关键词： Aquaporin-4   Biomarker   Ischemic stroke   Neurological recovery   Prognosis  

摘要： Patients' outcome prediction after ischemic stroke is still challenging. Aquaporin-4 (AQP4) is a water channel that is up-regulated in the brain after the ischemic event, but its presence in bloodstream of stroke patients has not been previously studied. The aim of this pilot study was to investigate circulating AQP4 levels after stroke and its correlation with infarct growth and neurological outcome. AQP4 level was determined by ELISA in serum from 42 t-PA-treated ischemic stroke patients at admission (before t-PA) and 13 healthy subjects. To assess infarct growth, serial brain diffusion-weighted magnetic resonance images were performed at hospital admission and 1-3 days after. Neurological improvement was defined as a >= 4-point decrease in NIHSS score compared to baseline score. Despite stroke patients and healthy controls had similar baseline circulating AQP4 levels, among strokes AQP4 level negatively correlated with NIHSS score at admission (R = -0.34, p = 0.029) and with infarct growth after 1-3 days of stroke onset (R= - 0.36;p = 0.018). Furthermore, baseline AQP4 level was higher in those stroke patients showing a neurological improvement 48 h after stroke onset (p = 0.030) and at hospital discharge (p = 0.037). Baseline AQP4 levels also resulted to be an independent predictor of good neurological outcome at both studied time points (ORadj: 14.33[1.82-112.92], p = 0.012 at 48 h;ORadj: 4.86[0.98-24.12], p = 0.053 at discharge) in logistic regression analysis, adjusted by age, sex, baseline NIHSS and significant variables in the univariate analysis. Overall, we have explored circulating AQP4 levels, and our data suggest that AQP4 could be used as a biomarker of neurological recovery in the acute-subacute phase of ischemic stroke.

摘要： Background In infective endocarditis (IE), neurological complications (NC) may be a cause of delayed cardiac surgery. However, whether this delay impact prognosis or not is unknown. Purpose To evaluate prognosis in patients presenting IE with NC compared to a control group. To describe the impact of temporary surgical contraindication on patient mortality and evaluate the predictive factors for death among patients with NC. Methods In a prospective single-center study, all patients with IE had a systematic screening for cerebral complication. Six months mortality was compared and in patients presenting NC, prognosis according to surgical status was analyzed. The Cox regression model was used to analyze variables predictive of mortality in case of NC. Results Between 2014 and 2018, 351   patients with a diagnosis of left-sided IE were included. 94 patients (26.8%) presented at least one NC. Fifty-nine patients (17.9%) died in the first 6 months of follow-up. Six-months mortality was not significantly different between patients with NC and the control group ( P   =   0.6). Regarding patients with NC, mortality was higher in non-operated vs. operated patients when cardiac surgery was indicated ( P   =   0.02). Forty patients had temporary surgical contraindication due to NC. During the period of surgical contraindication, 7 patients (17.5%) died, 6 patients (15%) presented new embolic event, 12   patients (30%) presented cardiac or septic deterioration. By multivariate analysis, predictive factors for mortality among patients with NC were temporary surgical contraindication (HR 7.36; 95% CI 1.61–33.67; P   =   0.01) and existence of mechanical prosthetic valve (HR 16.4; 95% CI 2.22–121.17; P   =   0.006). Conclusion With current management of IE, mortality of patients with NC is not higher than in control patients. Patients with temporary surgical contraindication because of NC were high-risk patients: they presented a higher risk of death and frequent major complicati

关键词： CBL   PBL   神经病学   临床教学  

摘要： 目的:探讨CBL联合PBL教学法在神经病学临床教学中的应用效果及价值。方法:选择2019年1月至6月在蚌埠医学院第一附属医院神经内科临床实习的2015级临床医学本科生40名作为研究对象,随机分为观察组和对照组,每组各为20人。观察组采用CBL联合PBL教学法进行教学,而对照组采用传统的教学方法。在神经内科实习结束后,分别对两组学生进行理论知识、实践技能、临床思维和教学满意度的考核或问卷调查。结果:观察组和对照组两组在理论知识和实践技能成绩方面均无明显差异(P>0.05);而在临床思维和对教学满意度方面,两组之间存在统计学差异(P<0.05)。结论:CBL联合PBL教学法可以提高神经病学实习学生的教学效果,满意度较高,值得进一步推广和研究。

关键词： 疑难疾病   诊断治疗方法   神经病学   神经系统疾病   治疗困境   研究热点  

摘要： 时光无痕,岁月留声。2019年度神经病学领域的研究及进展给我们留下深刻印象,既有看到疑难疾病在新的诊断治疗方法取得突破进展时的振奋,也有在更多神经系统疾病缺乏有效治疗困境前的无奈。凡是过去,皆为序章,2019带给了我们更多的启发,将为2020年的工作提供重要参考。

关键词： 神经病学   翻转课堂   教学  

摘要： 目的:与传统教学方法相比较来探讨翻转课堂教学法在神经病中的应用优势,进而探寻提升神经病学教学效果的有效途径.方法:选取蚌埠医学院临床医学院临床医学专业2016级本科生100人随机分为两组,每组各50人,分别实施翻转课堂教学法和传统教学法,教学后进行考核和问卷调查,组间比较采用t检验.结果:实验组学生的基础理论知识成绩、论述和病例分析成绩、总成绩均显著高于实验组学生,且差异具有统计学意义(p<0.05).采用翻转课堂教学法后,学生对于神经病学的学习兴趣、学习的积极主动性、逻辑思维能力等均有提高且差异具有统计学意义(p<0.05).结论:在神经病学教学中,翻转课堂教学法与传统教学法相比能显著提高学生的学习效果,具有推广价值.

关键词： 北京天坛医院   个体化原则   中华医学会   静脉溶栓   缺血性卒中   神经病学   临床医生   脑血管病  

摘要： 由中华医学会北京分会、北京大学卒中论坛组委会、北京脑血管病防治协会等联合主办的“北京大学卒中论坛第四十八次学术会议”,2019年12月11日在北京举行。来自国内的20多位知名学者到会与近200位临床医生共同交流分享了近年来卒中领域的新进展新成果。首都医科大学附属北京天坛医院神经病学中心杨中华教授以“挑战静脉溶栓的适应证和禁忌证”为题并结合《2019 AHA/ASA缺血性卒中指南》,详细介绍了当前临床静脉溶栓(IVT)治疗的不同适应证和所面临的挑战。杨中华教授强调,静脉溶栓是目前改善脑血循环的最主要措施之一,静脉溶栓治疗应遵循个体化原则并要保证患者安全。

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。辟有包括令家论坛、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。

关键词： 多发性硬化症   中枢神经系统   神经病学   挪威奥斯陆   呼吸系统   泌尿系统   视神经   癌症风险  

摘要： 在挪威奥斯陆举行的欧洲神经病学大会(2019-07-06)上发表的一份研究显示,挪威一项新的长期研究表明,多发性硬化症(multiple sclerosis,MS)可能会增加患癌风险。总的来说,风险较小,只有12%。然而,患有MS的人患某些癌的风险——如中枢神经系统(脑、脊髓和视神经)癌和泌尿系统癌的风险大约高出50%。研究发现,患有MS的人患上呼吸系统癌的可能性要高出2/3。