关键词： 干燥综合征   神经病学表现   中枢神经系统疾病   临床特点  

摘要： 目的探究原发性干燥综合征(pSS)患者神经系统损害的临床特点。方法回顾性分析就诊于天津医科大学总医院风湿免疫科和北京协和医院风湿免疫科的pSS合并神经系统损害患者32例。分析pSS神经系统受累患者的人口学特征、临床表现、实验室检查及影像学检查特征。结果 32例pSS患者中,女30例(93.8%),男 2例(6.2%),年龄(46±12)岁。16例(50%)患者以神经系统损害为首发症状,其余以干燥症状为首发症状。13例(40.6%)患者表现为单独周围神经系统(PNS)损害,10例(31.3%)患者表现为单独中枢神经系统(CNS)损害,9例(28.1%)患者同时合并两种损害(CNS-PNS)。 PNS损害中最常见的是多发性神经病变(6例,18.8%), CNS损害中最常见是视神经脊髓炎谱系疾病(6例,18.8%)。 PNS损害的患者较CNS损害的患者更易伴有雷诺现象(P=0.046)。 PNS和CNS-PNS损害的患者肺间质病变(ILD)比例明显高于CNS损害的患者(P=0.013)。结论 pSS患者多发性神经病变和视神经脊髓炎谱系疾病分别是PNS和CNS损害的最常见形式,合并PNS损害的患者更易合并肺间质病变。

关键词： Molecular docking   Molecular dynamics   Enhanced sampling   Free energy calculations   Monoamine transporters   Membrane proteins  

摘要： The field of molecular mechanics studies of proteins has developed enormously since its origin in the 1970's, and many applications and methodologies have branched from the original idea of the force field. The applications of such methodologies are far spread and commonplace in neuroscience research today. In this mini-review, we outline the main methodologies applied when studying events ranging from ligands binding within small binding sites, through overall large-scale conformational changes, to the even larger-scale oligomerization events of neurological membrane proteins. The limitations and caveats of the methods are discussed, while examples of recent applications are described and their implications discussed. We have chosen to focus on the monoamine transporters throughout, with a few examples from neurological membrane proteins such as ionotropic and metabotropic neurotransmitter receptors.

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

摘要： 《中国现代神经疾病杂志》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《中国现代神经疾病杂志》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： 医学教育   农村订单定向免费医学生   教学方法   岗位胜任力   教学满意度   神经病学  

摘要： 目的:为培养具备优秀岗位胜任力的农村订单定向免费医学人才,以《神经病学》为教材,制定以岗位胜任力为核心的教学方法并检测教学效果。方法:选择蚌埠医学院2014级49名农村订单定向免费医学生作为观察组,2013级52名农村订单定向免费医学生作为对照组,观察组应用以岗位胜任力为核心的教学方法,对照组应用传统教学方法。结果:观察组学生理论知识考试成绩与对照组比较,差异有统计学意义(P<0.05),实践技能考试成绩高于对照组(P<0.05),观察组科研能力高于对照组(P<0.05),观察组学生对教学满意度高于对照组(P<0.01)。结论:以岗位胜任力为核心的教学方法可提高学生理论知识,实践技能和科研能力,提高学生对教学的满意度,可增进临床学科教育教学质量。

关键词： 视神经脊髓炎   利妥昔单抗   治疗   中枢神经系统   多发性硬化   免疫紊乱   神经病学   综合征  

摘要： 视神经脊髓炎(neuromyelitis optica,NMO),也叫Devic综合征,是一种严重的中枢神经系统免疫紊乱,曾经有较多神经病学专家认为NMO 是多发性硬化(multiple sclerosis,MS)的一种亚型,目前已证实两种疾病各不相同[1]。

关键词： 编者   神经病学   临床实践   脑血管病   BMJ  

摘要： 神经病学近年来有飞速的发展,BMJ中文版每年均有围绕神经病学相关内容进行阐述的期刊,既有贴近临床实践的指南,又有最新的研究结果。本期选取了神经病学领域最重要并且常见的两大类疾病为主题:痴呆与脑血管病。

关键词： 教学模式   神经病学   PBL教学  

摘要： 目的探讨PBL教学模式在皖南医学院弋矶山医院神经内科住院医师规范化培训临床教学中具体应用及教学效果,并比较其与传统教学方法的优劣。方法前瞻性纳入2018年3-12月皖南医学院附属弋矶山医院神经内科临床实习人员80人,进行随机分组,分别进行PBL教学及传统教学,教学后行考核及问卷调查。结果 PBL教学模式下学生的临床分析能力和实践操作能力优于常规教学组学生(P<0.05)。在专业理论成绩方面,试验组和对照组比较差异无统计学意义(P>0.05)。结论 PBL教学模式相较传统教学模式在神经病学临床教学中具有相对优势,值得在今后神经病学教学中不断探索和研究。

