关键词： 案例教学法   三位一体教学方法   临床神经病学   硕士研究生   临床思维能力  

摘要： 为探讨提高硕士研究生临床思维能力的方法,课题组选择了18名神经内科硕士研究生为研究对象,采用了以案例教学为基础,联合提问-回答-总结及学生自主讲课的三位一体教学方式,并采取问卷调查和考试的方式评估该教学方法的有效性,发现绝大部分学生对该教学方式表示满意。在理论和技能考试中,成绩优秀者(≥90分)8人,良好者(80~89分)10人,优秀率44%。得出结论:该教学方式有助于学生对理论知识的理解和记忆,提高其学习效率和自主学习能力,培养其临床思维能力。

关键词： 中华医学会   附属同济医院   同济医科大学   神经精神病学   危重疾病   儿童癫痫   神经病学   神经系统疾病  

摘要： 朱遂强教授,医学博士,教授,主任医师,二级教授,博士生导师。1993年毕业于同济医科大学获博士学位。华中科技大学同济医学院附属同济医院神经精神病学教研室主任。现任承担卫生部、科技部、国家自然科学基金及湖北省、武汉市基金项目多项。从事临床工作近30年,经验丰富、对神经系统疾病的诊治精准、规范,特别是对神经系统疑难危重疾病诊治有独到经验,擅长难治性癫痫的规范治疗及术前评估、儿童癫痫、脑出血、帕金森氏病及神经系统疑难疾病诊治,开展了大量脑血管病及癫痫相关的临床和实验研究,在专业领域权威期刊发表论文100余篇,其中SCI收录20余篇。中国抗癫痫协会常务理事、中华医学会神经病学分会委员、中华医学会神经病学分会脑电图与癫痫学组副组长、中华医学会神经病学分会脑血管病学组委员等。

关键词： 神经精神疾病   全国性学术会议   精神病学   临床荟萃   神经内科   精神科   神经病学   被引频次  

摘要： 由国家教育部主管、中山大学主办的《中国神经精神疾病杂志》创刊于1975年,是国内神经病学、精神病学领域内具有重要影响力的专业学术性核心期刊,被引频次及影响因子居临床医学期刊前列。我刊主要报道我国神经内科、神经外科、精神科临床和基础研究的新成果,介绍相关领域研究的新进展,推广先进的诊疗技术,组织专题学术讨论和召开全国性学术会议。辟有包括专家论坛、论著、短著述、研究简报、临床荟萃、讲座、综述、疑难病例讨论等诸多栏目,全面、实时地反映最新的学术思想和临床经验,其从基础到临床的广阔领域给致力于神经科学发展的研究者们提供了博大的舞台。

摘要： AIM: To describe the magnetic resonance imaging (MRI) findings of the cervical spine of patients with mucopolysaccharidosis type VI (MPS VI) and correlate them with clinical manifestations. MATERIALS AND METHODS: This is a cross-sectional study involving 12 patients with MPS VI. A limited neurological examination was undertaken in each patient including Tinel's test, assessment of muscle tone, and the evaluation of deep tendon reflexes. Additionally, each patient underwent cervical spine MRI to evaluate platybasia, odontoid dysplasia, periodontoid soft-tissue thickening, spinal canal stenosis, myelopathy, basilar invagination, platyspondyly, and reduction of nasopharyngeal airway. RESULTS: Nine patients were male (75%). The average age was 12.5 (+/- 3.5 years). Tinel's test was negative in all patients. No muscle tone abnormalities were observed. Approximately 48% of the tested reflexes were considered abnormal, 10 of which (8.3%) were pathological occurring in five different patients (41.6%). At MRI, all patients showed periodontoid soft-tissue thickening and cervical spinal stenosis;six showed spinal cord compression and two showed myelopathy. Odontoid hypoplasia and basilar invagination were observed in nine patients. All patients with cervical stenosis on MRI had abnormal reflexes;however, only two of the six patients with evidence of cord compression on MRI had abnormal reflexes on clinical examination. CONCLUSIONS: The present study of 12 patients with MPS VI demonstrated that a normal neurological examination cannot confidently exclude potential cord compression in patients with this condition. MRI may aid in the timely identification of cervical spine abnormalities, and potentially play a role in lessening morbidity and mortality in patients with MPS. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

