OBJECTIVE: To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of diabeticperi pheral neuropathy(DPN).METHODS: Randomized controlled trials investigating the efficacy of ...OBJECTIVE: To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of diabeticperi pheral neuropathy(DPN).METHODS: Randomized controlled trials investigating the efficacy of puerarin injection on DPN were searched for in China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, and Cochrane Library from establishment to April 30.Two reviewers independently retrieved and extracted the information.The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.2 software.RESULTS: Twenty-two studies involving 1664 participants were included. The quality of the studies was found to be relatively low. Meta-analysis showed that puerarin injection combined with western medication was more effective than conventional therapy for rate, nerve conduction velocity(NCV), and hemorheology index. Six adverse drug reactions(ADRs) from puerarin injection were reported in two studies. Reactions included facial flushing, palpitations, and pain at infusion locations. However,noserious ADRs were reported.CONCLUSION: Puerarin injection was effective for the treatment of DPN. Puerarin can improve the total effective rate, correct NCV that was decreased by diabetes, and improve the hemorheology index.Puerarin was also relatively safe clinically. However,since the articles included in the study were not high-quality, more studies should be conducted to strengthen their findings.展开更多
Diabetic neuropathy (DN) is the most commonly seen complication in diabetes mellitus (DM), and can occur in its early stage. With the prolongation of the course of the disease, the incidence of DN can reach 90％. The ...Diabetic neuropathy (DN) is the most commonly seen complication in diabetes mellitus (DM), and can occur in its early stage. With the prolongation of the course of the disease, the incidence of DN can reach 90％. The lesion can involve any location of neural system, it can occur展开更多
Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated wit...Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.展开更多
AIM：To evaluate the structural injure patterns in peripapillary retinal fiber layer （pRNFL）, retinal ganglion cell layer （RGCL） and their correlations to visual function in various mitochondrial optic neuropathi...AIM：To evaluate the structural injure patterns in peripapillary retinal fiber layer （pRNFL）, retinal ganglion cell layer （RGCL） and their correlations to visual function in various mitochondrial optic neuropathies （MON） to offer help to their differential diagnosis.METHODS：Totally 32 MON patients （60 eyes） were recruited within 6mo after clinical onsets, including 20 Leber hereditary optic neuropathy （LHON） patients （37eyes）, 12 ethambutol-induced optic neuropathy （EON）patients （23 eyes）, and 41 age-gender matched healthy controls （HC, 82 eyes）. All subjects had pRNFL and RGCL examinations with optic coherence tomography （OCT） and visual function tests.RESULTS：In the early stages of MON, the temporal pRNFL thickness decreased （66.09±22.57μm）, but increased in other quadrants, compared to HC （76.95±14.81μm）. The other quadrants remaining stable for LHON and EON patients besides the second hour sector of pRNFL thickness reduced and the temporal pRNFL decreased （56.78±15.87μm） for EON. Total macular thickness in MON reduced remarkably（279.25±18.90μm; P=0.015）, which mainly occurring in the inner circle （3 mm diameter of circle） and the nasal temporal sectors in the outer circle （5.5 mm diameter of circle）, in contrast to those in HC. RGCL thickness reduced in each sector of the macula （61.90±8.73μm; P≤0.001）. It strongly showed the correlationship of best corrected visual acuity （R=0.50, P=0.0003） and visual field injury （R=0.54,P=0.0002） in MON patients.CONCLUSION：OCT is a potential tool for detecting structural alterations in the optic nerves of various MON. Different types of MON may have different damage patterns.展开更多
AIM To investigate the causes of the recurrent carpal tunnel syndrome(CTS) and implemented surgical interventions.METHODS Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical inte...AIM To investigate the causes of the recurrent carpal tunnel syndrome(CTS) and implemented surgical interventions.METHODS Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.RESULTS Thirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center. CONCLUSION We concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.展开更多
AIM To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. METHODS The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic para...AIM To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. METHODS The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists' perspectives(n= 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system.RESULTS The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease,(the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net(Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity(true positive rate)(89%), specificity(true negative rate)(98%), and accuracy(a proportion of true results, both positive and negative)(93%).CONCLUSION The system designed in this study can help specialistsand general practitioners to diagnose the disease more quickly to improve the quality of care for patients.展开更多
