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Brain-derived extracellular vesicles:A promising avenue for Parkinson's disease pathogenesis,diagnosis,and treatment
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作者 Shurui Zhang Jingwen Li +7 位作者 Xinyu Hu Hanshu Liu Qinwei Yu Guiying Kuang Long Liu Danfang Yu Zhicheng Lin Nian Xiong 《Neural Regeneration Research》 2026年第4期1447-1467,共21页
The misfolding,aggregation,and deposition of alpha-synuclein into Lewy bodies are pivotal events that trigger pathological changes in Parkinson's disease.Extracellular vesicles are nanosized lipidbilayer vesicles ... The misfolding,aggregation,and deposition of alpha-synuclein into Lewy bodies are pivotal events that trigger pathological changes in Parkinson's disease.Extracellular vesicles are nanosized lipidbilayer vesicles secreted by cells that play a crucial role in intercellular communication due to their diverse cargo.Among these,brain-derived extracellular vesicles,which are secreted by various brain cells such as neurons,glial cells,and Schwann cells,have garnered increasing attention.They serve as a promising tool for elucidating Parkinson's disease pathogenesis and for advancing diagnostic and therapeutic strategies.This review highlights the recent advancements in our understanding of brain-derived extracellular vesicles released into the blood and their role in the pathogenesis of Parkinson's disease,with specific emphasis on their involvement in the aggregation and spread of alpha-synuclein.Brain-derived extracellular vesicles contribute to disease progression through multiple mechanisms,including autophagy-lysosome dysfunction,neuroinflammation,and oxidative stress,collectively driving neurodegeneration in Parkinson's disease.Their application in Parkinson's disease diagnosis is a primary focus of this review.Recent studies have demonstrated that brainderived extracellular vesicles can be isolated from peripheral blood samples,as they carryα-synuclein and other key biomarkers such as DJ-1 and various micro RNAs.These findings highlight the potential of brain-derived extracellular vesicles,not only for the early diagnosis of Parkinson's disease but also for disease progression monitoring and differential diagnosis.Additionally,an overview of explorations into the potential therapeutic applications of brain-derived extracellular vesicles for Parkinson's disease is provided.Therapeutic strategies targeting brain-derived extracellular vesicles involve modulating the release and uptake of pathological alpha-synuclein-containing brain-derived extracellular vesicles to inhibit the spread of the protein.Moreover,brain-derived extracellular vesicles show immense promise as therapeutic delivery vehicles capable of transporting drugs into the central nervous system.Importantly,brain-derived extracellular vesicles also play a crucial