关键词： Blood-brain barrier   Stem cells   Diseases modeling   Endothelial cells   Neurological diseases   Induced pluripotent stem cells  

摘要： The blood-brain barrier (BBB) is a component of the neurovascular unit formed by specialized brain microvascular endothelial cells (BMECs) surrounded by a specific basement membrane interacting with astrocytes, neurons, and pericytes. The BBB plays an essential function in the maintenance of brain homeostasis, by providing a physical and chemical barrier against pathogens and xenobiotics. Although the disruption of the BBB occurs with several neurological disorders, the scarcity of patient material source and lack of reliability of current in vitro models hindered our ability to model the BBB during such neurological conditions. The development of novel in vitro models based on patient-derived stem cells opened new venues in modeling the human BBB in vitro, by being more accurate than existing in vitro models, but also bringing such models closer to the in vivo setting. In addition, patient-derived models of the BBB opens the avenue to address the contribution of genetic factors commonly associated with certain neurological diseases on the BBB pathophysiology. This review provides a comprehensive understanding of the BBB, the current development of stem cell-based models in the field, the current challenges and limitations of such models.

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： 神经病学   微信平台   翻转课堂  

摘要： 目的探讨基于微信平台的翻转课堂在神经病学教学中的应用及其效果。方法以浙江中医药大学滨江学院2014级临床医学专业学生为教学对象,设一班、三班共74名学生为实验组,二班38名学生为对照组。选择周围神经病、神经肌肉-接头疾病为教学内容,实验组采用翻转课堂教学,并利用微信平台进行课前预习、课后复习和互动交流;对照组采用传统教学。两组学生课前和课后分别进行微测试、不记名问卷调查;课程结束后统一进行期末考试,其中包含病例分析题,记录并分析每组学生期末考试和病例分析题成绩。所有数据用SPSS 20.0处理,行t检验或卡方检验。结果实验组学生的课后微测试成绩明显高于对照组(P=0.038);期末考试成绩高于对照组(P=0.046),且期末考试中病例分析题得分高于对照组(P=0.026)。课前问卷调查显示,在学习内容了解程度和预习情况的评价上,实验组选择"良"的学生比例高于对照组(P<0.05)。课后问卷调查显示,实验组在学习兴趣的评价中选择"优""良"的学生比例均高于对照组(P<0.05);自学能力评价中选择"良"的学生比例、临床思维能力和教学满意度评价中选择"优"的学生比例均高于对照组(P<0.05);且实验组在所有项目评价中选择"优""良"的学生总体比例均高于对照组(P<0.05)。课后实验组学习兴趣评价中选择"优""良"的学生总体比例高于课前(P<0.01)。结论基于微信平台的翻转课堂在神经病学教学中的应用可行且有效,可弥补传统教学的不足,有助于提高学生的学习兴趣和自主学习能力、锻炼学生的临床思维,值得推广。

关键词： 精神卫生中心   精神病医院   新乡医学院   应用心理学   神经病学   医学影像   专科医院   精神疾病  

摘要： 河南省精神卫生中心(河南省精神病医院,新乡医学院第二附属医院)1951年6月建院,是一所以治疗精神疾病为主的三级甲等专科医院,是国务院学位委员会批准的精神病与精神卫生学、神经病学、应用心理学、老年医学、内科学、护理学、医学影像与核医学、临床检验诊断8个硕士学位授予单位,是国家人力资源和社会保障部及全国博士后管委会批准的博士后科研工作站。

关键词： Brain-derived neurotrophic factor fused with a collagen-binding domain   inflammation   microglia   traumatic brain injury   TrkB  

摘要： Objectives As one of the vital nutrient factors in central nervous system (CNS), brain-derived neurotrophic factor (BDNF) can significantly attenuate neuron damage and promote neurogenesis. Nevertheless, little research has been conducted on regulating the effect of BDNF on the inflammatory response after traumatic brain injury (TBI). Methods In this study, we used BDNF fused with a collagen-binding domain (CBD-BDNF) to maintain a sufficient concentration of BDNF in the TBI hemisphere, and then, the regulatory effects of BDNF and CBD-BDNF on the inflammatory response of microglia were investigated both on a TBI mice model in vivo and LPS-stimulated microglia experiment in vitro. Key findings The results revealed that BDNF and CBD-BDNF had similar effects on attenuating the pro-inflammatory reactions but promoting anti-inflammatory responses of microglia induced by LPS in vitro. Furthermore, CBD-BDNF significantly improved the neurological behaviours of TBI mice and alleviated the inflammatory reaction after TBI, while BDNF had weaker effects compared with those of CBD-BDNF. Additionally, the TrkB inhibitor K252a significantly inhibited the above effects of CBD-BDNF. Conclusions In conclusion, CBD-BDNF can promote the anti-inflammatory function of microglia and neurological recovery of TBI mice through TrkB signalling.

