关键词： blood-brain barrier   drug delivery   nanomaterials   nanoparticles   neurological diseases  

摘要： Therapies directed toward the central nervous system remain difficult to translate into improved clinical outcomes. This is largely due to the blood-brain barrier (BBB), arguably the most tightly regulated interface in the human body, which routinely excludes most therapeutics. Advances in the engineering of nanomaterials and their application in biomedicine (i.e., nanomedicine) are enabling new strategies that have the potential to help improve our understanding and treatment of neurological diseases. Herein, the various mechanisms by which therapeutics can be delivered to the brain are examined and key challenges facing translation of this research from benchtop to bedside are highlighted. Following a contextual overview of the BBB anatomy and physiology in both healthy and diseased states, relevant therapeutic strategies for bypassing and crossing the BBB are discussed. The focus here is especially on nanomaterial-based drug delivery systems and the potential of these to overcome the biological challenges imposed by the BBB. Finally, disease-targeting strategies and clearance mechanisms are explored. The objective is to provide the diverse range of researchers active in the field (e.g., material scientists, chemists, engineers, neuroscientists, and clinicians) with an easily accessible guide to the key opportunities and challenges currently facing the nanomaterial-mediated treatment of neurological diseases.

关键词： PBL教学模式   神经病学   临床教学  

摘要： 神经病学是一门具有高度抽象性、逻辑性和专业性的临床学科,临床教学是其教学模式的重要组成部分。将PBL教学模式应用于神经病学临床教学中,有利于培养医学生的临床思维,促进其向临床医生角色转变。

关键词： PCGF2   Polycomb Group Ring Finger 2   MEL18   intellectual disability   dysmorphism   polymicrogyria  

摘要： PCGF2 encodes the polycomb group ring finger 2 protein, a transcriptional repressor involved in cell proliferation, differentiation, and embryogenesis. PCGF2 is a component of the polycomb repressive complex 1 (PRC1), a multiprotein complex which controls gene silencing through histone modification and chromatin remodelling. We report the phenotypic characterization of 13 patients (11 unrelated individuals and a pair of monozygotic twins) with missense mutations in PCGF2. All the mutations affected the same highly conserved proline in PCGF2 and were de novo, excepting maternal mosaicism in one. The patients demonstrated a recognizable facial gestalt, intellectual disability, feeding problems, impaired growth, and a range of brain, cardiovascular, and skeletal abnormalities. Computer structural modeling suggests the substitutions alter an N-terminal loop of PCGF2 critical for histone biding. Mutant PCGF2 may have dominant-negative effects, sequestering PRC1 components into complexes that lack the ability to interact efficiently with histones. These findings demonstrate the important role of PCGF2 in human development and confirm that heterozygous substitutions of the Pro65 residue of PCGF2 cause a recognizable syndrome characterized by distinctive craniofacial, neurological, cardiovascular, and skeletal features.

关键词： 翻转课堂   CBT   临床   教学   应用   神经病学  

摘要： 目的探究临床专业学生采用翻转课堂与CBT联合教学模式的效果和作用。方法选择2016级70名临床专业学生作为研究对象。采用抽签法,将其分为实验组与参照组,每组均35名。其中,参照组采用常规小班教学模式,实验组实施翻转课堂与CBT联合教学模式,对比2组学生神经病学考核成绩与教学满意度。结果实验组基础知识、疾病诊断、疾病症状及临床检查考核评分均优于参照组,实验组对教学总满意率(97.14%)高于参照组(77.14%),组间各数据比较,差异均具有意义(P <0.05)。结论翻转课堂结合CBT模式能够吸引学生注意力,学生学习积极性较高,神经病学临床教学质量得以大幅度提升。

关键词： 新型教学模式   神经解剖   三维动画   多媒体教学   三维立体   神经病学  

摘要： 神经病学教学内容繁多、神经解剖结构复杂、抽象且理论性很强,历来是医学教育的重点和难点,新时代下传统的医学教育模式已经不能满足学科教学的发展。而随着多媒体教学的发展,将三维动画应用到神经病学的教学中,能够在有限的时间内从不同角度、不同视点对神经系统的解剖关系进行清晰、准确的展示,使得学生们更容易形成各种三维立体空间结构的概念,可以把抽象、深邃的知识直观地呈现给学生,调动学生学习的积极性,并加深学生对神经病学知识的理解,有利于学生们将解剖结构与临床紧密相联系,培养了学生定位诊断的临床思维与分析问题的能力,从而提高神经病学的教学水平。

