Early incidence and prognosis of ICU-acquired weakness in mechanical ventilation patients / 中华危重病急救医学

Objective To observe the early morbidity of ICU-acquired weakness (ICU-AW) in mechanical ventilation patients, and to analyze the risk factors and prognosis of ICU-AW. Methods A prospective cohort study was conducted. The patients undergoing mechanical ventilation admitted to intensive care unit (ICU) of Fu Xing Hospital of Capital Medical University from April 2016 to February 2017 were enrolled. The peroneal nerve test was performed on (3±1) days of mechanical ventilation, and complete neuro-electrophysiological examination was performed next on the patients with positive result of peroneal nerve test. The abnormal cases were enrolled in the observation group, others were enrolled in the control group, then the early incidence of ICU-AW was obtained. The control group reviewed the peroneal nerve test after 10 days, and the late ICU-AW incidence was obtained. Death, ICU discharge, or over 60 days of ICU stay were set to the endpoints of observation. Demographic data, basic indicators, drug usage, comorbidities and metabolic markers during the study period, outcome data were collected and analyzed, and risk factors and of early ICU-AW in mechanical ventilation patients were identified by multivariate Logistic regression analysis. Results A total of 60 patients were enrolled in the study, with 19 patients in the observation group, and 41 in the control group, with the early ICU-AW incidence of 31.7%. In the control group, 8 patients reviewed the peroneal nerve test after 10 days, of

Relationship of BMI and wrist joint index with carpal tunnel syndrome in manual laborers / 中华劳动卫生职业病杂志

Objective@#To evaluate the severity of median nerve damage in patients with carpal tunnel syndrome (CTS) , and to analyze its relationship with body mass index (BMI) and wrist joint index.@*Methods@#From May 2016 to January 2017, 23 patients with mild CTS (mild group) and 35 patients with moderate to severe CTS (moderate to severe group) were enrolled in this study. And 22 healthy volunteers matched for sex and age were selected as control group. The neuroelectrophysiological monitor was used to measure the median nerve movement and sensory nerve conduction in the subjects. The BMI and wrist joint index were calculated. The relationship of neuroelectrophysiological parameters with BMI and wrist joint index was analyzed in the CTS patients.@*Results@#Compared with the control group, the mild group and the moderate to severe group had significantly higher wrist joint index, significantly longer distal motor latency (DML) of the median nerve, and significantly lower sensory nerve conduction velocity (SNCV) and sensory nerve action potential (SNAP) amplitude of the finger 1-wrist and finger 3-wrist (P<0.01) ; the moderate to severe group had significantly higher BMI and significantly lower composite muscle action potential (CMAP) amplitude (P<0.01) . The wrist joint index and BMI were positively correlated with DML of the median nerve and negatively correlated with SCV and SNAP amplitude of the finger 1-wrist and finger 3-wrist (all P<0.05) . The patients with a wrist joint index of >0.73 had a significantly higher risk of CTS than those with a wrist joint index of <0.73 (odd ratio=30.67, 95% confidence interval: 3.79-248.36) .@*Conclusion@#A wrist joint index of >0.73 is an independent risk factor for CTS in manual laborers. CTS should be prevented in the manual laborers with high wrist joint index and BMI.

Analysis on risk factors of peripheral neuropathy in type 2 diabetes mellitus and observation on the effect of prostaglandin analogue / 中国生化药物杂志

Objective To explore the electrophysiological examination results and risk factors of type 2 diabetic peripheral neuropathy. Methods 337 patients with type 2 diabetes from August 2014 to December 2016 in the first people's hospital in Shizuishan city were divided into DPN group (n=218) and NPDN group(n=119) according to the results of NCV and SSR examinations. The general information and laboratory biochemical indicators in the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of DPN. Results The diagnosis rate of DPN detected by NCV combined with SSR was higher than that of NCV or SSR alone(P<0.05);There were significant differences in age,duration of diabetes,history of hypertension,systolic blood pressure,2h FBG,HbA1c,FINS,2 h INS,FC-P, 2h FC-P,ACR between the DPN group and NPDN group(P<0.05);Logistic multivariable analysis showed that age, duration of diabetes, 2h FBG, HbA1c, ACR were independent risk factors for DPN. Conclusion It is beneficial to increase the diagnosis rate of DPN by NCV combined with SSR. There is a higher incidence rate of DPN type 2 diabetes patients with older grade, longer duration of diabetes, higher 2h FBG, HbA1c and ACR.