关键词： bunyavirus   cattle   central nervous system   neurological signs   phylogeny   Shuni virus  

摘要： The insect-transmitted Shuni virus (SHUV) belongs to the Simbu serogroup of orthobunyaviruses and it is known to induce abortions, stillbirths and severe congenital malformations in ruminants and may cause neurological signs in infected horses. Here, SHUV was detected in brain samples of two Israeli cattle, which suffered from severe neurological signs that led to the deaths of the animals. During histopathological examination of the first case, a 5-month-old calf, small perivascular cuffs, composed mainly of neutrophils with few lymphocytes were observed in the brain stem and cerebrum. Similar infiltrates were also found to a lesser extent in the cerebellar meninges leading to the diagnosis of acute-subacute meningoencephalitis. The histological examination of the brainstem from the second case, a 16-month-old heifer, revealed perivascular infiltration composed of equal numbers of macrophages and neutrophils associated with cerebral and meningeal haemorrhages. In this case encephalitis was diagnosed. Viral RNA was extracted from brain samples of both cattle that suffered from severe neurological signs and was subsequently tested by a polymerase chain reaction PCR assay specific for Simbu serogroup viruses and found positive. The presence of SHUV was subsequently confirmed by the isolation of the virus from one sample and sequence analysis of both brain samples. The comparison of the complete sequences of the coding regions of all three genome segments from both cases revealed a close relationship to Shuni viruses detected in tissue samples of aborted or malformed calves or lambs born during the last years in Israel.

关键词： Traumatic brain injury   Neuroprotection   SkQR1   C12R1  

摘要： The protective effect of SkQR1, a mitochondria-targeted antioxidant, was investigated on the model of focal one-sided traumatic brain injury (TBI) of the sensorimotor cortex region from 1 to 7 days after the injury. TBI caused a reliable disruption of the functions of the limbs contralateral to injury focus. The intravenous single injection of SkQR1 (250 nmol/kg) but not C12R1 (a SkQR1 homologue devoid of the antioxidant group) 30 min after TBI reduced the impairment of the motor functions of the limbs. A statistically significant improvement in limb function in animals was shown using 3 different tests: limb-placing test, beam-walking test and grip strength test. A pronounced therapeutic effect appeared on the 1th day and lasted until the end of the experiment - the 7th day after TBI. Histopathological examination showed that in the group of animals that did not receive SkQR1 in the marginal layer of the lesion there was a marked increase in astroglial expression, infiltration with segmented neutrophils, and poor survivability of neurons compared with animals treated with SkQR1. The obtained results demonstrate that the single use of plastoquinone-containing mitochondria-targeted antioxidant SkQR1 at the early stages of development of traumatic brain damage can reduce TBI-related disruptions of limb functions, and that mechanisms of the brain damage after trauma are dependent on the production of mitochondrial reactive oxygen species.

关键词： Vertebral venous system   VVS   Intra-abdominal pressure   IAP   Intra-abdominal hypertension   IAH   Prone position   Idiopathic intracranial hypertension   IIH   Hydrocephalus   Traumatic brain injury   TBI   Prone position   Cerebrospinal venous system   CSVS   Extradural neural axis compartment   EDNAC  

摘要： Intra-abdominal pressure (IAP) is a physiological parameter that has gained considerable attention during the last few decades. The incidence of complications arising from increased IAP, known as intra-abdominal hypertension (IAH) or abdominal compartment syndrome in critically ill patients, is high and its impact is significant. The effects of IAP in neurological conditions and during surgical procedures are largely unexplored. IAP also appears to be relevant during neurosurgical procedures (spine and brain) in the prone position, and in selected cases, IAH may affect cerebrospinal fluid drainage after a ventriculoperitoneal shunt operation. Furthermore, raised IAP is one of the contributors to intracranial hypertension in patients with morbid obesity. In traumatic brain injury, case reports described how abdominal decompression lowers intracerebral pressure. The anatomical substrate for transmission of the IAP to the brain and venous system of the spine is the extradural neural axis compartment;the first reports of this phenomenon can be found in anatomical studies of the sixteenth century. In this review, we summarize the available knowledge on how IAP impacts the cerebrospinal venous system and the jugular venous system via two pathways, and we discuss the implications for neurosurgical procedures as well as the relevance of IAH in neurological disorders.