OBJECTIVE： The present study was undertaken to evaluate the effect of diosmin in diabetic neuropathy in type 2 diabetic rats. METHODS： Type 2 diabetes was induced in male Sprague-Dawley rats by single intraperitonea...OBJECTIVE： The present study was undertaken to evaluate the effect of diosmin in diabetic neuropathy in type 2 diabetic rats. METHODS： Type 2 diabetes was induced in male Sprague-Dawley rats by single intraperitoneal injection of streptozotocin （35 mg/kg） and high-fat diet. Four weeks after the confirmation of diabetes, diabetic rats were treated with diosmin （50 and 100 mg/kg, p.o.） for next 4 weeks. Rats were evaluated for biochemical, behavioral and oxidative stress parameters. Eddy＇s hot plate and tail immersion test were performed on 6th, 7th, 8th, 9th and 10th weeks of experiment to assess thermal hyperalgesia and cold allodynia respectively. Further, the walking function test was performed for assessing the motor responses at the end of the treatment schedule. RESULTS： Rats were fed with high-fat diet throughout the experiment schedule and administration of low-dose streptozotocin induced significant elevation in blood glucose level and insulin resistance which was confirmed by oral glucose tolerance test. Treatment with diosmin at doses of 50 and 100 mg/kg significantly restored the reduced body weight, elevated blood sugar and lipid profiles. Further the dose-dependent improvement was observed in thermal hyperalgesia, cold allodynia and walking function in diabetic rats treated with diosmin. Elevated levels of malondialdehyde, and nitric oxide and decreased glutathione levels and superoxide dismutase activity in diabetic rats were restored significantly after the 4 weeks of diosmin treatment. CONCLUSION： Diosmin has shown beneficial effect in preventing the progression of early diabetic neuropathy in rats.展开更多
Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady...Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.展开更多
Herpes zoster(HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. Peripheral ...Herpes zoster(HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. Peripheral neuropathy may reveal segmental motor paresis of either upper or lower limbs, the abdominal muscles or the diaphragm. We report the case of a 62-year-old male patient who presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall. Plain X-rays and computed tomography scan showed distended small bowel. A diagnosis of intestinal pseudo-obstruction was made secondary to segmental paresis of the small intestine and visceral neuropathy. Conservative management was successful and the patient was discharged uneventfully. Intestinal pseudo-obstruction ought to be consideredwhen dealing with non-obstructive(adynamic) conditions of the digestive tract associated with HZ infection; since early recognition may help to avoid unnecessary surgery.展开更多
OBJECTIVE:To study the features of the distribution and differentiation ofTraditional Chinese Medicine(TCM)syndromes in patients with diabetic peripheral neuropathy(DPN).METHODS:We collected clinical data on illness c...OBJECTIVE:To study the features of the distribution and differentiation ofTraditional Chinese Medicine(TCM)syndromes in patients with diabetic peripheral neuropathy(DPN).METHODS:We collected clinical data on illness course,age,fasting blood glucose,saccharogenic hemoglobin,TCM syndromes,tongue,and pulse of238 DPN patients.Differentiated main syndromes(Yin deficiency and exuberant heat,invasion of spleen by damp-heat,deficiency of both Qi and Yins,and deficiency of both Yin and Yang)and accompanying syndromes(blood stasis and phlegm-dampness)of diabetes were also recorded.The features of DPN syndromes were then analyzed.RESULTS:Among the four main syndromes of diabetes,deficiency of both Yin and Yang was the most common in the 238 DPN patients,of which89%-96%had blood stasis.CONCLUSION:The method of differentiating syndromes of diabetes can be applied to DPN patients.Deficiency of both Yin and Yang,often accompanied by blood stasis,is commonly seen.展开更多
OBJECTIVE: To investigate the effects of ginsenoside Rb1 on high glucose-induced neurotoxicity and the underlying molecular mechanism in primary cultured Schwann cells(SCs).METHODS: Cultured SCs were divided into six ...OBJECTIVE: To investigate the effects of ginsenoside Rb1 on high glucose-induced neurotoxicity and the underlying molecular mechanism in primary cultured Schwann cells(SCs).METHODS: Cultured SCs were divided into six groups that received(a) normal glucose,(b) osmotic control,(c) high glucose,(d) high glucose plus 1μM ginsenoside Rb1,(e) high glucose plus 10 μM ginsenoside Rb1, or(f) high glucose plus 100 μM alpha lipoic acid(ALA). Intracellular reactive oxygen species(ROS) generation and mitochondrial transmembrane potential(ΔΨm) were detected by flow cytometric analyses. Apoptosis was confirmed by the annexin V-FITC/propidium iodide(PI) method,and the concentration of 8-hydroxy-2-deoxy guanosine(8-OHd G) was detected by an enzyme-linked immunosorbent assay. Western blotting was performed to analyze the expression levels of important transcription factors such as cytochrome c, bcl-2, bax, activated caspase-3, and activated poly(ADP-ribose) polymerase(PARP).RESULTS: Ginsenoside Rb1 inhibited high glucose-induced oxidative stress by decreasing ROS and 8-OHd G levels as well as mitochondrial depolarization in SCs. 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide and annexin V-FITC/PI assays showed that incubating SCs with high glucose decreased cell viability and increased the number of apoptotic cells, whereas treatment with ginsenoside Rb1 protected SCs against high glucose-induced cell damage. Furthermore, ginsenoside Rb1 down-regulated the expression of high glucose-induced bax and cytochrome c release but up-regulated bcl-2 expression. In addition, ginsenoside Rb1 attenuated high glucose-induced activation of caspase-3 and minimized cleavage of PARP in SCs.CONCLUSION: These results suggest that ginsenoside Rb1 antagonizes high glucose-induced oxidative stress and activation of the mitochondrial apoptosis pathway in SCs.展开更多