关键词： Peroxiredoxin 2   Neurological disorders   Neuroprotection   Oxidative stress   Neuroinflammation  

摘要： Oxidative stress and neuroinflammation are closely related to the pathological processes of neurological disorders. Peroxiredoxin 2 (Prdx2) is an abundant antioxidant enzyme in the central nervous system. Prdx2 reduces the production of reactive oxygen species and participates in regulating various signaling pathways in neurons by catalyzing hydrogen peroxide (H2O2), thereby protecting neurons against oxidative stress and an inflammatory injury. However, the spillage of Prdx2, as damage-associated molecular patterns, accelerates brain damage after stroke by activating an inflammatory response. The post-translational modifications of Prdx2 also affect its enzyme activity. This review focuses on the effects of Prdx2 and its molecular mechanisms in various neurological disorders.

摘要： Objective: To evaluate the level of theory application and use of behaviour change techniques (BCTs) in dyadic health interventions for persons with chronic neurological conditions (CNCs) and their caregivers. Methods: A systematic review of five databases was conducted to locate articles published before January 2019. Methodological quality was assessed, study characteristics, theory application and BCTs were narratively summarized. Results: More than half of the studies identified (59% [16/27]) did not mention theory, and only 22% (6/27) were explicitly theory-based. Across the 27 studies, two to 17 BCTs (mean = 6.8 +/- 4.02) were used. Common BCTs were related to intervention implementation (e.g., credible source), knowledge (e.g., instruction on how to perform behaviour) and skill development (e.g., behavioural practice/rehearsal). Conclusions: Researchers need to incorporate theory-based dyadic techniques that target both people with CNCs and their caregivers into the design and implementation of future health interventions. Practice implications: Health professionals require explicitly theory-based interventions to provide dyads with CNCs techniques that they can apply in their daily life to the benefit of each individual and the partnership. (c) 2019 Elsevier B.V. All rights reserved.

关键词： Methylmalonic aciduria   Homocystinuria   Magnetic resonance imaging   Caudate nucleus   Neuropsychological test  

摘要： Purpose: We report on one patient with methylmalonic acidemia (MMA) who presented with symmetrical hemorrhage of the caudate nucleus accompanied by severe ventricular dilatation, follow-up magnetic resonance imaging (MRI) findings from one year later, and the clinical manifestations, neuropsychological scores, genetic test results, urine and blood laboratory results and evolution of the disorder. Materials and methods: This study describes the recent and remote neuropathologic findings, reviews the literature, and discusses the possible pathogenetic mechanisms of these central nervous system lesions. Results: Patients with MMA may have signs of basal ganglia hemorrhage during acute onset, and the hemorrhage may disappear after treatment. During the treatment, both laboratory examination indexes and neuropsychological scores improved. There was a correlation between the evolution of bilateral basal ganglia hemorrhage using MRI(magnetic resonance imaging) and neurological damage recovery in this infant with MMA. Conclusion: There was a correlation between the evolution of the bilateral basal ganglia hemorrhage using MR imaging and neurological damage recovery in an infant with MMA. We recommend performing conventional MR and diffusion-weighted imaging (DWI) examinations in patients with MMA who present with neurological symptoms. (C) 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

关键词： Cognitive reserve   Brain reserve   Traumatic brain injury   Post-anoxic encephalopathy   Functional recovery   Rehabilitation  

摘要： Objective: Patients with an equivalent clinical background may show unexpected interindividual differences in their outcome. The cognitive reserve (CR) model has been proposed to account for such discrepancies, but its role after acquired severe injuries is still being debated. We hypothesize that inappropriate investigative methods might have been used when dealing with severe patients, which have very likely reduced the possibility of observing meaningful influences in recovery from severe traumas. Methods: To overcome this issue, the potential neuroprotective role of CR was investigated, considering a wider spectrum of clinical symptoms ranging from low-level brain stem functions necessary for life to more complex motor and cognitive skills. In the present study, data from 50 severe patients, 20 suffering from post-anoxic encephalopathy (PAE) and 30 with traumatic brain injury (TBI), were collected and retrospectively analyzed. Results: We found that CR, diagnosis, time of hospitalization, and their interaction had an effect on the clinical indexes. When the predictive power of CR was investigated by means of two machine learning classifier algorithms, CR, together with age, emerged as the strongest factor in discriminating between patients who reached or did not reach successful recovery. Conclusions: Overall, the present study highlights a possible role of CR in shaping the recovery of severe patients suffering from either PAE or TBI. The practical implications underlying the need to routinely considered CR in the clinical practice are discussed.