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Objective To investigate the clinical characteristics of skull cranial langerhans cell histiocytosis in children and improve clinical understanding and therapeutic effect Methods A retrospective clinical study was conducted in 29 cases of skull cranial langerhans cell histiocytosis treated in Shengjing Hospital Affiliated to China Medical University from January 2012 to January 2018. Results The main lesion of skull bone was dissolved bone. Among them, there were 5 cases of frontal bone lesions, 10 cases of temporal bone lesions, 2 cases of occipital lesions, and 12 cases of multiple lesions in the skull;There were 10 cases of vertebral lesions and 5 cases of multiple bone lesions involved around the body. Other clinical manifestations included insipidus in 4 cases, erythra in 3 cases, hepatosplenomegaly in 2 cases and lymphadenectasis in 1 case. All cases were followed up for 0.5 to 5.0 years. In the group of combined surgery and chemotherapy treatment, the prognosis of single system involvement cases was that 9 patients were cured, 2 patients were stable and 1 patients were progressing, while the prognosis of multiple systems involvement cases was that 1 patient was cured, 2 patients were stable and 3 patients were progressing. The prognosis of patient with multiple systems lesions was relatively poor compared to that of the cases of single system lesion and there was statistical difference. In the pure operation group , the prognosis of single system involvement cases was that 5 patients were cured, 1 patient was stable and 1 patient was progressing, while the prognosis of multiple systems involvement cases was that 1 patient was stable and 3 patients were progressing. Conclusions Children with skull cranial langerhans cell histiocytosis present single or multiple cranial osteolytic lesions. It is often accompanied by multiple systems lesions around the body, and prognosis of children with multiple systems lesions was is relatively poor.
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Objective To investigate the clinical value of hysteroscopy and combined laparoscopic surgery in the treatment of previous cesarean scar diverticulum (PCSD).Methods 36 cases of PCSD in our hospital from January 2013 to January 2015 were selected.Among them,13 cases were treated with hysteroscopy diverticulum incision (hysteroscopic surgery group),and 23 cases underwent hysteroscopy combined with laparoscopy diverticulectomy repair (combined operation group).The diagnosis and surgical treatment of PCSD patients were recorded and the pregnancy outcome was followed up.Results The operation time [(39.5 ± 17.1) min vs (92.3 ± 30.8) min],the amount of bleeding [(18.2 ± 5.6) ml vs (98.6 ± 24.4) ml] and the length of hospital stay [(2.3 ± 0.6) days vs (5.2 ± 1.1) days] in hysteroscopic surgery group were less than those of hysteroscopy combined with laparoscopy (P ＜ 0.05).The time of vaginal bleeding after operation [(6.3 ± 1.7) days vs (13.4 ± 2.7) days] & [(6.9 ± 2.2) days vs (14.0 ± 3.1) days] was significandy less than that before operation in two operation methods (P ＜ 0.05).8 cases effective,1 cases partially effective,3 cases invalid were in the hysteroscopy group,while 16 cases effective,5 cases partially effective,2 cases invalid were in the combined operation group.The difference of curative effect between the two surgical methods was not statistically significant (P ＞0.05).17 cases of fertility requiring patients underwent hysteroscopy combined with laparoscopy diverticulectomy repair,of which 8 eases were successfully delivered after operation.Conclusions Individualized clinical decision-making should be made for PCSD patients.Hysteroscopy and combined hysteroperitoneal surgery have the same effect,but the latter should be chosen for those with severe clinical symptoms or reproductive needs.
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Objective@#To evaluate whether restricted breathing movement by wearing elastic chest belt within half a year postoperatively could decrease the incidence of chest wall deformity after costal cartilage harvesting.@*Methods@#The contour of chests of the patients receiving the third-stage operation of auricular reconstruction was assessed 1 year after costal cartilage harvesting with history collection and physical examination. The incidence of costal wall deformity was summarized and compared by wearing elastic chest belt or not within half a year postoperatively. Logistic regression was used to analyze the significance of results.@*Results@#Thirty-eight eligible patients were enrolled in the study. The incidence of chest wall deformity in patients wearing chest elastic chest belt as requested for half a year was lower (64.7% vs. 95.2%), and the difference was statistically significant, OR 10.9, 95%CI[1.16, 102.60], P=0.037.@*Conclusions@#Restricted breathing movement by wearing elastic chest belt within half a year postoperatively could decrease the incidence of chest wall deformity following costal cartilage harvesting through decreasing the traction force caused by respiratory muscles and intrathoracic negative pressure.
