Objective To establish a Chinese clinical controlled trials database of neurology. Methods We identified relevant studies by electronic searching of CBMdisc from 1978 to April 2002, and the Library of Evidence-Based Medicine (Chinese). We also searched manually 11 journals and 4 conference proceedings relevant to neurological diseases. The studies included in this database should be controlled studies relevant to treatment on neurological disease, randomized or only controlled without randomization. Results 3 641 studies were included in this database. Conclusions The Chinese neurological trials database was established. This database will provide Chinese evidence on treatments of various neurological diseases. Studies in this database will also be included in the Cochrane Library to facilitate systematic reviewers.
Objective To review the research process of telomerase reverse transcriptase (TERT) in the restoration of neurological diseases. Methods The related l iterature on TERT in the restoration of neurological diseases was extensively reviewed and comprehensively analyzed. Results TERT was the significant component of telomerase and the critical regulator of telomerase activity. It played an important role in the pathomechanism of neurological diseases including tumors,neurodevelopmental deficits, and nerve injury. TERT was becoming a research focus in the reparative therapy of neurological diseases. Conclusion TERT has manifested its great academic significance and appl ication prospects in the reparative therapy of neurological diseases, which deserves a further investigation.
Objective To analyze the therapeutic effect of olfactory ensheathing cells (OECs) transplantation for central nervous system diseases. Methods Between November 2001 and January 2008, 1 255 participants with central nervous system diseases were enrolled in this cl inical study for fetal OECs transplantation. There were 928 males and 327 femalesaged 1.2-87 (mean 40) years. The course of disease was (4.52 ± 4.67) years. Among them, 656 participants suffered from chronic spinal cord injury (SCI), 457 amyotrophic lateral sclerosis (ALS), 68 cerebral palsy (CP), 20 multiple sclerosis (MS), 11 the sequelae of stoke, 10 ataxia, and 33 residual diseases. The participants came from 71 countries or regions. Accidentally abortional fetal olfactory bulbs were donated voluntarily and were cultured for 2 weeks, then were transplanted. Results One thousand one hundred and twenty-eight cases were followed up for 2-8 weeks (mean 4 weeks) to obtain integrated data. Among them, the neurological functional amel ioration was noticed in 994 participants with the overall short-term improvement rate of 88.12%. Seventy-six patients experienced the various perioperative compl ications with the incidence rate of 6.74%. One hundred and twenty patients with SCI received over 1 year follow-up. And according to ASIA assessment, motor scores increased from (39.82 ± 20.25) to (44.55 ± 18.99) points, l ight touch scores from (51.56 ± 25.89) to (59.81 ± 27.72) points, pain scores from (50.36 ± 27.44) to (57.09 ± 28.51) points for foreign patients (P lt; 0.05); motor scores increased from (40.52 ± 20.80) to (46.45 ± 20.35) points, l ight touch scores from (55.64 ± 26.32) to (68.64 ± 25.89) points, pain scores from (57.05 ± 26.00) to (66.13 ± 24.29) points for good rehabil itation Chinese patients (overall P lt; 0.05); motor scores from (37.03 ± 18.52) to (38.03 ± 18.50 points (P lt;0.05), l ight touch scores from (45.88 ± 22.56) to (46.63 ± 23.09) points (P gt; 0.05), pain scores from (45.25 ± 23.68) to (45.28 ± 23.63) points (P gt; 0.05) for poor rehabil itation Chinese patients. Compared foreign patients and good rehabil itation Chinese patients with poor rehabil itation Chinese patients, difference in score change was remarkable (P lt; 0.05). One hundred and six cases of ALS, 32 CP, 8 MS, 7 ataxia, and 2 stroke sequelae were followed up for 3-48, 3-36, 2-20, 7-17, 6 and 24 months, One hundred and six cases of respectively. Majority of them (113/155, 72.9%）were benefited from OECs transplantation. Conclusion OECs transplantation into brain and spinal cord is feasible and safe . The therapeutic strategy is valuable treatment for such central nervous system diseases such as chronic SCI, ALS, CP and stroke sequelae and can improve the patients’ neurological functions and/or decrease the progressive deterioration.
