脑血管疾病后Holmes震颤的临床、影像和电生理特点

目的 总结脑血管疾病后Holmes震颤的临床、影像和电生理特点。 方法 回顾性分析2015年8月-2019年8月就诊于首都医科大学附属北京天坛医院的4例脑血管疾病 所致Holmes震颤患者，对其临床、影像及电生理资料进行分析总结。 结果 4例患者中2例由高血压性脑出血引起，另外2例分别由脑动静脉畸形和脑海绵状血管瘤破裂 出血引起。Holmes震颤出现于原发病后1～24个月，表现为病灶对侧肢体震颤，以上肢多见。头颅MRI 检查显示2例患者病灶仅累及丘脑，2例同时累及丘脑和中脑。震颤分析显示静止、姿势、意向及持物 1000 g几种状态下震颤的峰频率均在2.6～3.8 Hz，意向状态震颤半宽功率高于静止状态。主动肌与 拮抗肌在静息时以同步收缩为主，姿势、意向和持物时以交替收缩为主。3例接受普拉克索治疗均有 不同程度缓解。 结论 Holmes震颤多由累及中脑、丘脑部位脑血管疾病引起，表现为2～4 Hz低频震颤，意向状态震 颤明显，部分患者多巴胺受体激动剂治疗有效。     

散发性急性戊型肝炎血清抗体动态变化和肝脏超微…

为探讨散发性戊型肝为血清抗体动态变化，应用酶联免疫法（ＥＩＡ）检测了７例急性戊型肝炎抗戊型肝炎病毒（ＨＥＶ）ＩｇＧ和ＩｇＭ抗体、并对１例２进行了肝超微结构病理检测，结果表明，发病１０天至４５天内抗ＨＥＶ－ＩｇＧ和ＩｇＭ滴度最高，发病第４０天仍有肝细胞肿胀，胞浆空化和线粒体固缩等病理变化。患者轿清抗－ＨＥＶＩｇＭ滴度在４５天后逐渐下降，２个月内全中消失，抗－ＨＥＶＩｇＭ滴度在４５天后逐渐下降，２个月     

颅底粘液瘤与脊索瘤的临床及神经影像学和组织学对比分析

目的研究颅底粘液瘤和脊索瘤的临床表现及神经影像学和组织学之间的关系。方法对７例粘液瘤和１３例脊索瘤行神经影像学和组织学检查。结果（１）临床表现：粘液瘤以动眼神经损害及眼球突出为主,脊索瘤多表现为后组颅神经的损害。（２）头颅Ｘ线平片：粘液瘤组为病变局部有不规则点状钙化和骨质破坏,脊索瘤组可见斜坡骨质破坏,钙化呈菜花状。（３）ＣＴ及ＭＲＩ：可以清晰的显示粘液瘤和脊索瘤发生部位,侵犯方向及肿瘤与周围结构的解剖关系。（４）病理特点：粘液瘤为细胞呈星芒状排列,脊索瘤的特征为细胞呈囊泡状。结论颅底粘液瘤与脊索瘤的临床表现、神经影像学及组织学的对比分析,对临床鉴别诊断有重要意义,特别是对指导手术方式及入路更具有实用价值。     

药师处方权认知度和支持度的初步调查

目的：了解医护人员、药师和公众对药师"部分"处方权的认知度和支持度。方法：对医护人员、药师以及公众进行问卷调查。结果：医生、护士和公众对药师"部分"处方权非常清楚或比较清楚的分别占35.70%、36.24%、33.44%，药师占57.05%，医生、护士和公众对赋予药师"部分"处方权完全同意或同意的分别占82.01%、76.74%、83.12%，药师占94.82%，而且认知度与支持度在0.01水平上显著相关，不同年龄、学历、职业、职称、医院级别等的支持度有统计学意义。结论：医护人员、药师和公众对于药师"部分"处方权的概念、资格准入等内容认知不足，但认可赋予药师"部分"处方权的好处，并且对赋予药师"部分"处方权持积极态度，认知情况越好支持度越高；医护人员、药师和公众对于赋予药师"部分"处方权的支持度，存在"老年高于青年，高职称高于低职称，高级别医院高于低级别医院，学历差异较大"等现象。     

Large animal models of human cauda equina injury and repair: evaluation of a novel goat model

Previous animal studies of cauda equina injury have primarily used rat models, which display significant differences from humans. Furthermore, most studies have focused on electrophysiological examination. To better mimic the outcome after surgical repair of cauda equina injury, a novel animal model was established in the goat. Electrophysiological, histological and magnetic resonance imaging methods were used to evaluate the morphological and functional outcome after cauda equina injury and end-to-end suture. Our results demonstrate successful establishment of the goat experimental model of cauda equina injury. This novel model can provide detailed information on the nerve regenerative process following surgical repair of cauda equina injury.     

Case series of two patients with Fibrocartilaginous Embolism mimicking Transverse Myelitis of the Spinal Cord

Fibrocartilaginous Embolism (FCE) refers to the extrusion of some of the fibro-cartilaginous nucleus pulposus material from within the inter-vertebral disc to eventually embolize into one of the spinal cord vessels with resultant spinal cord infarction. According to a 2016 review, AbdelRazek et al. (2106) [1] there are 41 pathologically confirmed and 26 clinically suspected cases in the literature till the end of 2015. We add two more clinically diagnosed cases.     

不同磷脂肽段诱导的实验性自身免疫性脑脊髓炎模型病理特征多样性的研究

目的:探索是否不同磷脂肽段可以诱导Lewis大鼠产生不同的病理学表现。方法:采用髓鞘碱性蛋白82-99(MBP82-99)、MBP68-86、髓鞘少突胶质细胞糖蛋白35-55(MOG35-55)免疫Lewis大鼠,每天进行神经功能评分。免疫后取各组大鼠大脑、小脑、脑干和脊髓组织,观察炎性细胞浸润部位和浸润程度、有无脱髓鞘和轴索损害。结果:MBP68-86和MBP82-99两组大鼠的大脑、脑干、小脑和脊髓组织均有炎性细胞浸润,脊髓炎症程度重于其他部位;MBP68-86和MBP82-99诱导的脊髓炎症程度无统计学差异;MOG35-55组大鼠仅脊髓组织受累,且炎症程度明显低于MBP组,其余各组未见炎性细胞浸润。各组大鼠神经组织均未见脱髓鞘和轴索受累。结论:不同磷脂肽段诱导Lewis大鼠神经组织炎性细胞浸润的分布和程度不同。     

Implicit bias in stroke care: A recurring old problem in the rising incidence of young stroke

Stroke is a leading cause of morbidity and mortality worldwide. Although the majority of strokes affect the elderly, the incidence of stroke in young patients is on the rise. Prompt recognition of stroke symptoms and time critical therapies play a key role in management and prognosis of this condition. This is especially critical in young stroke patients, for whom delays in early recognition and treatment can result in many years of disability with associated social and financial burden. Misdiagnosis and unwarranted variation in treatment of stroke in young patients is problematic. Clinician implicit bias, the unconscious and unintentional process of judgement in healthcare decision-making, is a contributor to the short-falls in outcomes in this population. Interventions in this process have been shown to improve clinical outcomes in young stroke patients and represent an active area of study.     

The effect of drug dose and duration of adjuvant Amoxicillin-plus-Metronidazole to full-mouth scaling and root planing in periodontitis: a systematic review and meta-analysis

Clinical Oral Investigations - The aim is to explore the optimal drug dose and duration of adjunctive Amoxicillin-plus-Metronidazole (AMX/MET) to full-mouth scaling and planing (FMSRP) in...