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The Portrait of the Teacher 《教师画像
Pub Date : 2023-02-27 DOI: 10.31579/2578-8868/266
I. V. Hubetova
A teacher... pictures of careless childhood, sounds of the first school bell, the first answer board and all the things that happened for the first time in one's life pop up in memory of almost every person by mentioning of this word. I had luck not only with the first schoolteacher, memories and warm feelings about her will remain in my heart forever, but also with my teacher and mentor in adult life, a teacher whom I can call a true friend. This is Yury Lvovich Kurako. You can talk about him forever. He is a complex personality, and also he is talented, artistic, extremely curious, full of ideas, stout-hearted, tender, sentimental and very strict. He is an artist of his own destiny, and therefore his identity is inexhaustible.
一个老师……提到这个词,几乎每个人都会想起童年无忧无虑的情景、学校的第一声铃声、第一块答题板,以及人生中第一次发生的所有事情。我很幸运,不仅有第一个学校老师,她的记忆和温暖的感觉将永远留在我的心中,而且还有我的老师和导师,一个我可以称之为真正的朋友的老师。我是Yury Lvovich Kurako。你可以一直谈论他。他是一个复杂的性格,他也有才华,艺术,非常好奇,充满想法,坚强,温柔,多愁善感,非常严格。他是自己命运的艺术家,因此他的身份是无穷无尽的。
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引用次数: 0
Update on Management of Symptomatic Carotid Stenosis 症状性颈动脉狭窄的治疗进展
Pub Date : 2023-02-27 DOI: 10.31579/2578-8868/256
Annu L Kurian, Brandon Lucke-Wold
Carotid artery stenosis (CAS) is one of the leading causes of cerebral ischemia and stroke.7 When plaque builds up in the internal carotid artery, it blocks blood flow to the brain. Oftentimes, this condition only comes to light after a patient experiences a stroke or stroke-like symptoms. When this occurs, cholesterol-lowering medications and blood thinners can help to increase blood flow to the brain. However, if the plaque is so large that it severely narrows the lumen of the artery, surgery may be required to restore blood flow to the brain. Patients with severe stenosis can undergo procedures such as carotid endarterectomies (CEA), stenting, and transcarotid artery revascularization (TCAR) for this purpose. In this review, we discuss these procedures and which patients warrant which type of intervention. We look at the pathophysiology of internal carotid artery stenosis and current treatment options, while highlighting emerging treatment options. This review aims to increase understanding of the management of symptomatic carotid artery stenosis as well as provide a groundwork for more innovative treatments.
颈动脉狭窄(CAS)是脑缺血和脑卒中的主要原因之一当斑块在颈内动脉积聚时,它会阻碍血液流向大脑。通常,这种情况只有在患者出现中风或类似中风的症状后才会暴露出来。当这种情况发生时,降低胆固醇的药物和血液稀释剂可以帮助增加流向大脑的血液。然而,如果斑块太大,严重使动脉管腔变窄,可能需要手术来恢复脑部的血液流动。严重狭窄的患者可为此进行颈动脉内膜切除术(CEA)、支架置入和经颈动脉重建术(TCAR)等手术。在这篇综述中,我们讨论了这些程序和哪些患者需要哪种类型的干预。我们着眼于颈内动脉狭窄的病理生理学和目前的治疗方案,同时强调新兴的治疗方案。本综述旨在提高对症状性颈动脉狭窄治疗的认识,并为更多的创新治疗提供基础。
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引用次数: 0
Microsurgical Treatment of a Giant Intracavernous Carotid Artery Aneurysm in a Pediatric Patient. Case Report and Literature Review 小儿巨颈动脉海绵内动脉瘤的显微外科治疗。病例报告及文献复习
Pub Date : 2023-02-27 DOI: 10.31579/2578-8868/255
Edgar Nathal
Introduction: Intracranial aneurysms in pediatric age represent 4 - 5% of all cases, and 20% are giant (>25mm). The main sites of occurrence are ICA and MCA; about 55% - 72.5% of cases present rupture and secondary SAH with a 10% - 23% mortality. Case Description: We report the case of a previously healthy nine-year-old woman that initiated severe right retroocular pain and holocraneal headache. Her relatives detected paresis of the III, IV, and VI cranial nerves three days later. After evaluation, an MRI showed the presence of a giant aneurysm in the cavernous portion of the internal carotid artery (ICA) with a mass effect. The patient was treated surgically through a high-flow bypass using a radial artery graft and trapping of the aneurysm. The patient had an uneventful postoperative course and was discharged three days after the operation to continue in follow-up at the outpatient clinic. Discussion: The options for treatment are endovascular treatment through flow diverters or stenting and coiling, with the risk of incomplete occlusion or thrombosis. On the other hand, the goal of surgery is the permanent occlusion through the proximal closure of the ICA if a balloon occlusion test shows good collateral circulation or by trapping the aneurysm combined with a high-flow bypass if the collateral circulation is not good or absent. Conclusion: Even when the surgical option was successful in this case, there is no consensus about the best treatment; the selection of the method to use in these aneurysms depends on the center´s experience when confronting this rare entity.
