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find Keyword "中枢神经系统" 29 results
  • Development of a short-term mortality risk prediction model for patients with central nervous system infection based on cerebrospinal fluid lactate

    Objective To develop a novel prediction model based on cerebrospinal fluid (CSF) lactate for early identification of high-risk central nervous system (CNS) infection patients in the emergency setting. Methods Patients diagnosed with CNS infections admitted to the Department of Emergency Medicine of West China Hospital, Sichuan University between January 1, 2020 and December 31, 2023 were retrospectively selected. Patients were classified into a survival group and a death group according to their 28-day survival status, and clinical characteristics were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of 28-day mortality, which were subsequently used to construct a nomogram. Results A total of 173 patients were included, comprising 135 in the survival group and 38 in the death group. Multivariate analysis identified the Acute Physiology and Chronic Health Evaluation Ⅳ (APACHE Ⅳ) score [odds ratio (OR)=1.027, 95% confidence interval (CI) (1.002, 1.055), P=0.034], CSF lactate [OR=1.147, 95%CI (1.025, 1.286), P=0.018], and interleukin-6 [OR=1.002, 95%CI (1.001, 1.004), P=0.002] as independent predictors of 28-day mortality. The integrated model combining APACHE Ⅳ score, CSF lactate, and interleukin-6, demonstrated superior predictive performance compared with the APACHE Ⅳ score alone (P=0.020), and showed good calibration (Hosmer-Lemeshow P=0.50). Conclusions This tool may provide a useful instrument for emergency physicians to assess the 28-day mortality risk in patients with CNS infections, potentially facilitating early and targeted interventions for high-risk individuals. However, as the findings of this study are derived from a single-center retrospective dataset, the clinical applicability of this model requires further external validation through large-scale, prospective, multicenter studies to evaluate its generalizability.

    Release date:2025-09-26 04:04 Export PDF Favorites Scan
  • 原发性玻璃体视网膜淋巴瘤一例

    Release date:2017-07-17 02:38 Export PDF Favorites Scan
  • Central nervous system complications in patients with carotid artery stenosis undergoing off-pump coronary artery bypass grafting: A retrospective cohort study

    ObjectiveTo analyze the effect of carotid artery stenosis degree and intervention for carotid artery stenosis on the incidence of central nervous system complications after off-pump coronary artery bypass grafting (OPCABG) and explore the influencing factors. MethodsA total of 1 150 patients undergoing OPCABG in our hospital from June 2018 to June 2021 were selected and divided into two groups according to whether there were central nervous system complications, including a central nervous system complication group [n=61, 43 males and 18 females with a median age of 68.0 (63.0, 74.0) years] and a non-central nervous system complication group [n=1 089, 796 males and 293 females with a median age of 65.5 (59.0, 70.0) years]. The risk factors for central nervous system complications after OPCABG were analyzed. ResultsUnivariate analysis showed that age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intra-aortic ballon pump (IABP), postoperative arrhythmia, postoperative thoracotomy and blood transfusion volume were associated with central nervous system complications. The incidence of central nervous system complications in patients with severe carotid artery stenosis or occlusion (11.63%) was higher than that in the non-stenosis and mild stenosis patients (4.80%) and moderate stenosis patients (4.76%) with a statistical difference (P=0.038). The intervention for carotid artery stenosis before or during the operation did not reduce the incidence of central nervous system complications after the operation (42.11% vs. 2.99%, P<0.001). Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion were independent risk factors for postoperative central nervous system complications (P<0.05). Conclusion The age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intraoperative use of IABP, postoperative arrhythmia, secondary thoracotomy after surgery, blood transfusion volume and OPCABG are associated with the incidence of postoperative central nervous system complications in patients. Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion are independent risk factors for postoperative central nervous system complications. In patients with severe carotid artery stenosis, preoperative treatment of the carotid artery will not reduce the incidence of central nervous system complications.

    Release date:2022-06-24 01:25 Export PDF Favorites Scan
  • 原发性中枢神经系统淋巴瘤一例诊疗分析

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  • Discussion on the Value of MRI in the Diagnosis of Central Nervous System Lymphoma

    ObjectiveTo investigate the value of MRI in the diagnosis of central nervous system lymphoma (CNSL). MethodsWe retrospectively analyzed the clinical data of 20 cases of primary CNSL (PCNSL) and 13 cases of secondary CNSL (SCNSL) from the Second People's Hospital of Chengdu and Chengdu 363 Hospital from January to December 2013, and analyzed their clinical data and MRI image data. We observed the tumor location, tumor size and signal, and carried out the statistical analysis. ResultsTwenty patients had PCNSL in the brain, including single lesion in 9 (45.0%), and multiple in 11 (55.0%). Among the 48 lesions, there were 23 (47.9%) nodular lesions, 21 (43.8%) crumb lesions, and 4 (8.3%) dot patch lesions; MRI showed slightly low T1 signal and slightly high T2 signal in most lesions, and showed significant even enhancing, and mild to moderate edema around the tumor. SCNSL lesions were mainly meningeal disseminated with 3 cases (23.1%) of single lesions and 10 cases (76.9%) of multiple ones, and there were a total of 30 lesions. MRI manifested that T1 and T2 mainly showed equal signals, and showed an obviously even enhancing status, and mild to moderate edema around the tumor. ConclusionThe central nervous system lymphoma has a certain characteristic MRI image, and MRI images of the primary and secondary central nervous system lymphoma were similar.

