关键词： 临床医学  

ISBN: (纸本)9787030660466

摘要： 本书共二十二章，包括绪论、神经系统的解剖生理及病损的定位诊断、神经系统疾病的常见症状、神经系统疾病的病史采集和体格检查、神经系统疾病的辅助检查、神经系统疾病的诊断原则、头痛、脑血管疾病、脑血管疾病的介入治疗、神经系统变性疾病、中枢神经系统感染性疾病、中枢神经系统脱髓鞘疾病、运动障碍性疾病、癫痫、脊髓疾病、周围神经疾病、自主神经系统疾病、神经-肌肉接头和肌肉疾病、神经系统遗传性疾病、神经系统发育异常性疾病、睡眠障碍、内科系统疾病的神经系统并发症。

关键词： COVID-19   Neurological disease   Outcomes   Steroid therapy   Mortality  

摘要： Objective The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves. Methods In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic. Results Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (n = 41, 36.9% vs n = 79, 70.5%, p < 0.001) and lower mortality rates (14.4% vs 31.3%, p = 0.004). The different healthcare strategies and early steroid treatment emerged as significant predictors of mortality independently from age, pre-morbid conditions and COVID-19 severity in Cox regression analyses. Conclusions Differences in healthcare strategies during the second phase of the COVID-19 pandemic probably explain the differences in clinical outcomes independently of disease severity, underlying the importance of standardized early management of neurological patients with SARS-CoV-2 infection.

关键词： Adverse events   Disease-modifying treatment   Effectiveness   Fingolimod   Multiple sclerosis   Switch  

摘要： A critical issue in the management of relapsing MS (RMS) is the discontinuation of disease-modifying treatments (DMT) due to lack of efficacy, intolerability or impending risks. With new therapeutic agents introduced into the treatment of RMS, immediate- and long-term consequences of sequential drug use, as well as the effect of the sequence in which the drugs are given, are unclear but may affect efficacy, adverse events, and long-term immunocompetence. In the absence of clinical studies specifically addressing these concerns, observations from clinical practice are of particular value in guiding current management algorithms. Prompted by a study published by Ferraro et al. in this journal, we set out to provide an overview of the published real-world evidence on the effectiveness and safety of switching from fingolimod to another DMT in patients with active RMS. Seventeen publications reporting relevant information were identified. The literature suggests that immune cell depletion induced by alemtuzumab or ocrelizumab is associated with an increased risk of relapse and worsening disability in patients switching from fingolimod compared to patients switching from other therapeutic agents. However, the evidence reported for natalizumab and cladribine is inconclusive. While shortening of the washout period may limit early disease reactivation after fingolimod discontinuation, there is no strong evidence that the duration of the washout period or the absolute lymphocyte count at baseline are predictors of attenuated long-term efficacy. Further real-world studies are required to better understand outcomes among patients who are under-represented in controlled trials.

关键词： Glioblastoma   Volumetric analysis   MGMT methylation   Cutoff value  

摘要： Purpose Although the usefulness of O-6-methylguanine DNA methyltransferase (MGMT) promoter methylation analysis for predicting response to chemoradiotherapy and the prognosis of patients with glioblastoma has been widely reported, there is still no consensus regarding how to define MGMT promoter methylation percentage (MGMTpm%) cutoffs by pyrosequencing method. The aim of this study was to determine the optimal cutoff value of MGMT promoter methylation status using volumetric analysis focused on the tumor volume ratio (TVR) measured by MRI. Methods This retrospective study included newly diagnosed IDH wild-type glioblastoma patients with residual tumor after surgery, followed by local radiotherapy with temozolomide. TVR was defined as the tumor volume at 6 months after the initial chemoradiotherapy administration divided by the tumor volume before the start of therapy. The mean MGMTpm% of 16 CpG islands (74-89) was analyzed using pyrosequencing. We statistically analyzed the correlation between MGMTpm%, TVR, and change in Karnofsky performance status. Results The study included 44 patients with residual tumors. Thirteen (92.9%) of 14 patients with MGMTpm% >= 23.9% showed 50% or more volumetric response, leading to prolonged survival, and 17 (70.8%) of 24 patients with MGMTpm% < 8.2% had progressive disease after initial chemoradiotherapy administration. Three (50.0%) of six patients with MGMTpm% 8.2% to < 23.9% had stable disease or partial response. Conclusion Evaluation of MGMTpm% by pyrosequencing is important in predicting the volumetric response and prognosis of glioblastoma patients with residual tumors.