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Objective To investigate the value of serum D-dimer in evaluating the severity and the prognosis of patients with acute spontaneous subrachnoid hemorrhage.Methods The clinical data of 157 patients with acute spontaneous subrachnoid hemorrhage were collected,and the level of D-dimer in elbow vein serum were measured.The severity of the disease was judged by Hunt-Hess classification,and the patients,brain CT scans were scored according to the modified Fisher scale.The patients were followed up for 3 months.Based on the modified RANKIN scale (mRS scale),patients were divided into unfavorable prognosis group (3≤ mRS ≤5) and good prognosis control group (1 ≤ mRS ≤2).Results In the 157 cases of spontaneous subrachnoid hemorrhage patients,there were 45 cases in the unfavorable prognosis group and 112 cases in the good prognosis control group.The level of D-dimer in the unfavorable prognosis group was significantly higher than the level of control group and there were significant differences between them (P ＜ 0.01).By the Spearman correlation analysis,the level of D-dimer was positively correlated with Hunt-Hess score (r =0.831,P ＜0.01),and it was also positively correlated with unfavourable prognosis mRS scale (r =0.834,P ＜0.01).Furthermore,regression analysis showed that high level of D-dimer was an independent risk factor for the poor prognosis of patients (OR =1.011,95％ CI:1.007-1.016,P ＜ 0.01).Through the receiver operating characteristic curve (ROC) analysis of the D-dimer in patients with poor prognosis,the area under ROC curve was 0.964 (95％ CI:0.93-0.98,P ＜ 0.01),sensitivity and specificity were 88.9％ and 99.1％,respectively.The cut-off point of D-dimer content was 739 μg/L.Conclusions The level of D-dimer in patients with acute spontaneous subrachnoid hemorrhage was closely related to the severity of the diseases,and high level of D-dimer was an independent risk factor for the prognosis of patients.
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Objective To retrospectively analyze and compare the intraoperative and postoperative clinical efficacies between the interhemispheric approach and pterional approach in craniotomy anterior communicating aneurysm clipping surgery.Methods A total of 21 cases of anterior communicating artery aneurysms with subarachnoid hemorrhage undergoing surgery of craniotomy clipping from January 2012 to December 2016 in the Department of Neurosurgery of Shengjing Hospital of China Medical University,in which 13 cases were treated by pterional approach and 8 cases were treated by interhemispheric approach.Two kinds of operation approaches were compared in operation time,intraoperative aneurysm rupture rate,intraoperative bleeding volume,average length of stay,incidence rate of postoperative fection,and Glasgow Outcome Scale (GOS).Results There were no significant difference in intraoperative aneurysm rupture rate,intraoperative bleeding volume,inicidence rate of postoperative infection rate,and GOS scores (P ＞ 0.05).But the opreration time and average length of stay in interhemispheric approach group were significantly shorter than the pterional approach group (P ＜ 0.05).Conclusions Approach of interhemispheric was a safe,effective,and convenient approach for the craniotomy of clipping in anterior communicating artery aneurysm.
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Objective To retrospectively analyze and compare the intraoperative and postoperative clinical efficacies between the interhemispheric approach and pterional approach in craniotomy anterior communicating aneurysm clipping surgery.Methods A total of 21 cases of anterior communicating artery aneurysms with subarachnoid hemorrhage undergoing surgery of craniotomy clipping from January 2012 to December 2016 in the Department of Neurosurgery of Shengjing Hospital of China Medical University,in which 13 cases were treated by pterional approach and 8 cases were treated by interhemispheric approach.Two kinds of operation approaches were compared in operation time,intraoperative aneurysm rupture rate,intraoperative bleeding volume,average length of stay,incidence rate of postoperative fection,and Glasgow Outcome Scale (GOS).Results There were no significant difference in intraoperative aneurysm rupture rate,intraoperative bleeding volume,inicidence rate of postoperative infection rate,and GOS scores (P ＞ 0.05).But the opreration time and average length of stay in interhemispheric approach group were significantly shorter than the pterional approach group (P ＜ 0.05).Conclusions Approach of interhemispheric was a safe,effective,and convenient approach for the craniotomy of clipping in anterior communicating artery aneurysm.
