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目的研究以孤立性头昏为表现的病毒性脑炎患者的临床特点，分析前庭功能检查、脑脊液细胞学等对这类患者的诊断效能。方法收集以孤立性头昏为表现的病毒性脑炎患者37例，健康志愿者10名。收集患者临床资料如眩晕障碍量表（ DHI）评分、头部影像学、脑电图、前庭功能检查、脑脊液常规、生化、细胞形态学、病原学二代测序、误诊情况等。分析各类检查对患者诊断价值的ROC曲线下面积（AUC）。对比治疗前后各检查的变化情况。结果89.19%（33/37）患者的初步诊断存在误诊。64.86%（24/37）患者前庭功能平滑跟踪试验提示前庭中枢病变（AUC值：0.82）。86.49%（32/37）患者CSF转化型淋巴细胞数量增多（AUC值：0.93），97.30%（36/37）患者CSF大淋巴细胞增多（AUC值：0.99），94.59%（35/37）患者激活单核细胞增多（AUC值：0.97）。18.92%（7/37）患者脑电图慢波增多（AUC值：0.60）。13.51%（5/37）患者头MR表现为皮层肿胀（AUC值：0.60）。抗病毒治疗后患者的头昏等级下降（Z=-4.899，P<0.001），平滑跟踪异常（Z=-4.583，P<0.001）减少，CSF转化型淋巴细胞比例（t=4.281，P<0.001）、大淋巴细胞比例下降（t=6.905，P<0.001）。结论孤立性头昏表现的病毒性脑炎误诊率高。将脑脊液细胞学检查中大淋巴细胞、转化型淋巴细胞、激活单核细胞的增高和前庭功能检查相结合，可使平滑跟踪实验具有较高诊断效能。

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This paper reviews a collective narrative practice project conducted by the Wellness Mind Centre of the Hong Kong Federation of Youth Groups and HKBU for junior secondary students whose lives have been affected by "internet addiction." Despite the pathological label of "internet addiction," the project was able to rebuild young people’s preferred identity and reconnect their knowledge, skills, values, commitment, hopes, and dreams about life through collaboration with their significant others. Inviting teachers and parents as outsider witnesses, young people’s stories and achievements were shared, heard, understood, retold, and thickened in the telling and retelling process. Student participants, teachers, and parents were invited to share their experiences of the project in different focus group interviews. This paper discusses the project and the reflections it brings on the lives of young people, teachers, and parents. [ABSTRACT FROM AUTHOR]