关键词： 神经病学   网络平台   多模式联合教学法   应用策略  

摘要： 神经病学是研究中枢神经系统、周围神经系统等疾病的一门临床医学学科,其在为社会培养优秀神经病学临床专业人才方面发挥着重要的作用。近年来,随着时代的不断发展,再加上人口老龄化进程的加快,各种神经系统疾病的发病率也在不断增加,在此背景下,社会对神经病学临床专业人才的需求也越来越大。为了满足社会发展所需,各大学校均积极扩大了学科教学规模。神经病学学科的复杂性、专业性较高,所以很多学生都倍感困难,整体教学不算理想。基于此,加强对神经病学教学的创新就显得十分重要。信息化教育发展背景下,就为教学创新提供了更多的思路和路径。本文就网络平台下多模式联合教学法在神经病学教学中的应用进行分析,旨在更好地提高神经病学教学质量。

关键词： LBL教学法   PBL教学法   CBL教学法   EBM教学法  

摘要： 探讨CBL、PBL结合EBM教学法在神经病学见习课程中的应用效果。将62名学生随机分为实验组与对照组,实验组采取CBL、PBL结合EBM教学法,对照组采取LBL教学法。结果表明前者的基础理论等5项成绩均优于后者,问卷调查显示此教学法得到学生的认可。

关键词： 教学评价体系   教师角色   一体化改革   神经病学   规划教材   流程再造   国际化水平   翻转课堂  

摘要： 2016年,广西医科大学为进一步加快教育国际化进程,提高我校在管理、师资、学生、教学、科研方面的国际化水平,实现把学校建设成为“优势突出、特色鲜明、具有一定国际影响力的国内一流地方医科大学”的奋斗目标,全面开展教学改革以推进教育国际化进程。神经病学教研室采用翻转课堂的教学模式,进行《神经病学》课程教、学、评一体化改革,实现教育流程再造,重新规划教材,重新定义教师角色,重新设计课程模式,重新建立教学评价体系,从而打造出“四新”神经病学教育模式。

摘要： Purpose/Objective(s) Cranial neuropathy is a common presenting symptom of advanced T4 nasopharyngeal carcinoma (NPC). Data on neurological outcomes after modern intensity-modulated radiotherapy (IMRT) and chemotherapy are scarce. This study sets to evaluate the prognostic factors and recovery pattern of cranial neuropathies, using longitudinal clinical data from two tertiary oncology centers in endemic areas. Materials/Methods Case records of consecutive T4 NPC patients who received definitive IMRT in 2004-2019 were reviewed. Distribution of cranial neuropathies at disease presentation were recorded. Time to partial and full neurological recovery, time from neurological recovery to re-palsy, relapse-free survival (RFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Predictors for neurological recovery were analyzed using multivariable Cox regression. Results During the study period, 257 T4 NPC patients presented with 504 individual cranial neuropathies. The median time from neuropathy onset to NPC diagnosis was 2 months (IQR, 1-4 months). All patients completed definitive IMRT, and 94% of patients received chemotherapy. The 5-year RFS and OS of the combined cohort were 50.8% and 60.1% respectively. Median RFS of patients with single versus multiple neuropathies were 5.8 years and 4.2 years (P  = 0.62). Cranial nerves (CN) VI (56.4%), V2 (47.9%) and V3 (29.2%) were most frequently involved. Over a median follow-up of 6.4 years, 111 (22%) and 289 (57.3%) neuropathies attained partial and full recovery respectively, and 86% of the recoveries occurred within the first year after definitive radiotherapy. CN III, IV, VI had the highest 5-year full recovery rate (72.7%), followed by CN V1-3 (60.3%), CN XII (48.6%), and CN II (18.2%) (P < 0.001). Positive smoking history, optic nerve involvement, and long duration of neuropathy were independent negative predictors for neurological recovery. After full recovery, re-palsy was observed in 6.9% (20/289) of

关键词： 癫痫,颞叶   神经病学表现   情景重现先兆   定位  

摘要： 目的初步探讨情景重现先兆在癫痫发作定位中的作用。方法回顾性分析2015年1月至2020年6月首都医科大学宣武医院功能神经外科收治的8例以情景重现为先兆的癫痫发作患者的临床资料。基于临床症状、术前影像学资料、神经电生理结果进行癫痫发作定位诊断。8例患者中,5例行立体定向脑电图(SEEG)电极置入定位致痫灶及皮质电刺激定位功能区后手术切除致痫灶;另3例仅接受致痫灶切除术。术后分别于3、6、12及24个月进行门诊随访。根据改良Engel分级评估手术疗效。结果8例患者中,癫痫起源于左侧颞叶5例,右侧颞叶3例;颞底2例,颞上回3例,颞叶内侧3例。8例患者均顺利完成致痫灶切除术。8例患者术后随访1~5年。至末次随访,8例患者均无癫痫发作,疗效分级均为改良Engel分级Ⅰ级。结论初步观察发现,情景重现为先兆的癫痫发作多起源于颞叶,但未观察到明显的定侧作用。

