介绍一种医用神经科病人治疗护理床

腰椎穿刺术是神经科常用的穿刺技术,对神经科疾病的治疗和诊断起到了非常重要的作用。躁动病人因脑神经不同程度的损伤,常不配合输液、治疗及腰椎穿刺。在治疗过程中,常会出现不配合治疗,挣扎、躁动等狂躁行为,这些行为往往会导致护士在给药过程中发生药液外渗、肢体肿胀及腰椎穿刺定位不准,进而造成反复穿刺等多种安全隐患[1]。为满足神经科或精神中心临床护理、医疗工作需要,研制了一款具有人性化设计、集躁动病人安全控制、腰椎穿刺术制动和固定装置为一体的医用神经科专用治疗护理床,有效避免了因药液外渗导致肢体肿胀、腰椎穿刺定位不准确和反复穿刺等问题[2],现报道如下。     

神经内科住院患者营养风险发生情况及营养支持的现况调查

目的：调查神经内科住院患者营养风险和营养支持情况。 方法：2018年1月~4月抽取某医院神经内科住院患者209例,采用营养风险筛查工具2002(NRS 2002)和自设计问卷调查其营养风险和营养支持情况。 结果：神经内科住院患者营养风险发生率53.6%(112/209),不同年龄段和相关疾病史营养风险发生率差异有统计学意义(P<0.05)。营养支持率仅为20.1%(42/209),存在营养风险患者中,仅有30.4%(34/112)接受了营养支持,而不存在营养风险的97例中也有8例(8.2%)接受了营养支持。42例接受营养支持的患者中,7例仅接受肠内营养(EN),17例仅接受肠外营养(PN),18例接受肠内联合肠外营养(EN+PN)。 结论：神经内科住院患者营养风险发生率高,但营养支持率和合理营养支持率低,临床上应积极进行营养风险筛查,并根据筛查结果指导临床医生选择合理的营养支持方式。     

Current perception thresholds in toe-to-digit transplantation and digit-to-digit replantation

Recovery of digital nerve function in toe-to-digit transplantation and digit-to-digit replantation was evaluated by transcutaneous constant current sine wave stimulation at 5-, 250-, and 2000-Hz frequencies to determine the current perception thresholds (CPT). For toe transplantation and digit replantation, the mean interval between injury and surgery was 9 months and 7 h, respectively, while the mean interval between surgery and CPT study was 52 months and 20 months, respectively. Control CPTs evoked by three frequency stimuli were obtained from contralateral corresponding normal finger and normal toe. Normal finger had significantly lower 250- and 2000-Hz CPTs than normal toe, but the 5-Hz CPT was not different between them. Replanted digit achieved nearly complete recovery of these three frequency CPTs when compared to normal finger. In toe transplantation, 2000-Hz CPT was comparable to normal finger, while 5- and 250-Hz CPTs were comparable to normal toe. The present findings suggest that the transplanted toe was intermediate between normal finger and normal toe, but more like normal toe than normal finger with regard to detection thresholds of the current-evoked sensation. © 1996 John Wiley & Sons, Inc.     

抗癫痫药物对戊四氮点燃大鼠认知功能影响的研究

目的研究抗癫痫药物（AEDs）对大鼠认知功能的影响。方法10周龄健康雄性SD大鼠70只,随机分为7组,每组10只。随机选取1组作为正常对照组（NS组）;其余6组用戊四氮（PTZ）点燃,致痫后随机选取1组作为癫痫对照组（PTZ组）,其余5组分别给予卡马西平（CBZ组）、苯妥英钠（PHT组）、丙戊酸钠（VPA组）、妥泰（TPM组）及拉莫三嗪（LTG组）控制癫痫发作。治疗2周后用Morris水迷宫进行测试。结果TPM组较其他6组在每次测试中所用时间长（P〈0．05）。在第1天测试中,TPM组LTG组所用时间长（P〈0．05）;在第2天测试中,TPM组比VPA组、LTG（P〈005）;在第3天测试中,TPM组比PTZ组、LTG组所用时间长（P〈0．05）;在第4天测试中,TPM组比CBZ组、VPA组、LTG组所用时间长（P〈0．05）。6次测试所用总时间TPM组最长,PHT组次之,LTG组最短（P〈0．05,P〈0、01）。4天总测试时间TPM组比CBZ组、VPA组、PTZ、LTG组长（P〈0．05）。TPM组定向寻找平台象限时间较其他6组长（P〈0．01）。TPM组逗留时间明显短于CBZ组（P〈0．05）、LTG组（P〈0．01）。结论TPM、PHT可损害大鼠认知功能,而VPA、CBZ、LTG对大鼠认知功能有改善作用。     

