关键词： 专业型硕士研究生   住院医师规范化培训   神经病学   教学方法  

摘要： 临床医学专业型硕士研究生(简称专硕生)培养和住院医师规范化培训(简称住培)双轨合并,是研究生教育的重要改革,已经成为医学生毕业从事临床工作的必经阶段。神经病学具有高度的专业性、系统性、逻辑性和推理性,是住培阶段的难点。如何在有限的时间内做好非神经病学专科专硕生住培临床教学培养,该文做了一些初步的探索。

关键词： 中华神经科杂志   中华医学会   脑血管病临床   神经病学   病例报告   中国脑血管病   会议投稿  

摘要： 中华神经科杂志将与2020年4月份在武汉召开、由中华医学会神经病学分会主办的“第20次中国脑血管病大会2020”合作出版脑血管病重点号(正刊,非增刊)。凡向会议投稿的作者,可把没有发表过的、有关脑血管病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。中华神经科杂志投稿网址:http://***。

摘要： Background: In the biopsychosocial formulation of functional neurological (conversion) disorder (FND), little is known about relationships between social behavior and brain anatomy. We hypothesized that social behavior would relate to brain areas implicated in affiliative behaviors and that social network size would correlate with symptom severity and predisposing vulnerabilities in FND. Methods: This neuroimaging pilot probed how social network size, as measured by the Social Network Index, related to structural brain profiles in 23 patients with motor FND (15 woman and 8 men). FreeSurfer cortical thickness and subcortical volumetric analyses were performed correcting for multiple comparisons. Stratified analyses compared FND patients with a low social network size to matched healthy controls. Secondary exploratory analyses in an expanded sample of 38 FND patients investigated relationships between social network size, risk factors and patient-reported symptom severity. Results: Adjusting for age and gender, neuroimaging analyses showed that social network size positively correlated with left nucleus accumbens and hippocampal volumes in patients with FND;stratified analyses did not show any group-level differences. In individuals with FND, social network size correlated with health-related quality of life, graduating college, working full-time and a non-epileptic seizure diagnosis;social network size inversely related to lifetime trauma burden, post-traumatic stress disorder severity and age. Limitations: Only patient-reported scales were used and social network size information was not collected for healthy subjects. Conclusions: This neuroimaging pilot adds to the literature linking affiliation network brain areas to pro-social behaviors and enhances the biopsychosocial conceptualization of FND.

关键词： 神经精神疾病   康复医学   精神病学   神经遗传学   神经病学   科研方法   科研成果   核心期刊  

摘要： 《中国神经精神疾病杂志》为我国神经病学与精神病学核心期刊,国内外公开发行。本刊以广大神经内科、神经外科、精神科及相关学科(包括神经生物学、神经遗传学及康复医学等)医师为主要读者,报道神经精神学科领域领先的科研方法、科研成果和临床诊疗经验,以及对神经精神疾病临床有指导意义的基础理论研究。一直被《中文核心期刊要目总览》、《中国科技论文统计源期刊》、中国科学引文数据库(CSCD)等收录为核心期刊。

关键词： PBL教学法   神经病学   住院医师   规范化培训   教学   应用  

摘要： 目的探讨以问题为导向的教学法(PBL)在神经病学住院医师规范化培训教学中的应用效果。方法采用随机数字表将本院48名在培神经病学住院医师随机分为对照组(24名,传统教学法)和观察组(24名,PBL教学法)进行规范化培训,比较两组医师培训3个月后的考核成绩及满意度。结果培训3个月后,观察组规培医师的理论考核、实际操作、病史书写及平时成绩均显著优于对照组,差异有统计学意义(P<0.05);观察组医师的满意度评分较对照组显著增高(95.83%vs 75.00%),差异有统计学意义(P<0.05)。结论PBL教学法在神经病学住院医师规范化培训教学中的应用效果显著,教学效果好,满意度高。

关键词： 慕课   MOOC   混合式教学   高等职业教育   神经病学   教学  

摘要： 目的 在"MOOC"背景下,探索混合式教学模式在高职课堂神经病学教学中的应用效果.方法 将广西中医药大学接受神经病学课程教育的高职学生96名平均分为3组.课程结束后,分别采用理论、技能、问卷调查等考核方式对3组接受不同教学模式学员的教学效果进行比较和评价.结果 在理论、技能、效果评价上,混合教学组得分均显著高于常规与慕课教学组,在技能与效果评价上,慕课教学组得分高于常规教学组,但在理论考试上,慕课与常规教学组之间差异无统计学意义(P>0.05).结论 混合式学习法能有效提高神经病学教学效果,提高学生学习兴趣及临床操作技能等.

