patient was self-harm free and able to walk unaided and no longer met EUPD diagnostic criteria. We include "A's"personal views on her illness and how Springbank ward facilitated her recovery, together with results from structured clinical outcome measures. © 2021 Jessica Henry et al.

关键词： Severe spinal deformity   Neurological complication   Osteotomy   Risk factor  

摘要： Background Difficult procedures of severe rigid spinal deformity increase the risk of intraoperative neurological injury. Here, we aimed to investigate the preoperative and intraoperative risk factors for postoperative neurological complications when treating severe rigid spinal deformity. Methods One hundred seventy-seven consecutive patients who underwent severe rigid spinal deformity correction were assigned into 2 groups: the neurological complication (NC, 22 cases) group or non-NC group (155 cases). The baseline demographics, preoperative spinal cord functional classification, radiographic parameters (curve type, curve magnitude, and coronal/sagittal/total deformity angular ratio [C/S/T-DAR]), and surgical variables (correction rate, osteotomy type, location, shortening distance of the osteotomy gap, and anterior column support) were analyzed to determine the risk factors for postoperative neurological complications. Results Fifty-eight patients (32.8%) had intraoperative evoked potentials (EP) events. Twenty-two cases (12.4%) developed postoperative neurological complications. Age and etiology were closely related to postoperative neurological complications. The spinal cord functional classification analysis showed a lower proportion of type A, and a higher proportion of type C in the NC group. The NC group had a larger preoperative scoliosis angle, kyphosis angle, S-DAR, T-DAR, and kyphosis correction rate than the non-NC group. The results showed that the NC group tended to undergo high-grade osteotomy. No significant differences were observed in shortening distance or anterior column support of the osteotomy area between the two groups. Conclusions Postoperative neurological complications were closely related to preoperative age, etiology, severity of deformity, angulation rate, spinal cord function classification, intraoperative osteotomy site, osteotomy type, and kyphosis correction rate. Identification of these risk factors and relative development of su

关键词： Neurology   Routinely collected data   Electronic health record  

摘要： Background This review focuses on neurology research which uses routinely collected data. The number of such studies is growing alongside the expansion of data collection. We aim to gain a broad picture of the scope of how routine healthcare data have been utilised. Methods This study follows a systematic mapping review approach which does not make a judgement on the quality of the papers included in the review, thereby enabling a complete overview of the field. Results Of 4481 publications retrieved, 386 met the eligibility criteria for this study. These publications covered a wide range of conditions, but the majority were based on one or only a small number of neurological conditions. In particular, publications concerned with three discrete areas of neurological practice - multiple sclerosis (MS), epilepsy/seizure and Parkinson's disease - accounted for 60% of the total. MS was the focus of the highest proportion of eligible studies (35%), yet in the recent Global Burden of Neurological Disease study it ranks only 14th out of 15 neurological disorders for DALY rates. In contrast, migraine is the neurological disorder with the highest ranking of DALYs globally (after stroke) and yet it was represented by only 4% of eligible studies. Conclusion This review shows that there is a disproportionately large body of literature pertaining to relatively rare disorders, and a correspondingly small body of literature describing more common conditions. Therefore, there is potential for future research to redress this balance.

关键词： Antagonists   Agonists   Nervous system diseases   Rodent models   Receptors  

摘要： The sigma-1 (sigma(1)) receptor, an enigmatic protein originally classified as an opioid receptor subtype, is now understood to possess unique structural and functional features of its own and play critical roles to widely impact signaling transduction by interacting with receptors, ion channels, lipids, and kinases. The sigma(1) receptor is implicated in modulating learning, memory, emotion, sensory systems, neuronal development, and cognition and accordingly is now an actively pursued drug target for various neurological and neuropsychiatric disorders. Evaluation of the five selective sigma(1) receptor drug candidates (pridopidine, ANAVEX2-73, SA4503, S1RA, and T-817MA) that have entered clinical trials has shown that reaching clinical approval remains an evasive and important goal. This review provides up-to-date information on the selective targeting of sigma(1) receptors, including their history, function, reported crystal structures, and roles in neurological diseases, as well as a useful collation of new chemical entities as sigma(1) selective orthosteric ligands or allosteric modulators.

