功能神经外科发展十年

功能神经外科是神经外科的一个重要分支,它是运用各种外科手术技术改善中枢神经系统的功能失调,通过对中枢神经系统的某些结构进行刺激、破坏或重建,实现新的各系统之间的平衡,达到缓解症状、恢复神经功能的目的[1].功能神经外科治疗的常见疾病包括癫痫、运动障碍性疾病(帕金森病、肌张力障碍等)、疼痛(三叉神经痛、幻肢痛、癌性疼痛等)、脑神经疾病(面肌抽搐等)、精神疾病(强迫症、重度抑郁症、抽动秽语综合征、药物依赖等)以及脑瘫等.     

功能神经外科发展十年

功能神经外科是神经外科的一个重要分支,它是运用各种外科手术技术改善中枢神经系统的功能失调,通过对中枢神经系统的某些结构进行刺激、破坏或重建,实现新的各系统之间的平衡,达到缓解症状、恢复神经功能的目的。功能神经外科治疗的常见疾病包括癫痫、运动障碍性疾病（帕金森病、肌张力障碍等）、疼痛（三叉神经痛、幻肢痛、     

微创神经外科的过去、现在和将来

微创神经外科（minimally invasive neurosurgery，MINS）又称微侵袭神经外科，是继显微神经外科之后现代神经外科发展的第二个里程碑。它始于二十世纪九十年代后期，是二十一世纪神经外科发展的方向。虽然没有公认的MINS定义及其包涵范围，但是较一致的看法是MINS应在最小创伤思想指导下，以外科方法获得最大治疗效果。     

2009年度国家自然科学基金资助神经外科学基础研究概述

本文概述了2009年度神经外科学领域国家自然科学基金(以下简称科学基金)的受理、评审和资助情况,通过对申请和资助项目的分析,反映神经外科学领域基础研究的现状、发展趋势及存在的问题,并提出建议.谨供从事神经外科学研究的科研工作者在申报科学基金时参考.     

微侵袭神经外科的过去、现在和展望

随着现代科学技术成果在神经外科领域中的应用 ,使得神经外科医生能够通过微小的神经组织损伤来治疗某些神经外科疾病。根据 1990年Ｗｉｃｋｈａｍ和Ｆｉｔｚｐａｔｒｉｃｋ提出的“微侵袭外科” (ｍｉｎｉｍａｌｌｙｉｎｖａｓｉｖｅｓｕｒｇｅｒｙ)的名称 ,1992年Ｂａｕｅｒ和Ｈｅｌｌｗｉｎｇ首先提出“微侵袭神经外科” (ｍｉｎｉｍａｌｌｙｉｎ ｖａｓｉｖｅｎｅｕｒｏｓｕｒｇｅｒｙ)的名词 ,当时主要是指内镜神经外科。1994年Ｂａｕｅｒ和Ｈｅｌｌｗｉｎｇ指出 :“从大体神经外科到显微神经外科的发展现已近于完成 ,下一步迈向微侵袭…     

神经外科住院医师脊柱亚专业培训的思考

随着神经外科向广度和深度的不断发展,各个亚专业的出现成为必然,除传统的肿瘤外科、创伤外科和血管外科外,一些新的亚专业不断发展壮大,例如血管内神经外科、功能神经外科等.     

精神外科过去、现在与未来

用外科方法治疗精神病的历史约120余年,发展的过程中一直充满了争议和曲折.虽然在1935年Moniz-Lima进行双侧前额叶脑白质切断术来治疗严重精神病,从而开创了真正的精神外科,通过长期随访和观察,手术并发症严重,又缺乏明确神经生理依据,精神外科受到社会舆论指责和批评随着临床精神病学、神经外科、神经生化、神经影像学、立体定向技术等深入研究与发展,精神外科手术方式由传统方式,转变成立体定向毁损术、立体定向放射外科和神经调控技术(DBS、VNS、TMS)治疗精神疾病新理念.今后精神外科治疗,将依赖于神经调控技术、基因治疗和干细胞治疗时代.精神障碍的病因很复杂,只有病因和发病机理充分揭示,才有可能更好地治疗和预防这类精神障碍.     

功能神经外科现状

传统功能神经外科主要以立体定向技术为基础,治疗一些药物难治性神经系统疾病以及精神疾病。现代功能神经外科领域已经越来越难界定,     

神经外科麻醉:现状与展望

神经外科学自1904年创立至今,经历了从经典神经外科、显微神经外科到微创神经外科3个发展阶段.近年来,神经外科学进入了一个崭新的时代,神经外科手术已经从传统的解剖学模式转变为现代解剖-功能模式,在尽可能切除病灶的同时最大限度地保护脑功能,大大提高了手术质量.神经外科学的发展与神经影像学、神经麻醉学、神经生理学、神经生物学等相关学科的发展密不可分.随着麻醉学的迅速发展,大量过去被认为是禁忌的疑难、危重病患者得到了及时的手术治疗,麻醉期间对生命功能的监测与调控,以及血液保护、手术后镇痛等不断普及,更在无形中推动了神经外科学的发展.麻醉学新药物、新方法、新技术、新理念有效保障了围手术期的正常脑功能,提高了手术治疗效果.     

