关键词： 教学方法   神经病学   数据收集   学生  

摘要： 目的探讨以问题为基础的教学法(PBL)在神经康复学教学中的应用效果。方法将2013级康复治疗专业本科学生54例作为试验组,采用PBL开展神经康复学的教学;将2012级康复治疗专业本科学生42例作为对照组,采用传统教学方式开展神经康复学的教学。教学结束后采用笔试、技能考核及问卷调查方式,比较两组教学效果。结果试验组理论成绩及技能考核成绩明显优于对照组。试验组在学习兴趣、基础知识掌握程度、抽象问题解决能力、理论联系实际能力、重点难点知识掌握程度等方面明显优于对照组。结论在神经康复学教学中,PBL教学方法比传统教学方法效果更有明显优势。

关键词： 神经病学教学   教学模式   多元化   临床基本技能   临床思维能力   内科医师   神经解剖   病理生理  

摘要： 神经病学属于临床二级学科,其理论性和逻辑性极强,要想成为优秀的神经内科医师,需要具备扎实的神经解剖、神经影像及病理生理等多学科知识,熟练掌握各种临床基本技能,培养敏锐的临床思维能力。神经病学是内科中的一门亚专科,各个学校的理论课时及实习时间均相对较短,但其知识点复杂、疾病种类繁多,诊疗思维独具特色,学习难度大[1]。本文对神经病学教学中理论授课、临床带教方法、临床实习等不同阶段的教学方法总结分析,以培养适应医学发展的神经内科专业人才。

关键词： 北京大学第三医院   运动神经元病   诊治技术   学习班   神经内科   师资力量   神经病学  

摘要： 由北京大学第三医院神经内科主办的北京大学第二届全国运动神经元病诊治技术新进展学习班拟于2018年7月23至27日在北京举行。本学习班集中了北京大学神经病学诊治领域雄厚的师资力量，同时邀请国内知名专家授课。

关键词： Out-of-Hospital Cardiac Arrest   In-Hospital Cardiac Arrest   Overweight   Obesity  

摘要： BackgroundMagnetic resonance imaging (MRI) of the brain including diffusion-weighted imaging (DWI) is reported to have high prognostic accuracy in unconscious post-cardiac arrest (CA) patients. We documented acute MRI findings in the brain in both conscious and unconscious post-CA patients treated with target temperature management (TTM) at 32-34 degrees C for 24 h as well as the relation to patients' neurological outcome after 6 months. MethodsA prospective observational study with MRI was performed regardless of the level of consciousness in post-CA patients treated with TTM. Neurological outcome was assessed using the Cerebral Performance Categories scale and dichotomized into good and poor outcome. ResultsForty-six patients underwent MRI at 3-5 days post-CA. Patients with good outcome had minor, mainly frontal and parietal, lesions. Acute hypoxic/ischemic lesions on MRI including DWI were more common in patients with poor outcome (P = 0.007). These lesions affected mostly gray matter (deep or cortical), with or without involvement of the underlying white matter. Lesions in the occipital and temporal lobes, deep gray matter and cerebellum showed strongest associations with poor outcome. Decreased apparent diffusion coefficient, was more common in patients with poor outcome. ConclusionsExtensive acute hypoxic/ischemic MRI lesions in the cortical regions, deep gray matter and cerebellum detected by visual analysis as well as low apparent diffusion coefficient values from quantitative measurements were associated with poor outcome. Patients with good outcome had minor hypoxic/ischemic changes, mainly in the frontal and parietal lobes.

关键词： brain development   Nucleic Acid Regulatory Sequences   variants   Gene regulation   Regulatory   Risk Factors   maladjustment   pipeline   Variation   disrupting   Neurologic Disorders  