role in neural regeneration by promoting neuronal protection,supporting axonal regeneration,and facilitating myelin repair,further enhancing their therapeutic potential in Parkinson's disease and other neurological disorders.Further clarification is needed of the methods for identifying and extracting brain-derived extracellular vesicles,and large-scale cohort studies are necessary to validate the accuracy and specificity of these biomarkers.Future research should focus on systematically elucidating the unique mechanistic roles of brain-derived extracellular vesicles,as well as their distinct advantages in the clinical translation of methods for early detection and therapeutic development. 展开更多
关键词 ALPHA-SYNUCLEIN biomarker brain-derived extracellular vesicles DIAGNOSIS EXOSOME extracellular vesicles nerve regeneration Parkinson's disease PATHOGENESIS therapeutics
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Low-density lipoprotein receptor–related protein 1 mediatesα-synuclein transmission from the striatum to the substantia nigra in animal models of Parkinson's disease
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作者 Hanjiang Luo Caixia Peng +5 位作者 Chengli Wu Chengwei Liu Qinghua Li Shun Yu Jia Liu Min Chen 《Neural Regeneration Research》 2026年第4期1595-1606,共12页
α-Synuclein accumulation and transmission are vital to the pathogenesis of Parkinson's disease,although the mechanisms underlying misfoldedα-synuclein accumulation and propagation have not been conclusively dete... α-Synuclein accumulation and transmission are vital to the pathogenesis of Parkinson's disease,although the mechanisms underlying misfoldedα-synuclein accumulation and propagation have not been conclusively determined.The expression of low-density lipoprotein receptor–related protein 1,which is abundantly expressed in neurons and considered to be a multifunctional endocytic receptor,is elevated in the neurons of patients with Parkinson's disease.However,whether there is a direct link between low-density lipoprotein receptor–related protein 1 andα-synuclein aggregation and propagation in Parkinson's disease remains unclear.Here,we established animal models of Parkinson's disease by inoculating monkeys and mice withα-synuclein pre-formed fibrils and observed elevated low-density lipoprotein receptor–related protein 1 levels in the striatum and substantia nigra,accompanied by dopaminergic neuron loss and increasedα-synuclein levels.However,low-density lipoprotein receptor–related protein 1 knockdown efficiently rescued dopaminergic neurodegeneration and inhibited the increase inα-synuclein levels in the nigrostriatal system.In HEK293A cells overexpressingα-synuclein fragments,low-density lipoprotein receptor–related protein 1 levels were upregulated only when the N-terminus ofα-synuclein was present,whereas anα-synuclein fragment lacking the N-terminus