关键词： 卒中   脑缺血   神经病学检查   行为评定量表   疾病模型   动物   灵长目  

摘要： 由于神经保护药的临床研究均以失败告终,因此卒中治疗专业委员会建议利用非人灵长类动物开展卒中临床前研究。非人灵长类动物是基础实验与临床研究之间的桥梁,所取得的实验结果极具参考价值。但是,非人灵长类动物卒中模型的神经功能缺损和行为学评价方法多种多样,评分方法也是各有侧重点,测评时容易产生分歧,或量表本身存在不足导致评分不准确,直接影响实验结果和后续研究的开展。文章对非人灵长类动物卒中模型的神经功能缺损和行为学评价方法进行了总结。

关键词： 神经病学   体检中心   神经内科   校园生活   医学生   医院  

摘要： 2016年,我结束5+3年的校园生活,从神经病学专业毕业,进入了焦灼的找工作阶段,那时候医学生想要找到一份理想的工作已经很困难了,神经病学这个专业毕业的学生相对要多一点,找工作更加困难。那时候投了很多简历,也去面试了很多家医院。最后能去神经内科的医院离我老公太远。考虑到家庭的问题,我选择了近的单位,就这样阴差阳错地进入了医院的体检中心工作,成为一名体检医生。

关键词： 多媒体课件   网络教学模式   住院医师规范化培训   神经病学  

摘要： 为提高住院医师学习积极性和主动性,研究者通过反复探索和实践,建立并完善了多媒体课件结合网络教学模式。将神经病学相关知识分为若干个专题,制作了一系列多媒体课件,制作录制课程和直播课程。通过实践,新教学形式以其高效性、易操作性和灵活性获得住院医师的一致好评。

关键词： PBL教学法   TBL教学法   神经病学   教学模式   教学质量  

摘要： 神经病学属于临床医学学科,以研究中枢神经系统、周围神经系统及骨骼肌的疾病为主,该学科的特点为专业性强、涉及内容广泛、逻辑性强。人体的神经系统解剖不易掌握,比较抽象,理解困难,同时临床病例复杂多变,给临床医生诊断和治疗带来了一定困难,也更增加了学生学习神经病学的难度。当前教学模式种类繁多,如以问题为基础的教学法(PBL)、以团队为基础的教学法(TBL)等,但还不能满足当今医学教育的发展趋势。该文将PBL和TBL这两种常用的教学法结合,根据神经病学的课程特点设计教学方案,并在课程中应用,实施结果显示这两种教学方法的结合在课程中取得了满意的教学效果。

关键词： 神经病学   网络互动   互动平台   线上教学   教学改革   信息技术   教育  

摘要： 在临床医学教学过程中,神经病学是其中非常重要的学科,并且具有一定难度。因为神经解剖本身比较复杂,并且具有一定的抽象性,无法通过单一的文字准确描述。另外,在课程设置方面,与神经病学有关的课时相对较少,所以学生能够在课堂上掌握到的知识点有限。在课时这一因素的影响下,部分学生即便存在问题也无法在课堂学习的过程中找到答案。所以,针对一些比较难的神经内科知识点,很多学生都呈现出似懂非懂的状态。长此以往便会产生学习方面的压力,甚至会影响到医学行业人才培养。在高校信息化改革不断深入的当下,神经病学课程的教育学也可以采用网络互动平台,利用互联网帮助教师和学生之间高效互动,拉进彼此之间的距离,营造氛围浓厚且积极向上的线上教学环境。为了加快神经病学课程改革,在教学期间采用网络互动平台是目前比较常见的手段之一。首先阐述教学网络互动的必要性,明确其在信息化教学环境下的重要意义,总结当前神经病学教学现状,分别提出运用多媒体讲解神经病学基础知识、制定互动性的教学方案、及时更新神经病学教学内容三点建议,发挥网络互动平台教学模式的作用,拉近师生之间的距离,以期能够通过高效互动提升教学效率。

关键词： Air pollution   Cause-specific mortality   Ecological design   Greenness   Long-term exposure  

