伴后循环梗死烟雾病一例

<正>患者男性,37岁。主因头痛、视物模糊7 d,于2012年6月26日入院。患者入院前7 d无明显诱因出现左侧额部疼痛、视物模糊,无言语和肢体症状,无恶心、呕吐、抽搐、意识障碍、大小便失禁等症状。当地医院排除眼科疾病,遂至我院就诊,头部MRI检查显示左侧颞枕叶梗死,为进一步诊断与治疗收入院。既往糖尿病10年,口服格列齐特,平时未规律监测血糖。否认高血压、冠心病、胃病、自身免疫性疾病病史,否认肝炎、结核病等传染病病史,否认手术史、外伤史。无家族遗传性疾病病史。吸烟10余年(3~4支/d),偶饮酒。     

桥脑梗死引起一个半综合征合并面瘫

1病例报告 患者男，54岁，以“头昏、视物模糊伴左上肢麻木3d”入院。患者既往有高血压病史4年，否认糖尿病、心脏病病史。入院查体：PB260／140mmHg（34．7／18．7kPa），意识清楚，言语流利，双侧瞳孔等大等圆，直径约3mm，对光反射灵敏，双眼内收及右眼外展均受限，可见粗大水平眼球眼震，双眼上视、下视无受限，辐辏反射正常。     

可逆性后部白质脑病综合征一例报告

患者，男，51岁，因头痛、精神异常、视物模糊10d，于2004年9月23日入院。患者10d前因劳累突感头痛、头昏、恶心、呕吐，阵发性精神异常，伴视物模糊，行走不稳，无明显的意识障碍，初诊时血压曾达260／150mmHg（1mmHg=0．133kPa）。既往高血压病史5年，肾功能不全病史1年。30年吸烟，20年饮酒史。入院查体：血压205／130mmHg，     

用力排便致反常性栓塞一例报告

正1病例介绍患者,女,48岁。因"突发左侧肢体麻木无力4.5 h"于2016年4月5日就诊于福建省龙岩市第二医院神经内科。入院前4.5 h,患者排便时突发左侧肢体麻木无力,伴有一过性言语表达困难,伴有头痛、头晕。无意识不清、肢体抽搐,无视物模糊、复视,无吞咽困难,无胸闷、胸痛等不适。既往史:既往体健,否认高血压、糖尿病、卒中病史,无烟酒嗜好,否认脑血管疾病家族史。入院查体:右上肢血压130/90 mmHg,左     

脑型猫抓病1例报告

脑型猫抓病(CSD)临床罕见,现报告1例如下。1病例男,60岁。因“视物成双、头痛10d伴发热6d”于2007年3月28日入院。患者10d前无明显诱因出现视物成双,向左侧视物时症状明显,伴前额部胀痛,4d后出现高热(最高达39℃),发热多于午后出现,且有夜间盗汗。既往无结核病等特殊病史。查体     

原发性血小板增多症致颅内静脉窦血栓形成一例

正1病例资料患者,女性,24岁,主因"左眼视物模糊1个月"于2015年12月就诊本院神经内科。患者1个月前于劳累、情绪紧张后出现左眼视物模糊,伴左眼眶周痛,偶有恶心,视物模糊逐渐加重,无头痛、呕吐、一过性黑蒙、耳鸣、视物成双、四肢麻木无力等,外院诊断"视神经炎",并给予激素冲击治疗,上述症状一度曾有好转,但激素减量过程中左眼视物模糊再次加重。既往史:体健,否认外伤史和手术史,否认     

反常栓塞致双侧丘脑旁正中区域梗死一例

临床资料 患者,女,24岁,主因"7 d前突发视物模糊、头晕、意识丧失1次,视物成双6 d"于2009年5月22日入院.患者7 d前晚间上网时无明显诱因突感视物模糊、变形,伴头晕及视物旋转,几分钟后意识不清,12 h后意识渐好转,视物成双,问话回答反应慢,不切题.既往史、个人史无特殊.体检:血压95/65 mm Hg(1 mm Hg=0.133 kPa),心率70次/min,律齐,各瓣膜区可闻及3/6级收缩期吹风样杂音.意识清楚,语言流利.高级皮质功能粗测正常.左侧眼球位置高于右侧,双眼球垂直运动欠灵活,有复视.     

