关键词： 神经病学   住院医师规范化培训   教学模式   标准化  

摘要： 为培养具有扎实理论基础及较高临床能力的神经内科规培医师,将规范化培训的内容及方法进行了量化和标准化,采用多种教学方法相结合,建立了一套独立、完整、科学规范的新型教学模式系统。

关键词： 中华医学会   神经病学   神经科   会议   杂志   出版   合作   学术  

摘要： 中华神经科杂志将于2018年9月在上海召开的“中华医学会第21次全国神经病学学术会议”合作出版重点号（正刊，不是增刊）。凡向会议投稿的作者，可把没有发表过的、有关神经科临床或与临床相关的各类稿件（论著，病例报告，综述等）投到中华神经科杂志该期重点号发表。

关键词： Infant   Traumatic brain injury   Glasgow Coma Scale   Secondary brain injury  

摘要： The purpose of this study is to clarify risk factors for poor neurological outcomes and distinctive characteristics in infants with traumatic brain injury. The study retrospectively reviewed data of 166 infants with traumatic intracranial hemorrhage from three tertiary institutions in Japan between 2002 and 2013. Univariate and multivariate analyses were used to identify clinical symptoms, vital signs, physical findings, and computed tomography findings associated with poor neurological outcomes at discharge from the intensive care unit. In univariate analysis, bradypnea, tachycardia, hypotension, dyscoria, retinal hemorrhage, subdural hematoma, cerebral edema, and a Glasgow Coma Scale (GCS) score of 12 were significantly associated with poor neurological outcomes (P < 0.05). In multivariate analysis, a GCS score of 12 (OR = 130.7;95% CI, 7.3-2323.2;P < 0.001), cerebral edema (OR = 109.1;95% CI, 7.2-1664.1;P < 0.001), retinal hemorrhage (OR = 7.2;95% CI, 1.2-42.1;P = 0.027), and Pediatric Index of Mortality 2 score (OR = 1.6;95% CI, 1.1-2.3;P = 0.018) were independently associated with poor neurological outcomes. Incidence of bradypnea in infants with a GCS score of 12 (25/42) was significantly higher than that in infants with GCS score of > 12 (27/90) (P = 0.001). Infants with a GCS score of 12 are likely to have respiratory disorders associated with traumatic brain injury. Physiological disorders may easily lead to secondary brain injury, resulting in poor neurological outcomes. Secondary brain injury should be prevented through early interventions based on vital signs and the GCS score.

关键词： Conversion Disorder   Functional Neurological Disorder   Treatment  

摘要： "Ms. A," a 29-year-old woman, was referred for a second neurologic opinion. Several months earlier, she woke with a pins-and-needles sensation involving both legs from the knees to the toes. The following day, she could not move her legs without help from her fiance. Several hours later, she developed transient numbness of the left arm. Alarmed by her increasing symptoms, she presented to the emergency department. A brain and cervical MRI with gadolinium contrast showed no abnormalities. The patient was discharged with neurologic follow-up. Results of an electromyogram and nerve conduction study of the upper and lower extremities were normal. Later, because of increasing back and diffuse leg pain, the patient underwent a lumbar MRI, which also showed no abnormalities. She continued to experience lower extremity weakness and paresthesias as well as back and legpain. No diagnosis was made. The patient had been unable to work since her symptoms began.

关键词： motor coordination   neurological abnormalities   schizophrenia   soft neurological signs  