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Objective To investigate the diagnostic value of bronchoscopy in smear negative pulmonary tuberculosis.Methods 65 cases with cavernous and 35 non -cavernous negative smear pulmonary tuberculosis were examined by bronchoscopy.Results The positive rates of sputum examination in the empty group,the non empty group and the total sputum examination were 49.2%,17.1% and 38%,respectively.There was statistically signifi-cant difference in sputum positive rate between empty group and non empty group (χ2 =9.942,P =0.002).The posi-tive rate of sputum was 28%.The positive rate of sputum negative and sputum positive rate was 10% after operation. Microscopically visible tracheal and bronchial abnormalities,tracheal inflammatory change rates of empty group and non empty group were 52.3%,40.0%,the difference between the two groups had no statistically significant difference (χ2 =1.381,P =0.240).The tracheal stenosis rates of hole group and non empty group were 9.0% and 11.4%,the difference between the two groups had no statistically significant difference (χ2 =0.122,P =0.727).The overall trachea abnormal changes rate was 58.0%,including inflammatory change rate 48.0% and 10.0% stenosis rate. Conclusion Bronchoscopy has significant clinical value in smear negative pulmonary tuberculosis,especially with cavernous.The positive rate will be promoted after bronchoscopy,and can find abnormal changes of tube.
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Objective To investigate the effect of electrical stimulation to cerebellar fastigial nucleus on expression of nuclear fac-tor-kappa B (NF-кB) P50, tumor necrosis factor-α(TNF-α) and Bcl-xL mRNA in rats brain after cerebral ischemia-reperfusion. Methods Sprague-Dawley rats were randomly divided into normal control group (NC group), cerebral ischemia-reperfusion group (I/R group), fasti-gial nucleus stimulation (FNS) group, and fastigial nucleus lesion (FNL) group. A focal cerebral ischemia-reperfusion model was established with middle cerebral artery occlusion (MCAO). 7 and 14 days after operation, the infarct volume was measured, and the protein of NF-кB P50 in rats brain was detected with Western blotting;the expression of TNF-αand Bcl-xL mRNA was detected with RT-PCR. Results Com-pared with I/R group, the expression of NF-кB P50 protein increased in FNS group (P0.05). Conclusion FNS could induce the expression of P50 protein and Bcl-xL mRNA, and inhibit the expression of TNF-αmRNA, and reduce infarct size, which may associated with the neuroprotection of central ner-vous system from injury.
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Objective To investigate the value of adenosine deaminase( ADA) for the diagnosis of tubercu-lous pleural effusion.Methods A retrospective analysis was made of 324 cases of tuberculous pleural effusion patients which were effective treated and 68 cases were diagnosed of malignant pleural effusion.By drawing receiver operating characteristic curve, the best threshold of diagnosing of tuberculous pleural effusion was determined,and the distribution characteristics of ADA in tuberculous pleural effusion were analyzed.Results When the ADA was set at 19.5U/L it was good for identifying tuberculous empyema and tuberculous pleurisy.The activity of ADA in group of different gender did not have significant difference(Z=-0.572,P=0.283).The activity of ADA had significant difference between tuberculous empyema with tuberculous pleurisy patients(Z=-2.317,P=0.01),and the same as in group of different ages between less than or equal to 45 years old with the others(Z=-2.387,P=0.008).The activity of ADA had significant difference between tuberculous empyema and tuberculous pleurisy patients of younger than 45 years old(Z=-2.740,P=0.003),but not in the group of less than or equal to 45 years old (Z=-0.267, P=0.390).Conclusion The activity of ADA is good for identifying diagnosis of tuberculous pleural effusion and malignant pleural effusion, especially in tuberculous empyema and less than or equal to 45 years old patients.The standard of diagnosis and the nature of the tuberculous pleural effusion may affect the cut-off value of ADA.
