Problem-based learning (PBL) teaching method can improve students' ability of study,analysis and problem-solving.Network platform based PBL teaching mode combines the network education and PBL teaching mode; it has clear superiority in information acquisition,communication and transmission.Furthermore,it can also solve the problem of inadequate teaching sources.Network platform based PBL teaching mode was applied in neurology teaching to investigate the best scheme and form for teaching plan compilation,network platform building-up and teaching process implementation.At the same time,teaching effect was evaluated and summarized in an aim to improving neurology teaching quality and speeding up the reform of network-based PBL teaching.

Objective To study the correlation between the changes of sex hormone level in different perinatal periods and perinatal depression (PND). Methods Between February 2014 and February 2015, 300 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University were enrolled in this study. In the first trimester (12 weeks), the third trimester (34 weeks) and postpartum period (7 and 42 days), blood samples were collected and radioimmunoassay was performed to detect the levels of sex hormones, including estrogen, progesterone, prolactin, luteinizing hormone and follicle-stimulating hormone. Self Depression Scale and Edinburgh Postnatal Depression Scale were used for psychological assessment, and PND was diagnosed by psychiatrists as PND group, and non-PND cases served as control group. Two-sample t-test, variance analysis and Bonferroni test were used to compare the changes of sex hormones at different time points between the two groups. Results A total of 180 pregnant women completed the four stages of research. Fifity-four cases were diagnosed as PND, including 10 cases in the first trimester, 16 new cases in the third trimester, 14 new cases at postpartum 7 days, and 14 new cases at postpartum 42 days. (1) Comparison of the sex hormone levels between the two groups:The estrogen levels of the first trimester, the third trimester and postpartum 7 and 42 days in PND group were (4 107.30±344.68), (13 261.60±593.32), (1 281.70±151.54) and (161.40±12.21) pmol/L, and lower than in the control group [(8 619.60±514.92), (14 330.00±353.15), (3 585.90±150.83) and (270.50±11.86) pmol/L, respectively] (all P<0.05). The progesterone levels of the first trimester and postpartum 7 and 42 days in PND group were (105.49±20.40), (24.23±3.53) and (6.40±3.53) nmol/L, and higher than those in the control group [(85.80±19.06), (5.71±2.36) and (3.87±2.03) nmol/L] (t=-2.389, -2.660 and -2.103, all P<0.05). The prolactin and luteinizing hormone levels of the postpartum 42 days in PND group were lower than in the control group [(9.40±1.69) vs (17.50±1.64)μg/L, t=-4.059;(0.32±0.21) vs (2.21±0.17) mU/L, t=-12.302] (both P<0.05). The levels of follicle-stimulating hormone in the first trimester, the third trimester and postpartum 7 days were not detectable in both groups, but PND group had a lower level at postpartum 42 days than the control group [(2.22±0.58) vs (3.15±0.29) mU/L, t=-15.525, P=0.000]. (2) Sex hormone levels at different time points:There were significant differences in estrogen levels between the four time points in both groups. There was significant difference in progesterone in the PND group at four time points, while in the control group, significant differences were found between postpartum 42 days and the first and third trimester. Prolactin levels were lowest at postpartum 42 days in both groups among the four time points (Bonferroni test, all P<0.05). Conclusions Low estrogen levels and high progesterone levels and their changes in perinatal period may be correlated with PND.

Objective To analysis the clinical manifestations of a large Spinocerebellar Ataxia 3 pedigree to pro-vide the information for the early diagnosis of Ataxia 3. Methods SCA3/ATXN3 gene was determined by using Poly-merase Chain Reaction and fragment analysis in the large pedigree members and patients ’clinical data was collected. Five patients underwent MRI imaging and fundus examination. Results There were eighteen clinical patients and twelve ATXN3 carriers in this Pedigree . In addition to ataxia, three patients presented with intellectual disability, one with cer-vical spondylosis, one with dysmyotonia, one with disorder in visual system, and seven with abnormality in autonomic ner-vous system. The MRI revealed that pons and cerebellar atrophy in some patients inordinately. Undus examination did not reveal any obvious abnormality. Conclusions The symptoms of SCA3 are heterogeneous in the same pedigree. When patients present with symptoms of cerebellar system, visual system and autonomic nervous system, or cervical spondylosis and intellectual disability, SCA3 should be considered.

Objective To investigate the risk factors for clopidogrel resistance (CR) in patients with ischemic stroke.Methods Turbidimatry was used to measure the platelet aggregation rate changes after the patients with acute ischemic stroke taking 75 mg of clopidogrel per day for 10-14 days.The patients were divided into either a CR or a clopidogrel sensitivity (CS) group according to the platelet aggregation rate changes.The demographic and clinical data of both groups were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CR.Results A total of 147 patients with acute ischemic stroke were included,42 of them (28.57％ ) were in the RC group and 105 (71.43％) were in the CS group.The proportion of patients in diabetes (54.76％ vs.11.43％ ;x2 =31.054,P =0.000),the history of transient ischemic attack (TIA) (80.95％ vs.26.67％ ;x2 =36.251,P=0.000) or percutaneous coronary intervention (PCI) (26.19％ vs.3.81％;x2 =16.400,P=0.000),taking calcium channel blocker (CCB) (83.33％ vs.54.29％ ;x2 =10.810,P =0.001 ),angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) (66.67％ vs.42.86％;x2 =6.803,P=0.009),and proton pump inhibitor (47.62％ vs. 14.29％;x2 =18.375,P =0.000) in the CR group,as well as the levels of plasma total cholesterol (TC),glucose,and glycated hemoglobin were significantly higher than those in the CS group.Multivariate logistic regression analysis showed that diabetes (odds ratio [ OR] 13.711,95％ confidence interval [ CI] 1.667 - 112.784; P =0.015),increased TC level (OR 2.828,95％CI 1.574 - 5.080; P =0.001),previous history of TIA (OR16.627,95％ CI 4.691 - 58.934; P =0.000),and long-term taking CCB (OR 4.147,95％ CI 1.053 - 16.332;P =0.042),and ACEI/ARB (OR 4.841,95％ CI 1.539 - 15.231; P =0.007) were the independent risk factors for CR.Conclusions CR in patients with ischemic stroke is associated with a variety of factors,in which diabetes,increased TC,as well as long-term taking CCB and ACEI/ARB are the independent risk factors for CR.

Statins and antiplatelet drugs are the two cornerstones for the treatment of cerebrovascular disea －ses.This two drugs play a vital role in reducing platelet reactivity and inhibiting inflammation .Statins can effectively delay the progression of atherosclerosis ,reduce plaque volume and reduce the incidence of cerebrovascular diseases through multiple pathways .Clopidogrel is currently used primarily for anti －platelet aggregation .Some studies indicate that clopidogrel is also involved in the process of atherosclerosis ,but the mechanism is not clear .The anti－atheroscle－rosis effect of clopidogrel is often neglected , when statins are combined with clopidogrel .This article reviews the progress in the treatment of atherosclerotic plaque by statin combined with clopidogrel .

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human's health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumu-lates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.