瞬目反射与神经电图对Bell麻痹的诊断价值

目的：研究瞬目反射（BR）与面神经的神经电图（electroneurogram,ENG）对Bell麻痹（特发性面神经麻痹）的诊断价值。方法：对246例Bell麻痹患者在发病后10d内行BR和ENG检查。结果：BR检测阳性率为100％,ENG检测阳性率为63．8％（P〈0．01）。结论：BR与ENG均能反映面神经损害的严重程度、部位及预后,其中BR在早期诊断中更为敏感,两者结合的临床价值更大。     

改善微循环对Bell麻痹患者面神经功能恢复的影响

目的:研究改善微循环对Bell麻痹患者面神经传导功能恢复的影响.方法:将14例Bell麻痹患者分为两组:治疗组8例,基础治疗 盐酸丁咯地尔;对照组6例,只作基础治疗.采用瞬目反射(BR)这一客观的神经电生理检查作为观察指标来观察改善微循环的药物盐酸丁咯地尔对Bell麻痹患者面神经传导功能恢复的影响.结果:治疗组Bell麻痹患者的BR的(R1、R2)波潜伏期的恢复优于对照组(P＜0.01).结论:改善微循环可减轻Bell麻痹患者面神经功能的损害.     

面神经麻痹30例的瞬目反射和面神经电图检测

面神经麻痹(又称Bell麻痹)是临床常见病,根据病人发病的时间来正确选择电生理检查时机对临床帮助较大。笔者试用瞬目反射(BR)和面神经电图(ENoG)对30例面神经麻痹患者进行测试,现将结果报告如下。1资料和方法临床资料:本组30例患者为2006年12月至2007年6月本院门诊及住院患者,其中男17例,女13例;年龄12~73岁,平均(40±10.2)岁;左侧病变18例,右侧病变12例;病程3天~2年,其中3~7天15例,8~14天9例,15天至2年6例。所有患者无中耳炎、肿瘤、糖尿病及头面部外伤等。检测方法:采用丹麦Keypoint-4型肌电图/诱发电位仪进行检测。BR检测:分别刺激双侧眶上神经三叉神经眶上支,表面电极置于下眼睑中部记录,参考电极置于眼角外侧,手腕置接地电极,受试者眼睛微闭,刺激强度为10~18mA。面神经ENoG检测:记录电极置于患侧眼轮匝肌上方,参考电极置于鼻根部,刺激电极为盘状电极,置于耳根后茎乳孔处,阴极向上,手腕置接地电极。刺激强度以口角轻度抽动为度,且以引出最大和较稳定的负波(向上偏转的正弦波)为准。判断标准:BR主要观察反应的波幅和潜伏期;ENoG观察患侧面神经潜伏期和波幅的变...     

不同检测方式对瞬目反射结果判断的影响

近年来,国内有作者利用瞬目反射（blinkre—flex,BR）在Bell麻痹病程中进行检测,认为其早期检测异常率可达100％,并且在其后的随访观察中,BR的恢复与否与预后亦密切相关,故BR与面神经F波、面神经电图已成为面神经麻痹的重要电生理检查方法。但不同的检测手段对结果的影响报道较少。本研究通过不同方式对Belt麻痹患者进行BR检测,以期能发现不同的结果描述。     

应用电生理检查早期评估2型糖尿病合并面神经炎的研究

目的：应用瞬目反射（BR）和面神经运动传导测定以作早期诊断并评估合并2型糖尿病患者的面神经炎预后的研究。方法：对2009年1～10月我院收治的病程1～7d的面神经炎患者58例，分为合并糖尿病组（Ⅰ组）23例与单纯面神经炎组（Ⅱ组）35例，均进行面神经传导测定和BR检测，随访3个月，并行组间比较。结果：患侧BR异常率为100％，面神经传导测定异常率为47％。Ⅰ组临床面神经重度损害14例，Ⅱ组临床面神经重度损害7例；两组波幅及面神经运动传导速度比较差异有统计学意义（P〈0．05）。3个月后随访，Ⅱ组好转率较Ⅰ组明显增高，差异有极显著意义（χ2=15．851，P〈0．001）。结论：合并2型糖尿病患者的面神经炎预后差，能通过BR及面神经传导测定早期作出诊断及判断预后。     