did not lead to low-density lipoprotein receptor–related protein 1 upregulation.Furthermore,the N-terminus ofα-synuclein was found to be rich in lysine residues,and blocking lysine residues in PC12 cells treated withα-synuclein pre-formed fibrils effectively reduced the elevated low-density lipoprotein receptor–related protein 1 andα-synuclein levels.These findings indicate that low-density lipoprotein receptor–related protein 1 regulates pathological transmission ofα-synuclein from the striatum to the substantia nigra in the nigrostriatal system via lysine residues in theα-synuclein N-terminus. 展开更多
关键词 Α-SYNUCLEIN dopaminergic neurodegeneration INTERNALIZATION low-density lipoprotein receptor-related protein 1 lysine pre-formed fibril movement disorder nigrostriatal system Parkinson's disease TRANSMISSION
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A radiomics approach for predicting gait freezing in Parkinson's disease based on resting-state functional magnetic resonance imaging indices:A cross-sectional study
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作者 Miaoran Guo Hu Liu +6 位作者 Long Gao Hongmei Yu Yan Ren Yingmei Li Huaguang Yang Chenghao Cao Guoguang Fan 《Neural Regeneration Research》 2026年第4期1621-1627,共7页
Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indice... Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease. 展开更多
关键词 amplitude of low-frequency fluctuation degree centrality feedforward neural network freezing of gait machine learning parahippocampal gyrus Parkinson's disease receiver operating characteristic regional homogeneity resting-state functional magnetic resonance imaging
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Hydrogen sulfide reduces oxidative stress in Huntington's disease via Nrf2 被引量:2
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作者 Zige Jiang Dexiang Liu +7 位作者 Tingting Li Chengcheng Gai Danqing Xin Yijing Zhao Yan Song Yahong Cheng Tong Li Zhen Wang 《Neural Regeneration Research》 SCIE CAS 2025年第6期1776-1788,共13页
The pathophysiology of Huntington's disease involves high levels of the neurotoxin quinolinic acid. Quinolinic acid accumulation results in oxidative stress, which leads to neurotoxicity. However, the molecular an... The pathophysiology of Huntington's disease involves high levels of the neurotoxin quinolinic acid. Quinolinic acid accumulation results in oxidative stress, which leads to neurotoxicity. However, the molecular and cellular mechanisms by which quinolinic acid contributes to Huntington's disease pathology remain unknown. In this study, we established in vitro and in vivo models of Huntington's disease by administering quinolinic acid to the PC12 neuronal cell line and the striatum of mice, respectively. We observed a decrease in the levels of hydrogen sulfide in both PC12 cells and mouse serum, which was accompanied by down-regulation