摘要： Understanding the genetic factors underlying neurodevelopmental and neuropsychiatric disorders is a major challenge given their prevalence and potential severity for quality of life. While large-scale genomic screens have made major advances in this area, for many disorders the genetic underpinnings are complex and poorly understood. To date the field has focused predominantly on protein coding variation, but given the importance of tightly controlled gene expression for normal brain development and disorder, variation that affects non-coding regulatory regions of the genome is likely to play an important role in these phenotypes. Herein we show the importance of 3 prime untranslated region (3'UTR) non-coding regulatory variants across neurodevelopmental and neuropsychiatric disorders. We devised a pipeline for identifying and functionally validating putatively pathogenic variants from next generation sequencing (NGS) data. We applied this pipeline to a cohort of children with severe specific language impairment (SLI) and identified a functional, SLI-associated variant affecting gene regulation in cells and post-mortem human brain. This variant and the affected gene (ARHGEF39) represent new putative risk factors for SLI. Furthermore, we identified 3'UTR regulatory variants across autism, schizophrenia and bipolar disorder NGS cohorts demonstrating their impact on neurodevelopmental and neuropsychiatric disorders. Our findings show the importance of investigating non-coding regulatory variants when determining risk factors contributing to neurodevelopmental and neuropsychiatric disorders. In the future, integration of such regulatory variation with protein coding changes will be essential for uncovering the genetic causes of complex neurological disorders and the fundamental mechanisms underlying health and disease.

关键词： animal-assisted therapy (AAT)   pet therapy   dementia   schizophrenia   mood depression  

摘要： Animal-assisted therapy (AAT) includes a set of nonpharmacological interventions aimed at improving human health through the use of trained or untrained animals. In recent decades, AAT has been trialed for different neurological and psychiatric disorders. In patients with dementia, interaction with animals seems to have a positive influence on aggressiveness and anxiety and to ameliorate quality of life and relationship skills. In psychiatric patients, AAT seems to increase motivation and self-esteem, improve prosocial conduct, and decrease behavioral problems. The aim of this study is to review the literature on AAT for elderly people with dementia and psychiatric disorders. Other fields of possible application for AAT are suggested.

关键词： cardiac arrest   extracorporeal circulation   animal model hypothermia   neurological recovery  

摘要： Introduction: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named controlled integrated resuscitation device (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept. Here, we investigated the role of immediate short-term blood cooling after experimental CA and its influence on survival and neurological recovery. Methods: Twenty-one pigs were exposed to 20 minutes of normothermic CA. Afterwards, CIRD was immediately started for 60 minutes in all animals and the heart was converted to a sinus rhythm. The pigs either received normothermic reperfusion (37 degrees C, n=11) or the temperature was maintained at 32 degrees C for the first 30 minutes (n=10). Thermometric, hemodynamic and serologic data were collected during the experiment. After weaning from CIRD, neurological recovery was assessed daily by a species-specific neurological deficit score (NDS;0: normal;500: brain death). Results: One pig in each group could not be successfully resuscitated. Due to severe neurological deficits, only 6/11 animals in the normothermic group finished the observation time of seven days with an NDS of 3734. In the hypothermic group, all nine surviving animals reached day seven with an NDS of 16 +/- 13. Analogous to the lower NDS, animals in the hypothermic group also showed lower neuron-specific enolase end values as a marker of brain injury. Conclusions: Within this experimental setting, immediate moderate and short-term hypothermia after CA improves survival and seems to result in statistically non-significant better neurological recovery.

关键词： Health care economics   Health occupations   Health services   Neurological disorders  

摘要： Neurological disorders are the leading cause of global disability. However, for most people around the world, current neurological care is poor. In low-income countries, most individuals lack access to proper neurological care, and in high-income countries, distance and disability limit access. With the global proliferation of smartphones, teleneurology - the use of technology to provide neurological care and education remotely - has the potential to improve and increase access to care for billions of people. Telestroke has already fulfilled this promise, but teleneurology applications for chronic conditions are still in their infancy. Similarly, few studies have explored the capabilities of mobile technologies such as smartphones and wearable sensors, which can guide care by providing objective, frequent, real-world assessments of patients. In low-income settings, teleneurology can increase the capacity of local care systems through professional development, diagnostic support and consultative services. In high-income settings, teleneurology is likely to promote the expansion and migration of neurological care away from institutions, incorporate systems of asynchronous communication (such as e-mail), integrate clinicians with diverse skill sets and reach new populations. Inertia, outdated policies and social barriers - especially the digital divide - will slow this progress at considerable cost. However, a future increasingly will be possible in which neurological care can be accessed by anyone, anywhere. Here, we examine the emerging evidence regarding the benefits of teleneurology for chronic conditions, its role and risks in low-income countries and the promise of mobile technologies to measure disease status and deliver care. We conclude by discussing the future trends, barriers and timing for the adoption of teleneurology.