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@#Objective: To investigate the application of the calculated electrophysiological parameters in early diagnosis of carpal tunnel syndrome (CTS). Methods: 44 patients (60 hands) with a diagnosis of CTS and 31 healthy volunteers (44 hands) were enrolled. Acquired indicators include median nerve distal motor latency (DML), complex muscle action potential (CMAP) amplitude, conduction velocity (MCV), median nerve sensory nerve action potential (SNAP) amplitude, and conduction velocity (SCV). Then the terminal latency index (TLI), the residual latency (RL), and the difference in peak sensory latencies between the median and ulnar nerves (ΔPSL) were calculated. Results: The two groups were matched in age and gender distribution. The CTS group showed significant difference in SCV, DML, SNAP, and CMAP compared with the control group. The sensitivity, specificity, cutoff value, Youden index, and area under the curve of each indicator are respectively as follows: TLI (0.733, 0.932, 0.622, 0.629, and 0.877), RL (0.750, 0.977, 1.334, 0.727, and 0.907), ΔPSL (0.950, 0.841, 0.150, 0.791, and 0.942), SCV (0.950, 0.796, 56.5, 0.746, and 0.946), DML (0.867, 0.932, 3.55, 0.799, and 0.930), SNAP (0.683, 0.932, 21.68, 0.615, and 0.844), and CMAP (0.683, 0.773, 8.76, 0.456, and 0.758). Conclusion: The calculated electrophysiological parameters have higher sensitivities and specificities relative to a single electrophysiological parameter, which could greatly improve the accuracy of early diagnosis of CTS.
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Objective To evaluate the value of neurophysiological index ( NI) in evaluating the rate of progression of amyotrophic lateral sclerosis ( ALS ) . Methods Forty-eight patients with ALS were enrolled in Zhongda Hospital of Southeast University from January 2010 to August 2016, of whom 36 patients met the ALS definite diagnostic criteria , 12 patients met the ALS probable diagnostic criteria ( following study confirmed those patients met the ALS definite diagnostic criteria ) , including 8 bulbar-onset and 40 upper extremity onset forms of the disease .Fifty-four age-and sex-matched healthy subjects served as controls.After evaluated by the ALS Functional Rating Scale-revised ( ALSFRS-R) , all subjects underwent electrophysiological examination in the Electromyography Lab of the hospital .The rate of disease progression (ΔFS) =48-total ALSFRS-R score at initial visit/symptom duration (months).The relevance between the complex muscle action potential (CMAP), F frequency, distal motor latency (DML), NI and the ΔFS was investigated respectively.Results In ALS group, the ALSFRS-R score was 14.56 ±10.10, the duration from onset to diagnosis was (14.56 ±10.10) months, and theΔFS was 1.54 ±1.18 per month.The median nerve NI in ALS group was 0.60 ±0.76, in control group was 2.56 ±0.78, with statistically significant difference between two groups (t=-12.5, P<0.01).The ulnar nerve NI in ALS group was 0.70 ±0.55, in control group was 0.96 ±0.10, also with statistically significant difference between two groups (t=-0.31, P=0.003).The median nerve NI and ulnar nerve NI both were negatively correlated withΔFS (r=-0.63, P=0.000; r=-0.506, P=0.007).The ΔFS was exponentially based on median nerve NI (R2 =0.668, P<0.01).Conclusion NI is an objective electrophysiological index , which could be used to evaluate the rate of disease progression in ALS , and to evaluate the prognosis of the disease .
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Objective To analyze features of clinical manifestation, electrophysiology, imageology and molecular ge?netics of familial carpal tunnel syndrome (FCTS), especially research progress in genetics. Methods Clinical data, labo?ratory and electrophysiologyical results as well as medical images were collected from the propositus. In addition, genetic analysis around peripheral neuropathy was performed on the proband, son of the proband and the affected relatives in the family. Result Patients showed a typical bilateral CTS with early onset. The mode of inheritance in this family was auto?somal dominant.. Gene sequencing revealed point mutations in INF2, KIF1B, TRPV4 and SCN9A. Besides, the possibili?ty of having hereditary neuropathy with liability to pressure palsy(HNPP)or familial amyloidosis (FAP) was excluded by the molecular genetic studies. Conclusion Primary FCTS exists as a separate autonomic entity, which may be caused by other unknown genes and therefore warrants further exploration.
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Objective To explore the effect of morning nursing round and direction for key patients in geriatric comprehensive surgery department.Method Four hundred and twenty-six patients from January to December,2012 were assigned to control group,where routine morning nursing round was carried out.Another 453 patients from January to December in 2013 were assigned to observation group,where the morning nursing round and direction for key patients was carried out.The two groups were compared in terms of the general nursing quality,the rate of nurses knowing the disease condition and the rate of professional knowledge acquisition. Result After the application of morning nursing round for key patients,the general nursing quality,the rate of nurses knowing disease conditions and the rate of professional knowledge acquisition in the observation group were all significantly higher than those the control group(all P<0.05).Conclusion The morning nursing round and directions for key patients may remarkably improve the rate of nurses’knowing the disease conditions and professional knowledge acquisition and general nursing quality so that their professional skills and comprehensive quality can be further upgraded.
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The incidence of dysphagia after stroke is high.It may affect the rehabilitation of patients and increase mortality.The assessment is of great significance for early objective examination of dysphagia,in which the bedside screening tests are the most common assessment methods in the routine clinical work.This article reviews the advances in research on the commonly used bedside screening tests of dysphagia.
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Objective:To explore the effects of peroxisome proliferator-actived receptors-?(PPAR-?)agonists rosiglitazone and non-steroidal anti-inflammatory drugs(NSAIDs) ibuprofen on tumor necrosis factor-?(TNF-?)mRNA expression in the brain of rats with acute experimental autoimmune encephalomyelitis(EAE).Methods:EAE models on rat were established by inoculating the homogenate containing spinal cord of guinea pig and complete Freund's adjuvant,and then treated by rosiglitazone and ibuprofen respectively.The improvement of clinical manifestations was assessed to determine the curative effect of the two medicines and TNF-? mRNA expression level was detected by RT-PCR.Results:Compared with EAE group,the groups with rosiglitazone and ibuprofen showed improvement in clinical manifestations ,and the expression of TNF-? mRNA reduced markedly(P0.05).Conclusions:PPAR-? agonists rosiglitazone and NSAIDs ibuprofen could obviusely improve the clinical manifestations of EAE rats,and decrease the level of the expression of TNF-? mRNA,which suggested PPAR-? agonists may have the anti-inflammation neural protective function on EAE or multiple sclerosis(MS),and the anti-inflammation of ibuprofen may be related to the activation of PPAR-?.