中山医科大学期刊服务中心办理邮购医学新书业务

为了满足读者对医学知识不断更新的要求 ,中山医科大学期刊服务中心开展医学新书邮购服务 ,推介如下 :现代内科诊疗手册 4 6元现代传染病学诊疗手册 2 6元现代临床实用药物手册 6 0元现代儿科诊疗手册 4 1元现代急诊科诊疗手册 35元现代神经内科诊疗手册 16元现代精神病学诊疗手册 2 6元现代肿瘤病学诊疗手册 34元现代心电图诊断手册 2 2元现代外科诊疗手册 4 1元现代护理诊断手册 2 6元现代康复医学诊疗手册 2 4元现代实验诊断手册 4 0元临床免疫学 2 0元医院药师实用指南 2 2元心血管遗传病学 4 4元现代冠心病 82元现代急诊内科学 6 6元现…     

评述《临床诊疗指南:癫癎病分册》

为适应临床诊疗工作规范化的需要而由中华医学会编著的<临床诊疗指南:癫癎病分册>[1](以下简称<分册>)面世已将近两年.     

邮购医学书刊

为了满足读者对有关医学书刊的需求 ,中山医科大学期刊服务中心开展医学书刊邮购服务 ,现把有关书刊推介如下 :　　书藉 :临床执业医师资格考试复习要点 1 1 3元　临床执业医师资格考试复习试题集 81元　口腔执业医师资格考试复习试题集 6 0元　公卫执业医师资格考试复习试题集     

关于“癫痫专业医生能力建设项目——银河计划”第四期培训班报名的通知

<正>各位会员及相关专业人员、各相关单位：为了提升全国各级医疗机构癫痫诊疗的专业水平和综合能力,探索适合我国特点的三级癫痫中心分级管理模式,我协会于2020年开始实施“癫痫专业医生能力建设项目——银河计划”。目前已成功举办了三期培训班,共计3 457名临床医生参加了线上培训和考试,1 711人取得“癫痫专业医生中级水平考试合格证书”、700人取得“癫痫专业医生初级水平考试合格证书”。     

运动障碍与骨骼肌病国家级继续教育学习班通知

由复旦大学附属华山医院神经内科和《中国临床神经科学》杂志社主办的运动障碍与骨骼肌病国家级继续教育学习班将于2013年10月在江苏省徐州市举办。学习班将详细介绍近年来国内外有关运动障碍疾病的诊疗进展,内容包括少动-强直综合征、α-突触核蛋白病、神经棘红细胞病、早期帕金森病和晚期帕金森病的治疗与展望、发作性运动障碍诊疗进展、不安腿综合征诊疗进展、抽动秽语综合征的诊疗进展、肌张力障碍的诊疗     

脊柱外伤后脊膜瘤2例报告并文献复习

目的探讨脊柱外伤后脊膜瘤的发病机制、诊疗方案及预后。方法结合相关文献，对近期收治的2例脊膜瘤患者的临床诊疗经过进行回顾性分析。结果既往均有明确脊柱外伤史，MRI检查提示肿瘤相邻椎体骨折影，术后患者预后均不理想。结论脊柱外伤后脊膜瘤发病机制不明，与组织损伤一修复程序可能相关；临床预后多不理想；脊柱外伤后应定期行椎管肿瘤筛查，以期早期临床诊疗。     

广州管圆线虫病临床诊疗方案

2006年6-8月北京局部小范围爆发广州管圆线虫病。北京热带医学研究所于2006年8月组织专家编写了《广州管圆线虫病临床诊疗方案(试行)》,以指导临床医师对该病的正确识别和规范诊疗。     

天坛卒中学院第一届卒中高级研修班2014年春季开班（招生简章）

天坛卒中学院——简要介绍天坛卒中学院依托首都医科大学附属北京天坛医院脑血管病中心在卒中规范诊疗和临床研究等方面的学科群优势，高效的组织化医疗服务体系和卒中领域卓越的专家资源库，中国卒中杂志专业的卒中信息传播平台，联合北京脑血管病防治协会、中华预防医学会卒中预防与控制专业委员会的力量，以“为中国脑血管病领域培养一批临床诊疗规范化的临床医生和具有国际化视野的临床研究型学科带头人，促进中国脑血管病的临床诊疗人才梯队建设”为己任，传播脑血管病领域的新的学术理念，培养“知国际、知国内、知临床、知科研、知管理”的复合型人才。     