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A total of 41 patients with aspiration pneumonia after nasopharyngeal carcinoma radiotherapy were retrospectively selected from January 2005 to December 2010.They were divided into early bronchoscopy group (n =24) and conventional therapy group (n =17) to analyze the therapeutic effects of early bronchoscopy on temperature,white blood cell (WBC),absorption of chest radiography and mortality rates.The temperature and WBC were at the same level between both groups at pre-treatment [(38.7 ±0.7)℃ vs.(38.5 ±0.7)℃,P=0.633; (15.8 ±4.2) × 109/L vs.(16.2 ±3.4) × 109/L,P =0.430]while the temperature declined obviously after a 3-day treatment [(37.3 ±0.9)℃ vs.(38.4 ± 1.4)℃,P =0.015] and also WBC after a 5-day treatment[(10.6±4.2) × 109/L vs.(15.3 ±6.9) × 109/L,P=0.045].The bronchoscopy group had a faster absorption of chest radiography (Z =-3.515,P =0.00).The mortality rate showed no statistically significant difference between both groups.
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Objective To investigate changes in the expression of prepro-orexin and orexin receptor-1 ( OX1R) following permanent middle cerebral artery occlusion ( MCAO ) with or without preconditioning through electrical stimulation of the cerebellar fastigial nucleus (FNS). Methods Wistar rats were subjected to permanent MCAO and randomly divided into 5 groups: a sham-operated control group (PO), an FNS preconditioning + shamoperated control group (FNS-PO) , an ischemia group, an FNS preconditioning + ischemia group (FNS-PI) and a cerebellar fastigial nucleus injury + FNS preconditioning + ischemia group (FNL-FNS-PI). Each group was divided into 5 subgroups according to the time at which the animals were sacrificed after the MCAO ( 1, 3, 6, 12 and 24 h).RT-PCR was used to detect expression of OX1R mRNA, and ELISA to measure the levels of orexin-A in the hypothalamus and plasma. Results The immunoreactivity of prepro-orexin decreased significantly in the PI groups, with further decreases over time. At the 12th h after MCAO, the immunoreactivity of prepro-orexin reached a minimum.There were significant differences between the rats in the PO and FNS-PO groups. On the contrary, the immunoreactivity of OX1R increased significantly in the PI groups, with further increases continuing over time, peaking at 12 h after the MCAO. There were significant differences between the PO and FNS-PO groups. In the rats with FNS preconditioning (PI-FNS) , the decrease in prepro-orexin and the increase in OX1R were significantly inhibited compared to the PI subgroups at the 6th and 12th hour. There was no significant difference between the FNL-PIFNS group and the PI group. The expression of OX1R mRNA increased significantly in the PI group, with further increases continuing over time, peaking at 24 hours. The plasma levels of orexin-A were not significantly different among the groups, but the levels of orexin-A in the hypothalamus decreased significantly in the PI and FNL-PI-FNS groups, with further decreases continuing over time. At the 12th h after the MCAO the levels were significantly different compared with the PO and PO-FNS groups. While in the rats with FNS preconditioning (PI-FNS) , the decrease in orexin-A level was reversed and there was no significant difference compared with PO and PO-FNS groups. Conclusions The orexinergic system is altered following cerebral ischaemia. FNS preconditioning may be able to regulate these changes.
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Objective To investigate the effect of preconditioning through stimulation of the fastigial nucleus (FNS)on the expression of matrix metalloproteinase-9 after cerebral ischemia. Methods A total of 312 male Wistar rats were divided randomly into three groups:a control group,a sham-FNS group and a FNS group.All the rats in the sham-FNS and FNS groups were subjected to middle cerebral artery occlusion(MCAO)by using a thread to occlude the right middle cerebral artery,while those in the control group were subject only to a similar operative procedure without real MCAO.Twenty-four hours before the operation,all the rats in the FNS group were given 1 hour of preconditioning FNS,while those in the sham-FNS group was given sham-FNS.Individuals were sacrificed at the 6th,12th,24th,and 72nd hour after MCAO.The brain water content was measured by the dry-wet weight method.The blood-brain barrier(BBB)permeability was measured using Evan's blue.MMP-9 protein expression was measured by Western blotting.Results The water content in the ischemic brain tissue,the BBB permeability and the expression of MMP-9 were all found to be significantly higher in the sham-FNS group than in the control group.Compared with the sham-FNS group,the brain water content and BBB permeability were significantly lower in the FNS group,while M MP-9 protein expression also decreased significantly.Conclusion FNS preconditioning can inhibit MMP-9 expression,thereby relieving BBB permeability and ischemic brain edema.
