IgM and IgG responses during chronic relapsing experimental allergic encephalomyelitis (r-EAE)

During chronic relapsing experimental allergic encephalomyelitis (r-EAE) in guinea pigs, serum IgM and IgG concentrations increased markedly early in disease. Serum IgM and IgG increased similarly in control animals immunized with Freund's incomplete adjuvant (FIA) and Mycobacterium tuberculosis (MT). In the chronic phase of r-EAE but not in control animals, elevated IgM was also found in central nervous system (CNS) extracts, suggesting intrathecal IgM synthesis. IgG antibodies against myelin and myelin basic protein (MBP) were regularly detected in r-EAE sera from day 21 post inoculation (p.i.), reaching maximum levels in the early chronic phase. IgG antibodies against galactocerebroside (GC) and galactose appeared in some r-EAE sera. Oligoclonal IgG bands were demonstrated in all r-EAE guinea pig sera 21-26 days p.i. The bands in serum decreased in number and strength in the chronic phase. They could be traced to antibodies against MT in 4 of 10 animals, but not to antibodies against myelin, MBP, GC or galactose. Oligoclonal IgG bands were also regularly visualized in r-EAE CNS 124 days p.i., suggesting persistent intrathecal IgG synthesis. They varied in number and migration between different regions of individual CNS. Oligoclonal CNS IgG was related to antibodies against MT in only one of 7 animals, and in no case to antibodies against myelin.     

Induction of antimyelin and antioligodendrocyte antibodies by vaccinia virus An experimental study in the mouse

The appearance of serum antibodies binding to specific brain antigens was monitored in mice inoculated intracerebrally with a dermotropic or a neurotropic strain of vaccinia virus. Antibodies were measured with a binding assay using [¹²⁵I]protein A. Inoculation with the neurotropic strain caused an induction of serum antibodies binding to the myelin membrane, the myelin basic protein and oligodendrocytes while no induction of binding antibodies to neurons was observed. The dermotropic strain failed to elicit the formation of binding antibodies to brain antigens.     

神经病学硕士研究生能力培养评价体系研究

结合神经病学的特点，从神经病学硕士研究生的临床实践能力、创新能力、英语能力和临床沟通能力四大方面较全面地阐述了建立硕士研究生能力评价体系的目的与意义，描述了建立评价体系的基本思路，初步确定了评价指标和评价体系的内涵。     

Epilepsy, psychiatry, and neurology

This article reviews the relationship between the psychiatry and neurology of epilepsy, especially in the last 100 years. Throughout most of its recorded history of 3 to 4 millennia epilepsy has been viewed as a supernatural or mental disorder. Although first suggested by Hippocrates in the 5th century B.C., the concept of epilepsy as a brain disorder only began to take root in the 17th and 18th centuries. The discipline of neurology emerged from "nervous disorders" or neuropsychiatry in the late 19th century, when vascular theories of epilepsy predominated. By the turn of the 19th century psychiatry and neurology were diverging and epilepsy remained to some extent in both disciplines. It was only in the middle of the 20th century with the development of electromagnetic theories of epilepsy that the concept of epilepsy per se as a neurological disorder was finally adopted in international classifications of disease. This was associated with a refined definition of the ictal, pre-, post-, and interictal psychological disorders of epilepsy, which have contributed to a renaissance of neuropsychiatry. At the beginning of the 21st century and the centenary of the ILAE psychiatry and neurology have been converging again, led in some respects by epilepsy, which has provided several useful models of mental illness and a bridge between the two disciplines.     

Various Surfaces Benefited Functional Outcomes and Fall Incidence in Individuals With Spinal Cord Injury: A Randomized Controlled Trial With Prospective Data Follow-up

ObjectivesTo compare effects of walking training on a walking track with different surfaces (WTDS), including artificial grass, soft, and pebbles, as compared to overground walking training on the functional ability necessary for independence and incidence of falls of ambulatory individuals with spinal cord injury (SCI).DesignA randomized controlled trial (single-blinded design) with 6-month prospective fall data follow-up.SettingTertiary rehabilitation centers and several communities.ParticipantsIndependent ambulatory individuals (N=54) with SCI who walked with or without a walking device.InterventionParticipants were randomly arranged into a control group (overground walking training, n=26) or experimental group (walking training over a WTDS, n=28) for 30 min/d, 5 d/wk over 4 weeks.Main Outcome MeasuresThe 10-m walk test, timed Up and Go test, five times sit-to-stand test, and 6-minute walk test were repeatedly measured 4 times, including before training, and after 2 and 4 weeks, and 6 months. In addition, participants were prospectively monitored for the fall data over 6 months.ResultsParticipants who walked with an average speed of 0.52 m/s and postinjury time >7 years could safely walk over a WTDS. They demonstrated significant improvement at 2 and 4 weeks after experimental training (P<.001), but not after control training. During the 6-month follow-up, participants in the experimental group also had the number of those who fell (n=5, 18%) fewer than those in the control group (n=12, 46%).ConclusionsBeing at a chronic SCI with ability of independent walking, participants needed a challenging task to promote their functional outcomes and minimize fall risk. The findings suggest the use of various surfaces as an alternative rehabilitation strategy for these individuals.     

Braden评分预测神经科患者压疮的准确性及影响准确性因素的分析

目的探讨Braden评估表对神经科患者压疮发生危险预测的有效性,并分析在Braden评估表评估危险程度相同的情况下,其他相关因素对压疮发生的影响,以提高预防压疮的有效性。方法对135例神经科压疮患者应用Braden评估表进行评分,并收集包括年龄、意识状态、血清白蛋白、活动方式、体位等13个相关因素以及压疮分期状况。分析该评估表对预测压疮的准确性,及影响准确性的因素。结果135例患者中,Braden评分为极高危或高危者94例占69.63%,中危者31例占22.96%,低危者10例占7.41%,无危者无。相关性分析提示:血清白蛋白值与Braden评分成正相关(r=0.25,P<0.05),意识状态与Braden评分为显著负相关(r=-0.61,P<0.01),压疮严重程度与Braden评分成负相关(r=-0.210,P<0.05)。其他因素与Braden评分无显著相关性(P>0.05)。结论Braden评估表能有效地预测神经科患者发生压疮的危险性;对Braden评分具有相同危险者,血清白蛋白水平越低、意识障碍越重,其发生压疮的危险性越高。