关键词： Stroke   Triiodothyronineis   Prognosis   Bioinformatics analysis  

摘要： Backgroud Patients with acute ischemic stroke (AIS) often experience low serum free triiodothyronine (FT3), but the association of low FT3 with stroke severity, subtype and prognosis has not yet been thoroughly studied, and the molecular events underlying these clinical observation were also unclear. Methods We retrospectively collected 221 cases of AIS and 182 non-AIS cases with detailed clinical data from our department. FT3 concentrations were measured on admission to predict functional outcome within 3 months using multivariable models adjusted for other risk factors. Receiver operating characteristic (ROC) curves were calculated to define the best cutoff value of FT3 of stroke severity, subtypes and neurological outcome. Gene set enrichment, pathway mapping and network analyses of deferentially expressed genes (DEGs) were performed. Results FT3 was significantly decreased in AIS patients with National Institutes of Health Stroke Scale (NIHSS) > 3 and 3-months modified Rankin Scale (mRS) > 2. The cut-off value of FT3 for NIHSS on admission was 4.30 pmol/L. Also, FT3 level was significantly lower in large artery atherosclerosis (LAA) group and cardioembolism (CE) group than that in small vessel occlusion (SVO). FT3 value served as an independent predictor for neurological outcomes for which the cut-off value of FT3 was 4.38 pmol/l. Gene ontology (GO) analysis showed that the biological function of DEGs was mainly enriched in multicellur organism, neuron differentiation and cellular response to hypoxia. The cellular components were involved in extracelluar region, exosome and matrix, and the molecular functions were transcriptional activator activity, DNA binding and nuclear hormone receptor binding. Signal pathways analysis was indicative of neuroactive ligand-receptor interaction, thyroid hormone signaling pathway, and protein digestion and absorption these DEGs were involved in. Six related gene were identified as hubs from the protein-protein interaction (PPI)

关键词： Functional neurological disorders   Conversion disorders   Dissociative disorders   SPECT  

摘要： Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. Conclusions This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion".

关键词： 思维导图   PBL   教学模式   神经病学   规培医生   教学质量   住院医师规范化培训  

摘要： 目的探讨基于思维导图的PBL教学模式在神经病学规培医师中应用的可行性及有效性。方法将2017年9月—2018年9月于西安交通大学第二附属医院神经内科规培的医师125名进行随机分为传统教学组及基于思维导图的PBL教学组,教学结束后分别进行课程满意度调查及临床考核,比较两组规培医师的满意度及考核成绩。结果基于思维导图的PBL教学组对思维导图结合PBL教学法评价较好,超过90%的规培医师认为有利于知识巩固,提高检索能力,构建知识体系(P<0.05);临床考核方面:基于思维导图的PBL教学组从理论成绩、操作成绩及病例分析均优于传统教学组,差异具有统计学意义(P<0.05)。结论基于思维导图的PBL教学方法有利于知识巩固,提高检索能力,构建知识体系,在教学效果上更胜一筹,更符合当前的教育理念,更符合应用型人才的培养。

关键词： 中华医学会   神经肌肉病   多灶性运动神经病   神经病学   周围神经病   临床实践   肌电图   推荐理由  

摘要： 推荐理由:多灶性运动神经病(MMN)是一种纯运动神经受累的多发单神经病,运动神经传导阻滞为其诊断要点。国内外均缺乏MMN准确的患病率数据,有报道估算为(0.3~3)/10万。该病通常发展较慢,但随着病情的进展,最终可导致肌肉无力萎缩而致残。中华医学会神经病学分会、中华医学会神经病学分会周围神经病协作组、中华医学会神经病学分会肌电图与临床神经电生理学组、中华医学会神经病学分会神经肌肉病学组联合制定了《中国多灶性运动神经病诊治指南2019》,供临床实践中参考。

关键词： 中华医学会   附属同济医院   北京医院   中华神经科杂志   运动障碍病   中国医学科学院   同济医学院   神经病学  

摘要： 由中华医学会神经病学分会及其帕金森病及运动障碍学组和中华医学会中华神经科杂志编辑委员会主办的运动障碍病指南及新进展巡讲,于2019年10月27日在江西南昌召开。主要来自江西省的近200名代表参加了此次巡讲。北京医院陈海波教授、中国医学科学院北京协和医院万新华教授、北京医院苏闻教授、中南大学湘雅医院郭纪锋教授、上海交通大学医学院附属瑞金医院肖勤教授、南昌大学第二附属医院黄卫教授、华中科技大学同济医学院附属同济医院薛峥教授、福建医科大学附属协和医院叶钦勇教授、青岛大学附属医院谢安木教授,就各类运动障碍病的指南和诊治进展做了精彩报告。

