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Expert consensus on drug treatment of chronic subdural hematoma

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chinese neurosurgical Journal 2022年第1期8卷 51-59页

作者： Jianning Zhang chinese society of Neurosurgery chinese Medical Association chinese neurosurgical Critical Care Specialist Council Collaborational Group of chinese neurosurgical Translational and Evidence-based Medicine Department of Neurosurgery Tianjin Medical University General HospitalTianjin 300052China Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of EducationTianjin 300052China Tianjin Key Laboratory of Injuries Variations and Regeneration of Nervous SystemTianjin 300052China Tianjin Neurological Institute Tianjin 300052China 不详

Chronic subdural hematoma(CSDH)is a chronic space-occupying lesion formed by blood accumulation between arachnoid and dura mater,which is usually formed in the third week after traumatic brain injury.Surgical treatment is usually the first choice for patients with CSDH having a significant space-occupying effect.Most of the patients showed good results of surgical treatment,but still some patients had a postoperative recurrence(the recurrence rate was up to 33%).Because CSDH is often seen in the elderly,patients are weak and have many basic diseases.The risk of surgical treatment is high;serious complications and even death(the death rate is up to 32%)can often occur.The overall good prognosis rate of patients aged more than 90 years is 24%.The drug treatment can provide a safe and effective treatment for elderly patients who are weak,intolerable to surgery,or failed in surgery.Low-dose and long-term use of atorvastatin(20mg/d)is suggested for continuous treatment for at least 8 weeks,while low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on CSDH.Patients should undergo CT or MRI scanning at least one time within 2 weeks after the start of drug treatment.

关键词： CSDH treatment drug death

神经重症患者中枢神经系统感染多黏菌素局部应用的中国专家共识(2024年版)

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中华神经医学杂志 2024年第2期23卷 109-118页

作者：中国医师协会神经外科分会神经重症专家委员会中国神经外科重症管理协作组石广志冯光不详首都医科大学附属北京天坛医院重症医学科北京100070 河南省人民医院(郑州大学人民医院)神经外科郑州450003

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式... 详细信息

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式近年来越来越多地被临床采用,但缺乏相关的规范化操作指引,故本共识专家委员会围绕多黏菌素局部应用治疗中枢神经系统感染的适应证、用法用量、治疗途径等问题进行反复讨论,形成14条共识推荐意见,以期为多黏菌素中枢神经系统局部应用提供科学和切实可行的临床指导。

关键词：神经重症中枢神经系统感染多黏菌素鞘内给药脑室内给药

中国成人颅眶重建修复材料及应用专家共识(2023版)

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中华医学杂志 2023年第2期103卷 101-110页

作者：中华医学会神经外科学分会中华医学会眼科学分会眼整形眼眶病学组毛颖范先群史之峰周慧芳不详复旦大学附属华山医院神经外科上海200040 上海交通大学医学院附属第九人民医院眼科上海200011

由于各种原因导致的颅眶部骨骼缺损,可能影响患者的美观,甚至引起严重的并发症。国内神经外科、眼科领域的专家借鉴国外指南和相关循证医学证据,以牛津大学循证医学中心临床证据水平分级和推荐级别为依据,围绕各种重建修复材料性能、不... 详细信息

由于各种原因导致的颅眶部骨骼缺损,可能影响患者的美观,甚至引起严重的并发症。国内神经外科、眼科领域的专家借鉴国外指南和相关循证医学证据,以牛津大学循证医学中心临床证据水平分级和推荐级别为依据,围绕各种重建修复材料性能、不同疾病和情况下材料的选择和应用、材料相关并发症等问题,对不同原因造成的颅眶缺损下的修补策略制定和材料选择等问题进行反复讨论,采用改良德尔菲法征集专家建议,形成3个方面共计23条共识推荐意见,为颅眶重建修复的规范化诊疗方案提供科学和切实可行的临床指导。

关键词：颅骨颅骨缺损眼眶缺损重建材料共识德尔菲法

Deep brain stimulation in the treatment of secondary dystonia

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chinese Medical Journal 2006年第24期119卷 2069-2074页

作者： ZHANG Jian-guo,ZHANG Kai,WANG Zhong-cheng,GE Ming and MA Yu Department of Neurosurgery,Beijing Tiantan Hospital,Capital University of Medical Sciences Functional neurosurgical Department,Beijing neurosurgical Institute,Beijing 100050,China Department of Neurosurgery Beijing Tiantan Hospital Capital University of Medical Sciences

