经颅彩色多普勒对大脑血流动力学的研究

目的 :探讨认知过程中脑血流动力学的变化。方法 :应用经颅彩色多普勒对不同生理情况下大脑半球血流速度的变化进行监测。结果 :每项试验前后比较 ,血流速度的增加有显著差异 (P <0 0 1) ,语言试验血流速度增加偏侧在左半球 ,面视试验偏侧在右半球 ,光刺激试验时枕区血流速度最快。结论 :经颅多普勒能监测认知过程中半球血液动力学变化的差异     

神经内科患者难辨梭菌感染的报告

目的:了解住院老年病人难辨梭菌小区域暴发流行的情况。方法:对我院神经内科一起暴发流行难辨梭状芽胞杆菌相关性腹泻(CDAD)的5例老年患者进行回顾调查。结果5例难辨梭状芽胞杆菌相关性腹泻的病人占同期神经内科住院病人的3.57％(5/140);其中轻型1例,重型1例,暴发型3例;痊愈3例,死亡2例。结论:①老年住院患者、抗生素使用及严重的基础疾病、气管切开和胃管进食是导致难辨梭菌感染的高危因素。②区域性丛集分布的患病人群提示有外源性交叉感染的可能。③暴发型难辨梭状芽胞杆菌感染病情进展迅猛,并发症严重,预后极差。     

British Association of Urological Surgeons (BAUS) consensus document: management of bladder and ureteric injury

Injuries to the bladder and ureter are uncommon but usually require prompt urological management. Due to their infrequent nature, Urologists maybe unfamiliar with managing these acute problems and may not work in specialist centres with readily available expertise in open and abdominal surgery. We aim to provide advice in the form of a consensus statement led by the Female, Neurological and Urodynamic Urology (FNUU) Section of the British Association of Urological Surgeons (BAUS), in consultation with BAUS members and consultants working in units throughout the UK, to create a comprehensive management pathway and a series of statements to aid clinicians.     

大蒜素对脑出血大鼠细胞凋亡影响的实验研究

目的探讨脑出血大鼠血肿周边组织细胞凋亡的变化规律;观察大蒜素治疗对血肿周边组织细胞凋亡的影响及可能机制。方法将90只 Wistar 大鼠随机分成对照组、脑出血组及大蒜素组;脑出血组和大蒜素组又分为6h 及1、3、7天几个时相点。脑出血动物模型采用立体定位技术及“二次注血,二次退针”方法,将50μl 自体血注入大鼠尾状核;对照组只进针不注血。大蒜素组给予大蒜素注射液0.2mg/100g 体重,股静脉注射,于造型成功即刻及每日1次;TdT 介导的 dUTP 缺口末端标记法检测 TUNEL 阳性细胞的表达;免疫组化二步法测 Caspase-3 IR 细胞。结果 (1)脑出血组血肿周边 TUNEL 阳性细胞表达显著高于对照组,于3天时达高峰(P<0.01);Caspase-3IR 细胞出现较早,于造模后6h 即显著增高,1天达高峰(P<0.01);(2)大蒜素组治疗后 TUNEL 阳性细胞、Caspase-3IR 细胞表达显著降低(P<0.05)。结论脑出血后血肿周边组织出现凋亡性损伤,大蒜素治疗可减轻出血性细胞凋亡,其机制可能与大蒜素抑制 Caspase-3蛋白表达有关。     

Unintended effects of orphan product designation for rare neurological diseases

Since the introduction of the Orphan Drug Act in 1983, designed to promote development of treatments for rare diseases, at least 378 orphan drugs have been approved. Incentives include financial support, tax credits, and perhaps most importantly, extended market exclusivity. These incentives have encouraged industry interest and accelerated research on rare diseases, allowing patients with orphan diseases access to treatments. However, extended market exclusivity has been associated with unacceptably high drug costs, both for newly developed drugs and for drugs that were previously widely available. We suggest that a paradoxical effect of orphan product exclusivity can be reduced patient access to existing drugs. In addition, the costs of each new drug are arguably unsustainable for patients and for the American health care system. Of all the specialties, neurology has the third highest number of orphan product designations, and neurological diseases account for at least one‐fifth of rare diseases. Citing the use of tetrabenazine for chorea in Huntington disease, adrenocorticotropic hormone for infantile spasms, and enzyme replacement therapy with alglucosidase alpha for Pompe disease, we highlight these paradoxical effects. ANN NEUROL 2012;72:481–490     

语言刺激的功能性MR成像在自闭症诊断中的潜在应用价值

目的对自闭症病人给予被动性语言刺激,评价采用功能性磁共振(MR)成像作为判断病人有无语言缺陷的客观指标的可行性。材料与方法本研究为前瞻性研究,研究方     

改良电休克治疗专家共识（2019版）

为提高电休克治疗的安全性、疗效和舒适性,规范操作及管理流程,相关专家曾共同制定并发表了《电休克治疗方法专家共识（2017版）》。经过反复讨论,专家们认为需要增加一些新的内容,部分内容需要更新,特别是无麻醉的传统电休克已经不适合新时代的医疗需求,应明确废止。现将更新后的专家共识予以公布。     

妊娠高血压综合征及过期妊娠时胎膜超微结构的观察

报告正常足月产、妊娠高血压综合征及过期妊娠时胎膜在光镜和电镜下的结构及变化特点。观察发现,妊娠高血压综合征时胎膜为缺氧所致的可复性病变,而过期妊娠之胎膜则为不可复性自身老化。胎膜广泛纤维化表明在妊娠高血压综合征和过期妊娠时易发生早破膜。此外,尚讨论了胎膜屏障存在的可能机制及明、暗细胞这一现象。