关键词： Rats  

摘要： Oxidative stress is considered to play an important role in the cerebral ischemia-reperfusion injury. The nuclear transcription factor erythroid-2-related factor 2 (Nrf2)/NAD(P)H dehydrogenase [quinone] 1 (NQO1) pathway has been considered as a potential target for neuroprotection in cerebral ischemia-reperfusion injury. Nomilin (NOM) is a limonoid compound obtained from the extracts of citrus fruits. The purpose of our study was to determine whether NOM could exert beneficial effects in cerebral ischemia-reperfusion rats. Firstly, NOM treatment significantly mitigated cell death and decreased lactate dehydrogenase (LDH) release and ROS production in SH-SY5Y cells induced by oxygen-glucose deprivation (OGD), which was almost abolished by Nrf2 knockdown. Secondly, NOM improved infarct area, brain edema and neurological deficits in an experimental stroke rat model via middle cerebral artery occlusion (MCAO). Furthermore, NOM attenuated blood-brain barrier (BBB) disruption in MCAO rats, which might be associated with alleviating the loss of tight junction proteins, including ZO-1 and occludin-5. Further results revealed that NOM treatment effectively mitigated oxidative stress and facilitated the expressions of Nrf2 and NQO1, which might confirm that the loss of tight junction proteins in the microvasculature was likely mediated by oxidative stress. In conclusion, our study provided evidence that the protective effects of NOM in cerebral ischemia-reperfusion rats were related to the Nrf2/NQO1 pathway.

关键词： 对分课堂   CBL教学法   神经病学  

摘要： 目的探讨对分课堂联合基于案例的学习(CBL)教学法在神经病学教学中的应用效果。方法在临床本科生中随机选取一个教学班(48人)为实验班,实施对分课堂联合CBL教学法;另选一个班(48人)为对照班实施讲授式教学法。期末时实验班和对照班学生进行统一考试,同时接受教学情况问卷调查。结果实验班和对照班学生期末神经病学考试平均成绩分别为(75.45±6.64)分和(69.36±8.18)分,差异具有显著性(t=4.00,P<0.01)。调查问卷中学生对授课教师满意度、授课知识掌握情况满意度、临床思维能力提高满意度、知识运用能力提高满意度等方面,实验班学生的评分优于对照班。结论对分课堂联合CBL教学法有利于培养学生自主学习能力,提升教学质量。

关键词： PBL-seminar   教学模式   教学探索   神经病学   临床见习   应用研究  

摘要： 目的探讨PBL-seminar教学模式在神经病学临床见习应用的可行性及有效性。方法将我校2013级参加神经内科临床见习的本科学生153人随机分为两大组:传统教学组及PBL-seminar组,教学结束后分别进行课程满意度调查及临床见习考核,比较两组学生的满意度及考核成绩。结果1)参加PBL-seminar组的学生课程满意度高于传统教学组,即PBL-seminar组在学习兴趣提升、知识面拓展和临床思维能力方面优于传统教学组(P<0.05);2)临床见习考核方面:PBL-seminar组理论考试得分、基本技能及病例分析较传统教学组好,差异有统计学意义(P<0.05)。结论将PBL-seminar教学模式引入到神经病学见习中,有助于提高学生的学习兴趣,拓宽知识面,培养学生的临床思维及解决问题的能力,实现教学相长。

摘要： BACKGROUND CONTEXTIntraoperative Neuromonitoring (IONM) is frequently used by spine surgeons to predict emerging neurological insult and to provide functional feedback prior to development of irreversible neural injury. Despite its widespread use, however, it remains unclear whether various IONM changes are predictive of neurological outcomes in patients who undergo decompression surgery for cervical spondylosis with myelopathy (CSM). PURPOSETo evaluate the prognosticative ability of IONM changes for neurological outcomes after surgical decompression in patients with CSM. STUDY DESIGN/SETTINGRetrospective evaluation of a prospectively enrolled cohort of patients who underwent surgery for CSM at the Ohio State University Wexner Medical Center. PATIENT SAMPLEA total of 39 patients were prospectively enrolled in a CSM trial at our institution and underwent decompression surgery between 2013-17. All patients with available intraoperative somatosensory evoked potential (iSSEP), motor evoked potential (iMEP), and spontaneous electromyography (iEMG) recordings as well as perioperative mJOA scores were included in the study. OUTCOME MEASURESThe modified Japanese Orthopaedic Association (mJOA) scale evaluated at 1-year following surgery. METHODSEither univariate ANOVA with post hoc analysis (Student–Newman–Keuls) or t-tests were used to analyze DmJOA in relation to iSSEP, iMEP, and iEMG changes. RESULTSDuring surgery, iMEPs either improved, remained stable, or decreased in 5, 29 and 5 patients, respectively. iSSEPs improved, remained stable, or decreased in 1, 37 and 1 patient, respectively. Twenty-five patients showed spontaneous iEMG activity, which ultimately resolved in all cases. In patients in whom iMEP decreased, remained stable, or improved, mJOA improved by 1.3, 2.0, and 2.8 points 12 months after surgery, respectively. In contrast to iSSEP (p=0.58), iMEP changes and the presence/absence of iEMG activity during surgery were predictive of DmJOA at 12 months (p=0.02 a

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： AAV   mucopolysaccharidoses   gene therapy   lysosomal storage disease  

摘要： Patients with the lysosomal storage disease mucopolysaccharidosis IIIA (MPSIIIA) lack the lysosomal enzyme N-sulfoglucosamine sulfohydrolase (SGSH), one of the many enzymes involved in degradation of heparan sulfate. Build-up of un-degraded heparan sulfate results in severe progressive neurodegeneration for which there is currently no treatment. Experimental gene therapies based on gene addition are currently being explored. Following preclinical evaluation in MPSIIIA mice, an adeno-associated virus vector of serotype rh10 designed to deliver SGSH and sulfatase modifying factor 1 (SAF301) was trialed in four MPSIIIA patients, showing good tolerance and absence of adverse events with some improvements in neurocognitive measures. This study aimed to improve SAF301 further by removing sulfatase modifying factor 1 (SUMF1) and assessing if expression of this gene is needed to increase the SGSH enzyme activity (SAF301b). Second, the murine phosphoglycerate kinase (PGK) promotor was exchanged with a chicken beta actin/CMV composite (CAG) promotor (SAF302) to see if SGSH expression levels could be boosted further. The three different vectors were administered to MPSIIIA mice via intracranial injection, and SGSH expression levels were compared 4 weeks post treatment. Removal of SUMF1 resulted in marginal reductions in enzyme activity. However, promotor exchange significantly increased the amount of SGSH expressed in the brain, leading to superior therapeutic correction with SAF302. Biodistribution of SAF302 was further assessed using green fluorescent protein (GFP), indicating that vector spread was limited to the area around the injection tract. Further modification of the injection strategy to a single depth with higher injection volume increased vector distribution, leading to more widespread GFP distribution and sustained expression, suggesting this approach should be adopted in future trials.