关键词： 重庆医科大学   医学影像技术   神经病学   核医学专业   放射科   客座编辑   硕士研究生导师   附属第一医院  

摘要： 吕发金,重庆医科大学医学影像技术系主任,附属第一医院放射科副主任(主持工作),主任医师,教授,硕士研究生导师,医学影像与核医学专业硕士,神经病学博士。

关键词： American Spinal Injury Association (ASIA)   diffusion tensor imaging   motor index score (MIS)   neurological injury   neurological recovery   spinal cord injury  

摘要： The aim of this study is to determine the strength and accuracy of diffusion tensor imaging (DTI) parameters to predict neurological injury and recovery in adult cervical spinal cord injury (SCI). DTI magnetic resonance imaging (MRI) was performed on 23 acute cervical SCI patients within 12 h after injury and on 45 controls utilizing a rapid DTI sequence (similar to 5 min). Neurological assessments were conducted from within 24 h of injury up to 6 months utilizing detailed International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examinations. Spearman correlation and receiver operating characteristic (ROC) analysis were used to identify relationships between the DTI parameters at the lesion epicenter and adjacent regions, with injury severity and recovery. In proximity to the anatomical injury (within one level above and below epicenter), there was significant reduction in fractional anisotropy (FA), and elevation in mean diffusivity (MD) and radial diffusivity (RD). DTI values measured one level rostral to the injury epicenter showed stronger correlations with multiple clinical features at several time-points. Area under the curve (AUC) obtained from ROC analysis showed FA (AUC = 0.77) measured at lesion epicenter, and FA (0.83), MD (0.76), and RD (0.83) values measured immediately rostral (one level above) to epicenter discriminate injury severity. Further, MD (0.78) measured at lesion epicenter, and MD (0.79) and RD (0.74) values measured immediately rostral to epicenter discriminate neurological recovery. DTI indices measured immediately rostral to the anatomical level of injury consistently showed better correlation (moderate to strong) and accuracy in predicting neurological injury (FA, r = -0.51 and RD, r = 0.54) and recovery (MD, r = -0.51) than indices measured at the epicenter. There was weak to moderate correlation of all measures at lesion epicenter in predicting neurological injury (FA: r = -0.48;MD: r = 0.23;RD: r = 0.34;

关键词： Triage   Neurological emergency   Emergency room  

摘要： Background/objective Neurological syndromes are underrepresented in existing triage systems which are not validated for neurological patients;therefore, we developed and validated the new Heidelberg Neurological Triage System (HEINTS) in a prospective, single-center observational study. Methods Patients were triaged according to the new triage system by nurses and physicians (stage 1) as well as trained nurses (stage 2). In stage 1, all patients presenting to the neurological emergency room (ER) were triaged by nurses and physicians. In stage 2, three specially trained nurses triaged patients according to HEINTS. The main outcomes comprised interrater agreement between nurses' and physicians' triage (stage 1), sensitivity and specificity to detect emergencies (stages 1 and 2), and improvement in triage quality as a result of training (stage 2), as well as correlation of HEINTS with hospital admissions and resource utilization. Results In stage 1 (n = 2423 patients), sensitivity and specificity to detect neurological emergencies were 84.2% (SD 0.8%) and 85.4% (SD 0.8%) for nurses, as well as 92.4% (SD 0.6%) and 84.1% (SD 0.9%) for physicians, respectively. The interrater-reliability between nurses and physicians in stage 1 was moderate [Cohen's kappa 0.44, standard deviation (SD) 0.02]. In stage 2 (n = 506 patients), sensitivity of trained nurses increased to 94.3% (SD 1.0%), while specificity decreased to 74.8% (SD 1.9%). Correlation of HEINTS triage with hospital admission and resource utilization in both stages was highly significant. Conclusions HEINTS predicted hospital admissions and resource utilization. Agreement between nurses and physicians was moderate. HEINTS, applied by physicians and by nurses after training, reliably detected neurological emergencies.