Neurological Manifestations of COVID-19: A systematic review and current update

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in December of 2019 in the city of Wuhan, China. Since the outbreak, various reports detail its symptoms and outcomes, primarily focusing on respiratory complications. However, reports are emerging of the virus’ effects systemically, including that of the nervous system. A review of all current published literature was conducted, and we report that headache and anosmia were common neurological manifestations of SARS-CoV-2. Less common symptoms include seizure, stroke and isolated cases of Guillain-Barre syndrome. Further research is now warranted to precisely determine the relationship between those patients developing neurological sequelae, their clinical state and any subsequent morbidity and mortality.     

脑卒中康复护理实施现状及其影响因素的调查分析

目的调查脑卒中康复护理实施现状及其影响因素。方法自行设计脑卒中康复护理现状调查问卷,对813名护士进行问卷调查。结果 813名调查对象中对自己所分管的每例患者均实施康复的占38.38%;Logistic回归分析显示,学历、缺乏相关专业知识与技能、护士是否有必要实施康复护理,患者或家属认为不需要、患者或家属主动配合意识差、医院等级、工作繁忙、缺乏康复指引、效果评价及康复护理路径10个因素是护士实施康复护理的影响因素(P0.01或P0.05)。结论影响护士康复护理实施的因素是多方面的,应根据影响因素从宏观角度进行把控,采取多维度的干预措施,提高康复护理实施率。     

A Novel Rodent Orthotopic Forelimb Transplantation Model That Allows for Reliable Assessment of Functional Recovery Resulting From Nerve Regeneration

Improved nerve regeneration and functional outcomes would greatly enhance the utility of vascularized composite allotransplantation (VCA) such as hand and upper extremity transplantation. However, research aimed at achieving this goal has been limited by the lack of a functional VCA animal model. We have developed a novel rat midhumeral forelimb transplant model that allows for the characterization of upper extremity functional recovery following transplantation. At the final end point of 12 weeks, we found that animals with forelimb transplantation including median, ulnar and radial nerve coaptation demonstrated significantly improved grip strength and forelimb function as compared to forelimb transplantation without nerve approximation (grip strength: 1.71N ± 0.57 vs. no appreciable recovery; IBB scale: 2.6 ± 0.7? vs. 0.8 ± 0.40; p = 0.0005), and similar recovery to nerve transection‐and‐repair only (grip strength: 1.71N ± 0.57 vs. 2.03 ± 0.42.6; IBB scale: 2.6 ± 0.7 vs. 2.8 ± 0.8; p = ns). Moreover, all forelimb transplant animals with nerve coaptation displayed robust axonal regeneration with myelination and reduced flexor muscle atrophy when compared to forelimb transplant animals without nerve coaptation. In conclusion, this is the first VCA small‐animal model that allows for reliable and reproducible measurement of behavioral functional recovery in addition to histologic evaluation of nerve regeneration and graft reinnervation.     

Living his writings: The example of neurologist G. Gilles de la tourette

Gilles de la Tourette is known for the disease which now bears his name. As one of the closest followers of Jean‐Martin Charcot, he always remained faithful to his mentor's views and was one of the most vehement defenders of La Salpêtrière. His activities in the management of hysterics and in hypnotism helped build his reputation during his lifetime, but are now largely forgotten. Gilles de la Tourette had an unusual personality, with hypomanic and histrionic traits. We present some ignored aspects of his life based on the discovery of personal letters which illuminate the hidden side of this famous neurologist. © 2010 Movement Disorder Society