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  • 鞘氨醇激酶/1-磷酸鞘氨醇信号通路在中枢神经系统疾病中的研究进展

    我国当前约有 900 万以上的癫痫患者,每年新发癫痫患者 65~70 万,其中约 30% 为难治性癫痫。癫痫的发病机制复杂,其病理机制至今尚未完全了解,鞘氨醇激酶(Sphingosine kinase, SphK)/1-磷酸鞘氨醇(Sphingosine-1-phosphate, S1P)通路在癫痫中可能发挥的作用及其机制目前尚不十分清楚。为进一步探索难治性癫痫在分子水平的发病机制,现就 SphK/S1P 信号通路通过调控炎症反应及细胞凋亡参与癫痫发病机制和可能存在的理想治疗靶点作一综述。

    Release date:2018-03-20 04:09 Export PDF Favorites Scan
  • Ramsay Hunt综合征引起中枢神经系统感染的临床特征

    目的观察Ramsay Hunt综合征出现中枢神经系统感染的发病率、治疗方法及预后。 方法回顾性分析2011年2月-2014年1月连续收治的13例Ramsay Hunt综合征患者的临床资料。 结果13例患者中出现中枢神经系统感染3例,占23%,经治疗13例均有好转。 结论Ramsay Hunt综合征应早期完善脑脊液、头颅MRI等检查以明确是否存在中枢神经系统感染,尤其针对无中枢神经系统感染临床症状患者,避免漏诊,早期给予足量阿昔洛韦及糖皮质激素、神经营养药物等综合治疗,预后良好。

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  • Secondary recurrence of central nervous system leukemia complicated with epilepsy in children: a case report and literature review

    Objective To investigate the clinical features, diagnosis and treatment of symptomatic epilepsy complicated with central nervous system leukemia (CNSL) recurrence after acute lymphoblastic leukemia (ALL) treatment in children. MethodsThe clinical data of a child with secondary recurrence of CNSL complicated with symptomatic epilepsy after ALL treatment admitted to the Department of Pediatrics of the Second Affiliated Hospital of Auhui Medical University from December 2020 to February 2023 were retrospectively analyzed, and the relevant literature was reviewed and discussed. ResultsPatient was ALL for nealy two years after treatment in the central nervous system leukemia relapse of concurrent symptomatic epilepsy, two of the central nervous system leukemia relapse when starting symptoms are seizure, the first recurrence was status epilepticus, second recurrence of concurrent limb hemiplegia symptoms, cerebrospinal fluid, cranial magnetic resonance (MRI) and abnormal changes of electroencephalogram and clinical features, the abnormal changes of brain MRI lesions and electroencephalogram did not disappear. Chemotherapy, intrathecal injection and radiotherapy were given for the primary treatment, follow up CAR-T immunotherapy, and the treatment was successively combined with nalproate and levetiracetam. Currently, the seizures were controlled. ConclusionFor children with ALL, the recurrence of CNSL should be warned after the end of treatment. Cerebrospinal fluid, cranial imaging and electroencephalogram examination should be completed in time to confirm the diagnosis. If the crania imaging lesions persist after treatment and abnormal electroencephalogram discharge does not disappear, the possibility of CNSL recurrence should be warned when the epileptic seizures are repeated. On the basis of primary disease active treatment, combination of antiseizure medications is preferable.

    Release date:2023-05-04 04:20 Export PDF Favorites Scan
  • Central nervous system vascular diseases in ophthalmology clinic

    Central nervous system vascular disease can be combined with a variety of ocular signs, such as orbital pain, flash, visual field defects, vision loss, eye muscle paralysis. Therefore, some patients were first diagnosed in ophthalmology, including aneurysm rupture, arterial dissection, cerebral apoplexy and other critical nervous system diseases that need rapid treatment. If the doctors didn't know enough, the diagnosis and treatment might be delayed. Most of the vascular diseases of the central nervous system related to ophthalmology have clinical manifestations that cannot be explained by ophthalmology. In the face of chronic conjunctivitis, unexplained visual field defect or cranial nerve paralysis with local ineffective treatment, it is necessary to broaden the thinking of differential diagnosis. To understand the characteristics of vascular diseases of the central nervous system that are prone to ocular manifestations can provide references for the clinical diagnosis and treatment of ophthalmology.

    Release date:2020-05-19 02:20 Export PDF Favorites Scan
  • DIAGNOSIS AND TREATMENT OF MALIGNANT MELANOMA IN CENTRAL NERVOUS SYSTEM

    Objective To investigate the cl inical features of mal ignant melanoma (MM) in the central nervous system (CNS) and to improve the diagnosis and treatment of this disease. Methods Seven MM-in-CNS patients’ records between September 1996 and April 2007 were analyzed retrospectively, including 6 males and 1 female aged 18-74 years. The 5 cases were located in the supra-tentorial area, 1 in the spinal cord and 1 in the whole brain. CT or MRI scan was appl ied. The lesion was in the right frontal area in 4 cases, in the right temporal are in 1 case, in the left temporal area in 1 case, in the left apex area in 1 case and in the cervical spinal cord of C5-7 in 1 case. Six patients underwent neurosurgical operation and1 patient received the Gamma Knife therapy. The pathological examination revealed that 2 cases were metastatic MM and 5 were primary. Results One patient with primary MM received no follow-up, and the rest 6 patients were followed up for 2 weeks to 2 years with the time of median 8 months. One patient with metastatic MM died 2 months after operation, 1 patient to with metastatic MM died 2 weeks after Gamma-Knife treatment, 1 patient with metastatic MM with primary MM died 2 years after operation, and 3 patients with primary MM were still al ive and self-independent 6, 10 and 24 months after operation, respecti vely. Conclusion Since MM-in-CNS is short of specificity in cl inical symptoms and signs, its diagnosis mainly rel ies on the pathological examination and is assisted by MRI. The combined therapy giving priority to operation is recommended.

    Release date:2016-09-01 09:18 Export PDF Favorites Scan
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