经鼻蝶入路神经内镜下手术治疗鞍区软骨样脊索瘤1例

正1病例资料男,61岁,因左眼视力下降、视野缺损伴视物重影1 d于2017年7月21日入院。既往无头部外伤史、眼科疾病史、高血压病病史、糖尿病及结核病病史。否认特殊化学接触史及放射性接触史。入院时体格检查:神志清楚,双侧瞳等大等圆,直径约3.0 mm,对光反射灵敏,左侧上睑下垂,粗测左眼视野各象限严重缺损,左眼10 cm内视物模糊,右眼视力、视野正常,四肢肌力、肌张力正常,生理反射存在,病理反射未引出。头颅MRI检查示蝶鞍扩大,鞍背、斜坡骨质破坏,鞍区可见团块状混杂信号影部分突像鞍上池生长,大小约29mm×25 mm×26 mm,以长T_1、稍长T_2信号影为主,其内可见斑     

双侧延髓内侧梗死一例

<正>患者男性,49岁。主因突发头晕2 d,言语不清、四肢无力1 d,于2013年5月7日入院。患者于入院前2 d晨起无明显诱因突发头晕伴恶心、呕吐,无视物旋转、肢体无力,症状持续存在,未予处理。入院前1 d出现言语不清、饮水呛咳,四肢无力,以左侧显著,并逐渐出现嗜睡。发病后6 h至我院急诊就诊,头部MRI检查显示双侧延髓内侧梗死。既往高血压病史20余年,血压控制欠佳,波动于170/110 mm Hg(1 mm Hg=0.133 kPa)。患者10年前曾发生过短暂性左上肢麻木,具体经过不详,否认其他病史。     

视神经脊髓炎合并风湿性关节炎一例

1 病例报告 患者女,71岁,主因"头痛7 d,视物模糊、四肢无力4 d"入院.入院前7 d无明显诱因出现持续头痛,累及后枕、双颞及后颈,自服头痛片略缓解,于当地医院行头CT检查未见异常,静脉点滴血栓通、奥扎格雷钠等治疗6 d,入院前4 d出现右眼视物模糊,四肢无力,以左侧明显,左上肢不能持物,不能独立行走,伴尿便障碍及呼吸无力.     

早年创伤对认知功能影响的研究进展

早年创伤是一个全球普遍存在的问题,严重影响儿童、青少年的大脑发育,继而导致认知功能、人格水平、社会行为的改变。早年创伤主要是父母、监护人或其他年长者对孩子施加躯体虐待、躯体忽视、情感虐待、情感忽视或性虐待。美国一项调查显示：儿童虐待事件的发生率高达1．2％[1]。早年创伤影响认知功能的多个领域,包括学习／工作记忆、视觉空间能力、执行功能、言语智能、复杂推理搜决策、学业表现等比]。创伤造成的认知功能改变是目前国内外神经科学和精神医学领域研究的热点,但其发病机制仍不明确,鉴于早年创伤与认知功能的关系问题,现就早年创伤对大脑发育、神经认知的影响加以综述。     

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.     

Brain network markers of abnormal cerebral glucose metabolism and blood flow in Parkinson＇s disease

Neuroimaging of cerebral glucose metabolism and blood flow is ideally suited to assay widely-distributed brain circuits as a result of local molecular events and behavioral modulation in the central nervous system. With the progress in novel analytical methodology, this endeavor has succeeded in unraveling the mechanisms underlying a wide spectrum of neurodegenerative diseases. In particular, statistical brain mapping studies have made significant strides in describing the pathophysiology of Parkinson＇s disease （PD） and related disorders by providing signature biomarkers to determine the systemic abnormalities in brain function and evaluate disease progression, therapeutic responses, and clinical correlates in patients. In this article, we review the relevant clinical applications in patients in relation to healthy volunteers with a focus on the generation of unique spatial covariance patterns associated with the motor and cognitive symptoms underlying PD. These characteristic biomarkers can be potentially used not only to improve patient recruitment but also to predict outcomes in clinical trials.     

Effect of Ganoderma lucidum spore on expression of insulin-like growth factor-1, nuclear factor-kappa B, and neuronal apoptosis in the epileptic rat brain*★

BACKGROUND：It has been reported that Ganoderma lucidum spore powder, a very well known Chinese traditional medicine, can affect immunoregulation, free radical scavenging, and anti-hypoxia responses. OBJECTIVE： To investigate the effect of Ganoderma lucidum spore powder on expression of insulin-like growth factor-1 （IGF-1）, nuclear factor-κB （NF-κB） and neuronal apoptosis in rats with pentylenetetrazol （PTZ）-induced epilepsy. DESIGN, TIME AND SETTING： A cellular and molecular biology experiment with randomized controlled study design was performed at the Central Laboratory of Basic Medical College of Jiamusi University from June to August 2005. MATERIALS： Thirty healthy, adult, male, Wistar rats were selected and randomly divided into 3 groups （10 rats per group）： control, epilepsy model, and Ganoderma lucidum spore powder. A sub-eclampsia PTZ dose （35 mg/kg） was intraperitoneally injected to induce epilepsy in the latter two groups. Wild Ganoderma lucidum spore powder （30 g/L） was provided by the wild Ganoderma lucidum plant nursery at Jiamusi, China. Immunohistochemical detection and terminal deoxynucleotidyl transferase-mediate dUTP nick end-labeling （TUNEL） kits were purchased from Wuhan Boster Biological Technology Co., Ltd., China. METHODS： Ganoderma lucidum spore powder was intragastrically administered at a dose of 10.0 mL/kg, once a day for 28 days. In the epilepsy and control groups, an equivalent volume of normal saline was intragastrically administered. MAIN OUTCOME MEASURES： Immunoreactivity for IGF-1 and NF-κB/P65 were detected by immunohistochemical staining. Neuronal apoptosis was detected using TUNEL methods. RESULTS： The hippocampus and cerebral cortex of rats with PTZ-induced epilepsy exhibited a higher number of apoptotic cells at high magnification （×400）, compared with the control group. Expression of IGF-1 and NF-κB were higher in the epilepsy group, compared with the control group （P 〈 0.01）. In Ganoderma lucidum spore-treated rats,     

