PBL教学法在中医脑病专业住培中的应用

随着教学方法的不断改进,PBL教学法已被逐渐运用至中医脑病专业住院医师规范化培训(以下简称中医脑病专业住培)中,有效弥补了以往灌输式教学法的弊端,有利于提升培训学员的临床思维、临床技能以及综合素质,从而提升脑病科临床教学效果。基于此,本文主要对PBL教学法在中医脑病专业住培中的应用进行了分析探讨。     

新生儿缺氧缺血性脑病的CT诊断价值

[目的]探讨新生儿缺氧缺血性脑病(hypoxicischemicencephalopathy,以下简称HIE)的发生发展及CT对该病的诊断价值.[方法]选择有围产期窒息史,经临床诊断为HIE的足月新生儿110例,进行cCT扫描,按影像分级标准分轻、中、重三度.[结果]110例HIE患儿中,轻度58例(53％),中度38例(34％),重度14例(13％)与临床分级基本一致.[结论]CT对HIE的分级诊断,对其治疗及预后评估提供客观依据.     

Biochemical Basis of Heterogeneity in Acute Presentations of Propionic Acidemia

Propionic acidemia (PA), an uncommon organic acidemia has varied clinical and metabolic presentation causing difficulty and delay in the diagnosis. We report a case of PA in an infant who presented with failure to thrive, acute encephalopathy due to severe hyperammonemia without acidosis and fungal sepsis. The biochemical basis of severe hyperammonemia is discussed.     

新生儿缺氧缺血性脑病162例CT分析

目的:分析新生儿缺氧缺血性脑病(HIE)的CT表现.方法:162例HIE患儿均作头颅CT扫描,并在病灶部位测量CT值.结果:162例HIE患儿CT改变主要为脑白质低密度,可合并颅内出血.结论:据新生儿宫内窒息缺氧病史及临床表现,结合头颅CT表现,对本病可做出诊断.     

朊病毒与牛海绵状脑病

朊病毒是一种裸露的、小分子量、有侵染性的RNA或蛋白质分子。人和哺乳动物的多种神经系统疾病与朊病毒有关。牛海绵状脑病(Bovin spongiform encephalopathy,BSE)病毒与目前在英国发现的一种新型的人防病毒(vCJDV),是同一种病毒。     

Protein folding pathology in domestic animals

Fibrillar proteins form structural elements of cells and the extracellular matrix. Pathological lesions of fibrillar microanatomical structures, or secondary fibrillar changes in globular proteins are well known. A special group concerns histologically amorphous deposits, amyloid. The major characteristics of amyloid are: apple green birefringence after Congo red staining of histological sections, and non-branching 7-10 nm thick fibrils on electron microscopy revealing a high content of cross beta pleated sheets. About 25 different types of amyloid have been characterised. In animals,AA-amyloid is the most frequent type. Other types of amyloid in animals represent: AIAPP (in cats), AApoAⅠ, AApoAⅡ,localised AL-amyloid, amyloid in odontogenic or mammary tumors and amyloid in the brain. In old dogs Aβ and in sheep APrPsc-amyloid can be encountered. AA-amyloidosis is a systemic disorder with a precursor in blood, acute phase serum amyloid A (SAA). In chronic inflammatory processes AA-amyloid can be deposited. A rapid crystallization of SAA to shown to penetrate the enteric barrier. Amyloid fibrils can aggregate from various precursor proteins in vitro in particular at acidic pH and when proteolytic fragments are formed. Molecular chaperones influence this process. Tissue data point to amyloid fibrillogenesis in lysosomes and near cell surfaces. A comparison can be made of the fibrillogenesis in prion diseases and in enhanced AA-amyloidosis. In the reactive form, acute phase SAA is the supply of the precursor protein,whereas in tho prion diseases, cell membrane proteins form a structural source. Aβ-amyloid in brain tissue of aged dogs showing signs of dementia forms a canine counterpart of senile dementia of the Alzheimer type (ccSDAT) in man. Misfolded proteins remain potential food hazards. Developments concerning prevention of amyloidogenesis and therapy of amyloid deposits are shortly commented.     

Should Kids Play (American) Football?

In recent years, Pop Warner, the world’s largest youth football organization, has seen its numbers decline. This decline is due to concerns about new research establishing a link between football and chronic traumatic encephalopathy, a debilitating neurodegenerative disease. Hundreds of thousands of parents are now struggling with a difficult ethical issue: should kids play football? Since parents have an obligation to help children develop the capacities required for autonomous choice, the risks posed by football establish a strong presumption against allowing kids to play the game. I consider whether this presumption can be defeated by the arguments for allowing kids to play dangerous sports offered by John Russell in his papers ’The Value of Dangerous Sport’ and ‘Children and Dangerous Sport and Recreation’. While Russell does not argue that kids should be permitted to play football, and agrees that some sports may be too risky for children, he argues that kids should often be allowed to participate in extraordinarily risky sports. I contend that the reasons given in support of this position fail to defeat the presumption against allowing kids to play football. Thus, in the absence of further argument, or radical changes to the game, children should not play football.     

Wernicke encephalopathy following splenectomy in a patient with liver cirrhosis: a case report and review of the literature

Objective  

To report a case of Wernicke encephalopathy in the early stage after surgery.     

Review:Protein folding pathology in domestic animals

Fibrillar proteins form structural elements of cells and the extracellular matrix. Pathological lesions of fibrillar microanatomical structures, or secondary fibrillar changes in globular proteins are well known. A special group concerns histologically amorphous deposits, amyloid. The major characteristics of amyloid are: apple green birefringence after Congo red staining of histological sections, and non-branching 7-10 nm thick fibrils on electron microscopy revealing a high content of cross beta pleated sheets. About 25 different types of amyloid have been characterised. In animals, AA-amyloid is the most frequent type. Other types of amyloid in animals represent: AIAPP (in cats), AApoAI, AApoAII, localised AL-amyloid, amyloid in odontogenic or mammary tumors and amyloid in the brain. In old dogs Ap and in sheep APrPsc-amyloid can be encountered. AA-amyloidosis is a systemic disorder with a precursor in blood, acute phase serum amyloid A (SAA). In chronic inflammatory processes AA-amyloid can be depos     

脱髓鞘脑病的临床与病理(附70例分析)

目的：探讨脱髓鞘脑病的临床与病理特点。方法：对70例脱髓鞘脑病患者的临床与5例病理资料进行分析。结果：本组脱髓鞘脑病患者的临床特点：急性或亚急性病程(97．1％)，65％为青壮年，表现为弥漫性脑损害，尤以早期的精神障碍(74．1％)和运动障碍(84．2％)突出。影像学改变为全脑白质多处不规则病灶。其病理学特点为：小血管周围脱髓鞘破坏、脱失，并有血管周围的炎性细胞的袖套状浸润。结论：脱髓鞘脑病属于炎症性脱髓鞘疾病，其诊断依靠临床与影像学检查，脑活检为鉴别诊断提供主要依据。