儿童颅内动脉瘤占所有病例的4 - 5%,其中20%为巨大动脉瘤(25mm)。主要发生部位为ICA和MCA;约55% - 72.5%的病例出现破裂和继发性SAH,死亡率为10% - 23%。病例描述:我们报告一个病例以前健康的九岁妇女,开始严重的右眼后疼痛和全方位头痛。三天后,患者亲属发现颅内三、四、六神经麻痹。经评估,MRI显示在颈内动脉(ICA)海绵状部分存在一个巨大的动脉瘤,并伴有肿块效应。患者通过手术治疗,通过桡动脉移植物和捕获动脉瘤的高流量旁路。患者术后过程顺利,术后3天出院,继续在门诊随访。讨论:治疗的选择是血管内治疗,通过血流分流器或支架置入和盘绕,有不完全闭塞或血栓形成的风险。另一方面,如果球囊闭塞试验显示侧支循环良好,则手术的目标是通过近端关闭ICA进行永久性闭塞;如果侧支循环不好或不存在,则通过捕获动脉瘤并进行高流量旁路手术。结论:即使该病例的手术选择成功,对于最佳治疗方法仍未达成共识;治疗这些动脉瘤的方法的选择取决于中心在面对这种罕见的实体时的经验。
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引用次数: 0
Alternative Splicing Changes in Human Aging Brain Samples 人类衰老大脑样本的选择性剪接变化
Pub Date : 2023-02-27 DOI: 10.31579/2578-8868/257
Lilach Soreq
Alternative splicing affects differential isoform generation from genes and may also affect the protein products cellular function. Targeted splicing analysis of exon array analysis of young compared to middle and old post mortem brain samples from 1,234 samples (a total of 10 brain regions) aged from 16 to over 100 allowed me to detect significant alternative splicing changes upon human aging. This kind of data may allow us to better understand the underlying molecular mechanisms.
选择性剪接影响基因差异异构体的产生,也可能影响蛋白质产物的细胞功能。对年龄在16岁至100岁以上的1234个样本(共10个脑区)的年轻人和中老年尸检脑样本进行外显子阵列分析,使我能够检测到人类衰老过程中显著的选择性剪接变化。这类数据可以让我们更好地理解潜在的分子机制。
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引用次数: 0
Arteriovenous Malformations: An Update on Models and Therapeutic Targets 动静脉畸形:最新的模型和治疗靶点
Pub Date : 2023-02-27 DOI: 10.31579/2578-8868/250
Stephan Quintin, John W Figg, Yusuf Mehkri, Chadwin O Hanna, Maxwell G Woolridge, Brandon Lucke-Wold
Arteriovenous malformations (AVMs) are an anomaly of the vascular system where feeding arteries are directly connected to the venous drainage network. While AVMs can arise anywhere in the body and have been described in most tissues, brain AVMs are of significant concern because of the risk of hemorrhage which carries significant morbidity and mortality. The prevalence of AVM's and the mechanisms underlying their formation are not well understood. For this reason, patients who undergo treatment for symptomatic AVM's remain at increased risk of subsequent bleeds and adverse outcomes. The cerebrovascular network is delicate and novel animal models continue to provide insight into its dynamics in the context of AVM's. As the molecular players in the formation of familial and sporadic AVM's are better understood, novel therapeutic approaches have been developed to mitigate their associated risks. Here we discuss the current literature surrounding AVM's including the development of models and therapeutic targets which are currently being investigated.