of cystathionine β-synthase, an enzyme responsible for hydrogen sulfide production. However, treatment with NaHS(a hydrogen sulfide donor) increased hydrogen sulfide levels in the neurons and in mouse serum, as well as cystathionine β-synthase expression in the neurons and the mouse striatum, while also improving oxidative imbalance and mitochondrial dysfunction in PC12 cells and the mouse striatum. These beneficial effects correlated with upregulation of nuclear factor erythroid 2-related factor 2 expression. Finally, treatment with the nuclear factor erythroid 2-related factor 2inhibitor ML385 reversed the beneficial impact of exogenous hydrogen sulfide on quinolinic acid-induced oxidative stress. Taken together, our findings show that hydrogen sulfide reduces oxidative stress in Huntington's disease by activating nuclear factor erythroid 2-related factor 2,suggesting that hydrogen sulfide is a novel neuroprotective drug candidate for treating patients with Huntington's disease. 展开更多
关键词 apoptosis CYSTATHIONINE-Β-SYNTHASE nuclear factor erythroid 2-related factor 2 Huntington's disease hydrogen sulfide MITOCHONDRION NEUROPLASTICITY oxidative stress quinolinic acid reactive oxygen species
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DMPS驱铜联合甲泼尼龙治疗DWI高信号脑型Wilson病患者的疗效观察
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作者 李瑶瑶 胡文彬 +9 位作者 苏贝晴 刘娅 严彦 吴君霞 孙权 徐银 喻绪恩 王训 胡纪源 韩咏竹 《安徽医学》 2025年第6期689-695,共7页
目的探讨二巯丙磺酸钠(DMPS)常规驱铜疗法和DMPS驱铜联合甲泼尼龙琥珀酸钠(MPS)治疗磁共振弥散加权成像(DWI)高信号的脑型Wilson病(WD)患者临床疗效的差异。方法回顾性分析2023年1月至2024年12月在安徽中医药大学神经病学研究所附属医... 目的探讨二巯丙磺酸钠(DMPS)常规驱铜疗法和DMPS驱铜联合甲泼尼龙琥珀酸钠(MPS)治疗磁共振弥散加权成像(DWI)高信号的脑型Wilson病(WD)患者临床疗效的差异。方法回顾性分析2023年1月至2024年12月在安徽中医药大学神经病学研究所附属医院住院诊治的磁共振DWI高信号的70例脑型WD患者临床资料,依据治疗方式分为使用DMPS常规驱铜治疗的对照组(n=40),以及DMPS常规驱铜治疗基础上加用MPS治疗的观察组(n=30)。两组患者均驱铜治疗8个疗程,每个疗程为8 d。比较两组患者治疗前后改良版中文统一WD等级评定量表-神经障碍(UWDRS-Ⅰ)和改良版中文统一WD等级评定量表-精神障碍(UWDRS-Ⅲ)评分,24 h尿铜、同型半胱氨酸以及血常规、肝肾功能等临床指标。结果治疗前两组患者UWDRS-Ⅰ评分、UWDRS-Ⅲ评分、24 h尿铜,以及血常规、同型半胱氨酸、肝肾功能和头颅磁共振DWI高信号部位的比较,差异无统计学意义(P>0.05)。与治疗前相比,疗程后两组患者的组内UWDRS-Ⅰ与UWDRS-Ⅲ评分、同型半胱氨酸指标均有明显改善,24 h尿铜均明显增加(P<0.05);观察组的总胆红素和清蛋白指标均改善(P<0.05)。与对照组比较,观察组患者治疗前后UWDRS-Ⅰ与UWDRS-Ⅲ评分、清蛋白指标均明显改善,并且24 h尿铜增加明显(P<0.05)。结论使用DMPS驱铜联合MPS方案治疗DWI高信号脑型WD患者的疗效更佳,可有效地改善患者的神经精神症状及部分临床检验指标。 展开更多
关键词 WILSON病 弥散加权成像 统一WD等级评定量表 甲泼尼龙琥珀酸钠 二巯丙磺酸钠 铜代谢
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特发性震颤小鼠下橄榄核线粒体形态与神经元类型的关联
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作者 倪子薇 刘慧 +4 位作者 铁静静 刘勃志 吴菲菲 王亚云 阮彩莲 《神经解剖学杂志》 北大核心 2025年第2期131-140,共10页
目的:探究特发性震颤(ET)对下橄榄核(IO)中γ-氨基丁酸能(GABAergic)神经元和谷氨酸能(glutamatergic)神经元线粒体形态的影响。方法:利用哈马灵进行ET模型小鼠的制备,将12只8周龄雄性C57BL/6J小鼠随机分为生理盐水对照组和哈马灵处理组... 目的:探究特发性震颤(ET)对下橄榄核(IO)中γ-氨基丁酸能(GABAergic)神经元和谷氨酸能(glutamatergic)神经元线粒体形态的影响。方法:利用哈马灵进行ET模型小鼠的制备,将12只8周龄雄性C57BL/6J小鼠随机分为生理盐水对照组和哈马灵处理组(HA),采用旷场实验、转棒实验、平衡木实验和震颤评分进行小鼠行为学检测。利用转基因技术CRISPR/Cas9系统设计和制备6只8周龄雄性GAD2-Mito-GFP小鼠和6只8周龄雄性VGLUT2-Mito-GFP小鼠,两种鼠均随机分为对照组及HA组。采用免疫荧光染色技术分析对照组和HA组小鼠IO内c-FOS阳性细胞的表达情况并区分神经元类型;运用线粒体网络分析(MiNA)对ET状态中IO脑区不同类型神经元线粒体的面积、平均纵横比和分支长度等指标进行定量分析。结果:与对照组相比,HA组小鼠表现出运动异常和明显震颤;免疫荧光染色结果显示IO内c-FOS阳性细胞显著增加,主要为GABA能神经元。MiNA结果显示,GABA能神经元的线粒体面积增大,分支长度和直径增加,形态不规则。结论:ET会引起IO内GABA能神经元激活,并表现出更显著的线粒体形态学变化。为进一步研究ET的发病机制及其与线粒体的关系提供了新的视角。 展开更多