Naoxintong dose effects on inflammatory factor expression in the rat brain following focal cerebral ischemia

BACKGROUND： Certain components of tetramethylpyrazine, a traditional Chinese medicine, exhibit protective effects against brain injury. OBJECTIVE： To investigate the effects of different Naoxintong doses on expression of nuclear factor-kappa B （ kB）, interleukin-6, tumor necrosis factor-α, and complement 3 in rats following focal cerebral ischemia. DESIGN, TIME AND SETTING： The randomized experiment was performed at the Laboratory of Neurology, Second Hospital of Hebei Medical University from June 2004 to June 2006. MATERIALS： A total of 150 adult, healthy, male, Sprague Dawley rats, weighing 280-320g, were selected. Naoxintong powder （mainly comprising szechwan lovage rhizome, milkvetch root, danshen root, and radix angelicae sinensis） was obtained from Buchang Pharmacy Co., Ltd. in Xianyang City of Shanxi Province of China, lot number 040608. METHODS： The rats were randomly assigned into sham operation, saline, high-dose Naoxintong, moderate-dose Naoxintong, and low-dose Naoxintong groups, with 30 rats in each group. Rat models of middle cerebral artery occlusion were established using the suture method, with the exception of the sham operation group. Rats in the high-dose, moderate-dose and low-dose Naoxintong groups received 4, 2, and 1 g/kg Naoxintong respectively, by gavage. Rats in the saline group were treated with 1 mL saline by gavage All rats were administered by gavage at 5 and 23 hours following surgery, and subsequently, once per day. MAIN OUTCOME MEASURES： At 6, 24, 48, 72 hours, and 7 days following model establishment, brain water content was measured. Histopathological changes in brain tissues were detected using hematoxylin-eosin staining. Expression of nuclear factor- kB, interleukin-6, tumor necrosis factor- α, and complement 3 was examined by immunohistochemistry. RESULTS： A total of 150 rats were included in the final analysis with no loss. Brain water content was significantly increased in the ischemic hemisphere of rats from the saline, as well as the high-dose, mo     

Chaotic electrical stimulation of the subthalamic nucleus – mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats★

BACKGROUND： Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE： This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING： This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007. MATERIALS： Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by Chengdu Instrument Factory, China; the video electroencephalographic system （KT-88-2400） and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA. METHODS： The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μA, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups： （1） pre-stimulation （n = 10）, pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; （2） synchronous stimulation （n = 10）, rats received pentylenetetrazol and chaotic electrical stimulation concurrently; （3） post-administration stimulation （n = 10）, after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; （4） sham-stimulation （n = 10）, following pentylenetetrazol administration, an electrode was con     

Effect of bilobalide B on cholinergic hippocampal neurons exposed to cholesterol and apolipoprotein E4*☆

BACKGROUND： Extracts of ginkgo biloba leaves have been reported to improve nerve function and activity in Alzheimer＇s disease, which is associated with reduced secretion of cholinergic neurotransmitter in hippocampal neurons. OBJECTIVE： To validate the protective effect of bilobalide B against in vitro injury of cholinergic neurons of the hippocampus induced by combined cholesterol and apoE4 DESIGN, TIME AND SETTING： This randomized, controlled animal experiment was performed in the Pathology Laboratory, Tianjin University of Traditional Chinese Medicine from July 2003 to July 2006. MATERIALS： Neonatal Wistar rats, 1-day-old, both male and female, and mean body mass of 5 g were selected for this study. Cholesterol and apolipoprotein E4 （apoE4） were purchased from Sigma Company （USA）, bilobalide B was purchased from Tianjin Zhongyi Pharmaceutical Factory, batch number 20050312. METHODS： Hippocampal neurons were divided into three groups： a normal control group （routinely added media）, a model group （exposed to media containing 40 mg/L cholesterol and 30 mg/L apoE4 for 24 hours） and a bilobalide B group （exposed to media containing 160 mg/L bilobalide B for 16 hours, and then with addition of 40 mg/L cholesterol and 30 mg/L apoE4 for an additional 24 hours）. MAIN OUTCOME MEASURES： Levels of acetylcholine （ACh） and activity of acetylcholinesterase （ACHE） and choline acetyltransferase （CHAT） in hippocampal neurons were determined by microdosage hydroxylamine colorimetry, hydroxylamine colorimetry and radiological chemistry, respectively. RESULTS： The ACh level was significantly lower in the model group than that in the normal control group （P 〈 0.01）, while it was markedly higher in the bilobalide B group than in the model group （P 〈 0.05）. Activity of AChE was significantly decreased in the model group compared with the normal control group （P 〈 0.05）. However, there was no significant difference between the model group and the bilobalide B group ?     

