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关键词： 人体彩绘   解剖学教学   护理专业  

摘要： 目的初步探讨人体彩绘在本科护理专业解剖学教学中的应用效果。方法选取上海杉达学院护理系本科生作为研究对象,对照组为2017级120名学生,在解剖学教学中采用理论大课+传统实验教学方式;实验组为2018级120名学生,采用理论大课+彩绘辅助实验教学方式,并在每次课后计算每位学生的彩绘成绩。教学结束后,对两组填图考试成绩、标本指认考试成绩、期末理论考试成绩以及教学满意度问卷评分进行比较,并对实验组数据进行相关性分析。结果实验组填图考试成绩、标本指认考试成绩和期末理论考试成绩平均分、教学满意度评分均高于对照组,差异具有显著性(P<0.05)。实验组学生的彩绘成绩与填图考试成绩、标本指认考试成绩和期末理论考试成绩均呈正相关。结论将人体彩绘引入本科护理专业解剖学教学,有利于改善教学效果,提高学生满意度,有一定的推广价值。

关键词： 16p11.2 Copy number variants   Neurodevelopmental disorders   Genetics   Imaging   Brain development   Normative growth trajectories  

摘要： Most of human genome is present in two copies (maternal and paternal). However, segments of the genome can be deleted or duplicated, and many of these genomic variations (known as Copy Number Variants) are associated with psychiatric disorders. 16p11.2 copy number variants (breakpoint 4-5) confer high risk for neurodevelopmental disorders and are associated with structural brain alterations of large effect-size. Methods used in previous studies were unable to investigate the onset of these alterations and whether they evolve with age. In this study, we aim at characterizing age-related effects of 16p11.2 copy number variants by analyzing a group with a broad age range including younger individuals. A large normative developmental dataset was used to accurately adjust for effects of age. We normalized volumes of segmented brain regions as well as volumes of each voxel defined by tensor-based morphometry. Results show that the total intracranial volumes, the global gray and white matter volumes are respectively higher and lower in deletion and duplication carriers compared to control subjects at 4.5 years of age. These differences remain stable through childhood, adolescence and adulthood until 23 years of age (range: 0.5 to 1.0 Z-score). Voxel-based results are consistent with previous findings in 16p11.2 copy number variant carriers, including increased volume in the calcarine cortex and insula in deletions, compared to controls, with an inverse effect in duplication carriers (1.0 Z-score). All large effect-size voxel-based differences are present at 4.5 years and seem to remain stable until the age of 23. Our results highlight the stability of a neuroimaging endophenotype over 2 decades during which neurodevelopmental symptoms evolve at a rapid pace.

关键词： stuttering   speech   neurodevelopmental disorder   MRI   DTI  

摘要： Affecting 5% of all preschool-aged children and 1% of the general population, developmental stuttering-also called childhood-onset fluency disorder-is a complex, multifactorial neurodevelopmental disorder characterized by frequent disruption of the fluent flow of speech. Over the past two decades, neuroimaging studies of both children and adults who stutter have begun to provide significant insights into the neurobiological bases of stuttering. This review highlights convergent findings from this body of literature with a focus on functional and structural neuroimaging results that are supported by theoretically driven neurocomputational models of speech production. Updated views on possible mechanisms of stuttering onset and persistence, and perspectives on promising areas for future research into the mechanisms of stuttering, are discussed.

关键词： Human   Brainstem   Neurokinin   Choline acetyl-transferase   Acetylcholine   Immunohistochemistry  

摘要： The cholinergic system plays an important role in brain homeostasis and interacts with the neuropeptidergic systems, and the functional relationships between both systems are well known. However, in the brainstem the possible physiological interactions between neurokinins and acetylcholine are unknown, although both substances have been detected in the same brainstem nuclei and have been implicated in similar functions controlled from brainstem regions such as some cranial motor nuclei. The aim of this work is to determine whether these possible physiological interactions might have a neuroanatomical basis by means of the double immunohistochemical detection of neurokinins (NK) and the enzyme choline acetyl-transferase (ChAT) in the human brainstem. No double-labelled structures were detected, although both NK and ChAT were observed in cell bodies and fibers of the same brainstem nuclei. The distribution of immunoreactive fibers is widespread, and NK and ChAT were observed in several motor cranial nerves as well as in the substantia nigra. The results obtained in the present work provide a neuroanatomical basis for possible physiological interactions between NK and ChAT that may be carried out by volume-transmission mechanisms. These interactions might participate in motor regulation or in limbic pathways as well as influence on other neurotransmitter systems such as the dopaminergic system.

