北京地区神经外科状况的调查报告

目的 了解北京地区神经外科医师的工作现状和神经外科的疾病种类.方法 调查北京地区27家有独立神经外科建制的医院(三级医院19家,二级医院8家),统计2004-2006年三个年度的各医院神经外科收治的病人资料.结果 19家三级医院神经外科平均床位67张,平均医师18人,主要治疗难度较高的颅脑肿瘤、脊髓脊柱病等.8家二级医院神经外科平均床位27张,平均医师7人,主要收治颅脑外伤和高血压脑出血.每个医院年平均收治的病例数量从高到低依次为:颅脑肿瘤(31%)、颅脑外伤(26%)、功能神经外科病(14%)、脑血管病(12%)、脊髓脊柱病(8%)和先天畸形(5%).结论 北京地区的三级大医院神经外科承担了较多的来自全国各地的疑难病例的治疗.神经外科的规模化和亚专业化是今后北京地区神经外科事业发展的基础.     

提高我国颅脑创伤治疗水平的几个关键问题

颅脑创伤仍然是威胁人类生命的主要疾患之一,是从事神经外科基础研究人员和临床工作者长期为之奋斗和必须面对的重要课题。目前我国地县级医院的神经外科医师绝大多数从事颅脑创伤病人的救治工作,即使在发达地区的上海,全市所有医院神经外科住院手术病人中,颅脑外伤仍处于第1位。所以,正确诊治颅脑创伤病人十分重要。     

四川省神经外科疾病构成及诊治情况调查研究

目的 调查四川省2004-2006年神经外科疾病病种的构成和诊疗情况.方法 收集四川省71家医院神经外科住院病人的临床资料,统计分析不同疾病所占的比例及其治疗预后情况.结果 病种构成比位居前三位的疾病分别是颅脑外伤(66.93%),脑血管病(12.97%)、颅脑肿瘤(11.91%).死亡病例中以颅脑外伤所占比例最高,为60.64%,居二、三位的分别是脑血管病(28.75%)和颅脑肿瘤(7.78%).总死亡率为5.79%.而从各类疾病的死亡人数占该类疾病发病总人数的比例来看,脑血管病最高为12.82%,颅脑外伤和颅脑肿瘤分居第二和第三位,分别是5.24%和3.78%.结论 颅脑外伤仍然是神经外科致死率最高的疾病,而脑血管病已经超越颅脑肿瘤成为威胁人类健康的第二大类神经外科疾患.     

中国神经外科医师培养细则

一、神经外科医师培养原则 神经外科学是运用外科学的基本原则和方法,诊治中枢神经系统和外周神经系统疾病的医疗实践科学,是外科学的一个重要分支.神经外科学的主要亚专科有:神经肿瘤、神经创伤、脑血管病、脊髓脊柱病、功能神经外科、小儿神经外科、放射神经外科等.由于神经外科学是处理人体最高中枢问题的科学,因此对神经外科医师的培训标准要有更高的要求.应该在有完善条件(包括人力资源、设备条件、病源、成就)的单位成立“中国神经外科医师培训基地”,以达到正规化培养合格的神经外科专业医师的目的.神经外科医师的培训为连续性5年制,将医学院毕业的学生培养成掌握神经外科及相关学科基本知识和技能的神经外科医师,为他们今后的事业发展奠定坚实的基础.要求达到能独立诊治神经外科常见病和多发病的水平,能独立完成颅脑外伤、大脑和小脑凸面肿瘤、脊髓外肿瘤、简单型脑动静脉畸形等手术.     

中国颅脑创伤十年

十年来,全国神经外科医师共同推进颅脑创伤事业不断发展,颅脑创伤的基础临床研究体系日臻完善,成果迭出,在临床规范化诊治体系建设、循证医学探索和转化医学研究领域均呈现出与时代医学特征相契合的生机与活力,为探寻具有中国特点的颅脑创伤救治方案,造福广大颅脑创伤患者作出了不懈努力. 一、临床规范化诊治体系逐渐健全 受颅脑创伤发病率的激增推动,许多县级医院均于上世纪90年代后建立单独运行的神经外科,十年来,颅脑创伤救治工作散乱、缺乏统一规范的现状得到改善.     