摘要： Long-term exposure to air pollution has been associated with increased natural-cause mortality, but the evidence on diagnoses-specific mortality outcomes is limited. Few studies have examined the potential synergistic effects of exposure to pollutants and greenness. We investigated the association between exposure to air pollution and greenness with nervous system related mortality, cardiometabolic and chronic obstructive pulmonary diseases (COPD) mortality in Greece, using an ecological study design. We collected socioeconomic and mortality data for 1035 municipal units from the 2011 Census. Annual PM2.5, NO2, BC and O-3 concentrations for 2010 were predicted at 100 x 100 m grids by hybrid land use regression models. The normalized difference vegetation index (NDVI) was used for greenness. We applied single and two-exposure Poisson regression models on standardized mortality rates accounting for spatial autocorrelation. We assessed interactions between pollutants and greenness. An interquartile range increase in PM2.5, NO2 and BC was associated with increased risk in mortality from diseases of the nervous system (relative risk (RR): 1.14, 95% confidence interval (CI): 1.01, 1.28);1.03 (95% CI: 0.99, 1.07);1.05 (95% CI: 1.00, 1.10) respectively) and from cerebrovascular disease (RR: 1.14, 95% CI: 1.10, 1.18);1.02 (95% CI: 1.01, 1.04);1.02 (95% CI: 1.00, 1.04) respectively). PM2.5 was associated with ischemic heart disease mortality (RR: 1.05, 95% CI: 1.01, 1.10). We estimated inverse associations for all outcomes with O-3 and for mortality from diseases of the nervous system or COPD with greenness. Estimates were mostly robust to co-exposure adjustment. Interactions were identified between NDVI and O-3 or PM2.5 on mortality from the diseases of the nervous system, with higher effect estimates in greener areas. Our findings support the adverse effects of air pollution and the beneficial role of greenness on cardiovascular and nervous system related mortality. Further

关键词： cerebral oximetry   electroencephalography   neuroanaesthesia   neurocritical care   neuromonitoring  

摘要： Surgery and anaesthesia subject the brain to considerable stress in the peri-operative period. This may be caused by potentially neurotoxic anaesthetic drugs, impaired cerebral perfusion and reperfusion injury related to surgery or thromboembolic events. Patient monitoring using electroencephalogram and cerebral oximetry can assist in optimising depth of anaesthesia and assessment of cerebral metabolic activity. However, research findings have been contradictory as to whether these monitors can help ameliorate peri-operative neurocognitive complications. In this narrative review, we will discuss recent evidence in the use of electroencephalography and cerebral oximetry and the underlying scientific principles. It is important to appreciate the raw electroencephalographic changes under anaesthesia and those associated with ageing, in order to interpret depth of anaesthesia indices correctly. Cerebral oximetry is useful not only for the detection of cerebral desaturation but also to identify those patients who are particularly vulnerable to injury, for better risk stratification. An algorithm-based approach may be most effective in managing the episodes of cerebral desaturation.

关键词： Dendritic cells   Drug delivery systems   Neurological disorders   Dendritic cell-targeted therapies   Disease-specific therapies  

摘要： Dendritic cells (DCs) are the immune system's highly specialized antigen-presenting cells. When DCs are sluggish and mature, self-antigen presentation results in tolerance;however, when pathogen-associated molecular patterns stimulate mature DCs, antigen presentation results in the development of antigen-specific immunity. DCs have been identified in various vital organs of mammals (e.g., the skin, heart, lungs, intestines, and spleen), but the brain has long been thought to be devoid of DCs in the absence of neuroinflammation. However, neuroinflammation is becoming more recognized as a factor in a variety of brain illnesses. DCs are present in the brain parenchyma in trace amounts under healthy circumstances, but their numbers rise during neuroinflammation. New therapeutics are being developed that can reduce dendritic cell immunogenicity by inhibiting pro-inflammatory cytokine production and T cell co-stimulatory pathways. Additionally, innovative ways of regulating dendritic cell growth and differentiation and harnessing their tolerogenic capability are being explored. Herein, we described the function of dendritic cells in neurological disorders and discussed the potential for future therapeutic techniques that target dendritic cells and dendritic cell-related targets in the treatment of neurological disorders.

关键词： Neurology   Neuroradiology   Neurosurgery   Psychiatry  

关键词： Mitochondrial DNA   Immune response   Central nervous system   Gut microbiome   SARS-CoV-2   COVID-19  

摘要： Mitochondrial DNA (mtDNA) heteroplasmy is the dynamically determined co-expression of wild type (WT) inherited polymorphisms and collective time-dependent somatic mutations within individual mtDNA genomes. The temporal expression and distribution of cell-specific and tissue-specific mtDNA heteroplasmy in healthy individuals may be functionally associated with intracellular mitochondrial signaling pathways and nuclear DNA gene expression. The maintenance of endogenously regulated tissue-specific copy numbers of heteroplasmic mtDNA may represent a sensitive biomarker of homeostasis of mitochondrial dynamics, metabolic integrity, and immune competence. Myeloid cells, monocytes, macrophages, and antigen-presenting dendritic cells undergo programmed changes in mitochondrial metabolism according to innate and adaptive immunological processes. In the central nervous system (CNS), the polarization of activated microglial cells is dependent on strategically programmed changes in mitochondrial function. Therefore, variations in heteroplasmic mtDNA copy numbers may have functional consequences in metabolically competent mitochondria in innate and adaptive immune processes involving the CNS. Recently, altered mitochondrial function has been demonstrated in the progression of coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Accordingly, our review is organized to present convergent lines of empirical evidence that potentially link expression of mtDNA heteroplasmy by functionally interactive CNS cell types to the extent and severity of acute and chronic post-COVID-19 neurological disorders.