神经传导速度早期诊断糖尿病性周围神经病

本文对58例糖尿病人进行了神经传导速度(NCV)测定,其中有周围神经损害的症状和体征,临床诊断为糖尿病并发周围神经病者32例,临床无周围神经损害的糖尿病者26例。其结果表明,NCV测定为判断周围神经损害的一种客观指标,且感觉神经测定比运动神经敏感,下肢胫神经测定比上肢敏感,也可提示亚临床期的周围神经病变,有助于糖尿病性周围神经病的早期诊断。     

糖尿病性周围神经病神经传导速度的电生理研究

目的:探讨糖尿病性周围神经病的电生理改变特征。方法:对58例临床确诊的Ⅱ型糖尿病(NIDDM)患者和25例健康对照组进行正中神经和腓总神经运动神经传导检测,对刺激所诱发的复合肌肉动作电位进行分析。结果:两组对比,糖尿病组中MCV减慢(72.41%),DPL延长(56.89%),波幅降低(34.48%),时限延长(53.45%),有显著性差异(P<0.01)。结论:检测和分析正中神经、腓总神经的运动神经传导和复合肌肉动作电位有助于了解糖尿病性远端神经病变的电生理改变,有助于DPN早期诊断和鉴别诊断。     

感觉电流阈值在糖尿病周围神经病变诊断中的临床应用

目的:探讨感觉电流阈值(CPT)在糖尿病周围神经病变(DPN)诊断中的价值.方法:选取符合入选条件的52例2型糖尿病( T2DM)患者和50例健康人的感觉电流阈值.以神经传导速度检查( NCV)为诊断糖尿病周围神经病变的“金标准”,使用X 2检验评价电流感觉阈值的灵敏度、特异度、阳性预测值、阴性预测值及Kappa值.结果:以NCV为标准,电流感觉阈值的灵敏度61.1％,特异度62.5％,阳性预测值78.6％,阴性预测值41.7％,Kappa值0.207.结论:电流感觉阈值能评估个体感觉通路功能,有助于筛查DPN患者.     

实验性糖尿病大鼠胸腺的形态学研究

用四氧嘧啶诱导复制的大鼠实验性糖尿病动物模型，在光，电镜下，观察了糖尿病大鼠胸腺的形态学变化。结果表明：糖尿病大鼠胸皮质明显就薄，皮质淋巴细胞大量减少，细胞分裂盯计数显著降低。细胞退化。明上皮细胞呈明显的退行性变，其胞质内张力细丝束和溶酶体样致密颗粒明显增多，出现空泡化，自噬体及较多的含颗粒状物质的囊泡。     

脊髓诱发电位在糖尿病神经病变早期诊断中的价值

在８０例Ⅱ型糖尿病患者，观察了正中神经和胫后神经刺激引起的脊髓诱发电位（ＳＣＥＰ）。结果表明，糖尿病患者ＳＣＥＰ的Ｎ＿（１３）、Ｎ＿（２０）潜伏期均比正常人明显延长（ｐ＜０．００１），并可发现无神经病变征象的亚临床型神经损害；同时，Ｎ＿（１３）、Ｎ＿（２０）潜伏期与病人的病程、病情及神经病变征象呈正相关（ｒ＝０，２５－０．５８，ｐ＜０．０５－０．０００１）．而与空腹血糖水平无关（ｒ＝０．０５－０．１１，ｐ＞０．０５）。提示ＳＣＥＰ检查有助于糖尿病神经病变的早期诊断和疗效观察。     

SEX DIFFERENCES IN SKIN CONDUCTANCE MEASURES AS A FUNCTION OF SHOCK THREAT

Investigations of sex differences in various electrodermal measures have yielded inconsistent results. The present investigation attempted to examine sex differences primarily as a function of varied conditions of threat (stated probability of receiving electric shock). Thirty males and 30 females were randomly assigned to three conditions: High Threat Probability (HTP), Moderate Threat Probability (MTP), or No Threat Probability (NTP). All Ss heard, under assigned threat instructions, 2 sets of 11 tones, preceded by a nonstimulation period and followed by 11 tones with shock threat removed. Results indicated that the threat conditions did affect electrodermal measures as expected. In addition, males exhibited higher tonic (basal conductance) levels throughout, while females displayed greater phasic reactivity (GSR magnitude) and a larger number of nonspecific GSRs. In addition, nonspecific frequency was affected by the interaction of sex with treatment (threat), such that females displayed higher frequencies under moderate threat, while males increased linearly with increased threat. Degree of stress or threat, the possibility of differential perceptions, and a theory of differential hormonal functioning were applied in interpreting results.     