关键词： GRIN1   GluN1   NR1   NMDA   Encephalopathy   Autism   Schizophrenia   MRI   Volumetric change   Neurodevelopment   White matter  

摘要： NMDA receptor dysfunction is central to the encephalopathies caused by missense mutations in the NMDA receptor subunit genes. Missense variants of GRIN1, GRIN2A, and GRIN2B cause similar syndromes with varying severity of intellectual impairment, autism, epilepsy, and motor dysfunction. To gain insight into possible biomarkers of NMDAR hypofunction, we asked whether a loss-of-function variant in the Grin1 gene would cause structural changes in the brain that could be detected by MRI. We also studied the developmental trajectory of these changes to determine whether structural changes coincided with reported cognitive impairments in the mice. We performed magnetic resonance imaging in male Grin1-/- knockdown mice (GluN1KD) that were three, six, or twelve weeks old. Deformation-based morphometry was used to assess neuroanatomical differences. Volumetric reductions were detected in substantia nigra and striatum of GluN1KD mice at all ages. Changes in limbic structures were only evident at six weeks of age. Reductions in white matter volumes were first evident at three weeks, and additional deficits were detected at six and twelve weeks. FluoroJade immunofluorescence revealed degenerating neurons in twelve-week old GluN1KD mice. We conclude that Grin1 loss-of-function mutations cause volume reductions in dopaminergic structures early in development, while changes to limbic and white matter structures are delayed and are more pronounced in post-adolescent ages. The evidence of degenerating neurons in the mature brain indicates an ongoing process of cell loss as a consequence of NMDAR hypofunction.

关键词： Subthalamic nucleus   Immunocytochemistry   Neuroanatomy   Basal ganglia  

摘要： The subthalamic nucleus (STN) is successfully used as a surgical target for deep brain stimulation in the treatment of movement disorders. Interestingly, the internal structure of the STN is still incompletely understood. The objective of the present study was to investigate three-dimensional (3D) immunoreactivity patterns for 12 individual protein markers for GABA-ergic, serotonergic, dopaminergic as well as glutamatergic signaling. We analyzed the immunoreactivity using optical densities and created a 3D reconstruction of seven postmortem human STNs. Quantitative modeling of the reconstructed 3D immunoreactivity patterns revealed that the applied protein markers show a gradient distribution in the STN. These gradients were predominantly organized along the ventromedial to dorsolateral axis of the STN. The results are of particular interest in view of the theoretical underpinning for surgical targeting, which is based on a tripartite distribution of cognitive, limbic and motor function in the STN.

关键词： Antipsychotic-naive first-episode schizophrenia   cognition   diffusion tensor imaging   electrophysiology   machine learning   structural magnetic resonance imaging  

摘要： Background. A wealth of clinical studies have identified objective biomarkers, which separate schizophrenia patients from healthy controls on a group level, but current diagnostic systems solely include clinical symptoms. In this study, we investigate if machine learning algorithms on multimodal data can serve as a framework for clinical translation. Methods. Forty-six antipsychotic-naive, first-episode schizophrenia patients and 58 controls underwent neurocognitive tests, electrophysiology, and magnetic resonance imaging (MRI). Patients underwent clinical assessments before and after 6 weeks of antipsychotic monotherapy with amisulpride. Nine configurations of different supervised machine learning algorithms were applied to first estimate the unimodal diagnostic accuracy, and next to estimate the multimodal diagnostic accuracy. Finally, we explored the predictability of symptom remission. Results. Cognitive data significantly dassified patients from controls (accuracies = 60-69%;p values = 0.0001-0.009). Accuracies of electrophysiology, structural MRI, and diffusion tensor imaging did not exceed chance level. Multimodal analyses with cognition plus any combination of one or more of the remaining three modalities did not outperform cognition alone. None of the modalities predicted symptom remission. Conclusions. In this multivariate and multimodal study in antipsychotic-nalve patients, only cognition significantly discriminated patients from controls, and no modality appeared to predict short-term symptom remission. Overall, these findings add to the increasing call for cognition to be included in the definition of schizophrenia. To bring about the full potential of machine learning algorithms in first-episode, antipsychotic-nalve schizophrenia patients, careful a priori variable selection based on independent data as well as inclusion of other modalities may be required.

关键词： 基础医学  

ISBN: (纸本)9787030639394

摘要： 由于原版《HUMAN ANATOMY》的框架结构与我国医学课程设置的总体安排和教学习惯不完全吻合，需更改以适应我国医学教育的实际需求。我们在不改变原书总体风格和基本内容的前提下，通过删减、精编和增补使其内容和编排次序，使之成为符合我国的教学习惯和知识的构建规律的教科书。本书的章、节次序以及具体内容的编排根据我国的教学习惯和知识的内在逻辑关系来编排，使得章、节以及具体内容的次序与我国大部分医学院校和综合性大学系统解剖学的授课计划基本吻合，便于教学使用。书中删除了原版教材中的《组织胚胎学》《生理学》或《局部解剖学》的大部分内容，少部分有助于加深知识的理解、拓展学生视野的内容则予以保留。

关键词： 解剖学教学   德育渗透  

摘要： 解剖学作为一门重要的医学基础形态学科,如何在教学中有机渗透德育内容,培养学生正确的人生观、世界观、价值观,培养良好职业道德素养。围绕崇尚科学,培养学生动手能力、团队协作能力,教师要充分利用理论及实践教学活动对学生进行良好的思想品德教育,突出培养学生适应社会发展的良好道德品质,培养学生健全的心理素质,作了一些探讨,并取得一定效果。