思维导图在神经病学住院医师培训中的应用研究

目的 探讨思维导图在神经病学住院医师培训中应用的可行性和应用效果。 方法 选取2016年1月-2017年1月在首都医科大学附属北京天坛医院神经病学中心神经重症医学科参 加住院医师规范化培训的医生26人,随机选择13人应用思维导图的方法学习脑血管病的临床诊疗知 识、改良患者的管理方法,另外13名医生应用传统学习方法。学习期限为2个月。用出科考试的方法评 估教学效果。 结果 在参与本项研究的学员中,男性6人（23.1%）,平均年龄（25.54±1.067）岁,博士学历4人,硕 士19人,本科3人。实验组与对照组之间年龄、性别、学历无显著性差异。在出科考试评估中,思维导 图学习组临床知识掌握程度、临床思维能力、对患者的管理能力、自身满意度评估、教学满意度评估 均显著高于对照组,比较差异有显著性（P＜0.05）。 结论 应用思维导图的方法对神经病学住院医师进行临床教学,有助于提高学员的临床思维能力和 对患者的综合管理能力,有效提高自主学习能力及学习效率,值得借鉴与推广。     

弥散张量成像在弥漫性轴索损伤临床诊疗中的应用

弥漫性轴索损伤(DAI)是脑外伤(TBI)中一种常见且危重的类型,此类型疾病从发现、命名至今,通过大量尸检病理学检查,其病理学改变特征已经较为明确。但从影像学角度对于此类疾病诊断及治疗标准的认识尚处于模糊状态,从而导致DAI在临床诊疗过程中被低估。通过查阅近几年的相关文献,本文将介绍弥散张量成像(DTI)技术以及其在DAI临床诊疗过程中的应用,以期待为临床医务人员对DAI的诊疗提供新思路。     

论临床经验的总结和积累——深入探究某些特殊病例的重要性

在日常临床工作中,由于我们知识的欠缺,对患者病情观察不仔细,对化验、检查结果认识不透彻,会使得某些病例的临床诊治过程充满曲折。本文通过详述一例以脑梗死为首发表现的隐匿性恶性肿瘤病例以及两例视神经脊髓炎谱系疾病病例的诊治过程并加以剖析,试图探讨深入研究这些特殊病例在临床思维训练及经验积累方面的重要意义。通过研究这些病例的临床诊治过程,我们能够掌握最新知识和进展,学会关注病情演变、化验、检查等细节,梳理其中的逻辑思维过程从而训练临床思维能力,不断总结经验和教训,做到举一反三。     

基于人工神经网络与人工智能的计算机系统在儿童心理障碍诊断领域的应用

背景：将人工智能和人工神经网络二者相结合应用于精神卫生领域的文献在国内外还未见报道,更未见将人工神经网络与人工智能相结合用于模拟人类医学专家大脑诊断思维模式诊断儿童心理障碍的相关报道。 目的：用计算机模拟人脑诊断思维模式,建立一套基于人工神经网络与专家系统的儿童心理障碍标准化诊断与防治的人工智能专家系统。 方法：儿童心理障碍标准化诊断与防治的人工智能专家系统涉及儿童心理学、儿童精神病学、心理测量、心理治疗、计算机科学等诸多学科,诊断系统结合了ICD-10、DSM IV及CCMD-2等诊断标准、大规模流行病学调查数据、资深精神医学专家的丰富临床经验和临床资料。临床资料来源于全国14 家医院流调及门诊收集的原始病例,共回收有效资料1 125份,用基于神经网络与专家系统相结合的方法进行智能诊断系统的编制。 结果与结论：诊断系统能诊断61种儿童心理障碍,它包括95%以上的儿童心理障碍,在诊断之后,计算机将给出一个治疗方法建议。将195例计算机系统诊断结果与资深儿童心理精神医学专家的诊断结果进行双盲比较,诊断符合率是99%,有助于年轻医生学习资深儿童心理精神医学专家丰富的临床经验,也能帮助全国各地的心理障碍患儿,更好地为儿童心理卫生事业服务。     

Hashimoto’s Encephalopathy: A Brief Review

Hashimoto’s encephalopathy (HE) is a syndrome of altered mental status, hallucinations, delusional thinking, and often, epileptic seizures. It is diagnosed by the clinical syndrome, the presence of elevated titers of antithyroid antibodies, the lack of another diagnosis based on clinical evaluation, and the response to corticosteroid and other immunosuppressant treatment. This review discusses the symptoms, pathophysiology, and treatment of HE. The disorder is important to recognize because aggressive treatment may bring about a favorable clinical outcome. The disorder has a relatively benign prognosis, compared with many of the entities for which it can be mistaken.     

PBL 与 CBL 教学法在精神科住院医师规范化培训中的联合应用

住院医师规范化培训就是要将学员培养成为具有扎实的临床技能,缜密的临床思维,能独立处置临床常见病、多发病的临床医生。精神症状具有复杂抽象、主观色彩浓厚的特点;精神疾病的诊断和治疗同时涉及生物学、心理学和社会学等多方面的因素,对医生的知识广度和深度以及灵活运用知识的能力都提出了挑战。CBL教学法中导师引导学员充分运用所掌握的各种知识,对病例进行分析、判断,做出正确的诊断和合理的处置;PBL教学中导师调动学员自主学习的能动性,对于CBL中尚不能透彻解决的关键问题继续进行自主学习以及进一步讨论,从而使学员更加全面深入地认识疾病,具备独立处理复杂临床案例的能力,顺利完成从医学生到合格临床医生的转变。     

Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review

Degenerative cervical radiculopathy: clinical diagnosis and conservative treatment. A review. To provide a state-of-the-art assessment of diagnosis and non-surgical treatment of degenerative cervical radiculopathy a literature search for studies on epidemiology, diagnosis including electrophysiological examination and imaging studies, and different types of conservative treatment was undertaken. The most common causes of cervical root compression are spondylarthrosis and disc herniation. Diagnosis is made mainly on clinical grounds, although there are no well-defined criteria. Provocative tests like the foraminal compression test are widely used but not properly evaluated. The clinical diagnosis of degenerative cervical radiculopathy can be confirmed by magnetic resonance imaging. The role of electromyography is mainly to rule out other conditions. Cervical radiculopathy is initially treated conservatively, although no treatment modality has been evaluated in a randomized controlled trial. Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review.     

The deficiency model: an exploration of current approaches to late-life disorders.

Many of the terms used to describe conditions in elderly individuals, whether medical (deterioration, involution, degeneration) or neurobehavioral (impairment, dysfunction), imply deficiency. The complex of distorted views of real impairment, illness, or disability may be described as the deficiency model. Although developmental theory has expanded explosively and could offer an alternative frame of reference to dispel denigration of the elderly condition, late life continues to be viewed as lacking all redeeming aspects, while mortality is considered an obstacle to prolonging life rather than one of its determinants. Deficiency-model thinking has influenced the conduct of epidemiologic, neurobiologic and clinical research, whose results in turn have often been interpreted to reinforce such thinking. It can also distort clinical approaches to diagnosis and treatment of late-life disorders. This paper offers instead an alternative approach that focuses on late life as a developmental task.     

Dexamethasone suppression test, TRH test and Newcastle II depression rating in the diagnosis of depressive disorders

The dexamethasone suppression test (DST), the thyrotropin releasing hormone (TRH) test and the Newcastle II depression rating (NII) were compared with the clinical diagnosis and evaluated in 61 patients fulfilling the criteria of an affective disorder according to the DSM-III classification. A statistically significant correlation between clinical diagnosis and DST as well as NII, but not between clinical diagnosis and TRH test, was found. There was no correlation between DST and the severity of depression according to the Hamilton depression rating. The nosographic and the diagnostic specificities and sensitivities for the DST, TRH test and NII and DST and NII, a nosographic sensitivity of 50% and a nosographic specificity of 84% were found. Correspondingly, the diagnostic sensitivity was 43% and the diagnostic specificity was 88%. The DST and the TRH test were found of no value in the prediction of the response to antidepressive treatment. Mainly because of a low diagnostic sensitivity the NII, the DST and the TRH test are of limited value in the diagnosis of depressive disorders.     

Accuracy of initial stroke subtype diagnosis. a decision analysis

BACKGROUND: The clinical diagnosis of stroke subtype is often inaccurate during the first 24 h after stroke onset. Several candidate diagnostic tests might be useful for early determination of subtype, but there is no consensus on what level of accuracy is required to be useful in the selection of patients for subtype-specific studies or therapies. METHODS: A decision analysis was developed to explore the treatment options and estimate the requisite threshold of diagnostic accuracy. Four management strategies were considered: treat all (TA), treat based on new test (TBNT), treat based on clinical diagnosis (TBCD) and treat none (TN). Sensitivity analyses were performed over a wide range of the assumptions in the model. RESULTS: The preferred treatment strategy was dependent on the probability and severity of adverse effects and the positive predictive value (PPV) of the proposed diagnostic test. For a potential therapy with infrequent (7.5%) but severe side effects, TN was preferable, but TBNT dominated if the PPV of the new test was at least 81%. For a therapy with frequent (25%) but mild adverse effects, TBNT was preferable. TA was favored for a therapy with infrequent and mild side effects and TN for a therapy with severe and frequent adverse events. TBCD was never the preferred option unless the PPV of the new test was less accurate than clinical diagnosis alone. CONCLUSIONS: Clinical diagnosis of stroke subtype is insufficient for patient selection, but a new diagnostic test with PPV >/=81% may be useful for early subtype diagnosis and patient selection for stroke subtype-specific clinical trials.     

颅内结核瘤的诊断及外科治疗

目的探讨颅内结核瘤的临床特点、诊断及治疗效果。方法回顾分析2001-01-2011-06我院收治的17例颅内结核瘤的临床表现、影像学表现、实验室检查及治疗。结果临床表现结合CT/MRI及实验室检查,17例患者中12例（70.6%）得以明确诊断,手术切除病灶11例,其中5例（29.4%）术前误诊为脑肿瘤或脑脓肿,所有患者均行规律抗结核治疗,无死亡病例,随访无复发。结论颅内结核瘤的诊断应根据临床表现、影像学特点、实验室检查和抗结核疗效进行综合分析。手术结合抗痨药物治疗效果良好。