关键词： Cerebrospinal fluid   Stem cells   Induced differentiation   Neural stem cells   Stem cell transplantation therapy  

摘要： Recent studies have suggested that the regulation of endogenous neural stem cells (NSCs) or transplanting of exogenous nerve cells are the newest and most promising methods for the treatment of dementia and other neurological diseases. The special location and limited number of endogenous NSCs, however, restrict their clinical application. The success in directional differentiation of exogenous stem cells from other tissue sources into neural cells has provided a novel source for NSCs. Study on the relative mechanisms is still at the preliminary stage. Currently the induction methods include: 1) cell growth factor induction;2) chemical induction;3) combined growth factor-chemical induction;or 4) other induction methods such as traumatic brain tissue homogenate, gene transfection, traditional Chinese medicine, and coculture induction. Cerebrospinal fluid (CSF), as a natural medium under physiological conditions, contains a variety of progrowth peptide factors that can promote the proliferation and differentiation of mesenchymal stromal cells (MSCs) into neural cells through the corresponding receptors on the cell surface. This suggests that CSF can not only nourish the nerve cells, but also become an effective and suitable inducer to increase the yield of NSCs. However, some other studies believed that CSF contained certain inhibitory components against the differentiation of primary stem cells into mature neural cells. Based on the above background, here we review the relative literature on the influence of the CSF on stem cells in order to provide a more comprehensive reference for the wide clinical application of NSCs in the future.

关键词： Peripheral neuropathy   Hepatitis C virus   Cognitive impairment   Sensory perception   Cognitive neurology   Chronic hepatitis   Viral load   Hepatitis C  

摘要： Background Chronic hepatitis C infection is a major public health concern, with a high burden in SubSaharan Africa. There is growing evidence that chronic hepatitis C virus (HCV) infection causes neurological complications. This study aimed at assessing the prevalence and factors associated with neurological manifestations in chronic hepatitis C patients. Methods Through a cross-sectional design, a semi-structured questionnaire was used to collect data from consecutive chronic HCV infected patients attending the outpatient gastroenterology unit of the Douala General Hospital (DGH). Data collection was by interview, patient record review (including HCV RNA quantification, HCV genotyping and the assessment of liver fibrosis and necroinflammatory activity), clinical examination complemented by 3 tools;Neuropathic pain diagnostic questionnaire, Brief peripheral neuropathy screen and mini mental state examination score. Data were analysed using Statistical package for social sciences version 20 for windows. Results Of the 121 chronic hepatitis C patients (51.2% males) recruited, 54.5% (95% Confidence interval: 46.3%, 62.8%) had at least one neurological manifestation, with peripheral nervous system manifestations being more common (50.4%). Age >= 55 years (Adjusted Odds Ratio: 4.82, 95% CI: 1.02 +/- 18.81, p = 0.02), longer duration of illness (AOR: 1.012, 95% CI: 1.00 +/- 1.02, p = 0.01) and high viral load (AOR: 3.40, 95% CI: 1.20 +/- 9.64, p = 0.02) were significantly associated with neurological manifestations. Peripheral neuropathy was the most common neurological manifestation (49.6%), presenting mainly as sensory neuropathy (47.9%). Age >= 55 years (AOR: 6.25, 95% CI: 1.33 +/- 29.08, p = 0.02) and longer duration of illness (AOR: 1.01, 1.00 +/- 1.02, p = 0.01) were significantly associated with peripheral neuropathy. Conclusion Over half of the patients with chronic hepatitis C attending the DGH have a neurological manifestation, mainly presenting as sensory perip

关键词： Krabbe’s disease   AAV   gene therapy   psychosine   galactosylceramidase   oligodendrocytes   microglia   myelin   leukodystrophy   demyelination  

摘要： We report a global adeno-associated virus (AAV)9-based gene therapy protocol to deliver therapeutic galactosylceramidase (GALC), a lysosomal enzyme that is deficient in Krabbe's disease. When globally administered via intrathecal, intracranial, and intravenous injections to newborn mice affected with GALC deficiency (twitcher mice), this approach largely surpassed prior published benchmarks of survival and metabolic correction, showing long-term protection of demyelination, neuroinflammation, and motor function. Bone marrow transplantation, performed in this protocol without immunosuppressive preconditioning, added minimal benefits to the AAV9 gene therapy. Contrasting with other proposed pre-clinical therapies, these results demonstrate that achieving nearly complete correction of GALC's metabolic deficiencies across the entire nervous system via gene therapy can have a significant improvement to behavioral deficits, pathophysiological changes, and survival. These results are an important consideration for determining the safest and most effective manner for adapting gene therapy to treat this leukodystrophy in the clinic.