急性面神经炎患者面神经传导速度研究

目的 :探讨急性面神经炎 (Bell麻痹 )患者的面神经传导速度与病程及预后的关系。方法 :对 6 8例不同病程的Bell麻痹患者行健、患侧面神经传导速度检查 ,并和 10例正常对照组进行比较。结果 :面神经传导速度 :病程 <7天的患者的患侧与健侧及对照组比较无明显差异 (P >0 0 5 ) ;病程 >7天患侧与健侧及对照组比较有极显著性差异 (P <0 0 0 1) ;病程 1个月内完全恢复者患侧与健侧及对照组比较无显著性差异 (P >0 0 5 ) ;病程 2个月、6个月内完全恢复和未完全恢复者患侧与健侧及对照组比较有显著性差异 (P <0 0 1) ;不同转归组两两比较有显著性差异 (P <0 0 1)。面神经传导速度减慢程度越重 ,面神经功能临床恢复所需要的时间越长。结论 :Bell麻痹患者患病一周后的面神经传导速度可作为评价面神经功能及预后的一项可靠指标。     

周围性面神经麻痹脑诱发电位的初步研究

对９６例周围性面神经麻痹患者进行了脑干听觉诱发电位（ＢＡＥＰ）检查，其中并作三叉神经体感诱发电位（ｔＳＥＰ）检查５３例、视觉诱发电位（ＶＥＰ）检查６例，其异常率分别为２４％、４３％和０％。本文发现周围性面神经麻痹患者有临床下的诱发电位改变，并对其异常原因作了初步分析。     

神经传导检测在Bell麻痹预后判断中的价值

目的：探讨神经传导检测在Bell麻痹预后判断中的价值。方法：对发病10～21d的56例Bell麻痹患者进行神经传导检测和F波检查,以随访3个月时患者的House—Brackmann分级结果来判断神经传导检测的价值。结果：预后好组和预后差组患侧面神经复合肌动作电位（CMAP）波幅分别为1．15（0．90,1．60）mV和0．20（0．13,0．40）mV,远端运动潜伏期（DML）分别为2．70（2．40,3．00）ms和3．00（2．85,3．68）ms,波幅下降比分别为（31．14±18．47）％和（79．03士13．14）％,F波出现率分别为25．00（15．00,30．00）％和5．00（0．00,15．00）％,两组比较差异有显著意义。结论：虽然神经传导检测和F波是评价面神经功能的敏感方法,但是CMAP波幅、DML并不适合作为Bell麻痹的预后判断指标,F波出现率也可能不可靠,患侧波幅下降比仍然是判断预后的较好指标。     

特发性面神经麻痹病变部位与神经电生理检测关系探讨

目的：探讨特发性面神经麻痹病变部位与电生理检测结果的关系。方法：对发病20d内的109例特发性面神经麻痹患者,根据临床表现进行面神经病变定位,分为4个组：膝状神经节病变组、面神经管镫骨神经以上病变组、面神经管镫骨神经以下病变组、茎乳孔以外病变组,并行面神经电生理检查,各组数据进行统计学处理。结果：109例患者中膝状神经节病变组15例,面神经管镫骨神经以上病变组21例,面神经管镫骨神经以下病变组38例,茎乳孔以外病变组35例;患侧瞬目反射、面神经复合肌肉动作电位（CMAP）潜伏期、波幅及患侧波幅下降比、F波消失率各组比较差异有统计学意义。结论：面神经麻痹电生理指标波幅下降比、瞬目反射、F波与其病变部位有关。     

后循环梗死患者的BAEP、BR、TSEP检测

目的：探讨后循环脑梗死（PCI）患者脑干听觉诱发电位（BAEP）、瞬目反射（BR）、三叉神经诱发电位（TSEP）三种电生理变化。方法：选择60例经头颅MRI检查证实为PCI患者（病例组）,分别于入院一周之内行BAEP、BR、TSEP检查,观察BAEP波形及I、Ⅲ、V波潜伏期（PL）、峰间期（IPL）,计算BR既R1、R2、R2波平均PI。、波幅及TSEP各成分PL,并与40例健康体检者作对照。结果：病例组60例中BAEP异常35例（58％）,异常主要表现为I、V波的PL、I—V波的IPL延长和I／V波幅比〉1。BR异常33例（55％）,异常主要表现为R2波的PL延长,R2、R2’波幅下降。TSEP检查病例组与对照组PL比较未见明显差异。结论：BAEP、BR两种电生理检查方法能够较好地检测出PCI患者神经功能异常,联合应用BAEP及BR能够为PCI患者的神经功能的判断提供重要参考。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.