河南省神经外科状况调查报告

为了解河南省神经外科的疾病种类和神经外科医师的工作现状,为卫生行政主管部门制定与神经外科有关的卫生政策提供资料.根据<中华神经外科杂志>编辑部和中国医师协会神经外科医师分会组织实施的全国神经外科状况调查的部署,对河南省117家有独立神经外科建制的医院进行调查,统计了2004-2006年各医院神经外科收治的疾病种类资料和神经外科医师队伍状况.     

西南医科大学附属医院神经外科简介

正科室创立于1977年,是四川省神经外科临床医学研究中心,国家卫生健康委脑卒中筛查与防治基地,上海颅脑损伤研究所四川协作中心,中国医师协会颅脑损伤临床适宜技术培训基地,四川省专科医师规范化培训基地——神经外科医师培训基地,欧盟颅脑创伤研究计划中国项目成员,中国卒中中心联盟急性缺血性卒中血管内治疗协作组成员,国家神经系统疾病临床研究中心——神经系统疾病专科联盟成员单位,2018年,脑血管病专业组成功入选国家《疑难病症诊治能力提升工程》项目,并入围中国医院科技影响力百     

2014全国小儿神经外科(秋季)学术研讨会征文通知

<正>为推动我国小儿神经外科的进一步发展,提高全国神经外科医师对小儿神经外科疾病的认识和诊治水平,由天津市医师协会神经外科医师分会、中国医师协会神经外科医师分会小儿专业委员会、世界华人神经外科协会、北京市王忠诚医学基金会、《中华神经外科杂志》编辑部主办,天津市医师协会神经外科医师分会、天津市环湖医院承办的"2014全国小儿神经外科(秋季)     

早期干预对重型颅脑创伤患者生存质量的影响

颅脑创伤发生率近年呈上升趋势,重型颅脑创伤患者病死率和病残率居高不下,是神经外科医师所面临的重要问题之一[1].笔者自2007年7月-2009年6月对河北省唐山市丰南区医院神经外科重症监护室(ICU)的227例重型颅脑创伤患者采用早期干预治疗,以观察患者预后情况.     

中国神经外科医师培训基地细则

一、“中国神经外科医师培训基地”资格认定标准 由于神经外科是诊治中枢神经系统疾病的学科,为保证神经外科医师的培训质量,应该在有完善条件(包括人力资源、设备条件、病源、成就)的单位成立“中国神经外科医师培训基地”,所有从事神经外科临床诊疗活动的医师,必须要经过此基地的正规培训,以达到正规化培养合格的神经外科专业医师的目的.要从法律法规的高度来保证培训基地的高质量和可持续发展.将这些经过正规化培养的医师分配到全国各级医院,为中国神经外科事业的发展提供人才保障.     

视频脑电图在小儿癫痫诊断中的应用

目的评价视频脑电图(video-EEG)在小儿癫诊断中的应用价值。方法对126例具有发作性症状的患儿进行连续8h的包括清醒、睡眠、诱发试验及必要的认知测验的视频脑电图监测。结果经发作期视频脑电图证实,39例初诊为癫性发作的患儿中14例(35%)为非癫性发作;15例其他症状发作中13例(86%)为非癫性发作。64例样放电患儿中51例(80%)确定发作类型,22例(34%)确定癫类型。视频脑电图可发现短暂轻微的癫发作及样放电引起的一过性认知损伤。结论视频脑电图在排除非癫性发作、确定癫性发作的类型、评价脑电-临床关系方面可提供准确可靠的证据,进一步提高癫的临床诊断水平。     

Role of glutathione in repair of free radical damage in hippocampus in vitro.