关键词 特发性震颤(ET) 下橄榄核(IO) 线粒体 哈马灵 小鼠
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多模态MRI在威尔逊病相关认知障碍的研究进展
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作者 张晓枫 王斐 +2 位作者 陆韻宜 王静(综述) 马立恒(审校) 《临床放射学杂志》 北大核心 2025年第8期1554-1558,共5页
威尔逊病(Wilson disease,WD),是一种由常染色体ATP7B[1]突变引起的铜代谢异常隐性遗传病,导致铜在脑、肝、角膜(K-F环)[2]等多组织中积聚,继而造成器官损伤,其中脑部损伤病理特征是脱髓鞘、星形胶质细胞增生、脑桥中央髓鞘溶解、空化[3... 威尔逊病(Wilson disease,WD),是一种由常染色体ATP7B[1]突变引起的铜代谢异常隐性遗传病,导致铜在脑、肝、角膜(K-F环)[2]等多组织中积聚,继而造成器官损伤,其中脑部损伤病理特征是脱髓鞘、星形胶质细胞增生、脑桥中央髓鞘溶解、空化[3]。根据临床症状可分为肝性(H-WD)和有神经症状(N-WD)的神经型和混合型。H-WD患者主要发展为肝硬化。N-WD中高达60%的患者在发病时常伴有神经或精神症状[4],表现为认知障碍[5]及锥体外系症状。认知障碍虽常见,但通常较轻[6]。其包含多领域,如抽象推理、执行功能、记忆、处理速度、视觉空间功能和社会认知等功能均可能受到影响[5,7,8]。认知障碍多终身存在,若不及时治疗,将严重影响生活质量[9]。 展开更多
关键词 多模态MRI 认知障碍 铜代谢异常 威尔逊病
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亨廷顿舞蹈症中星形胶质细胞转录异质性分析
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作者 陈贝宁 杨清湖 +1 位作者 袁增强 郭兴 《南京医科大学学报(自然科学版)》 北大核心 2025年第4期487-497,587,共12页
目的:解析亨廷顿舞蹈症(Huntington’s disease,HD)病程中小鼠大脑内星形胶质细胞活化状态及转录异质性,筛选和鉴定HD病程相关的核心基因。方法:利用免疫荧光考察HD病程早期和后期星形胶质细胞的激活情况,采用RT-qPCR分析星形胶质细胞... 目的:解析亨廷顿舞蹈症(Huntington’s disease,HD)病程中小鼠大脑内星形胶质细胞活化状态及转录异质性,筛选和鉴定HD病程相关的核心基因。方法:利用免疫荧光考察HD病程早期和后期星形胶质细胞的激活情况,采用RT-qPCR分析星形胶质细胞激活表型;利用单细胞解离和磁珠分选技术分离小鼠脑星形胶质细胞,进行转录组学测序;结合生物信息学分析,分别对HD早期和后期转录组学数据进行差异表达基因(differentially expressed genes,DEG)及基因本体论(Gene Ontology,GO)功能富集分析;筛选HD病程相关基因进行蛋白质相互作用(protein-protein interaction,PPI)网络分析,并验证核心基因的表达。结果:在HD病程后期,星形胶质细胞转变为A1型反应性星形胶质细胞;病程早期,HD小鼠星形胶质细胞的差异基因主要与突触间隙和突触结构维持等突触相关功能有关,而病程后期则主要涉及趋化活性、信号转导和细胞响应等功能;最后,HD病程中星形胶质细胞的核心基因功能主要体现在血管发生、RNA剪接与代谢以及肌肉运动方面。结论:HD病程早期星形胶质细胞影响神经元发育和突触形成,病程后期星形胶质细胞转变为具有神经毒性的A1型反应性星形胶质细胞;排除衰老过程影响的星形胶质细胞异质性基因可作为HD病理进展和预测的有效分子标志物,这有望为HD早期发现和诊疗提供新的实验证据。 展开更多
关键词 亨廷顿舞蹈症 星形胶质细胞 转录组学
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1例肝豆状核变性家系报告分析:依从性与预后之间相关性
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作者 杨慧琳 廖金卯 +1 位作者 杨慧明 张征 《肝脏》 2025年第2期276-278,共3页
病例1:先证者。患者,男性,20岁。16年前第一次入我院儿科确诊肝豆状核变性,后间断至医院复诊,给予驱铜、护肝等对症治疗,目前服用青霉胺(500 mg/d)。2022年12月21日患者因“眼黄1周”第二次入我院。查体:全身皮肤巩膜轻度黄染,腹部平坦... 病例1:先证者。患者,男性,20岁。16年前第一次入我院儿科确诊肝豆状核变性,后间断至医院复诊,给予驱铜、护肝等对症治疗,目前服用青霉胺(500 mg/d)。2022年12月21日患者因“眼黄1周”第二次入我院。查体:全身皮肤巩膜轻度黄染,腹部平坦,腹部移动性浊音可疑阳性。 展开更多
关键词 肝豆状核变性 基因突变 预后
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脑白质病变与阿尔茨海默病的研究进展 被引量:1
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作者 薛清 赵丰丽 《中国实用神经疾病杂志》 2025年第4期508-513,共6页
阿尔茨海默病(AD)是以进行性认知功能减退和行为损害为特征的神经退行性疾病系统,是老年最常见的痴呆类型。以往对AD的研究大多集中在大脑灰质的改变,而对大脑白质的关注较少。随着影像学技术的发展,脑白质微观结构的变化可能成为AD早... 阿尔茨海默病(AD)是以进行性认知功能减退和行为损害为特征的神经退行性疾病系统,是老年最常见的痴呆类型。以往对AD的研究大多集中在大脑灰质的改变,而对大脑白质的关注较少。随着影像学技术的发展,脑白质微观结构的变化可能成为AD早期生物标志物,预测AD的进展。本文分析了脑白质病变与AD患者认知功能、精神行为和日常生活能力之间的关联,探讨脑白质病变对AD的影响。 展开更多
