神经电生理对腓总神经卡压的诊断价值

目的 观察神经电生理检测对腓总神经卡压的诊断价值。方法 对腓总神经卡压的临床特征及病因进行分析，并作神经传导速度和肌电图检测和分析。结果 21条患病神经中1条神经波形消失。其余有不同程度的传导速度减慢，尤其是跨腓骨小头段，波幅降低，传导时间延长，42块腓总神经支配的肌肉中有30块出现失神经电位。结论 神经电生理检查在腓总神经卡压的诊断中有重要意义。     

Localization and axonal transport of immunoreactive cholinergic organelles in rat motor neurons—An immunofluorescent study

Antisera produced in rabbits against pure fractions of cholinergic vesicles from Narcine brasiliensis were used to study cholinergic organelles in rat motor neurons. The indirect immunofluorescence method was used on perfusion-fixed material. The rats were surgically sympathectomized to remove sympathetic adrenergic and cholinergic nerves from the sciatic nerve. In the intact animal immunoreactive material, likely to represent cholinergic vesicles, was observed in motor endplates, identified by labelling with rhodamine-conjugated α-bungarotoxin or with subsequent acetylcholinesterase staining. The motor perikarya contained very little immunoreactive material. Non-terminal axons were virtually devoid of immunofluorescence in the intact animal. After crushing the sciatic nerve, immunoreactive material (likely to represent axonal cholinergic organelles) accumulated rapidly on both sides of the crush, indicating a rapid bidirectional transport. The transport was sensitive to local application of mitotic inhibitors.The axons which accumulated immunoreactive organelles were motor axons, as demonstrated by various procedures: (1) Cutting of ventral roots prevented accumulation of immunoreactive material in the nerve. (2) Deafferentation did not notably influence accumulations of immunoreactive material. (3) Ligated axons with immunoreactive material were acetylcholinesterase positive when identification was made on the same section; the intra-axonal distribution of immunoreactive material and acetylcholinesterase was not identical, however, and the Narcine antisera did not cross-react with bovine acetylcholinesterase in a solid phase immunoassay. (4) Most axons in ventral roots, but not in dorsal roots, accumulated strongly fluorescent immunoreactive material, while axons in dorsal roots contained weakly fluorescent material. On the other hand, substance P-like immune reactivity was present in many dorsal root axons, but only very rarely in ventral roots.It is suggested that the antisera against Narcine cholinergic vesicles can be used as a marker for cholinergic organelles in the motor neuron, and may be an important tool for studying the axonal cholinergic vesicles. It cannot, however, be used to identify cholinergic structures in unknown locations because it recognizes common antigenic determinants in transmitter organelles of other nerves e.g. adrenergic nerves. The axonal cholinergic organelles may carry important molecules, other than acetylcholine to the nerve endings.     

腕管综合征患者的临床与神经电生理研究

目的：观察神经电生理检测对腕管综合征(CTS)的诊断价值。方法：对腕管综合征的临床特征及病因进行了分析，并作神经传导速度(NCV)和肌电图检测和分析。结果：40条患病神经中8条正中神经诱发波形消失，32条正中神经感觉潜伏期延长、波幅降低或(和)感觉神经传导速度减慢。25例患者伴有30条正中神经运动末梢潜伏期延长或(和)动作电位波幅降低。22块正中神经支配肌有去神经电位。结论：神经电生理检查在腕管综合征的诊断与鉴别诊断中有重要意义。     

脉络宁弥可保治疗糖尿病周围神经病变的临床研究

目的观察脉络宁、弥可保联用治疗糖尿病周围神经病变(DPN)的临床疗效并探讨其作用机理.方法将102例DPN患者随机分为脉络宁与弥可保治疗组和弥可保时照组(各51例),观察其对DPN的临床疗效、NCV及血流变等指标的影响.结果治疗组在治疗后临床疗效明显改善(P＜0.05),NCV明显加快(P＜0.01),血流变学指标明显改善(P＜0.05).结论脉络宁与弥可保能够明显减轻DPN患者的临床症状,改变神经传导速度,改善血流变指标,对防治DPN有较好疗效.     