关键词： 潍坊市益都中心医院   山东省   中西医结合学会   专业委员会   神经内科   硕士生导师   主任委员   神经病学  

摘要： 牛建一,现任山东省潍坊市益都中心医院理事长兼大神经内科主任。兼任山东省中西医结合学会神经内科专业委员会委员,潍坊市中西医结合学会副会长,潍坊市神经病学专业委员会副主任委员,神经内科专业主任医师、教授、硕士生导师,潍坊名医。

关键词： 临床病理讨论   神经科   北京市   CPC   首都医科大学宣武医院   学术思想   神经病学   国内外  

摘要： 11月3日,2018年神经科临床病理高峰论坛暨北京市神经科临床病理讨论会(CPC)成立40周年纪念会在首都医科大学宣武医院举行。国内外专家与参会代表们济济一堂,共同庆祝CPC成立40周年,同时交流学术思想,共同推动我国神经病学的发展。

关键词： 文献报告会   血管神经病学   研究生培养  

摘要： 目的探讨定期文献报告会在血管神经病学研究生临床教学中的效果。方法选取首都医科大学附属北京天坛医院神经病学中心血管神经病学科2病区的临床实习轮转研究生,开展定期文献报告会,最终评价教学效果。结果研究生的文献阅读量明显增加,查阅文献、归纳整理文献的能力、临床专业知识及制作幻灯、表达交流能力均有了很大提高,能够更好地发现和解决临床问题,临床教学效果良好。结论定期文献报告会对提高学生临床能力、科研能力及表达能力有重要意义,值得推广。

关键词： Soluble CD163   acute HIV infection   neurocognitive impairment   central nervous system   cerebrospinal fluid   plasma   combination antiretroviral therapy  

摘要： Background. Myeloid activation contributes to cognitive impairment in chronic human immunodeficiency virus (HIV) infection. We explored whether combination antiretroviral therapy (cART) initiation during acute HIV infection impacts CD163 shedding, a myeloid activation marker, and in turn, implications on the central nervous system (CNS). Methods. We measured soluble CD163 (sCD163) levels in plasma and cerebrospinal fluid (CSF) by enzyme-linked immunosorbent assay in Thais who initiated cART during acute HIV infection (Fiebig stages I-IV). Examination of CNS involvement included neuropsychological testing and analysis of brain metabolites by magnetic resonance spectroscopy. Chronic HIV-infected or uninfected Thais served as controls. Results. We examined 51 adults with acute HIV infection (Fiebig stages I-III;male sex, >90%;age, 31 years). sCD163 levels before and after cART in Fiebig stage I/II were comparable to those in uninfected controls (plasma levels, 97.9 and 93.6 ng/mL, respectively, vs 99.5 ng/mL;CSF levels, 6.7 and 6.4 ng/mL, respectively, vs 7.1 ng/mL). In Fiebig stage III, sCD163 levels were elevated before cART as compared to those in uninfected controls (plasma levels, 135 ng/mL;CSF levels, 10 ng/mL;P < .01 for both comparisons) before normalization after cART (plasma levels, 90.1 ng/mL;CSF levels, 6.5 ng/mL). Before cART, higher sCD163 levels during Fiebig stage III correlated with poor CNS measures (eg, decreased N-acetylaspartate levels), but paradoxically, during Fiebig stage I/II, this association was linked with favorable CNS outcomes (eg, higher neuropsychological test scores). After cART initiation, higher sCD163 levels during Fiebig stage III were associated with negative CNS indices (eg, worse neuropsychological test scores). Conclusion. Initiation of cART early during acute HIV infection (ie, during Fiebig stage I/II) may decrease inflammation, preventing shedding of CD163, which in turn might lower the risk of brain injury.

关键词： 翻转课堂   中西医   神经病学   临床教学   问题   应用效果  

摘要： 依据中西医结合神经病学的临床教学实际特点,引入翻转课堂教学模式,初步分析在中西医结合神经病学临床教学中翻转课堂的实施措施,改善以往教学模式的不足和缺点,尽可能将课前以及课堂时间最大化利用,将学生积极性和学习兴趣激发,最终展现以学生为中心的临床教学目的,不但可将学生掌握相关知识程度提升,也能够更好的提升学生团队合作、自主学习、分享交流能力。中西医结合神经病学实际上是结合现代神经病学和传统中医理论通过现代化技术对神经系统疾病发展以及发生研究的诊疗技术。文章主要阐述中西医结合神经病学临床教学中应用翻转课堂模式的作用。