内镜神经外科—过去、现在和未来

1910年,美国医生Lespinasse首次应用硬性膀胱镜对脑积水患儿实施侧脑室脉络丛电灼术.迄今为止,整整一个世纪已经过去,内镜神经外科从蹒跚学步到飞速前行.内镜神经外科飞速发展带来的变化:近10年来,得益于现代科学技术的迅猛发展,内镜神经外科的理论体系日新月异.     

神经内镜技术在神经外科应用的过去、现在和将来

一、发展历史 最早有记载的神经外科内镜手术是由一位芝加哥的泌尿外科医生Espinasse 1910年开始实施,他采用一个硬制的膀胱镜对两位患有脑积水的婴儿进行了直视下双侧脑室脉络丛电灼术,手术效果很不理想[1,2].1922年Dandy采用鼻窦镜观察脑室,尝试直视下切除侧脑室脉络丛,首次提出脑室镜的概念.     

Epilepsy surgery in China: past,present, and future

Since the 1990s, China has experienced a boom in epilepsy surgery. Five cities have established epilepsy centers, and at least one hospital in each of the 32 provinces provides epilepsy surgical services. Epilepsy surgery in China has benefited from the availability of advanced non‐invasive diagnostic tools to delineate epileptogenic lesions and epilepsy functional deficits, increased medical and social acceptance of epilepsy surgery, and collaborations with the International League Against Epilepsy, the International Bureau for Epilepsy, and international epilepsy centers. However, national demand for epilepsy surgery still far exceeds supply, and epilepsy surgery is underutilized in many economically underdeveloped provinces. This paper analyzes the current progress of epilepsy surgery in China and details necessary steps for future development. Specifically, the growing need for standardized quality control, multidisciplinary research, and continued worldwide collaboration is addressed. Surgical therapy for epilepsy has experienced rapid growth in recent years, but many patients with active epilepsy did not receive appropriate treatment in China. Improved epilepsy education remains an important tool to correct the treatment gap. Epilepsy surgery has rapidly grown in China. The establishment of additional epilepsy centers, enhancement of multidisciplinary cooperation, standardization of surgical indications and techniques, increased public education, and government recognition of epilepsy treatment as a medical priority are interventions that will improve the surgical treatment of people with epilepsy in China.     

Stereopsychopharmacology: past, present and future

Stereoisomers have been used for more than a century to study the role of three-dimensional (spatial) features in biological processes. Configuration and conformation are spatial features of primary interest for effects of drugs. The role of configuration has been studied mainly by comparing effects of optical isomers (enantiomers), whereas the role of conformation has been investigated primarily using geometrical isomers and semi-rigid molecules. Spatial features have been shown to play a role in many effects of stereoisomers on noradrenergic, dopaminergic, serotonergic, cholinergic, opioid and GABAergic mechanisms. Further information on psychopharmacological effects of stereoisomers may lead to a better understanding of mental disorders and to improvements in drugs used to treat them.     

Brain-machine interfaces: past, present and future

Since the original demonstration that electrical activity generated by ensembles of cortical neurons can be employed directly to control a robotic manipulator, research on brain-machine interfaces (BMIs) has experienced an impressive growth. Today BMIs designed for both experimental and clinical studies can translate raw neuronal signals into motor commands that reproduce arm reaching and hand grasping movements in artificial actuators. Clearly, these developments hold promise for the restoration of limb mobility in paralyzed subjects. However, as we review here, before this goal can be reached several bottlenecks have to be passed. These include designing a fully implantable biocompatible recording device, further developing real-time computational algorithms, introducing a method for providing the brain with sensory feedback from the actuators, and designing and building artificial prostheses that can be controlled directly by brain-derived signals. By reaching these milestones, future BMIs will be able to drive and control revolutionary prostheses that feel and act like the human arm.     

Suicide prevention: past, present and future

Efforts to prevent suicide are reviewed. Recent studies have shown that suicide prevention centers may be effective in preventing suicide, at least among females. However, in recent years, more attention has been directed toward the possibility that restricting access to methods for suicide may be an effective way for preventing suicide. In addition, there is a growing body of research on which medications and which techniques of psychotherapy may be most effective in decreasing the risk of suicide in depressed patients.     

帕金森病的昨天、今天和明天

帕金森病（Parkinson disease，PD）日益成为公共卫生关注的焦点，在我国，它影响了近1．7％的65岁以上的老年人。回顾PD的历史，有几个里程碑需要铭记。1817年Parkinson首次详述了PD的典型临床表征。1895年Brissaud从病理上提出中脑可能是PD的解剖基础。1912年Lewy发现黑质内嗜伊红包涵体，即Lewy小体是PD的重要病理特征。1960年Ehringer和Homykiewicz发现纹状体多巴胺（dopamine，DA）神经递质水平下降是产生PD运动症状的主要因素。1961年Birkmayer和Hornykiewicz首次应用左旋多巴治疗PD，但最终将其成功推向临床的要归功于Cotzias。