关键词 阿尔茨海默病 脑白质病变 生物标志物 弥散张量成像 认知障碍
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Brain-derived neurotrophic factor plays with TRiC:focus on synaptic dysfunction in Huntington’s disease
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作者 Yingli Gu Kijung Sung Chengbiao Wu 《Neural Regeneration Research》 SCIE CAS 2025年第10期2919-2920,共2页
Brain-derived neurotrophic factor(BDNF)exerts pleiotropic effects on brain processes including psychiatric disorders,aging,neurodegeneration,and metabolic homeostasis.A simple PubMed search using the key word“BDNF,”... Brain-derived neurotrophic factor(BDNF)exerts pleiotropic effects on brain processes including psychiatric disorders,aging,neurodegeneration,and metabolic homeostasis.A simple PubMed search using the key word“BDNF,”to date,yields over 33,000 publications.From fundamental biology to potential therapeutic applications,BDNF has clearly garnered extensive and significant attention in the field of neurobiology research. 展开更多
关键词 HUNTINGTON HOMEOSTASIS THERAPEUTIC
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Glial response in the midcingulate cortex in Huntington’s disease
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作者 Thulani H.Palpagama Andrea Kwakowsky 《Neural Regeneration Research》 SCIE CAS 2025年第1期207-208,共2页
Huntington’s disease(HD)is a genetic disease characterized by the progressive degeneration of the striatum and cortex.Patients can present with a variety of symptoms that can broadly be classified into motor symptoms... Huntington’s disease(HD)is a genetic disease characterized by the progressive degeneration of the striatum and cortex.Patients can present with a variety of symptoms that can broadly be classified into motor symptoms,inclusive of choreatic movements and rigidity,mood and psychiatric symptoms,such as depression and apathy,and cognitive symptoms,such as cognitive decline.The causal mutation underlying HD results from an expansion of a CAG repeat sequence on the IT15 gene,resulting in the formation and accumulation of a mutant huntingtin protein. 展开更多
关键词 HUNTINGTON DEGENERATION CORTEX
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Neuroinflammation as a therapeutic target in Huntington's disease
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作者 Andrea Kwakowsky Thulani H.Palpagama 《Neural Regeneration Research》 SCIE CAS 2025年第3期817-818,共2页
In 1872, George Huntington presented his essay “On Chorea” to the Meigs and Mason Academy of Medicine and, in doing so, detailed a disease that would later bear his name. Huntington's disease(HD) is a genetic, n... In 1872, George Huntington presented his essay “On Chorea” to the Meigs and Mason Academy of Medicine and, in doing so, detailed a disease that would later bear his name. Huntington's disease(HD) is a genetic, neurodegenerative disease that manifests as the loss of motor control,cognitive impairment,and mood and psychiatric changes in paents. 展开更多
