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ObjectiveTo evaluate the feasibility and value of mini-clinical evaluation exercise (Mini-CEX) in clinical neurology practice.MethodsNinety-four interns were randomly divided into observation group and control group,students in control group were teached and managed in accordance with existing management while those in observation group were evaluated by teachers after the 1 st,2nd and 3rd week.At the end of clinical practice,all the students( including students in control group and observation group)were cross assessed by teachers based on the methods mentioned above.Results The time to complete the assessment was about 25 - 40 min.The scores of nervous system examination at the end of the training were significant different between observation group and control group and the scores of diagnosis and treatment on the basis of examination were also significant different between observation group and control group ( P ＜ 0.05 ).ConclusionThe Mini-CEX assessment and feedback to promote teaching effect is feasible in the practice process of neurology,it can make up for the deficiency of current examination.
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Objective:To know the thermal and vibratory thresholds in normal subjects and their relation with age,sex,site and methods.Methods:We used TSA-2001 Ther mal Sensory Analyzer and VSA-6003 Vibratory Sensory Analyzer.Thermal and vibratory tests were performed in 100 healthy subjects on four sites with two methods(reaction time inclusive method and reaction time exclusive method).Results:The normative data of thermal and vibratory thresholds were presented in the table 2 to table 4 in the paper.There were no significant differences in TT and VT between men and females.TT and VT increased with age.There was difference in different sites.TT and VT obtained by the method of limits were higher than those obtained by the method of levels or staircases and it showed a significant positive correlation with each other.Repeatability of the QST allowed for longitudinal studies.Conclusion:QST may assess the sensory functions of human body quantitatively,and the TT and VT are influenced by testing method,site and age of subjects.
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Objective To evaluate the quantitative sensory testing in Guillain-Barre syndrome (GBS) and polyneuropathy (PNP). Methods The quantitative sensory test (QST) was performed with Thermal Sensory Analyzer(TSA-2001) and Vibratory Sensory Analyzer(VSA-6003). Thermal and vibratory sensory tests were performed in the left patients with GBS or PNP and healthy subjects, on four sites of the left limbs by the method of Limits. Stimultaneously sensory conduction velocity (SCV) was measured. Results There were increased TT and VT on distal limbs in the patients with GBS (with or without the symptoms or signs of disturbance of sensation) and PNP. QST in GBS and PNP was more sensitive than the clinical examination and SCV. There was significant association between VT and SCV in GBS, but not a significant association between TT\, VT and SCV in PNP. There was a paradoxical heat sensation in two patients with uremic PNP. Conclusions QST is a sensitive and reliable test and can be a useful test in the diagnosis of PNP.
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Objective: To understand the effect of different rates of stimulus on thermal threshold.Methods: TSA-2001 Thermal Sensory Analyzer was used.The cool,warm,cold pain and heat pain thresholds were determined at the two body sites in two group of age-matched health adults at different rates of stimulus by the method of "Limits".Results: There was no significant difference between the cool threshold and warm threshold at two sites.There was smaller cool pain threshold on left dorsum pedis and heat pain threshold on left fingers as the rate of stimulus was faster,while larger thresholds appeared as the temperature change was slower.There was significant difference between the above-mentioned two thresholds at different rates of stimulus.There was no significant difference between the thresholds of the cold pain on left fingers,the heat pain on left dorsum pedis.Conclusion: There is no significant difference between the warm,cool thresholds at the different rates of thermal stimulus by the method of "Limits" when the rate of thermal stimulus is low and the difference of two rates of thermal stimulus is smaller.The cool pain and heat pain threshold may degrade or not differentiate when the increase of the rate of stimulus is not enough.
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Objective To evaluate the application of quantitative sensory testing (QST) to diabetic peripheral neuropathy. Methods TSA 2001 thermal sensory analyzer and VSA 6003 vibratory sensory analyzer made in Israel were used for thermal, vibratory tests and sensory conduction velocity (SCV) at four different locations of extremities in 45 diabetics and 22 normal persons. Results The thermal threshold (TT) and vibratory threshold (VT) of the diabetics were higher than those of age matched normal controls. In diabetics the TT was more frequently abnormal than the VT, which suggested that the small nerve fibers were more vulnerable than large fibers. Quantitative thermal testing (QTT) was more sensitive than quantitative vibratory testing (QVT) and SCV in diabetic peripheral neuropathy, especially in subclinical neuropathy. There was no significant correlation between the TT or VT and blood glucose in diabetics. Conclusion QTT is a sensitive method for diagnosis of diabetic neuropathy.
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Objective To evaluate the feasibility of monitoring intracranial pressure(ICP) by determining intraocular pressure(IOP).Methods ICP(55 case times) in 34 patients with central neural system diseases was measured by lumbar puncture,and their IOP of both eyes was measured by two scales of Schiotz tonometer and the mean value was calculated.Results There was a significant correlation between ICP and mean IOP(P