摘要： Coronavirus disease 19 (COVID-19) is a highly transmissible viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China and has since spread rapidly around the world. In addition to neurological symptoms accompanying the classical respiratory presentation of COVID-19, case reports and series have identified a wide range of acute clinical neurological syndromes which largely fall into three main categories: stroke, Guillain-Barré Syndrome (GBS) and variants and meningoencephalitis/encephalopathy/encephalitis. Of the 19 patients with ischemic stroke, four patients died, six were still supported on an intensive care unit (ICU), one remained on a stroke unit, two were at a stroke rehabilitation facility and five made a good recovery. In a series of six patients from the UK, one patient had medium titre for IgM anticardiolipin antibodies and lupus anticoagulant was positive in five of six cases [[10]]. [Extracted from the article]

关键词： wireless sensors   wearables   balance   posturography   Alzheimer's disease   Parkinson's disease   multiple sclerosis   cerebellar ataxia   stroke   vestibular syndrome  

摘要： Balance impairment is a major mechanism behind falling along with environmental hazards. Under physiological conditions, ageing leads to a progressive decline in balance control per se. Moreover, various neurological disorders further increase the risk of falls by deteriorating specific nervous system functions contributing to balance. Over the last 15 years, significant advancements in technology have provided wearable solutions for balance evaluation and the management of postural instability in patients with neurological disorders. This narrative review aims to address the topic of balance and wireless sensors in several neurological disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, stroke, and other neurodegenerative and acute clinical syndromes. The review discusses the physiological and pathophysiological bases of balance in neurological disorders as well as the traditional and innovative instruments currently available for balance assessment. The technical and clinical perspectives of wearable technologies, as well as current challenges in the field of teleneurology, are also examined.

摘要： Following the COVID-19 outbreak, significant changes have been implemented on a national level in the organization of neurology units and associated stroke units. Regionally-designated COVID-19 hospitals have implemented an aggressive policy to relocate as many beds as possible to COVID-19 patients. In order to do so, the preferred strategy has been to reduce the number of beds in neurology units, and in some cases several units have been consolidated into one. In other cases, particularly in the northern regions, entire neurology units have been closed and converted into COVID-19 departments entrusted to other medical specialties. Some stroke units have followed the same path and become “hubs” and “spokes” for acute neurological pathology. In other situations, especially when it was necessary to meet the need for paramedical staff, the number of beds in neurology/stroke wards were significantly reduced and the nurses transferred to other units as needed to manage the COVID-19 emergency.

关键词： anti-TNF alpha antibodies   neurological adverse effects   pediatric inflammatory bowel disease  

摘要： Objectives: Neurological adverse effects (NAEs) induced by biotherapies have been reported in the literature mainly in adult patients with inflammatory bowel disease (IBD), rheumatic diseases, or psoriasis. There are scant data in children. Aims of this study are to report and describe noninfective NAE associated with anti-TNF alpha antibodies in pediatric IBD, and to evaluate their incidence. Methods: We retrospectively collected all reports of NAE in pediatric IBD treated with anti-TNF alpha antibodies recorded in the French Pharmacovigilance Database. To estimate the national incidence of NAEs, we extrapolated data from the French regional inception population-based cohort EPIMAD. Results: Between 2000 and 2018, 231 adverse events in pediatric IBD exposed to anti-TNF alpha antibodies were reported to this Database. Seventeen NAEs (7.36%) were collected: 8 severe NAE (1 demyelinating neuropathy, 1 optic neuritis, 1 acute transverse myelitis, 1 polyradiculoneuritis, 1 sensorineural hearing loss, 1 seizure, 1 stroke, and 1 glioma), 7 moderate NAE (headaches), and 2 neuropsychic events. The median delay between anti-TNF alpha start and NAE occurrence was 6 months (range: 13 days to 26 months). In 10 of 17 patients, anti-TNF alpha antibodies were stopped. Nine of 17 patients had a complete resolution (including 2 severe NAE) and 8 of 17 a partial resolution (including 6 severe NAE). We estimate the incidence of severe NAE in pediatric IBD treated with anti-TNF alpha antibodies at 1 case for 10,000 patients-year in France. Conclusions: NAE associated with anti-TNF alpha antibodies in pediatric IBD are rare. In severe NAE, we recommend to discontinue anti-TNF alpha therapy and to consider alternative treatment.