关键词 HUNTINGTON INFLAMMATION MEDICINE
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联合评估在急诊分级分诊中的应用 被引量:14
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作者 王蕾 谢小华 +6 位作者 陈晖 李嘉辉 彭刚刚 古楚旋 黄文龙 张剑 荣慧萍 《护理研究》 北大核心 2018年第6期933-935,共3页
[目的]探讨联合常规评估分诊法、改良早期预警评分法(MEWS)与疼痛数字评分量表(NRS)在急诊分级分诊中的应用效果。[方法]抽取我院475例急诊就诊病例,记录病例主诉、各项评估指标及经校准的分诊级别,将病例所有评估指标由2名护士采用常规... [目的]探讨联合常规评估分诊法、改良早期预警评分法(MEWS)与疼痛数字评分量表(NRS)在急诊分级分诊中的应用效果。[方法]抽取我院475例急诊就诊病例,记录病例主诉、各项评估指标及经校准的分诊级别,将病例所有评估指标由2名护士采用常规法(A组)、常规法+MEWS(B组)、常规法+MEWS+NRS(C组)分别进行再次病情分级,将再次分级结果与校准分级结果进行比较,计算3种方法分级结果的准确率、漏检率及判别病情差异性。[结果]2名护士采用C组方法分级的准确率(85.47%,82.53%)均高于A组法(82.11%,80.21%)和B组法(70.95%,77.05%)(P<0.05);3组方法对病情的判别结果存在差异。[结论]联合评估能更好地反映病情严重程度,在完善分诊评估内容的同时进一步提高急诊分级分诊准确率。 展开更多
关键词 联合评估 急诊 分级分诊 准确率 漏检率 改良早期预警评分 数字疼痛评分量表
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阵发性运动源性舞蹈手足徐动症的临床分析 被引量:7
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作者 王向波 蒋景文 +4 位作者 王新德 匡培根 朱克 龙洁 李军杰 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2003年第5期342-344,共3页
目的 探讨阵发性运动源性舞蹈手足徐动症的临床特征、诊断和治疗。方法 观察 15例PKC病人的临床表现 (2例做了录像 ) ,进行EEG、CT、MR等辅助检查 ,均用卡马西平治疗并观察其转归。结果 本组 15例中 ,男 13例、女 2例 (男∶女 =6.5∶... 目的 探讨阵发性运动源性舞蹈手足徐动症的临床特征、诊断和治疗。方法 观察 15例PKC病人的临床表现 (2例做了录像 ) ,进行EEG、CT、MR等辅助检查 ,均用卡马西平治疗并观察其转归。结果 本组 15例中 ,男 13例、女 2例 (男∶女 =6.5∶1) ,发病年龄 8~ 2 2岁 ,平均 11.4岁。生活环境及家族史 :本组 13例病人主要分布在中国东北部地区 (13 /15 ) ,14例无家族史 ,1例有家族史。临床突出表现为发作性一侧肢体的肌张力障碍和异动症 ,多数持续 10~ 3 0s(一般 <5min) ,每天发作 4~ 3 0次。均有明显的诱发因素 :紧张时或突发运动 (要跑步和突然站立 )时容易发作。头颅MR、CT、EEG、2 4小时EEG、视频EEG、肌电图 (EMG)等辅助检查均无异常发现。小剂量卡马西平可使症状完全消失 ,0 .0 5~ 0 .1g/d维持治疗 ,10例随访 1~ 1 5年无发作。结论 PKC是以运动诱发的表现为舞蹈样手足徐动症等肌张力障碍为特征的良性疾病 ,有异于癔病和神经症的发作特征 ,卡马西平能有效控制其发作。 展开更多
关键词 阵发性运动源性舞蹈手足徐动症 临床特征 诊断 治疗 临床分析 EEG CT MR 卡马西平
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少年型亨廷顿病临床与基因突变分析 被引量:6
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作者 郝莹 陈园园 +6 位作者 顾卫红 王国相 马惠姿 李丽林 王康 金淼 段晓慧 《中国现代神经疾病杂志》 CAS 2012年第3期288-293,共6页
研究背景亨廷顿病是一种常染色体显性遗传性神经系统退行性疾病,临床主要表现为舞蹈样动作、进行性认知功能减退及精神症状,神经影像学检查显示尾状核和大脑皮质萎缩。其致病基因IT15定位于4p16.3,由67个外显子组成编码亨廷顿蛋白,在其... 研究背景亨廷顿病是一种常染色体显性遗传性神经系统退行性疾病,临床主要表现为舞蹈样动作、进行性认知功能减退及精神症状,神经影像学检查显示尾状核和大脑皮质萎缩。其致病基因IT15定位于4p16.3,由67个外显子组成编码亨廷顿蛋白,在其第1个外显子内存在一段多态胞嘧啶腺嘌呤鸟嘌呤(CAG)三核苷酸重复序列,正常范围为6~35次、异常36~250次。亨廷顿病多于成年期发病,具有外显不完全和延迟外显现象,而青少年型亨廷顿病临床较为少见。本研究针对一例少年期发病的亨廷顿病患者临床表型及其家系IT15基因CAG重复动态突变特征进行细致分析。方法采用聚合酶链反应结合荧光标记毛细管电泳片段分析方法,对115例临床拟诊为亨廷顿病家系的先证者进行IT15基因CAG重复次数分析,经pMD18T载体克隆测序验证部分阳性或携带中间重复等位基因的样本。结果经基因分析共发现109例患者携带异常扩展的IT15基因CAG重复序列,其中一例为少年期发病患者,临床以认知功能障碍和运动功能减退为首发症状,其父母临床表型正常。基因片段分析显示,患者IT15基因CAG重复次数为15/68次;其父母分别为17/37次和15/17次。结论 (1)少年期发病的亨廷顿病与成年型临床表型不同,后者临床表现以舞蹈样运动、智能减退和精神异常为主,而少年型患者大多以认知功能障碍发病。(2)IT15基因扩展CAG重复序列在代间传递过程中会出现动态突变,引起发病年龄逐代提前,症状加重,即遗传早现。该家系患者之父携带中间等位基因37次重复,遗传给患者成为68次重复,在代间传递过程中发生了大幅度扩展,使CAG三核苷酸重复次数增加了31次,提示重复序列在父系遗传更不稳定。 展开更多