关键词： Cerebral ischemia/reperfusion (I/R)   Inflammation   Cytokines   Microglial activation   NF-kappa B pathway  

摘要： Kaempferol has been reported to act as an anti-inflammatory agent in LPS-induced neuroinflammation in vitro and in vivo, but its role in the inflammation after cerebral ischemia/reperfusion (I/R) is unclear. The present study was to investigate the effect of kaempferol on inflammation in ischemic brain tissue and explore its mechanisms in cerebral I/R rats. Cerebral I/R rat model was established by middle cerebral artery occlusion for 60 min and following reperfusion. Kaempferol at doses of 25, 50 and 100 mg/kg was administered for 7 days after cerebral Kaempferol treatment significantly reduced cerebral infarct volume, attenuated inflammation and blood-brain barrier (BBB) disruption after cerebral I/R, thus improved neurological outcomes at the day 7 after cerebral I/R. Furthermore, the results also showed kaempferol treatment decreased the phosphorylation and nuclear transposition of transcription factor NF-kappa B p65, thus inhibited expression of various pro-inflammatory proteins. In conclusion, kaempferol attenuates neuroinflammation and blood brain barrier dysfunction to improve neurological deficits in cerebral I/R rats, its mechanism is related to NF-kappa B pathway.

关键词： 北京大学出版社   文献计量学   《中文核心期刊要目总览》   核心期刊   神经病学   精神病学   专家评审   中华神经医学杂志  

摘要： 《中华神经医学杂志》主编:我们谨此郑重通知:依据文献计量学的原理和方法,经研究人员对相关文献的检索、统计和分析,以及学科专家评审,贵刊《中华神经医学杂志》入编《中文核心期刊要目总览》2017年版(即第8版)之“神经病学与精神病学”类的核心期刊。该书由北京大学出版社出版。

关键词： Metal-organic frameworks   Fluorescence sensing   GSH   Neurological diseases  

摘要： Precise measurement of GSH in serum is of great significance for the prevention and diagnosis of neurological disorders such as schizophrenia and Alzheimer's. In this work, we incorporated Eu3+ and Cu2+ into UiO-67-bpydc to synthesize post-modified Eu3+/Cu2+@UiO-67-bpydc. Based on the interaction between thiol and Cu2+ ions, biomolecules containing sulfhydryl groups such as GSH can coordinate with Cu2+ chelated on Eu3+/Cu2+@UiO-67-6pydc and increase its fluorescence intensity, thus the post-modified Eu3+/Cu2+@UiO-67-bpydc can serve as a platform for the detection of GSH. It exhibits a sensitive "Turn-on" response in the detection of GSH over other biological interference can even select GSH from Cys. The LOD of Eu3+/Cu2+@UiO-67-bpydc was 54.3 nM in aqueous solution. Further fluorescence tests in physiological environment demonstrate that it can also be applied in serum for the diagnosis of neurological diseases.

关键词： 中华医学会   中华神经科杂志   神经科临床   神经病学   病例报告   学术会议   临床相关   会议投稿  

摘要： 中华神经科杂志将与2020年9月份在珠海召开的“中华医学会第23次全国神经病学学术会议”合作出版重点号(正刊,不是增刊)。凡向会议投稿的作者,可把没有发表过的、有关神经科临床或与临床相关的各类稿件(论著,病例报告,综述等)投到中华神经科杂志该期重点号发表。

关键词： 临床思维诊疗教学   神经病学   教学  

摘要： 目的:探究在神经病学教学中,引入虚拟情景化临床思维诊疗教学系统的教学效果。方法:选取南京医科大学2016级影像专业本科生共65人为研究对象,随机分为实验组和对照组,实验组学生采用虚拟情景化临床思维诊疗教学系统,对照组学生采用传统教学方法,比较两组学生神经病学理论成绩和学生对教学方法的满意程度。结果:实验组和对照组理论考核成绩无明显统计学差异。实验组学生在学习价值和成就感、教学热情与组织清晰性、群体互动3个维度对教学方法满意程度得分比对照组高(P <0.05)。在功课量及难度维度上,实验组学生满意程度得分较对照组低(P=0.049)。结论:虚拟情景化临床思维诊疗教学系统在神经病学教学中提高了学生的学习价值和成就感,激发了学生的学习主动性和积极性,更多的学生参与了互动,具有一定的应用价值。