用多种非创伤性方法检测糖尿病病人心脏功能

本研究对101例糖尿病病人进行多种非创伤性心功能检查。结果显示:合并高血压及/或冠心病的糖尿病人79％心功能异常,无合并冠心病,高血压及微血管病变,但合并心脏植物神经病变病人为56％,而无以上合并症的病人为47％,且心功能损害程度与微血管病变程度呈正相关。3组病人均以舒张功能损害为主,但各组病人心功能改变形式无明显不同。     

脑心通联合弥可保治疗糖尿病周围神经病变疗效观察

目的观察脑心通胶囊联合弥可保治疗糖尿病周围神经病变的临床疗效。方法选择90例糖尿病合并周围神经病变患者，随机分成两组，治疗组47例，口服脑心通胶囊3粒／次，3次／天，同时应用弥可保500μg，肌肉注射，1次／天，连续4周。对照组43例用弥可保500μg，肌肉注射，1次／天，连续4周。结果治疗4周后两组神经症状与检查评分均明显下降，但以治疗组下降显著，治疗后两组评分差异有统计学意义（P〈0．01）。结论脑心通胶囊联合弥可保治疗糖尿病周围神经病变有较好疗效。     

穴位注射弥可保治疗2型糖尿病周围神经病变疗效观察

目的观察穴位注射弥可保治疗2型糖尿病周围神经病变的临床疗效。方法将98例2型糖尿病周围神经病变患者随机分为2组:治疗组于足三里穴注射弥可保500μg/次,每日1次,左右两穴交替,疗程2周。对照组肌肉注射弥可保500μg/次,每周3次,疗程2周。结果治疗组总有效率91%,对照组总有效率69%,治疗组疗效明显优于对照组(P<0.05)。结论弥可保穴位注射治疗糖尿病周围神经病变疗效显著。     

灵异胶囊防治早期糖尿病性周围神经病变临床研究

目的观察灵异胶囊治疗早期糖尿病性周围神经病变的临床有效性和安全性。方法采用多中心、随机、盲法对照的方法,将206例患者分为治疗组（n=107）和对照组（n=99）。对照组给予降血糖、降血压基础治疗及弥可保口服,治疗组给予基础治疗及灵异胶囊口服,两组均治疗8周。采用简化McGill疼痛量表进行疼痛综合评定、神经电生理检测。结果治疗组总有效率为82.24%,对照组为76.77%,差异无统计学意义（P〉0.05）。治疗组疼痛综合评分下降,且低于对照组（P〈0.05）。两组均未有不良事件发生。结论灵异胶囊能有效改善糖尿病性周围神经病变症状。     

针药并用治疗糖尿病周围神经病变临床观察

比较针药疗法与口服西药弥可保治疗糖尿病周围神经病变(DPN)的疗效差异.方法:将60例DPN患者按随机1:1分为针药组与西药组.针药组以针刺通里、少府、曲池、少海、足三里、阳陵泉、血海、太溪、委中、太白、三阴交为主,配以口服糖周宁一号(院内制剂)治疗;西药组口服西药弥可保.结果:针药组疗效明显优干西药组.结论:针药结合疗法治疗DNP疗效显著.     

Approach to the patient with chronic polyneuropathy

Background –  Chronic polyneuropathy is a common disorder with heterogenic clinical presentation and many different etiologies. Diagnostic investigation is challenging.
Materials and methods –  An algorithm for diagnostic investigation of chronic polyneuropathy is presented. It was designed to secure practical usefulness for general neurologists, identification of the most common causes with an adequate number of laboratory tests, and more focused investigation when necessary. The proposal is based on review of articles found by PubMed search using the terms 'peripheral neuropathy, cause, and investigation', relevant book chapters, and own clinical experience.
Results –  All patients should undergo a routine investigation for the most common causes of polyneuropathy by asking for diabetes, heredity, alcohol abuse, toxic medications and agents, symptoms of Sjögren's syndrome, renal failure, and the following laboratory tests; glucose, haemoglobin, leucocytes, thrombocytes, ESR, creatinin, ALAT, GT, vitamin B12, serum electrophoresis, TSH and thyroxin. If routine investigation is negative, a targeted approach based on clinical type and electrophysiological findings is recommended. The most common type with slowly progressive, symmetric sensory symptoms beginning in the feet can often be classified as cryptogenic without further investigation. Polyneuropathies with subacute onset, progressive weakness, asymmetric symptoms, proximal weakness, selective involvement of sensory fibers or demyelinating pathology, or other organ manifestations, have various etiologies that necessitate individual focused investigation.
Interpretation –  Diagnostic investigation of polyneuropathy can be simplified and systematized.     

Neuropathic Pain: Mechanisms and Treatment Options

Abstract : Neuropathic pain results from damage to the nervous system. The diseases responsible for neuropathic pain are diverse but they may have in common pathophysiological mechanisms. This review will focus on these mechanisms both in the peripheral as well as within the central nervous system. In addition, there will be discussion on the various treatment choices including both pharamcological and interventional options.     

Cuba: response of medical science to a crisis of optic and peripheral neuropathy

We made two trips to Cuba, as part of an invited international delegation, to investigate an epidemic of optic neuropathy-induced blindness. We worked closely with Cuban scientists and clinicians in their efforts to understand and then deal with 50,000 cases of blindness and an entire population at risk. This gave an unparalleled opportunity to understand the Cuban system of ophthalmologic health care and, in particular, to appreciate the responses of the scientific and health care communities to this crisis. Several features of the very different Cuban medical and scientific infrastructure were both problematic and advantageous as they affected the Cuban efforts to understand, contain and treat this remarkable epidemic.     

BDNF和NT-3在糖尿病周围神经病大鼠肌肉中的表达

目的观察链脲佐菌素(Streptozotocin STZ)诱导的糖尿病周围神经病大鼠腓肠肌脑源性神经生长因子(BDNF)、神经营养素-3(NT-3)的mRNA表达。方法用STZ复制Wistar大鼠糖尿病周围神经病模型。成模8周、12周麻醉后处死大鼠,提取腓肠肌组织RNA,应用RT-PCR半定量方法检测其BDNF及NT-3mRNA含量。结果糖尿病周围神经病组大鼠腓肠肌BDNF的mRNA含量明显高于正常对照组(P<0.01),12周糖尿病周围神经病大鼠组明显高于8周糖尿病周围神经病大鼠组(P<0.01);腓肠肌NT-3的mRNA含量各组间无显著性差异(P>0.05)。结论糖尿病周围神经病大鼠腓肠肌组织BDNF的mRNA含量随着病程逐渐增加,而NT-3的mRNA含量无明显变化,二者在糖尿病周围神经病中发挥不同作用。     

The Mitochondrial DNA Mutation at Position 11778 in Chinese Families with Leber‘s Hereditary Optic Neuropathy

We amplified the 340 bp of mitochondrial DMA (mtDNA) by PCR including the recognized sequence of restriction enzyme of SfaN I . After amplification and digestion of SfaN I , two bands of 190 bp and 150 bp appeared in the mtDNA of four normal individuals but only one band of 340 bp appeared in the mtDNA with the mutation of G to A at the site of the nucleotide 11778 because such mutation destroyed the recognized sequence of SfaN I . We studied the mtDNAs of the patients with Leber‘s hereditary optic neur...