Depletion of glutathione (GSH), an intrinsic antioxidant, increases vulnerability to free radical damage in a number of cell systems. This study investigates the role of GSH in limiting electrophysiological damage and/or recovery from free radical exposure in slices of guinea pig hippocampus. Synaptic potentials (PSPs) and population spikes (PSs) were recorded from field CA1. Free radicals were generated from 0.006% peroxide through the Fenton reaction. Analysis of the input-output curves showed that peroxide treatment decreased PSPs and impaired ability of the PSPs to generate PSs as previously reported. Recovery was nearly total within a half hour. Treatment with 5 mM buthionine sulfoximine (BSO) for 2 h depleted hippocampal GSH to 79.2% of control values. The extent of free radical damage was not increased. Recovery, however, was only partial. GSH was further depleted by oxidation with diamide or covalent bonding with dimethyl fumarate (DMF) immediately before and during the peroxide treatment. Neither diamide nor DMF treatment in BSO-incubated tissue enhanced peroxide-induced electrophysiological deficits. Following these treatments, however, tissue showed little recovery from free radical damage. We conclude that glutathione is essential for repair processes in hippocampal neurons exposed to oxidative damage.     

Neuroprotective properties of memantine in different in vitro and in vivo models of excitotoxicity

The pathogenesis of stroke, trauma and chronic degenerative diseases, such as Alzheimer's disease (AD), has been linked to excitotoxic processes due to inappropriate stimulation of the N-methyl-D-aspartate receptor (NMDA-R). Attempts to use potent competitive NMDA-R antagonists as neuroprotectants have shown serious side-effects in patients. As an alternative approach, we were interested in the anti-excitotoxic properties of memantine, a well-tolerated low affinity uncompetitive NMDA-R antagonist presently used as an anti-dementia agent. We explored in a series of models of increasing complexity, whether this voltage-dependent channel blocker had neuroprotective properties at clinically relevant concentrations. As expected, memantine protected neurons in organotypic hippocampal slices or dissociated cultures from direct NMDA-induced excitotoxicity. However, low concentrations of memantine were also effective in neuronal (cortical neurons and cerebellar granule cells) stress models dependent on endogenous glutamate stimulation and mitochondrial stress, i.e. exposure to hypoxia, the mitochondrial toxin 1-methyl-4-phenylpyridinium (MPP+) or a nitric oxide (NO) donor. Furthermore, memantine reduced lethality and brain damage in vivo in a model of neonatal hypoxia-ischemia (HI). Finally, we investigated functional rescue (neuronal capacity to migrate along radial glia) by memantine in cerebellar microexplant cultures exposed to the indirect excitotoxin 3-nitropropionic acid (3-NP). Potent NMDA-R antagonists, such as (+)MK-801, are known to block neuronal migration in microexplant cultures. Interestingly, memantine significantly restored the number of neurons able to migrate out of the stressed microexplants. These findings suggest that inhibition of the NMDA-R by memantine is sufficient to block excitotoxicity, while still allowing some degree of signalling.     

Knowledge of management of epilepsy in young adults in Jordan

PURPOSE: Nationwide studies on public knowledge of epilepsy have been undertaken in several countries, but not in Jordan. The purpose of this study was to evaluate knowledge of the management of epilepsy in Jordan. METHODS: A cross-sectional study was performed during the period February-June 2005 on 16,044 individuals selected randomly to represent all regions of Jordan. Respondents were interviewed and asked to complete a five-item questionnaire testing their knowledge of the management of epilepsy. RESULTS: Most of the individuals (77.9%) agreed that patients with epilepsy are best treated in a specialized hospital for neurological diseases. Although the largest percentage of the sample (86.7%) agreed that the best person to treat epilepsy is a neurologist, others believed that a hypnotherapist (25.4%) or a religious healer (22.6%) is. As an immediate measure during an attack of epilepsy, most respondents (82.6%) agreed that protecting the patient's head is most important. During the postseizure period, 45.8% of respondents believed that offering the patient water or a cold or hot drink is appropriate. Two-thirds of the respondents (66.2%) agreed that epilepsy can be treated with drugs. Responses of the participants to the five items significantly differed with respect to age, gender, level of education, and occupation. CONCLUSION: Jordanians are reasonably well informed about most aspects of the management of epilepsy, but there is still a need for public education about this disorder.