Objective To introduce the current situation and futureof myoblast transfer therapy (MTT) in clinical application Methods The latest fifteenyear literatures were extensively reviewed, concerninggene therapy for Duchenne’s muscular dystrophy, Parkinson’s disease, myelopathy, permanent facial paralysis, angiocardiopathy, injuries of bone, joint and muscle, hematopathy, and pituitary dwarf. Results In medical field, MTT is an ideal method to treat some common diseases. The problems were immunologic rejection and better carriers for myoblasts implantation. Conclusion It is the focus on the use of myoblast as a vector to carry exogenous gene in some disease therapy. The major problems of MTT include transplantation immunity, cell fusion and target protein expression. It is easy to gain,culture and transfuse to the host for myoblasts, these merits are beneficial to clinical application.
Objective To investigate the neuropathogenesis of Adieprime;s pupil. Methods The neuroelectrophysiological and neuroimaging data of 42 patients with Adie's pupil (lightnear dissociation and segmental palsy of iris sphincter) were retrospectively analyzed. There were 37 patients with unilateral pupil dilation and 5 patients with bilateral pupil dilation. Cranial magnetic resonance imaging (MRI, 23 patients), Cranial CT scanning (1 patient), nerve conduction velocity (NCV, 14 patients), limb electromyogram (EMG, 5 patients), both lower extremities EMG (9 patients), visual evoked potential (VEP, 18 patients), somatosensory evoked potential (SEP, 11 patients) and electroencephalograms (EEG,5 patients) were performed on some of those patients. Results Central nervous system midline anatomic variations or minor lesions were found in 13/23 cases of MRI/CT imaging. Slowed sensory NCV and multiple sensorymotor peripheral nerve damages were evident in 6/14 cases of the NCV/EMG assay. 5/18 patients showed prolonged latency of VEP P100. 2/11 cases showed peripheral nerve damage in SEP recording, and 1/5 cases showed abnormal EEG. Conclusion Peripheral nerve damage may be an important pathogenesis of Adie's pupil, while the central nervous system damage is also involved in its pathogenesis.
ObjectiveTo analyze the characteristics of outpatients in Neurological Department in different periods and to provide guidance on medical decision-making for Neurological Department. MethodOutpatients treated between August and September 1994 (group 1994) and between August and September 2012 (group 2012) in the Department of Neurology of a general hospital were included in our study. Group 1994 had 1 000 consecutive patients; while group 2012 had 18 995 patients excluding those repeat visitors, patients waiting to be treated (including dizziness), patients misdiagnosed to have severe mental diseases (such as schizophrenia), and patients with physical diseases. Then we compared the demographic and disease distribution of patients in the two groups, and performed statistical analysis. ResultsCompared with the year 1994, the year 2012 had more female, less young and more elderly patients (P<0.05). The constituent ratio of neurosis, cerebrovascular disease, internal medicine diseases with nerve damage, peripheral nerve disease, brain post-traumatic syndrome, intracranial space-occupying lesions reduced significantly while headache, epilepsy, extrapyramidal disease (such as Parkinson's disease) increased significantly (P<0.01) with no obvious change of constituent ratio of muscle disease, neuropathic muscular dystrophy, spinal cord, brain atrophy and dementia diseases. ConclusionsThere are significant changes in characteristics of neurology clinical patients between 1994 and 2012. Revelation of these differences can provide evidence for the optimization of outpatient resources allocation and the prevention policy.
Idiopathic intracranial hypertension (IIH) is a neurological disease, characterized by increased intracranial pressure and papilledema, and often associated with headache, transient loss of vision and pulsatile tinnitus. IIH typically occurs in women of childbearing age. Over 90.0% of patients are with obesity or over weighted. Loss of sensory visual function is the major morbidity associated with IIH and some patients even develop into blindness. Most patients will have varied degrees of visual impairment, or even a few become blind. Frisén grading system, visual field examination and spectral-domain optical coherence tomography can be used to evaluate and monitor the IIH papilledema functionally and morphologically. In recent years, IIH treatment trials in other countries confirmed that, weight loss and low-salt diet combined with acetazolamide treatment has a clear improvement for IIH patients with mild visual impairment. In-depth understanding of the etiology, clinical manifestations, diagnostic criteria and the main treatment has important clinical significance for IIH patients