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| 1 | 美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:阿尔茨海默病源性轻度认知障碍诊断标准推荐显示文摘美国国立老化研究所(NIA)和阿尔茨海默病协会(ADA)组织了一个工作组,负责阿尔茨海默病(AD)痴呆前症状阶段——即本文所称的AD源性轻度认知障碍(MCI)的诊断标准的制订及完善。该工作组制订了以下两套标准:(1)在缺乏相应条件进行先进影像技术及脑脊液检查时,医务人员适用的核心临床标准;(2)适用于包括临床试验在内的科学研究的研究标准。后者纳入了基于影像技术及脑脊液检查的生物标志物的应用。并根据所出现的生物标志物的性质,将最终MCI诊断的确定性程度分为4个级别。而要使生物标志物有效应用于诊断,并在社区医疗服务中规范使用,尚需做大量的工作。 | McKhann GM Knopman DS Chertkow H Hyman BT Jack CR Jr Kawas CH Klunk WE Koroshetz WJ Manly JJ Mayeux R Mohs RC Morris JC Rossor MN Schehens P Carrillo MC Thies B Weintraub S Phelps CH 贾建平(译) 陆璐(译) 张逸驰(译) 黄丽黄(译) 礼媛(译) | 2012 | 中华神经科杂志2012，45，5： | 51 |
| 2 | 美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:阿尔茨海默病痴呆诊断标准的推荐显示文摘由美国国立老化研究所(NIA)和阿尔茨海默病(AD)协会组织了一个工作组,负责修订1984年版AD痴呆的诊断标准。旨在确保修订后的标准具有足够的灵活性,既可供缺乏神经心理学测验、先进的影像技术和脑脊液检查措施的普通医务人员使用,也可供具备上述措施的科研、临床试验的专业研究者使用。新的标准广泛适用于各种原因的痴呆以及专门针对AD痴呆的标准,保留了1984年版标准中的“很可能的AD痴呆”的总体框架。在过去27年的经验基础上,工作组对临床诊断标准做了一些修改,保留了“可能的AD痴呆”的术语,但对其进行了更有针对性的重新定义。在科研用的“很可能的和可能的AD痴呆”的诊断标准中纳入了生物标志物证据。AD痴呆的核心临床标准仍将是临床实践中诊断的基础,但用生物标志物证据来提高AD痴呆诊断的病理生理学特异性也被人们寄予厚望。要实现AD痴呆的生物标志物诊断,还有许多工作摆在面前。 | McKhann GM Knopman DS Chertkow H Hyman BT Jack CR Jr Kawas CH Klunk WE Koroshetz WJ Manly J J Mayeux R Mohs RC Morris JC Rossor MN Scheltens P Carrillo MC Thies B Weintraub S Phelps CH 贾建平(译) 陆璐(译) 张逸驰(译) 黄丽(译) 韩阅(译) | 2012 | 中华神经科杂志2012，45，5： | 52 |
| 3 | 美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:对阿尔茨海默病诊断指南的推荐和介绍显示文摘背景:尽管早在1984年就制定了阿尔茨海默病(AD)的临床诊断标准,但是近年来的研究进展从未被补充到诊断标准中。因此,制定一个新的临床诊断标准已经成为大家的共识。方法:在2009年,美国国立老化研究所与AD协会组织了一系列圆桌会议,目的是讨论用于AD临床和科研的诊断标准的修订路线。经讨论后决定组建3个独立的工作组,分别制定AD在3个不同疾病发展阶段的诊断标准,即痴呆阶段、有症状的痴呆前期、无症状的临床前期。结果:修订版AD诊断标准与1984年版诊断标准有两处显著的差别:加入了能提示潜在疾病状态的生物标志物的内容;制定了不同认知障碍阶段的诊断标准。其中,3个工作组一致认为,生物标志物的诊断价值还需要更多研究来规范和验证。另外,修订版中还明确区分了仅存在AD病理生理改变(语义性)和仅存在AD临床表现(概念性)两种诊断的差别,该内容在1984年版中没有体现。结论:修订版AD诊断标准中共产生了3个文件,其中,核心的关于AD的痴呆阶段诊断标准和可归于AD的MCI阶段标准推荐用于临床诊断,而临床前期诊断标准仅推荐用于研究使用。 | Jack CR Jr Albert MS Knopman DS McKhann GM Sperling RA Carrillo MC Thies B Phelps CH 贾建平(译) 李丹(译) 閵芳菊(译) 陆璐(译) 张逸驰(译) 黄丽(译) | 2012 | 中华神经科杂志2012，45，5： | 26 |
| 4 | 术中应用荧光素钠有利于胶质母细胞瘤浸润边缘的手术切除(英文)显示文摘Objective Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma( GBM).Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue,facilitating safe maximal resection of GBM. In this study,the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing( CE) regions,where this relationship has been established,and into the nonCE( NCE),diffusely infiltrated margins. Methods Thirty-two patients received fluorescein sodium( 3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter.Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis,histopathological evaluation of localized biopsy specimens,and radiological volumetric assessment of the extent of resection.Results Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors,thus serving as a visual guide during resection. Gross-total resection( GTR) was achieved in 84% of the patients with an average resected volume of 95%,and this rate was higher among patients for whom GTR was the surgical goal( GTR achieved in 93. 1% of patients,average resected volume of 99. 7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions,with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. Conclusions Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findingssupport the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal. | Neira JA Ung TH Sims J Malone HR Chow DS Samanamud JL Zanazzi GJ Guo X Bowden SG Zhao B Sheth SA McKhann GM 2nd Sisti MB Canoll P D'Amico RS Bruce JN | 2016 | 中华神经外科疾病研究杂志2016，15，5： | 2 |
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