关键词： medical image processing   image resolution   neurophysiology   neural nets   image fusion   computerised tomography   particle swarm optimisation   image denoising   NSST domain CT-MR neurological image fusion   optimised biologically inspired neural network   diagnostic medical imaging   imperative role   clinical assessment   medical abnormalities   multimodal medical images   clinical diagnosis   complementary information present   multisource images   nonsubsampled shearlet domain   tomography-magnetic resonance neurological image fusion method   particle swarm optimisation   firing maps   high-frequency NSST subbands   optimisation process   spatial frequency   edge index   resultant fused image   inverse NSST   fused subbands   fusion performance   CT-MR neurological image datasets   edge information present   better-fused images   optimised neural model  

摘要： Diagnostic medical imaging plays an imperative role in clinical assessment and treatment of medical abnormalities. The fusion of multimodal medical images merges complementary information present in the multi-source images and provides a better interpretation with improved diagnostic accuracy. This paper presents a CT-MR neurological image fusion method using an optimised biologically inspired neural network in nonsubsampled shearlet (NSST) domain. NSST decomposed coefficients are utilised to activate the optimised neural model using particle swarm optimisation method and to generate the firing maps. Low and high-frequency NSST subbands get fused using max-rule based on firing maps. In the optimisation process, a fitness function is evaluated based on spatial frequency and edge index of the resultant fused image. To analyse the fusion performance, extensive experiments are conducted on the different CT-MR neurological image dataset. Objective performance is evaluated based on different metrics to highlight the clarity, contrast, correlation, visual quality, complementary information, salient information, and edge information present in the fused images. Experimental results show that the proposed method is able to provide better-fused images and outperforms other existing methods in both visual and quantitative assessments.

关键词： Azepine   5H-dibenzo[b   f]azepine   iminostilbene   inverseelectron demand Diels-Alder   PIFA   pyridazine   tetrazine  

摘要： Syntheses of pyridazine derivatives of dibenzoazepine, starting fromN-substituted-dibenzoazepines, are reported here for the first time. In the reaction sequence,N-substitute dibenzoazepine derivatives were synthesized and then, examinedinverseelectron demand Diels-Alder (IEDDA) reactions betweenN-substituted dibenzoazepine derivatives and tetrazines. While in some reactions, targeted products were obtained using phenyliodo-bis(trifluoroacetate) (PIFA), in other reactions, they were obtained directly with tetrazines which also behaved as the oxidizing agent. Structures of these compounds were fully characterized by NMR, IR, and HRMS spectroscopic techniques.

关键词： COVID-19   Inflammation   Cytokines   Post Covid19 neurology syndrome   PCNS  

关键词： Neurology   Posture   Kinematic analysis   CUELA system  

摘要： Background The aim of this pilot study was to analyze postures during the work of neurologists with respect to their occupational activities. Methods A total data material of 64.8 h (3885.74 min) of nine (three m/six f) neurologists (assistant physicians) was collected. Kinematic data were collected using the CUELA system (electro-goniometry). In addition, the occupational tasks performed on-site were subject to a detailed objective activity analysis. All activities were assigned to the categories "Office activities" (I), "Measures on patients" (II) and "Other activities" (III). The angle values of each body region (evaluation parameters) were evaluated according to ergonomic ISO standards. Results Only 3.4% of the working hours were spent with (II), while 50.8% of time was spent with (I) and 45.8% with (III). All tasks of category (II) revealed an increased ergonomic risk to the head, neck, trunk and back areas. During category (I) especially neck and back movements in the sagittal plane showed higher ergonomic risk levels. Conclusion Despite frequently performed awkward body positions in (II), the ergonomic risk is considered as rather low, since the percentage time share totaled only 3.4%. As a result, "Office activities" have been detected as high predictor to cause stress load on the musculoskeletal system in the daily work of neurologists.