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BACKGROUND: International research discovers that the risk factors of stroke have certain correlation with microalbuminuria(MAU) but the results are inconsistent.OBJECTIVE: To investigate the relationship between the incidence of MAU in patients with acute cerebral infarction and the risk factor of stroke and the recurrence of cerebral infarction.DESIGN: A case-control study based on patients with acute cerebral infarction and individuals with risk factors of cerebral infarction, and the healthy elderly as controls.SETTING: Inpatient department of neurology in a university hospital.PARTICIPANTS: Totally 214 cases with cerebral infarction or risk factors of cerebral infarction aged between 50 and 80 years old were selected from the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University between January 2000 and December 2001. Acute cerebral infarction group (infarction group, attack within one week, n =78), cerebral infarction risk factor group(risk group, n = 56), such as, hypertension, diabetes,coronary heart disease (CHD), transient ischemic attack(TIA) or stroke history(more than 6 months), and healthy elderly(control group, n=28) .Thereinto, combined group( n = 109) included 78 cases of acute cerebral infarction and 31 cases with TIA or stroke history of risk factors.METHODS: Seralbumin, serum creatine(SCr), blood sugar, total cholesterol, total triacylglycerol(TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol(LDL-C) were detected after more than 12 hours of fasting. The albumin in the first urine in the morning was detected by radio-immunity analysis.the incidence of neo-vascular affair in 2 years of follow-up including recurtute indicator: incidence of MAU in each group.RESULTS: Patients with MAU accounted for 35% of acute cerebral infarction, which were significantly higher than that of risk group(15% ) and control group(3.5%, P ＜ 0.01). Six independent risk factors predicting MAU existed in infarction group and combined group, which were diabetes, seralbumin level, age, CHD, hypertension, and HDL-C( P ＜ 0. 05, or P ＜ 0.01).After(1.5 ±0. 9) years of follow-up, 23% of patients of infarction group suffered from recurrent vascular accident, which was significantly higher than that of risk group(12% ) and control group(0%, P ＜ 0.01 ). 36% of MAU patients in infarction group suffered from recurrent vascular accident, which was significantly different from that of patients with a great deal of albuminuria(41% ) and normal albuminuria(10%, P ＜ 0. 05). MAU is the independent predicting indicator for the recurrence of stroke after the control of diabetes and hypertension in patients of infarction group and risk group with the risk rate of 3.8 (95% CI, 1.2-13.5; P ＜0.05) or 4. 7(95%CI,1.4-16.7, P ＜ 0.01).CONCLUSION: MAU is quite common in acute cerebral infarction patients. After the adjustment of basic risk factors, MAU is the independent risk factor of the recurrence of cerebral infarction.