Background Dystonia is one of the most challenging movement disorders to treat. Medications and surgeries are the two methods to control dystonic symptoms. For patients with dystonia in whom symptoms are inadequately controlled with pharmacologic measures, the use of deep brain stimulation （DBS） can improve symptoms and enhance functional capacity. The best candidate for DBS is believed to be primary generalized dystonia, especially the DYT-1 type. Here, we report 9 cases of secondary dystonia to explore the feasibility, indications and complications of DBS in the treatment of secondary dystonia. Methods From July 2003 to June 2006, nine patients with secondary dystonia underwent surgery at Beijing Tiantan Hospital. Among them, 2 were diagnosed as having tardive dystonia, 1 had posttraumatic dystonia, 3 had a history of perinatal anoxia, 1 had neonatal pathologic jaundice, and 2 had no exact contributory history; MRI showed bilateral lentiform nuclei degeneration in one patient. Six patients underwent bilateral subthalamic nucleus （STN）-DBS, two underwent unilateral STN-DBS, the other underwent left STN and fight globus pallidus internus（GPi）-DBS. Results With intraoperative microelectrode recording, the targeted nucleus was accurately localized. Tentative stimulation could decrease muscle tension to the same extent, but twisting was not obviously improved. Follow-up for 3 months to 3 years showed satisfactory results in 3 patients with tardive dystonia and posttraumatic dystonia and that Burke-Fahn-Marsden Dystonia Scale （BFMS） decreased by more than 90%. The improvement of symptoms was progressive along with time. The other 6 patients had slight to moderate improvement. None of them had severe surgery-related complications. One had lead fracture 16 months after surgery and the lead was then evacuated. Conclusions DBS could be an ideal treatment for patients with tardive and posttraumatic dystonia. For patients with perinatal anoxia and diffuse impairment in the basal ganglia, DBS seemed not to be a good choice.

关键词： subthalamic nucleus deep brain stimulation secondary dystonia

颅内肿瘤周围水肿药物治疗专家共识(第1版)

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中华医学杂志 2010年第1期90卷 5-9页

作者：中华医学会神经外科学分会中华医学会神经外科学分会

一、前言肿瘤周围水肿(peritumoral brain edema,PTBE)多见于胶质瘤、脑膜瘤和转移瘤,是神经外科常见的临床问题,直接影响肿瘤的诊断、治疗及预后。本文旨在加深神经外科医生对神经系统PTBE的认识,明确对PTBE诊断和治疗的基本原则,提供... 详细信息

一、前言肿瘤周围水肿(peritumoral brain edema,PTBE)多见于胶质瘤、脑膜瘤和转移瘤,是神经外科常见的临床问题,直接影响肿瘤的诊断、治疗及预后。本文旨在加深神经外科医生对神经系统PTBE的认识,明确对PTBE诊断和治疗的基本原则,提供切实可行的规范化的药物治疗建议。

关键词：颅内肿瘤水肿药物治疗专家共识

Molecular diagnosis and treatment of meningiomas:an expert consensus(2022)

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chinese Medical Journal 2022年第16期135卷 1894-1912页

作者： Jiaojao Deng Lingyang Hua Liuguan Bian Hong Chen Ligang Chen Hongwei Cheng Changwu Dou Dangmurenjiapu Geng Tao Hong Hongming Ji Yugang Jiang Qing Lan Gang Li Zhixiong Liu Songtao Qi Yan Qu Songsheng Shi Xiaochuan Sun Hajun Wang Yongping You Hualin Yu Shuyuan Yue Jianming Zhang Xiaohua Zhang Shuo Wang Ying Mao Ping Zhong Ye Gong Group of Neuro-Oncology society of Neurosurgery chinese Medical Association Department of Neurosurgery Huashan HospitalFudan UniversityShanghai 200040China National Center for Neurological Disorders Huashan HospitalFudan UniversityShanghai 200040China Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration Shanghai 200040China neurosurgical Institute of Fudan University Shanghai 200040China Shanghai Clinical Medical Center of Neurosurgery Shanghai 200040China Department of Neurosurgery Rujn HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Pathology Huashan HospitalFudan UniversityShanghai 200040China Department of Neurosurgery The Affiliated Hospital of Southwest Medical UniversityLuzhouSichuan 646000China Department of Neurosurgery The First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui 230022China Department of Neurosurgery The Affiliated Hospital of Inner Mongolia Medical UniverstyHohoInner Mongolia 750306China Department of Neurosurgery The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjang 830011China Department of Neurosurgery The First Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006China Department of Neurosurgery Shanxi Medical Universty Shanxi Provincial People's HospitaTaiyuanShanxi 030012China Department of Neurosurgery The Second Xiangya HospitalCentral South UniversityChangshaHunan 410011China Department of Neurosurgery The Second Affiliated Hospital of Soochow UniversitySoochowJjangsu 215004China Deparment of Neurosurgery Qiu HospitalCheeloo College of Medicine and Insttute of Brain and Brain-Inspired ScienceShandong University JinanShandong 25003China Department of Neurosurger Xiangya HospitalCentral South UuniversitChangshaHunan 410008China Department of Neurosurgery Nanfang HospitalSouthern Medical UniverstyGuangzhouGuangdong 510515China Department of Neurosurgery Tangdu HospitalThe Fourth Miltay Medial UniverstXi'anShaanxi 710038China Department of Neurosurgery Fujian Medial University fliated Union H

Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations.The fifth edition of the WHO Classification of Tumors of the Central Nervous System(WHO CNS5),published in 2021,introduces major changes that advance the role of molecular diagnostics in meningiomas.To follow the revision of WHO CNS5,this expert consensus statement was formed jointly by the Group of Neuro-Oncology,society of Neurosurgery,chinese Medical Association together with neuropathologists and evidence-based experts.The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients.

关键词： Clinical diagnosis Expert consensus Meningioma Molecular subtyping Therapeutic treatment

Effect of Rat Schwann Cell Secretion on Proliferation and Differentiation of Human Neural Stem Cells

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Biomedical and Environmental Sciences 2003年第1期16卷 90-94页

作者： YI-HUA AN, HONG WAN, ZE-SHUN ZHANG, HONG-YUN WANG, ZHI-XING GAO, MEI-ZHEN SUN, AND ZHONG-CHENG WANGBeijing neurosurgical Institute, Beijing 100050, China Beijing neurosurgical Institute 北京 100050

Objective To investigate the effect of rat Schwann cell secretion on the proliferation and differentiation of human embryonic neural stem cells (NSCs). Methods The samples were divided into three groups. In Group One, NSCs were cultured in DMED/F12 in which Schwann cells had grown for one day. In Group Two, NSCs and Schwann cells were co-cultured. In Group Three, NSCs were cultured in DMEM/F12. The morphology of NSCs was checked and β-tubulin, GalC, hoechst 33342 and GFAP labellings were detected. Results In Group One, all neural spheres were attached to the bottom and differentiated. The majority of them were p-tubulin positive while a few of cells were GFAP or GalC positive. In Group Two, neural spheres remained undifferentiatied and their proliferation was inhibited in places where Schwann cells were robust. In places where there were few Schwann cells, NSCs performed in a similar manner as in Group One. In Group Three, the cell growth state deteriorated day after day. On the 7th day, most NSCs died. Conclusion The secretion of rat Schwann cells has a growth supportive and differentiation-inducing effect on human NSCs.

关键词： Stem cells Schwann cells Nerve growth factors Coculture Immunohistochemistry

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帕金森病人的图形辨别障碍

心理学报 1993年第3期25卷 258-263页

作者：汤慈美刘颖中国科学院心理研究所北京100012 北京神经外科研究所中国科技大学认知实验室

对56名帕金森病人用视觉形状辨别测验(VFDT)进行了测查,44名年龄、文化水平与帕金森组相当的正常人作为对照组。结果发现帕金森病人对图形辨别有明显障碍。对帕金森病人在图形辨别障碍中的特点进行了分析,并对其可能机制进行了讨论。

关键词：图形辨别震颤性麻痹 VFDT

chinese specialist consensus on imaging diagnosis of intracranial arterial dissection

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中华神经外科杂志（英文） 2017年第4期3卷 224-237页

作者： Yan-Min Wang Yi-Sen Zhang Bin-Bin Sui Xin-Jian Yang Pei-Yi Gao Department of Neurosurgery First Affiliated Hospital of Zhengzhou University Zhengzhou Henan Province China Department of Interventional Neuroradiology Beijing Neurosurgical Institute and Beijing Tian Tan HospitalCapital Medical University Beijing 100050 China Department of Neuroimaging Beijing Tiantan Hospital Capital Medical University Beijing 100050 China

Intracranial arterial dissection is an important cause of stroke in young and middle-aged adults, but there are no domestic or globally-accepted criteria for the diagnosis and classification of intracranial arterial dissections. The evidence base for the benefits of diagnostic and interventional angiography techniques is lacking, and the imaging features of intracranial arterial dissections are not yet universally recognized or understood by clinicians. These issues influence the diagnosis and treatment of intracranial arterial dissection. Therefore, a consensus conference was convened by Neurointerventional Expert Committee of chinese Congress of Neurological Surgeons, chinese Interventional Neuroradiology society of chinese Stroke Association and Young Physicians Committee of chinese Congress of Neurological Surgeons. The aim of this document is to report an expert consensus on the imaging diagnosis of intracranial arterial dissection. The participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. The expert consensus was intended to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.

关键词： Intracranial arterial dissection Expert consensus Imaging diagnosis