动静脉畸形(AVMs)是血管系统的一种异常,其中供血动脉直接连接到静脉引流网络。虽然动静脉畸形可以出现在身体的任何地方,并且在大多数组织中都有描述,但脑动静脉畸形是一个值得关注的问题,因为它有出血的风险,有很高的发病率和死亡率。AVM的患病率及其形成机制尚不清楚。因此,接受症状性AVM治疗的患者后续出血和不良后果的风险仍然增加。脑血管网络是微妙的,新的动物模型继续提供洞察其动态在AVM的背景下。随着家族性和散发性AVM形成的分子机制被更好地理解,新的治疗方法已经被开发出来以减轻其相关风险。在这里,我们讨论了目前关于AVM的文献,包括目前正在研究的模型和治疗靶点的发展。
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引用次数: 1
Update on Management of Symptomatic Carotid Stenosis. 症状性颈动脉狭窄的最新治疗方法。
Pub Date : 2023-01-01 Epub Date: 2023-01-27
Annu L Kurian, Brandon Lucke-Wold

Carotid artery stenosis (CAS) is one of the leading causes of cerebral ischemia and stroke.7 When plaque builds up in the internal carotid artery, it blocks blood flow to the brain. Oftentimes, this condition only comes to light after a patient experiences a stroke or stroke-like symptoms. When this occurs, cholesterol-lowering medications and blood thinners can help to increase blood flow to the brain. However, if the plaque is so large that it severely narrows the lumen of the artery, surgery may be required to restore blood flow to the brain. Patients with severe stenosis can undergo procedures such as carotid endarterectomies (CEA), stenting, and transcarotid artery revascularization (TCAR) for this purpose. In this review, we discuss these procedures and which patients warrant which type of intervention. We look at the pathophysiology of internal carotid artery stenosis and current treatment options, while highlighting emerging treatment options. This review aims to increase understanding of the management of symptomatic carotid artery stenosis as well as provide a groundwork for more innovative treatments.

颈动脉狭窄(CAS)是导致脑缺血和中风的主要原因之一。7 当颈内动脉中的斑块堆积时,就会阻碍血液流向大脑。通常,只有在患者出现中风或类似中风的症状后,这种情况才会被发现。出现这种情况时,降低胆固醇的药物和血液稀释剂可以帮助增加流向大脑的血液。但是,如果斑块过大,导致动脉管腔严重狭窄,则可能需要通过手术来恢复流向大脑的血液。为此,严重狭窄的患者可以接受颈动脉内膜切除术(CEA)、支架植入术和经颈动脉血运重建术(TCAR)等手术。在这篇综述中,我们将讨论这些手术以及哪些患者需要接受哪种类型的干预。我们探讨了颈内动脉狭窄的病理生理学和当前的治疗方案,同时强调了新出现的治疗方案。本综述旨在加深对无症状颈内动脉狭窄治疗的理解,并为更多创新治疗奠定基础。
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引用次数: 0
Arteriovenous Malformations: An Update on Models and Therapeutic Targets. 动静脉畸形:模型和治疗目标的最新进展。
Pub Date : 2023-01-01 Epub Date: 2023-01-26
Stephan Quintin, John W Figg, Yusuf Mehkri, Chadwin O Hanna, Maxwell G Woolridge, Brandon Lucke-Wold

Arteriovenous malformations (AVMs) are an anomaly of the vascular system where feeding arteries are directly connected to the venous drainage network. While AVMs can arise anywhere in the body and have been described in most tissues, brain AVMs are of significant concern because of the risk of hemorrhage which carries significant morbidity and mortality. The prevalence of AVM's and the mechanisms underlying their formation are not well understood. For this reason, patients who undergo treatment for symptomatic AVM's remain at increased risk of subsequent bleeds and adverse outcomes. The cerebrovascular network is delicate and novel animal models continue to provide insight into its dynamics in the context of AVM's. As the molecular players in the formation of familial and sporadic AVM's are better understood, novel therapeutic approaches have been developed to mitigate their associated risks. Here we discuss the current literature surrounding AVM's including the development of models and therapeutic targets which are currently being investigated.