Analysis of esoPhageal electro Physiological examination of 12 wide QRS comPlex with tachycardia / 中国综合临床

Objective To identify the charactor of wide QRS complex tachycardia( WCT)throuGh transesophaGeal atrial pacinG( TEAP ). Methods TEAP and intracadiac electrophysioloGical examination infoamation of l2 cases WCT were collected and analyzed from January to February in 20l2 of Wuhan Asia Heart Hospital. Results Comparison of TEAP and intracadiac electrophysioloGical examination showed that l0 in l2 patients were match. Conclusion TEAP is a rapid and convenient method to diaGnose most WCT.

The features and diagnostic value of electrophysiological examination in tarsal tunnel syndrome / 中华物理医学与康复杂志

Objective To investigate the diagnostic value of electrophysiological examination for tarsal tunnel syndrome (TTS).Methods Motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),F wave and electromyographic measurements were carried out with 26 clinically suspected TTS patients.Results Of the 26,22 patients were unilaterally affected and 4 were bilaterally affected,so 30 tarsal tunnels in total were affected.All received electrophysiological examination.Of the 30 affected tarsal tunnels,abnormal MCV was detected in 28 of the posterior tibial nerves (93.3％),while abnormal SCV was detected in 27 medial plantar nerves (90％) and 24 lateral plantar nerves (80％).Needle electromyography of 156 targeted foot muscles detected abnormal spontaneous potentials in 90 of them (57.7％),giant potential in 12 muscles (7.7％) and decreased recruitment in 76 (48.7％).Conclusions The distal posterior tibial nerve is impaired in TTS,presenting axonal damage in an electrophysiological examination.Such examinations should have an important role in the diagnosis and differential diagnosis of TTS.

The effect of Riche-Cannieu anastomosis on the diagnosis of patients with carpal tunnel syndrome / 中华物理医学与康复杂志

Objective To study the effect of the Riche-Cannieu anastomosis, an anomalous anastomosis between the deep branch of ulnar nerve and the recurrent branch of median nerve in the palm of the hand, on the diagnosis of patients with carpal tunnel syndrome. Methods Twelve patients (2 male, 10 female, mean age 49.8 years) with carpal tunnel syndrome with the presence of Riche-Cannieu anastomosis were tested in this study. Their clinical data including the symptoms and signs, electrophysiological findings and diagnosis were collected and discussed in relation to an anatomical review of these nerves. Results Due to the existence of the Riche-Cannieu anastomosis, the patients with carpal tunnel syndrome spared part or all of the function of the abductor pollicis brevis (APB) muscle. It may result in an unconformity of the patients′lesion degree caused by carpal tunnel syndrome and its clinical symptoms and electrophysiological findings. Conclusion Knowledge of the Riche-Cannieu anastomosis is of crucial importance in the clinical evaluation, diagnosis and treatment of carpal tunnel syndrome, as well as in avoiding errors in interpreting the electrophysiological data of the patients.

The effects of the accessory deep peroneal nerve on the diagnosis of the deep peroneal nerve injury / 中华物理医学与康复杂志

Objective To study the effects of the accessory deep peroneal nerve,an anomalous branch of the superficial peroneal nerve, on the diagnosis of the deep peroneal nerve injuries. Methods Ten cases (7 male, 3 female, mean age 32.8 years) of deep peroneal nerve injuries with the presence of accessory deep peroneal nerve were examined in this study. All the cases were reviewed and analyzed with regard to the basic anatomy, clinical symptoms, electrophysiological data and diagnosis. Results In the presence of the accessory deep peroneal nerve, the lesions of the deep peroneal nerve spare the function of the lateral portion or the whole of the the extensor digitorum brevis (EDB) muscle. It may result in an unconformity of the severity of lesion and its clinical symptoms as well as the electrophysiological findings. Conclusion Knowledge of this anomaly is of crucial importance in the clinical evaluation of nerve injuries of deep peroneal nerve, as well as in avoiding errors in interpreting the electrophysiological data of this nerve.