AN EVALUATION OF FOREARM BLOOD FLOW AS A PSYCHOPHYSIOLOGICAL MEASURE

The usefulness of forearm blood flow (FBF) as a psychophysiological measure was investigated by comparing changes occurring during mental tasks in cardiovascular, sudomotor, and electromyographic measures. The measures were divided into those clearly physiologically independent and those physiologically related. ANOVA results showed that FBF, heart rate (HR), and skin conductance fluctuations (SCF) were equally reactive, and correlational analysis suggested that a close relationship existed between FBF, HR, and SCF, although correlations fell to near zero levels when intra-individual correlations were calculated with between task variance extracted. For some experimental purposes HR response may be considered equivalent to FBF response. The relationship between EMG and FBF was more variable, and tends not to support the idea that FBF is an indirect measure of muscle activity. The reliability of FBF in normal subjects at rest was poor, although it improved when measured during a simple task, and is probably stable enough for most experimental purposes.     

DIRECT MEASUREMENT OF SKIN CONDUCTANCE: A PROPOSAL FOR STANDARDIZATION

A provisional standard method of measuring tonic skin conductance (SCL) and GSR (SCR) is advocated, using a constant-voltage method for which circuits are provided useable with Beckman, Grass, and other common polygraphs. A standard electrode methodology is also presented. The problem of units of measurement is considered in detail with an analysis of the so-called Law of Initial Values. Methods are given for correcting both tonic SC and SCRs for individual differences in their respective ranges of variation and the purpose and relative advantages of these range-correction methods are discussed.     

EVALUATION OF TUMOUR ANGIOGENESIS AS A PROGNOSTIC MARKER IN MALIGNANT MESOTHELIOMA

Angiogenesis plays an important role in the growth, progression, and metastasis of solid tumours. Malignant mesothelioma (MM) of the pleura is a highly invasive tumour with a poor prognosis. In the present study, microvascular quantification was undertaken on 25 specimens of mesothelioma and 15 specimens of non-neoplastic mesothelium (NNM), by staining for the antigens CD34 and CD31. Areas of highest intratumoural microvascular density (IMD) were identified and counted either manually (mIMD) or on a computerized image analysis system (CIAS; iIMD). The two IMDs were significantly correlated with each other ( r =0·736; P <0·001). The average IMD for MM was significantly ( P <0·001) higher than in NNM. Moreover, each unit increment in iIMD for MM, when regarded as a continuous variable, was significantly ( P =0·001) associated with an increased hazard of about 4 per cent. When regarded as a categorical variable, the patients in the highest tertile (>58 vessels/field) had a significantly ( P <0·01; log-rank test) shorter survival than patients in the lowest tertile (<45 vessels/field). This association was independent of the age of the patient and of the histological type or grade of the MM. No association was noted with p53 immunoexpression. Although the mean vascular area of blood vessels measured on the CIAS did not correlate with survival, assessment of IMDs can be an important independent prognostic indicator in malignant mesothelioma. © 1997 John Wiley & Sons, Ltd.     

阴股沟区皮瓣再造阴茎的应用解剖

提要:在专供研究用的15具(30侧)男性成人尸体上解剖、观察了阴部外动脉的起始、走行和分布范围。皮瓣区的主要血管为阴部外动脉和阴部外静脉,神经为髂腹股沟神经的皮支。阴部外动脉起始处和分支前的外径平均值分别为:1.60±0.28mm,1.13±0.29mm。阴部外静脉在汇入大隐静脉处的外径平均值为:2.56±0.51mm,髂腹股沟神经在皮下环处的宽、厚度的平均值分别为:1.69±)0.54mm和0.82±0.20mm。血管蒂的长度平均为:37.73±10.41mm。皮瓣前、中、后部的厚度平均值分别是:5.72±1.44mm、5.13±1.12mm、4.37±0.91mm。本文认为:阴股沟区皮瓣具有血供良好、皮肤薄、富有弹性、感觉神经丰富,切口可以一期缝合等优点是阴茎再造和用作游离皮瓣的一个新的供区。[