摘要： AIM To characterize the neurological and cognitive outcomes in children with antibody-negative autoimmune encephalitis (Ab-negative AE). METHOD A cohort of children presenting to our institution over a 10-year period with autoimmune encephalitis was identified by structured retrospective review of medical records. Clinical features at presentation and final follow-up were recorded. Neuropsychological testing was performed in a subset of patients. Outcomes after Ab-negative AE were compared with outcomes after N-methyl-D-aspartate receptor antibody encephalitis (NMDARE). RESULTS Forty-four patients (26 females, 18 males, median age 9y 2mo [interquartile range 4y 5mo-11y 8mo], 23 with NMDARE) with a diagnosis of autoimmune encephalitis were included. Postencephalitic epilepsy was more frequent after Ab-negative AE compared to NMDARE (61% vs 14%, p=0.002). Cognitive testing was performed in a subset of patients (n=21;Ab-negative AE=11, NMDARE=10). Full-scale IQ was lower after Ab-negative AE than NMDARE (mean IQ 75 vs 92, p=0.02), primarily because of reduced verbal comprehension index (80 vs 98, p=0.01) and working memory index (77 vs 95, p=0.09). The cognitive function most commonly impaired was executive function (80% [8/10] vs 22% [2/9]). INTERPRETATION Ab-negative AE was associated with poorer cognitive outcomes than NMDARE at 1-year follow-up. Further studies are required to evaluate if immunotherapy can be optimized to improve outcome.

关键词： Viral infection   Trace elements   Neurological disorders   Immunity system   Antiviral  

摘要： Background: Several studies have suggested that COVID-19 is a systemic disease that can affect several organs, including the brain. In the brain, specifically, viral infection can cause dyshomeostasis of some trace elements that promote complex biochemical reactions in specialized neurological ***: Understand the neurovirulence of SARS-CoV-2 and the relationship between trace elements and neurological disorders after infection, and provide new insights on the drug development for the treatment of SARS-CoV-2 ***: The main databases were used to search studies published up September 2021, focusing on the role of trace elements during viral infection and on the correct functioning of the brain. Results: The imbalance of important trace elements can accelerate SARS-CoV-2 neurovirulence and increase the neurotoxicity since many neurological processes can be associated with the homeostasis of metal and metalloproteins. Some studies involving animals and humans have suggested the synapse as a vulnerable region of the brain to neurological disorders after viral infection. Considering the combined evidence, some mechanisms have been suggested to understand the relationship between neurological disorders and imbalance of trace elements in the brain after viral infection. Conclusion: Trace elements play important roles in viral infections, such as helping to activate immune cells, produce antibodies, and inhibit virus replication. However, the relationship between trace elements and virus infections is complex since the specific functions of several elements remain largely undefined. Therefore, there is still a lot to be explored to understand the biochemical mechanisms involved between trace elements and viral infections, especially in the brain.

关键词： 办公系统   在线注册   登录系统   邮件主题   网址   确认书   网站首页   在线提交  

摘要： 1.请打开本刊网址(http://***),点击“投稿及审稿办公系统”,进行在线注册。2.注册后登录系统,并以第一作者的中文姓名在线提交稿件(请勿以通讯作者或姓名拼音提交稿件)。3.在网站首页下载中心下载《版权转让确认书》,签字并加盖公章后拍照或扫描成电子版发至2105933141@***,并在邮件主题中注明“第一作者姓名”及“投稿”字样。

关键词： 一稿两用   学位论文   共识性   一稿两投   临床神经病学   诊断标准   文稿   新闻报道类  

摘要： 为维护本刊声誉和广大读者的利益,现对一稿两投和一稿两用问题的处理声明如下:(1)本声明中所涉及的文稿均指原始研究的报告或尽管2篇文稿在文字的表达和讨论的叙述上可能存在某些不同之处,但这些文稿的主要数据和图表是相同的。所指文稿不包括重要会议的纪要、学位论文、疾病的诊断标准和防治指南、有关组织达成的共识性文件、新闻报道类文稿以及在一种刊物发表过摘要或初步报道而将全文投向另一种期刊的文稿。

关键词： 审稿专家   审稿人   临床神经病学   编辑部   编委   杂志   保质保量   年度  

摘要： 在2021年度,《临床神经病学杂志》得益于各位编委和审稿人的大力支持,保质保量地完成了审稿任务。本刊编辑部在此向以下各位审稿专家表示诚挚的谢意!

关键词： 神经外科学   神经病学   期刊分级   邮发代号   ISSN   专业学术期刊   中国科技核心期刊   中南大学  

摘要： 《国际神经病学神经外科学杂志》创刊于1974年,由中华人民共和国教育部主管,中南大学、中南大学湘雅医院主办。是目前国内唯一一本同时涵盖神经病学和神经外科学的专业学术期刊。本刊为“中国科技核心期刊(中国科技论文统计源期刊)”,并且进入“《中国高质量科技期刊分级目录》T3区”。国内外公开发行,刊号为ISSN2096-921X(online),ISSN 1673-2642(print),CN 43-1456/R,双月刊,邮发代号42-11。每期定价20元,全年定价120元。