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Objective To investigate the effect of preconditioning electrostimulation of fastigial nucleus (FNS) on the neuronal mitochondrion of rats early after cerebral ischemia. Methods Forty Wistar rats were used and divided into 5 groups: a normal control group, a sham FNS group and 3 FNS groups. The FNS of the rats in the FNS groups was conducted for 1 hr, 1 day or 7 days, respectively, before the models of middle cerebral artery occlusion(MCAO)were made with them. Three hours after the model was established, the animals were sacrificed and the water content of the brain of the ischemic side was measured. The neuronal mitochondrion was observed by electron microscope, and its Vv, specific volume (Sv) and specific surface (Ss) were analyzed. The rats in the normal control group were not given any special treatment. For the rats in the sham-FNS group, intrinsic neurons of FN were destroyed with ibotenic acid (IBO), and 5 days later, the FN was electrically stimulated, and 1 day later, MCAO models were made. Results Three hours after MCAO, the water content of the brain increased and neurological function score decreased in the sham-FNS group, while the Vv and Sv of neuronal mitochondrion increased and the Ss decreased, which were significantly different from those of the normal control group(P
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Objective To investigate the relation between plasma matrix metalloproteinase 9 (MMP 9) levels and transcranial Doppler (TCD) detected microemboli in patients with cerebral infarction and evaluate the clinical significance. Methods The plasma MMP 9 levels were quantified by ELISA and the microemboli were detected with TCD in 50 stroke patients and 20 controls. Results The level of plasma MMP 9 was significantly higher in microembolic signal positive patients than that in negative ones [median (392.87?210.90) ng/ml for those with emboli versus (202.27?153.40) ng/ml for those without, P
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Objective To investigate the effects of cerebellum fastigial nucleus stimulation (FNS) on right middle cerebral artery occlusion (MCAO) rats with autonomic cardiovascular function disturbances. Methods MCAO model was employed in this study. A total of 60 MCAO rats were randomly divided into FNS group and non cerebellum fastigial nucleus stimulation group (NFNS). The time domain, power spectral components, and chaos of heart rate variability (HRV) were analyzed. Results The power spectral components and chaos of HRV at 3, 5, and 10 d after MCAO were significantly lower than those in the sham group ( P
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Objective To investigate the mechanism of preconditioned neuroprotection of cerebellar fastigial nucleus electrical stimulation(FNS) by means of observation of the effect of FNS on the expressions of PKC? and PKC? in the somatosensery cortex and basal ganglia in rats. Methods FNS models in rats were established. Brain tissue containing the somatosensery cortex and basal ganglia was removed at 0 h and 1, 3, 7 and 10 d respectively after FNS and 20 ?m coronal sections were obtained with a sliding cryo microtome. Immunocytochemical analysis of PKC? and PKC? in 2 sections from each rat was performed and the average optical density of immunostaining was quantified by computer assisted image analysis system. Sham stimulation rats and cerebral dentate nucleus (DN) stimulation rats were used as the control. Results At 0 h after FNS, no significant changes of the expressions of PKC? and PKC? were found in the contralateral somatosensery cortex and basal ganglia. The expressions of PKC? and PKC? increased significantly at 1 d and decreased at 3 d but were still higher than those in sham stimulation group at 7 d and decreased to the basal level of the control at 10 d. However, the expressions of PKC? and PKC? in the ipsilateral somatosensery cortex and basal ganglia were also elevated at 1 d after FNS but the increase was significantly lower than that in the contralateral ones and reached the basal level at 3 d. There was no change of PKC? and PKC? in sham stimulation group at 1 d after DN stimulation. Conclusion The increased expressions of PKC? and PKC? in the somatosensery cortex and basal ganglia induced by FNS may participate in the preconditioned neuroprotection of FNS.
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Objective To observe the effects of electrical stimulation of the cerebellum′s fastigial nucleus on neurogenic autonomic functional disturbances in rats after ischemic stroke. Methods Right middle cerebral artery occlusions (MCAOs) were performed on rats and their heart rate variability (HRV) was analysed. The MCAO rats were randomly divided into a group whose cerebellar fastigial nuclei (FNS) were stimulated and a control group. The power spectrum components and chaos of their heart rate variability were analysed. The MCAOs were performed after two cerebellar fastigial nuclei had been destroyed by pretreatment with ibotenic acid (IBO), to investigate the effect of stimulating the cerebellum′s fastigial nucleus on heart rate variability. Results The power spectral components and chaos in the heart rate variability of the MCAO rats were reduced, and there was a significant difference in the effectiveness rate compared with the sham groups (P
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EEG represents the electric activity of neurons in human brain; it is of course repeatedly used for studying and analyzing the brain activity and the status of brain function. In this paper, we analyzed the patients' and normal persons' EEG in different physiological state, with the aid of two algorithms as a complexity measure. One is Kc complexity defined by Kaspar and Schuster, the other is a new statistical method to measure complexity sequences-Approximate entropy (ApEn). In our work, we analyzed two groups of persons' EEG. Six subjects in 4 different experimental condition are reported. From the results we can discriminate the different state of brain effectively: normal, being injured, and various thinking state. The result suggests that the two algorithms as a complexity measure could be regarded as valued methods in the study of EEG time series and clinical diagnosis.
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Humans , Algorithms , Brain , Physiology , Electroencephalography , EntropyABSTRACT
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.