动静脉畸形(AVMs)是一种血管系统异常,供血动脉与静脉排水管网直接相连。虽然动静脉畸形可以发生在身体的任何部位,并且在大多数组织中都有描述,但脑部动静脉畸形却引起了人们的极大关注,因为它有出血的风险,会导致严重的发病率和死亡率。人们对脑室动静脉畸形的发病率及其形成机制还不甚了解。因此,接受无症状 AVM 治疗的患者后续出血和不良后果的风险仍在增加。脑血管网络十分微妙,新型动物模型不断让人们深入了解其在动静脉畸形中的动态变化。随着人们对家族性和散发性视网膜血管瘤形成过程中的分子角色有了更深入的了解,新的治疗方法也应运而生,以降低其相关风险。在此,我们将讨论有关 AVM 的现有文献,包括目前正在研究的模型和治疗靶点的发展情况。
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引用次数: 0
Properties of Multifilament PGA Suture Coated with Graphene Oxide 氧化石墨烯涂层多丝PGA缝线的性能研究
Pub Date : 2022-05-18 DOI: 10.31579/2578-8868/236
N. Gokarneshan, M. Jenita, PG Anandhakrishnan, D. Haritha
With the development of fine surgery and desire for low-injury methods, the frictional properties of surgical sutures are one of the crucial factors that can cause damage to tissue, especially for some fragile and sensitive human tissues such as the eyeball. In this study, dopamine hydrochloride and graphene oxide were used as external application agents to prepare a biological coating for the surface of multifilament surgical sutures. The effects of this biocoating on the surface morphology, chemical properties, mechanical properties, and tribological properties of surgical sutures were studied. The friction force and the coefficient of friction of surgical sutures penetrating through a skin substitute were evaluated using a penetration friction apparatus and a linear elastic model. The tribological mechanism of the coating on the multifilament surgical sutures was investigated according to the results of the tribological test. The results showed that there were uniform dopamine and graphene oxide films on the surface of the surgical sutures, and that the fracture strength and yield stress of the coated sutures both increased. The surface wettability of the surgical sutures was improved after the coating treatment. The friction force and the coe_cient of friction of the multifilament surgical sutures with the dopamine hydrochloride and graphene oxide coating changed little compared to those of the untreated multifilament surgical sutures.
随着精细外科手术的发展和对低损伤方法的渴望,手术缝合线的摩擦特性是造成组织损伤的关键因素之一,特别是对于一些脆弱和敏感的人体组织,如眼球。本研究以盐酸多巴胺和氧化石墨烯作为外敷剂,制备多丝手术缝合线表面的生物涂层。研究了该生物涂层对手术缝合线表面形貌、化学性能、力学性能和摩擦学性能的影响。采用穿透式摩擦仪和线弹性模型对手术缝合线穿透皮肤替代物的摩擦力和摩擦系数进行了评估。根据摩擦学试验结果,探讨了涂层在多丝手术缝合线上的摩擦学机理。结果表明,手术缝线表面呈现均匀的多巴胺膜和氧化石墨烯膜,涂层缝线的断裂强度和屈服应力均有所提高。涂层处理后,手术缝合线的表面润湿性得到改善。盐酸多巴胺和氧化石墨烯涂层的多丝缝线的摩擦力和摩擦系数与未处理的多丝缝线相比变化不大。
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引用次数: 1
General Hospital Plus Psychiatric Ward: Unseen Challenges in an Integrated Model 综合医院加精神科病房:一体化模式下的未知挑战
Pub Date : 2022-05-18 DOI: 10.31579/2578-8868/242
Saeed Shoja Shafti
In recent years, the lack of psychiatric beds, especially in developing countries, has encouraged the inauguration of psychiatric wards in general hospitals, which is usually fulfilled by allotting a number of medical beds to psychiatric patients, in the same building or in separate office blocks.