摘要： Histone deacetylase (HDAC) inhibitors are of significant interest as drugs. However, their use to treat neurological disorders has raised concern because HDACs are required for brain function. We have previously shown that a triple combination formulation (TCF) of the pan HDACi vorinostat (Vo), 2-hydroxypropyl-beta-cyclodextrin (HPBCD) and polyethylene glycol (PEG) 400 improves pharmacokinetic exposure and entry of Vo into the brain. TCF treatment significantly delayed both neurodegeneration and death in the Npc1(nmf164) murine model of Niemann-Pick Type C (NPC) disease. The TCF induces no metabolic toxicity, but its risk to normal brain functions and potential utility in treating lung disease, a major NPC clinical complication, remain unknown. Here we report that TCF administered in healthy mice for 8-10 months was not detrimental to the brain or neuromuscular functions based on quantitative analyses of Purkinje neurons, neuroinflammation, neurocognitive/muscular disease symptom progression, cerebellar/hippocampal nerve fiber-staining, and Hdac gene-expression. The TCF also improved delivery of Vo to lungs and reduced accumulation of foamy macrophages in Npc1(nmf164) mice, with no injury. Together, these data support feasibility of tolerable, chronic administration of an HDACi formulation that treats murine NPC neurological disease and lung pathology, a frequent cause of death in this and possibly additional disorders.

关键词： 中华医学会   神经病学   会议   学术   江苏省医学会   苏州市   学分  

摘要： 中华医学会第20次全国神经病学学术会议于2017年9月7—10日在江苏省苏州市召开。本次会议由中华医学会和中华医学会神经病学分会主办，江苏省医学会和江苏省医学会神经病学分会承办。

关键词： 在职培训   神经病学   住院医师   教学查房  

摘要： 住院医师规范化培训的实施对临床教学查房提出了新的要求。该文从神经内科住院医师规范化培训教学实践出发,对查房的准备、过程和总结等各方面进行归纳总结,提出提高教学查房的质量和效率,将更有助于住院医师规范化培训。

关键词： 神经病学   临床教学   方法   脑血管疾病  

摘要： 教学是临床工作重要的组成部分,是培养年轻医生成长的必要手段。神经病学和其他学科相比知识体系更加复杂。脑血管疾病是最常见的中枢神经系统疾病,脑血管病教学的目的就是通过临床实践、教学查房和讲座,让年轻医师在短时间内掌握脑血管病相关的基础和临床知识,并在此基础上形成正确的诊疗思路,能跟踪国内外最新进展,将新的诊疗方法应用到临床工作中来,并能在临床工作中发现问题,建立科研假说,进行科学研究,更好地指导下一步临床工作。本文介绍了首都医科大学附属北京世纪坛医院神经内科脑血管病教学的临床体会。

关键词： 神经病学   硕士研究生   科学学位   招生培养模式   改革  

摘要： 新形势下,我国医学教育提出了培养高素质创新人才的要求,硕士研究生培养是医学教育的关键环节和重要途径。随着临床医学及其二级学科神经病学的快速发展,不仅对研究生的临床水平提出了越来越高的要求,而且还要求合格的毕业生必须具备一定的独立科研能力。因此,神经病学科学学位硕士研究生的招生和培养模式成为值得探索的新课题。笔者在本文中分析了我国硕士研究生招生培养的现状,并着重对科学型硕士研究生的培养模式提出有建设性的改革意见和方案。

关键词： 中加联合医学院   教学大纲   课程   神经病学  

摘要： 上海—渥太华联合医学院的神经病学教学大纲是以学生能力发展为导向的课程设计。与现行教纲和课程比较有以下特点:有效学时增加,依托疾病的知识整合重构,临床实用性原则以及教学目标制度化。