《中国临床神经科学》投稿须知（2008）

一.总则和内容刊登与神经病学有关的神经科学基础研究、应用基础研究和临床研究的论著、对神经疾病的新认识、新治疗及其实验方法和诊断技术、简讯、报道。兼登医药动态的进展综述等栏目。二.稿件栏目要点(一)论文起始导引依次序包括:1.题目;2.作者;3.单位;4.关键词;5.摘要;6.中图分类号;7.第一作者简介(姓名、性别、出生年、所     

1993年WHO的中枢神经系统肿瘤分类

一、神经上皮组织的肿瘤 (一)星形细胞性肿瘤 1.星形细胞瘤分型:纤维型、原浆型、肥胖细胞型或混合型 2.间变性(恶性)星形细胞瘤 3.胶质母细胞瘤 分型:巨细胞胶母细胞瘤、胶质肉瘤     

儿童后颅窝硬膜外血肿

儿童后颅窝硬膜外血肿相对少见.以往由于诊断较困难及病程进展迅速,其病残率及死亡率都较高.目前诊断技术不断改进,尤其是应用CT以来,诊断正确率已有明显提高.作者自应用CT以来遇到三例后颅窝硬膜外血肿.年龄为5～7岁,均有枕部外伤史.当时意识清楚,分别于伤后3天,13天及14天出现呕吐、头痛(两例位于枕部,一例为前额)、一例仅外展神经麻痹、一例出现复视伴乳头水肿.颅骨平片发现一例枕骨右侧线形骨折.CT均显示为硬膜外血肿的典型表现.一例行椎动脉造形,见右侧小脑后部有一无血管区.三例均行手术治疗,清除血肿约30～50克.其中有骨折者血块大部分附着于骨折线上.术     

精神医学及其有关知识有奖征答(三)答案

一、是非题1.+2.一5.一6.+9.+10.+二、单项选择题:11. 4)12.(1)，13. (}4-) 14.(1)一、’兔，16. (2)' 17. (3)19. (9)’20.' (2)三{多项选择题21. (2) (3) (5)22. 23. (2) <4) <5) 24.25.(1)(4)(5) 26.27. (3)(4) (5) 28.29. <3) <5)30.四、填空题31. 7，37.+.+(4)15. (2) 18. (4)(1)(3) (A)(1)(J)(1)(2) (3)(1)(2)(3)(5)<2)(3)(5)精神医学及其有关知识有奖征答(三)答案~~…     

654—2注射液股动脉注射治疗糖尿病足的护理体会

目的 为了促进糖尿病患者肢端慢性溃疡的愈合,探索一种有效的治疗护理方法 .方法 30例糖尿病肢端溃疡患者在控制血糖及抗感染等基础治疗及换药的同时,隔日一次用654-2注射液股动脉注射.10次为一疗程.结果 患者的肢端溃疡较不用654-2注射液治疗愈合快,全部愈合,无截肢.此后随访一年,未发现有不良后果,如局部疼痛、肿胀等.结论 本方法 操作方便、有效,可作为糖尿病肢端慢性溃疡的常规治疗护理方法 之一.     

单孔双置管治疗慢性硬膜下血肿

目的 介绍一种慢性硬膜下血肿的手术治疗方法.方法 采取单孔双置管法(一根指向前方进行冲洗,另一根指向后方进行引流)对50例慢性硬膜下血肿的病人进行手术处理.结果 50例病人血肿均彻底引流,回访6个月,无复发.结论 单孔双置管法是处理慢性硬膜下血肿的一种彻底、安全、有效的方法,值得推广使用.     

自身免疫性多发性肌炎

多发性肌炎〔Polymyositis, PM〕是一种急性、亚急性或慢性起病、主要累及四肢近端肌群、多发性、血管周围炎性细胞浸润、伴或不伴肌纤维萎缩的疾病.病因未明,可能与感染、中毒、恶性肿瘤、胶原病、病毒性肝炎、重症肌无力和药物〔青霉胺、氨苄青霉素〕等有关.所以,有些作者认为这是一种综合征而非一种疾病.     

伴发于亚急性细菌性心内膜炎和B抗原性肝炎的颞动脉炎

作者报告了两例主诉颞部痛性小结,经活检为亚急性细菌性心内膜炎并发颞动脉炎和B抗原性肝炎性颞动脉炎.病例1、男、63岁,诊为二尖瓣和主动脉瓣狭窄9个月后曾发生过一过性黑朦.牙齿术后五天,右颞上方出现一痛性小结和右眼视力模糊.体温38.7℃,脉搏90次/分、血压140/60毫米汞柱,右颞部触及一波动性和痛性小硬结,右视网膜出血.ESR39mm/一小时.强的松治疗的次日,左颞部又出现一痛性小结.曾进了右侧颞动脉的活检.血培养变异型链球菌.继经适当治疗后,左颞部小结变     

老年性痴呆出现短暂的周期性脑电图放电

弥漫性周期性三相尖波可见于变性、缺氧-缺血性、代谢性脑病患者脑电图;常见于海棉样白质脑病;而在为病理证实的阿尔茨海默病例中却很少见到.阿尔茨海默病伴发热及肺炎的短暂性周期性三相波尚未见报告过.本文报告一例临床诊断为阿尔茨海默病患者在发热、肺炎时出现短暂的周期性放电.患者女性,88岁,因咳嗽、发热、精神错乱及嗜睡一天入院.一年前逐渐出现记忆衰退,生活难     

神经内窥镜手术治疗小儿脑积水

目的介绍一种治疗导水管狭窄性梗阻性脑积水的新方法.方法经侧脑室-室间孔-三脑室置入神经内窥镜,于三脑室底与脚间池之间造一瘘孔.结果 9例近期疗效好,前囟张力正常,2例改行脑室腹腔分流术.结论神经内窥镜下三脑室底脚间池造瘘是一种安全、有效、并发症少的微创手术.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.