近年来,精神病病床的缺乏,特别是在发展中国家,促使综合医院开设了精神病病房,这通常是通过在同一栋楼或不同的办公楼为精神病患者分配一些病床来实现的。
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引用次数: 0
Short-Term Prognosis of Patients Hospitalized for Status Epilepticus in Ouagadougou, Burkina Faso 布基纳法索瓦加杜古癫痫住院患者的短期预后
Pub Date : 2022-05-18 DOI: 10.31579/2578-8868/230
Djingri Labodi Lompo, K. Cissé, Adja Mariam Ouédraogo, Nagaonlé Éric Some, O. Diallo
Introduction: Status epilepticus is one of the most common neurological emergency, with high morbidity and mortality and an often poor functional prognosis in survivors. We carried out the present study, to describe the intra-hospital clinical course and to identify the risk factors for intra-hospital death of patients hospitalized for status epilepticus in Ouagadougou, Burkina Faso. Patients and methods: it was a prospective, cross-sectional, multi-center hospital, descriptive and analytical study, which took place from January 1, 2015 to December 31, 2019, involving patients consecutively hospitalized in the university hospitals of Ouagadougou, for status epilepticus. Sociodemographic characteristics, clinical data on admission, biological assessment on admission, EEG characteristics, brain scan and / or brain MRI results ; etiological diagnosis of status epilepticus and intra hospital evolutionary data of the patients, have been analyzed. Univariate analysis between the general characteristics of patients and the intra-hospital mortality, was performed in order to identify the risk factors for the intrahospital mortality. Results: The mean age of the patients was 36.6 years with an M / F sex ratio of 1.4 ; 66 patients (72.5%) had no clinical history of epilepsy, while 25 patients (27.5%) were already known to have epilepsy. The generalized tonic-clonic SE immediately (50.5%) and the focal secondarily generalized convulsive status epilepticus (29.7%) were the most common seizure types. The average duration of an SE episode was 18 hours. status epilepticus were subdivided into status epilepticus symptomatic of acute brain conditions with 61 cases (67%), dominated by central nervous system infections and acute strokes, and status epilepticus of non-acute or sequelae etiologies with 30 cases (33%), dominated by the sequelae of head trauma. Intra-hospital complications were dominated by prolonged post-critical mental confusion, 45 cases (49.4%) and aspiration pneumonia, 30 cases (33%). In-hospital mortality was 12.1% (11 patients). At the end of hospitalization, 49 patients (53.9%) still had moderate to severe disabilities. In univariate analysis, comatose non convulsive status epilepticus (p = 0.003), and altered consciousness on admission (p = 0.026), were the risk factors for in-hospital mortality. Conclusion: Prognosis of status epilepticus in Burkina Faso remains unfavorable with early mortality in more than one in 10 patients and poor functional outcome in more than half of the patients. Altered consciousness on admission and non-convulsive comatose status epilepticus were risk factors for early mortality. The fight against infectious diseases, the prevention of vascular risk factors, the promotion of helmet wearing in cyclists and motorcyclists, early admission of patients sufferinf of status epilepticus, and adequate and standardized management of status epilepticus, will help reduce the frequency and severity of this disease in our African
引言:癫痫持续状态是最常见的神经系统紧急情况之一,发病率和死亡率很高,幸存者的功能预后往往很差。我们进行了本研究,以描述布基纳法索瓦加杜古因癫痫持续状态住院的患者的院内临床过程,并确定院内死亡的风险因素。患者和方法:这是一项前瞻性、横断面、多中心医院的描述性和分析性研究,于2015年1月1日至2019年12月31日进行,涉及因癫痫持续状态在瓦加杜古大学医院连续住院的患者。社会形态特征、入院临床数据、入院生物学评估、脑电图特征、脑部扫描和/或脑部MRI结果;对癫痫持续状态的病因诊断和患者的院内进化数据进行了分析。对患者的一般特征和院内死亡率进行单因素分析,以确定院内死亡率的危险因素。结果:患者平均年龄36.6岁,男女性别比1.4;66名患者(72.5%)没有癫痫临床病史,而25名患者(27.5%)已知患有癫痫。最常见的癫痫发作类型为立即全身性强直阵挛SE(50.5%)和局灶性继发全身性痉挛性癫痫持续状态(29.7%)。SE发作的平均持续时间为18小时。癫痫持续状态可分为急性脑疾病症状性癫痫持续状态61例(67%),以中枢神经系统感染和急性中风为主;非急性或后遗症病因的癫痫持续状态30例(33%),以头部创伤后遗症为主。院内并发症主要是危重后的长期精神混乱,45例(49.4%)和吸入性肺炎,30例(33%)。住院死亡率为12.1%(11名患者)。住院结束时,仍有49名患者(53.9%)患有中度至重度残疾。在单因素分析中,昏迷非惊厥性癫痫持续状态(p=0.003)和入院时意识改变(p=0.026)是住院死亡率的危险因素。结论:布基纳法索癫痫持续状态的预后仍然不利,超过1/10的患者早期死亡,超过一半的患者功能不良。入院时意识改变和非惊厥性昏迷癫痫持续状态是早期死亡的危险因素。与传染病作斗争,预防血管危险因素,提倡骑自行车和骑摩托车的人戴头盔,尽早收治癫痫持续状态患者,以及对癫痫持续状态进行充分和规范的管理,将有助于降低这种疾病在我们非洲地区的发生频率和严重程度。
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引用次数: 0
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Journal of neuroscience and neurological surgery
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