摘要： ObjectiveNeurological soft signs (NSS) are a group of minor non-localisable neurological abnormalities found more often in patients with schizophrenia. The aim of the current study was to test for the effect of gender, age, parental age, age at onset and clinical symptomatology on *** and methodsThe study sample included 133 patients suffering from schizophrenia according to DSM-IV-TR (77 males and 56 females;aged 33.5511.22 years old) and 122 normal controls (66 males and 56 females;aged 32.899.91 years old). The assessment included the Neurological Evaluation Scale (NES), and a number of scales assessing the clinical symptoms and adverse effects especially extrapyramidal. The statistical analysis included exploratory t-test, simple linear regression analysis, analysis of covariance and the calculation of correlation *** results of the current study confirm that NSS are more frequent in patients with schizophrenia in comparison with normal controls (Wilks=0.622, p<0.0001), but do not support an effect of gender, age, age at onset, paternal or maternal age, education, medication status or clinical subtype of schizophrenia on NES *** these results suggest that NSS constitute an independent (from the rest of symptoms), core (present in the vast majority of patients) and trait (unrelated to age and probably to the stage of schizophrenia) symptom of schizophrenia which could be of value in the clinical assessment and research of schizophrenia. Overall these results are not in full accord with the literature, but they could serve to fill in gaps and inconsistencies observed so far.

关键词： Alzheimer's disease   biomechanistics   epilepsy   Huntington's disease   neurological disorders   oxidative stress   parkinsonism, pathogenesis  

摘要： Neurological diseases like Alzheimer's disease, epilepsy, parkinsonism, depression, Huntington's disease and amyotrophic lateral sclerosis prevailing globally are considered to be deeply influenced by oxidative stress-based changes in the biochemical settings of the organs. The excess oxygen concentration triggers the production of reactive oxygen species, and even the intrinsic antioxidant enzyme system, i.e. SOD, CAT and GSHPx, fails to manage their levels and keep them under desirable limits. This consequently leads to oxidation of protein, lipids and nucleic acids in the brain resulting in apoptosis, proteopathy, proteasomes and mitochondrion dysfunction, glial cell activation as well as neuroinflammation. The present exploration deals with the evidence-based mechanism of oxidative stress towards development of key neurological diseases along with the involved biomechanistics and biomaterials.

摘要： On average, humans sleep for a third of their lives, and sleep disorders are common and treatable. However, services for most sleep disorders are highly variable across the UK, and sleep medicine is neglected in the medical curriculum. We report the findings of an audit of patients with neurological sleep disorders seen in a combined cognitive neurology and sleep disorder clinics over a seven-year period, 75 with hypersomnias, 67 with parasomnias and 39 with insomnia. Also, the results of a pilot of a cognitive behavioural therapy service for insomnia undertaken in the same population are analysed.

关键词： global health   neurology   medical education  

摘要： Neurology training is essential for providing neurologic care globally. Large disparities in availability of neurology training exist between higher- and lower-income countries. This review explores the worldwide distribution of neurology training programs and trainees, the characteristics of training programs in different parts of the world, and initiatives aimed at increasing access to neurology training in under-resourced regions.

关键词： Phenotype   Expand   maladjustment  

关键词： stem cell research   organoids   iPSCs   brain tumors   stem cell tourism   neural stem cells   ALS   MS  

摘要： Stem cell tourism is defined as the unethical practice of offering unproven cellular preparations to patients suffering from various medical conditions. This phenomenon is rising in the field of neurology as patients are requesting information and opportunities for treatment with stem cells for incurable conditions such as multiple sclerosis and amyotrophic lateral sclerosis, despite their clinical research and experimental designation. Here, we review the recent trends in stem cell tourism in both the United States and abroad, and discuss the recent reports of neurological complications from these activities. Finally, we frame critical questions for the field of neurology regarding training in the ethical, legal, and societal issues of the global stem cell tourism, as well as suggest strategies to alleviate this problem. Although there are ongoing legitimate clinical trials with stem cells for neurological diseases, procedures offered by stem cell clinics cannot be defined as clinical research. They lack the experimental and state-of-the-art framework defined by peers and the FDA that focus on human research that safeguard the protection of human subjects against economical exploitation, unwanted side effects, and futility of unproven procedures. Stem cell tourism ultimately exploits therapeutic hope of patients and families with incurable neurological diseases and can put in danger the legitimacy of stem cell research as a whole. We posit that an improvement in education, regulation, legislation, and involvement of authorities in global health in neurology and neurosurgery is required.