关键词 多态现象 遗传 杭廷顿病 核苷酸类 重复序列 核酸 青少年
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帕金森病患者生存质量及影响因素分析 被引量:10
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作者 高忠明 何吉庆 +2 位作者 姜海波 卢晓东 王小川 《中国慢性病预防与控制》 CAS 2016年第10期770-772,共3页
目的了解帕金森病患者的生存质量并探讨相关影响因素,为提高帕金森病患者的生存质量提供依据。方法选取2014年1月至2016年2月在我院神经内科门诊及住院治疗的原发性帕金森病患者89例做为研究对象,对照组90例选自在我院与病例相应时间段... 目的了解帕金森病患者的生存质量并探讨相关影响因素,为提高帕金森病患者的生存质量提供依据。方法选取2014年1月至2016年2月在我院神经内科门诊及住院治疗的原发性帕金森病患者89例做为研究对象,对照组90例选自在我院与病例相应时间段健康体检人员。采用中文版39项生存质量量表(PDQ-39)进行生存质量调查,同时结合改良Hoehn-Yahr(H-Y)分级量表、睡眠量表(PDSS)、汉密尔顿抑郁量表(HAMD)和焦虑量表(HAMA)评估帕金森病患者焦虑、抑郁程度以及睡眠质量。用SPSS 17.0软件对不同特征的帕金森病患者的生存质量评分进行统计分析,用逐步多元回归分析筛选影响帕金森病患者生存质量的相关因素。结果帕金森病患者在运动、日常活动能力、情感、耻辱感、社会支持、认知、交流、身体不适8个维度的得分均明显高于对照组,差异均有统计学意义(P<0.01);单因素及多元线性回归分析均显示,年龄、病程、病情分级、抑郁程度、焦虑程度和睡眠质量均影响帕金森病患者的生存质量得分。结论对于帕金森病患者更要注意焦虑、抑郁和睡眠质量等非运动症状对生存质量的影响。 展开更多
关键词 帕金森病 生存质量 抑郁 焦虑 睡眠障碍
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非酮症性高血糖合并偏侧舞蹈症的临床及影像学表现 被引量:25
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作者 马爱军 张本恕 +2 位作者 任华 王育新 洪雁 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2007年第11期700-701,共2页
关键词 非酮症性高血糖 偏侧舞蹈症
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舞蹈病-棘红细胞增多症 被引量:9
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作者 刘彩燕 高晶 +3 位作者 杨荫昌 崔丽 万新华 葛昌文 《中国现代神经疾病杂志》 CAS 2005年第3期175-178,共4页
目的回顾1例舞蹈病-棘红细胞增多症患者的诊断与治疗过程,以了解其临床特点。方法与结果32岁男性患者,因双上肢不自主运动加重,伴发作性意识丧失、行走不稳11年就诊。体格检查:双上肢不自主运动,右上肢舞蹈样运动,左手呈静止性震颤,行... 目的回顾1例舞蹈病-棘红细胞增多症患者的诊断与治疗过程,以了解其临床特点。方法与结果32岁男性患者,因双上肢不自主运动加重,伴发作性意识丧失、行走不稳11年就诊。体格检查:双上肢不自主运动,右上肢舞蹈样运动,左手呈静止性震颤,行走时躯干及下肢向右侧扭转,站立时脚趾不自主运动。肌张力偏低,四肢腱反射偏低。右侧指鼻试验略欠稳准,存在意向性震颤;双手轮替试验笨拙。智商评分为78分,焦虑、抑郁量表评分均于正常值范围。实验室检查:外周血涂片Giemsa染色棘红细胞占8%。透射扫描电子显微镜显示红细胞表面棘状突起。谷氨酰氨基转移酶29U/L,天冬氨酸氨基转移酶37U/L,血肌酸磷酸激酶1787U/L,乳酸脱氢酶295U/L,α-羟丁酸脱氢酶231U/L,脂蛋白(A)504mg/L,其余各项指标均于正常范围内。MR检查显示,双侧尾状核头萎缩明显,双侧侧脑室前角明显增宽。脑电图检查颞叶呈异常电活动。肌电图显示,上下肢周围神经源性损害,右侧正中神经感觉传导速度下降20%,波幅下降80%。临床拟诊为舞蹈病-棘红细胞增多症。经氟哌丁醇、维生素B和维生素E治疗,症状明显改善。结论对于存在多种锥体外系症状的患者,应注意考虑舞蹈病-棘红细胞增多症。该病为一组神经系统综合征,共同的特点是锥体外系症状和棘红细胞增多,可通过血涂片、红? 展开更多
关键词 舞蹈病-棘红细胞增多症 显微镜检查 锥体外系 神经系统
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腔隙性脑梗死患者110例复发因素分析 被引量:8
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作者 区腾飞 潘速跃 +4 位作者 杨洁 李永鸿 巫碧佳 李荣 周庆昆 《广东医学》 CAS CSCD 北大核心 2013年第17期2688-2691,共4页
目的探讨腔隙性脑梗死复发的危险因素。方法跟踪随访首次住院并确诊为腔隙性脑梗死患者381例,除去4例出血性卒中患者,按缺血性卒中复发情况分为尚未复发组(267例)和复发组(110例),采用单因素分析和logistic回归分析各种复发的危险因素... 目的探讨腔隙性脑梗死复发的危险因素。方法跟踪随访首次住院并确诊为腔隙性脑梗死患者381例,除去4例出血性卒中患者,按缺血性卒中复发情况分为尚未复发组(267例)和复发组(110例),采用单因素分析和logistic回归分析各种复发的危险因素。结果 (1)随访期内,尚未复发组与复发组单因素分析比较,年龄、严重心律失常及其他心脏疾病、脑供血动脉狭窄(所有类型)、脑供血动脉狭窄(单纯责任血管)、缺血性脑白质病变、多发腔隙性脑梗死、糖尿病、高脂血症、高血压病、酗酒、ESRS等因素差异有统计学意义;(2)logistic多元回归分析结果显示,高血压病、脑供血动脉狭窄(单纯责任血管)或脑供血动脉狭窄(所有类型)、缺血性脑白质病变、多发腔隙性脑梗死等因素差异有统计学意义。结论腔隙性脑梗死复发是多种危险因素共同作用的结果,其中高血压病、脑供血动脉狭窄(尤其是责任血管)、缺血性脑白质病变、多发腔隙性脑梗死是独立危险因素,为预防腔隙性脑梗死复发,必须做好上述危险因素的二级预防。 展开更多
关键词 腔隙性脑梗死 脑动脉狭窄 缺血性脑白质病变
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