氯丙烯中毒大鼠神经电生理时间效应关系

目的探讨氯丙烯亚慢性中毒大鼠坐骨神经的电生理指标改变时间效应关系。方法选用Wistar雄性大鼠,以200 mg/(kg.bw)剂量经口灌胃,每周3次,在第0,3,6,9,12周,用电生理仪分别测定相应对照组与染毒组大鼠坐骨神经传导速度、复合动作电位峰峰值、潜伏期、时程、阈强度及最大刺激强度等指标。结果电生理各指标变化随时间和步态评分呈进行性加重,坐骨神经传导速度从第6周和步态评分2分开始降低,与对照组相比差异有统计学意义(P<0.05);复合动作电位峰峰值从第12周和步态评分4分开始降低,与对照组相比差异有统计学意义(P<0.05);,其它各指标均从第9周和步态评分3分开始逐渐增大,与对照组相比差异亦有统计学意义(P<0.05)。结论氯丙烯引起的坐骨神经电生理各指标的改变存在时间效应关系,其中以传导速度改变的最早、最为敏感,为氯丙烯中毒的早期诊断提供一定的依据。     

Frequency of small-colony variants and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus in cystic fibrosis patients

Background

Small-colony variants (SCVs) are a distinct phenotype of Staphylococcus aureus, known for their role in chronic, difficult to treat infections, including cystic fibrosis (CF) lung disease. The goal of this study was to characterize SCV MRSA infection in an adult and pediatric CF population and to identify antibiotic susceptibility patterns unique to SCV MRSA.

神经肌电图检测对分娩性臂丛神经损伤的临床诊断价值

目的探讨神经肌电图评估分娩性臂丛神经损伤的临床价值。方法应用keypoint肌电-诱发电位仪对40例分娩性臂丛神经损伤患儿进行检测。测定臂丛神经主要支配肌肉的肌电图和神经传导速度,确定损伤部位、程度并评价预后。结果40例分娩性臂丛神经损伤患儿根据肌电图结果,按损伤部位分类:上干型12例,上中干型8例,下干型6例,中下干型6例,全臂丛8例。按损伤程度分类:完全损伤1例,不完全损伤39例,其中,严重损伤8例,轻度损伤31例。结论神经肌电图对分娩性臂丛神经损伤的客观定位、判断预后具有重要价值。     

疏血通对糖尿病周围神经病变患者神经传导速度的影响

目的观察疏血通治疗糖尿病周围神经病变的疗效。方法选出年龄在14～55岁之间的106例（女68例,男38例）作为受试对象,患者在有效地控制血糖、血脂、血压的基础上,应用疏血通治疗,在治疗期间均按饮食疗要求,固定每日总热量摄入,并固定运动量。采用自身对照的方法,于治疗前后进行血糖、糖化血红蛋白、胰岛素敏感性指数、甘油三酯、总胆固醇、高密度脂蛋白胆固醇的检测,并对糖尿病周围神经病变患者神经传导速度的指标进行效果观察。结果受试人群实验前后相比较,治疗后运动神经传导速度及感觉神经传导速度明显加快,其治疗前后差值比较有统计学意义（P〈0．05）。结论说明疏血通能改善糖尿病周围神经病变患者的神经传导速度,缓解临床症状,延缓疾病的发展。     

Prospective randomized controlled study of a Chinese herbal medicine compound Tangzu Yuyang Ointment for chronic diabetic foot ulcers: a preliminary report

Aim of the study

The purpose of this study was to evaluate the efficacy and safety of a topical Chinese herbal medicine (CHM) compound Tangzu Yuyang Ointment (TYO) for treatment of chronic diabetic foot ulcers.

Materials and methods

This multi-center, prospective, randomized, controlled and add-on clinical trial was conducted at seven centers in the China mainland. Fifty-seven patients with chronic diabetic foot ulcers of Wagner's ulcer grade 1-3 were enrolled in this study. Patients who were randomly assigned to the control group (n = 28) received standard wound therapy (SWT), whereas those randomized to the treatment group (n = 28) received SWT plus topical TYO. Only 48 patients who finished 24 weeks of observations were entered for data analysis.

Results

The TYO and SWT groups were comparable for baseline characteristics. Ulcer improvement was 79.2% in the TYO group and 41.7% in the SWT group (P = 0.017) at 12 weeks, and 91.7% vs. 62.5% (P = 0.036) at 24 weeks. The number of ulcers that were completely healed at 4, 12 and 24 weeks was similar in both groups, as were the numbers of adverse events. Healing time was 96 ± 56 days (n = 19) in the TYO group and 75 ± 53 days (n = 14) in the SWT group (P = 0.271).

Conclusion

TYO plus SWT is more effective than SWT in the management of chronic diabetic foot ulcers and has few side-effects.