摘要： Acute intussusception is one of the most common causes of intestinal obstruction in infants and small children and involves the invagination of one bowel segment into another. The clinical signs can be deceptively misleading when there is only one symptom or when an unusual symptom is in the foreground, especially in infants less than 1-year-old. We report a case of an infant with an acute intussusception where the neurological symptoms are predominant. The neurological form is the expression of major vascular narrowing of the collar of the intestinal intussusception;this form is rare and misleading and can be responsible for a delayed diagnosis.

关键词： Head trauma   intracranial pressure   ICP measurements   monitoring  

摘要： Primary Objective: Treatment paradigms for traumatic brain injury (TBI) rely on invasive monitoring of intracranial pressure (ICP) for planning intervention. Optical pupillometry is a non-invasive, objective monitoring method, measuring parameters of pupillary response and displaying a scalar value - a neurological pupil index (NPi). An impaired response on NPi has been tentatively correlated with ICP, through analysis of mean/peak NPi and ICP readings. We sought to evaluate this relationship more *** Design: Prospective *** and Procedures: We obtained hourly pupillometry readings, alongside ICP values, from 40 patients with TBI requiring invasive ICP monitoring. Significant events were identified for analysis based on the significant aberration of ICP or *** Outcomes and Results: On average, individuals experienced a few significant events. There was a weak relationship between ICP events and a preceding NPi event. The results show that there is a weak but statistically insignificant relationship between NPi and ICP, where reduced pupil reactivity may indicate a raised ICP. The strength of this trend appears to diminish post-decompressive ***: Whilst pupillometry may not be a reliable surrogate marker for ICP, NPi may still prove to be a useful tool in a multimodal prognostic assessment of the patient with acute brain injury.

关键词： oxidative stress   pathway   NRF2   cerebrovascular   neurodegenerative   alternative  

摘要： Cellular defense mechanisms, intracellular signaling, and physiological functions are regulated by electrophiles and reactive oxygen species (ROS). Recent works strongly considered imbalanced ROS and electrophile overabundance as the leading cause of cellular and tissue damage, whereas oxidative stress (OS) plays a crucial role for the onset and progression of major cerebrovascular and neurodegenerative pathologies. These include Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), Huntington's disease (HD), stroke, and aging. Nuclear factor erythroid 2-related factor (NRF2) is the major modulator of the xenobiotic-activated receptor (XAR) and is accountable for activating the antioxidative response elements (ARE)-pathway modulating the detoxification and antioxidative responses of the cells. NRF2 activity, however, is also implicated in carcinogenesis protection, stem cells regulation, anti-inflammation, anti-aging, and so forth. Herein, we briefly describe the NRF2 ARE pathway and provide a review analysis of its functioning and system integration as well as its role in major CNS disorders. We also discuss NRF2-based therapeutic approaches for the treatment of neurodegenerative and cerebrovascular disorders.

关键词： 神经病学   睡眠医学   交叉融合  

摘要： 2018年,几项机制和干预研究阐明了我们在临床神经病学和睡眠医学交叉领域的认识。发作性睡病是一种主要由下丘脑分泌素缺乏引起的睡眠疾病,常表现为日间过度思睡,有研究者考虑其发病可能与机体免疫反应对下丘脑分泌素神经元的攻击有关。一项研究报告在一些发作性睡病患者外周血和脑脊液中检测出下丘脑分泌素神经元特异性细胞毒性CD4 + T淋巴细胞[1]。这一发现强化了发作性睡病是一种自身免疫性疾病的认识,将来T淋巴细胞可能成为诊断或提示预后的生物标志物。关于下丘脑分泌素神经元的可塑性,在人类和小鼠的研究中都报道了阿片类药物的作用,在野生型小鼠中长期注射吗啡可保护下丘脑分泌素神经元免于死亡[2],但神经元的发生并非保护下丘脑分泌素神经元的机制。此外,应用吗啡可减少发作性睡病小鼠模型的猝倒发作。与此相关的研究是,对5例海洛因成瘾者进行尸检,发现其下丘脑分泌素神经元的数量比对照组多54%,这一转化研究发现了保护甚至重建下丘脑分泌素神经元功能的途径。

关键词： 《中文核心期刊要目总览》   文献计量学   神经病学   医学杂志   研究人员   专家评审   精神病学   北京大学  

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： 思维导图   教学案例   神经病学   临床教学   学习效率   临床思维  

摘要： 举例介绍思维导图在神经病学教学中的应用,学生绘制思维导图,梳理知识点,理论与实践相结合。进一步介绍思维导图应用的意义。并总结教学应用中的心得体会及注意事项。思维导图应用于教学的整个过程,有利于教师备课和总结知识点,方便学生笔记、理解和记忆所学课程的重点内容。同时能以一种生动、清晰的方式将知识的关键点联系起来。还可以作为一种测试工具,测试学生掌握知识的广度和深度。思维导图教学法不仅能够有效地提高医学生的学习效率,还能培养临床思维能力,是一种有效的教学途径。目前在国内医学教育中,无论是理论课教学还是实践课程教学均有采用,其评价均良好。

关键词： CBL教学模式   神经病学   临床教学   应用价值  

摘要： 目的:观察CBL教学模式在神经病学临床教学中的应用价值分析。方法:选取2017年1-12月于笔者所在医院神经内科实习的医生34例,采取常规以授课为基础传统教学方法(lecture based learning,LBL),设为LBL组。2018年1月笔者所在医院开展以案例为基础教学方法(case based learning,CBL),应用于2018年1-12月于笔者所在医院神经内科实习的医生34例,设置为CBL组。对两组教学后成绩(理论知识、专业操作、病案分析、患者管理、工作态度)进行评估,统计并比较两组对教学接受率、实习活跃率、依从性及对教学满意率。结果:CBL组实习医生理论知识、专业操作、病案分析、患者管理及工作态度评分均高于LBL组,差异均有统计学意义(P<0.05)。CBL组及LBL组对教学接受率分别为100%、85.29%,实习活跃率分别为100%、82.35%,依从率分别为100%、88.24%,对教学满意率分别为100%、88.24%,差异均有统计学意义(P<0.05)。结论:在神经病学实习医生的临床教学中应用CBL教学法,可明显提高实习医生学习及临床实践能力,改善其工作态度,提高对教学的接受性、依从性与实习活跃度,并提高实习医生对教学的满意度。

关键词： 神经病学见习课   Gelb指南  

摘要： 遵循Gelb指南和上海渥太华联合医学院八项能力培养原则,设计一个规范化神经病学实习前选修课。三轮的教学实施过程证实了课程内容、流程和考核方式的合理性及可操作,预设的教学目的有效达成。

关键词： 神经心理学   神经病学   认知功能缺损   行为   心理活动   神经机制   神经科学   神经功能  

摘要： 一、学科与学组概况神经心理学是研究高级认知功能或心理活动的神经机制的一门学科,是从神经科学角度研究心理学问题,研究脑结构与心理活动或认知功能的关系。传统神经心理学方法常常是通过研究脑损伤患者的高级认知功能缺损,确立脑结构和高级神经功能的关系,临床上也为神经损伤的定位诊断提供依据[1]。