关键词： 中国科协   科技工作者   期刊分级   中文期刊   神经病学   行为医学   专家评议   脑科学  

摘要： 《中华行为医学与脑科学杂志》入选全国高质量科技期刊分级目录,属临床医学神经病学学科。神经病学领域全球学术期刊共有70种入选,中文期刊仅有11种。根据中国科协、中宣部、教育部、科技部联合印发的《关于深化改革培育世界一流科技期刊的意见》,中国科协经过统一部署,开展了全国高质量科技期刊分级目录发布工作。遵照同行评议、价值导向、等效应用原则,国内各大学会、协会、组织机构通过科技工作者推荐、专家评议、结果公示等规定程序,形成了本领域科技期刊分级目录。

关键词： 课程思政   线上教学   医学   神经病学   脑梗死   临床实践  

摘要： 思想政治教育融入医学人才培养是线上授课的重点和难点,是全国医学教育系统教师的一项巨大的考验和重要的历史使命。本文以神经病学中脑梗死临床实践线上教学为例,探讨通过病例引导、小组讨论、角色扮演等多种线上教学方法,和录制视频、结合时事、讲人文故事等线上教学手段,实现思政教育与临床实践线上教学的有机融合,课后190份教学总体满意度调查问卷显示,非常满意达到32.11%,比较满意达到44.21%,一般满意达到22.11%,仅有1.58%不满意。思想政治教育融入医学人才培养是线上授课在帮助学生理解复杂难懂神经病学知识的同时,提高医患沟通能力,培养医学生职业素养、个人品德,树立医学生责任感和使命感、救死扶伤的价值观,时刻牢记不忘学医初心,护佑人民生命健康的爱国情怀。

关键词： electroencephalogram   physiological biomarker   advanced driver assistance system (ADAS)   mental workload   driving simulator  

摘要： Physiological signals are immediate and sensitive to neurological changes resulting from the mental workload induced by various driving environments and are considered a quantifying tool for understanding the association between neurological outcomes and driving cognitive workloads. Neurological assessment, outside of a highly-equipped clinical setting, requires an ambulatory electroencephalography (EEG) headset. This study aimed to quantify neurological biomarkers during a resting state and two different scenarios of driving states in a virtual driving environment. We investigated the neurological responses of seventeen healthy male drivers. EEG data were measured in an initial resting state, city-roadways driving state, and expressway driving state using a portable EEG headset in a driving simulator. During the experiment, the participants drove while experiencing cognitive workloads due to various driving environments, such as road traffic conditions, lane changes of surrounding vehicles, the speed limit, etc. The power of the beta and gamma bands decreased, and the power of the delta waves, theta, and frontal theta asymmetry increased in the driving state relative to the resting state. Delta-alpha ratio (DAR) and delta-theta ratio (DTR) showed a strong correlation with a resting state, city-roadways driving state, and expressway driving state. Binary machine-learning (ML) classification models showed a near-perfect accuracy between the resting state and driving state. Moderate classification performances were observed between the resting state, city-roadways state, and expressway state in multi-class classification. An EEG-based neurological state prediction approach may be utilized in an advanced driver-assistance system (ADAS).

关键词： Neurology   Psychopharmacology   Pharmacotherapy   Neurosciences   Psychiatry  

摘要： Secondary immunodeficiencies (SIDs) are acquired conditions that may occur as sequelae of immune therapy. In recent years a number of disease-modifying therapies (DMTs) has been approved for multiple sclerosis and related disorders such as neuromyelitis optica spectrum disorders, some of which are frequently also used in- or off-label to treat conditions such as chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, myositis, and encephalitis. In this review, we focus on currently available immune therapeutics in neurology to explore their specific modes of action that might contribute to SID, with particular emphasis on their potential to induce secondary antibody deficiency. Considering evidence from clinical trials as well as long-term observational studies related to the patients' immune status and risks of severe infections, we delineate long-term anti-CD20 therapy, with the greatest data availability for rituximab, as a major risk factor for the development of SID, particularly through secondary antibody deficiency. Alemtuzumab and cladribine have relevant effects on circulating B-cell counts;however, evidence for SID mediated by antibody deficiency appears limited and urgently warrants further systematic evaluation. To date, there has been no evidence suggesting that treatment with fingolimod, dimethyl fumarate, or natalizumab leads to antibody deficiency. Risk factors predisposing to development of SID include duration of therapy, increasing age, and pre-existing low immunoglobulin (Ig) levels. Prevention strategies of SID comprise awareness of risk factors, individualized treatment protocols, and vaccination concepts. Immune supplementation employing Ig replacement therapy might reduce morbidity and mortality associated with SIDs in neurological conditions. In light of the broad range of existing and emerging therapies, the potential for SID warrants urgent consideration among neurologists and other healthcare professionals.

关键词： Nervous system diseases   Neurology   Health services administration   Telemedicine   COVID-19  

摘要： Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization's (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income;44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.