氧化应激与认知功能障碍的研究进展

氧化应激（Oxidative Stress）不仅在糖尿病、高血压病等身心疾病中起着重要作用,而且对阿尔茨海默病（AlzheimerDisease,AD）、帕金森病（Parkin-son Disease,PD）等神经精神障碍的认知功能也有一定影响。强烈或持续性的氧化应激可通过诱导细胞凋亡和炎性反应导致细胞、组织损害。流行病学及动物研究均表明,母孕期遭受应激可能会影响胎儿的神经心理发育过程,造成胎儿大脑某区域的缺陷,引起持续性认知改变、神经内分泌和行为反应,增加后代精神疾病的患病风险。现对氧化应激与认知功能障碍的机制进行综述。     

Intrathecal MK-801 inhibits formalin-induced activation of spinal p38-MAPK in rats**★

BACKGROUND： p38 mitogen-activated protein kinase （MAPK） plays an instrumental role in signal transduction from the cell surface to the nucleus, while subcutaneous injection of formalin can induce increased activation of spinal p38 MAPK. However, the mechanisms underlying the formalin-induced activation of spinal p38 MAPK in rats are unclear. OBJECTIVE： To observe the effects of N-methyl-D-aspartic acid （NMDA） receptor antagonist MK-801 on the formalin-induced activation of spinal p38 MAPK in rats. DESIGN, TIME AND SETTING： This randomized grouping, controlled animal experiment was performed at the Department of Physiology and Neurobiology, Shanxi Medical University between May and November 2007. MATERIALS： Forty eight healthy, adult Wistar rats were randomly divided into two groups： formalin ＋ normal saline （n = 12） and formalin ＋ MK-801 （n = 36）. The formalin ＋ MK-801 group was further divided into three subgroups according to the dosage of MK-801 （10, 50, and 100 nmol/L, 12 rats for each subgroup） METHODS： Following anesthesia, polyethylene tubing filled with sterile normal saline was implanted into the subarachnoid cavity. On postoperative days 5-8, rats received a 15 minute perfusion of normal saline or MK-801 （10, 50, and 100 nmol/L） in the formalin ＋ normal saline and formalin ＋ MK-801 groups, respectively, followed by formalin injection for the induction of nociceptive behavior. MAIN OUTCOME MEASURES： Detection of total p38 MAPK and of phosphorylated p38 MAPK by western Blot analysis; observation of nociceptive behaviors in the 1 hour after formalin injection. RESULTS： Western Blot analysis revealed that injection of formalin had no effect on total p38 MAPK expression but resulted in increased phosphorylation of p38 MAPK in the spinal cord. This increase was apparent after 5 minutes, peaked at 20 minutes, and thereafter descended and reached control levels after 45 minutes. Pretreatment with MK-801 （10, 50, 100 nmol/L） resulted in a dose-dependent reduc     

Changes of 5-hydroxytryptamine and tryptophan hydroxylase expression in the ventral horn of spinal cord

Objective To investigate changes of 5-hydroxytryptamine （5-HT） and its synthesis rate-limiting enzyme tryp-tophan hydroxylase （TPH） in the ventral horn of spinal cord after exercise-induced fatigue, and to further discuss the mecha- nism of exercise-induced central fatigue at spinal level. Methods Sixteen healthy adult Wistar rats were randomly divided into 2 groups： exercise-induced fatigue group and control group. Immunohistochemical staining for 5-HT and TPH in the ventral horn were performed and analysized quantitatively. The mean optic densities of 5-HT and TPH positive fibers or terminals were measured by computerized image analyzer. Results Both 5-HT and TPH positive fibers/terminals decreased in the exercise-induced fatigue group. The immunohistochemical staining was weaker and the mean optic densities decreased obviously in the fatigue group compared with those in the control group （P 〈 0.05）. Conclusion 5-HT and TPH in the ventral horn of spinal cord might be involved in exercise-induced fatigue.