Objective： To evaluate the clinical efficacy of moxibustion plus Mecobalamin in treating diabetic peripheral neuropathy. Methods： Eighty subjects were equally allocated into combination and control groups. On the ba...Objective： To evaluate the clinical efficacy of moxibustion plus Mecobalamin in treating diabetic peripheral neuropathy. Methods： Eighty subjects were equally allocated into combination and control groups. On the basis of the same basic treatment, the combination group was treated by moxibustion plus Mecobalamin and the control group simply by Mecobalamin. Treatment lasted 3 months. Nerve conduction velocity and symptom severity were compared between pre-treatment and post-treatment. Results： Nerve conduction velocity was improved in both combination and control groups and more obviously in the combination group. The marked effective rate, effective rate and ineffective rate were respectively 52.5%, 32.5% and 15.0% in the combination group and 35.0%, 27.5% and 37.5% in the control group. There were statistically significant differences between the two groups （P〈0.01 or P〈0.05）. Conclusion： Based on a basic treatment, moxibustion plus Mecobalamin is superior to simple Mecobalamin in treating diabetic peripheral neuropathy.展开更多
BACKGROUND： Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy （DPN）. Microsurgical decompression of peripheral nerve m...BACKGROUND： Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy （DPN）. Microsurgical decompression of peripheral nerve maybe effectively releases the symptoms of DPN. OBJECTIVE： To investigate the curative effects of microsurgical decompression of median nerves for treatment of DPN in upper limbs. DESIGN： Case-follow up observation. SETTING： Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Health. PARTICIPANTS： Twelve patients with DPN in upper limbs （19 hands） who received treatment in the Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Public Health between March 2004 and July 2006 were involved in this experiment. The involved patients, 5 male and 7 female, were aged 44 to 77 years, with DPN course of 6 months to 16 years. They all met 1999 WHO diabetic diagnosis criteria. Both two hands had symptom in 7 patients, and only one hand had symptom in 5 patients. Informed consents of detected items were obtained from all the patients, who also received 21 months of follow-up treatment. METHODS： （1）Operation was carried out under the anesthetic status of brachial plexus. Under an operating microscope, transverse carpal ligament was exposed. Subsequently, transverse carpal ligament, forearm superficial fascia and palmar aponeurosis were fully liberated, and then part of them was cut off. Connective tissue around median nerve, superficial flexor muscle of fingers, radial flexor, palmaris longus and other flexor tendons were completely loosened. Finally, epineurium was opened with microinstrument for neurolysis. After tourniquet was loosened, and bipolar coagulator was used to stop bleeding, and the incision was closed. （2） In postoperative 21 months, the subjective symptom, two-point discrimination （The smallest distance of two normal points was 3 to 6 mm）, nerve conduction velocity and acti展开更多
BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2...BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.展开更多
Objective： To observe the clinical efficacy of warm acupuncture in the treatment of diabetic peripheral neuropathy and its effects on the conduction velocity of the tibial nerve and common fibular nerve. Methods： Fi...Objective： To observe the clinical efficacy of warm acupuncture in the treatment of diabetic peripheral neuropathy and its effects on the conduction velocity of the tibial nerve and common fibular nerve. Methods： Fifty-two subjects were evenly randomized into two groups and treated by conventional therapy; in addition, the control group was given mecobalamin injection at 500μg, once a day for four weeks, and treatment group was given warm acupuncture, 6 times a week for 4 weeks. The clinical efficacy and the conduction velocity of the tibial nerve and common fibular nerve were observed and compared between the two groups. Results： After four-week treatments, the total effective rate was 88.5% in the treatment group and 61.5% in the control group, with a higher rate in the treatment group than in the control group （P〈0.05）; the conduction velocity of tibial nerve and common fibular nerve was higher in both groups （P〈0.05）, with higher conduction velocity in the treatment group than in the control group （P〈0.05）. Conclusion： Warm acupuncture is quite effective to treat diabetic peripheral neuropathy and to improve nerve velocity.展开更多
Objective： To study the clinical effect of acupuncture combined with methylcobalamin in the treatment of diabetic peripheral neuropathy. Methods： Seventy-five diabetic patients complicated with peripheral neuropathi...Objective： To study the clinical effect of acupuncture combined with methylcobalamin in the treatment of diabetic peripheral neuropathy. Methods： Seventy-five diabetic patients complicated with peripheral neuropathies were included and randomly allocated into a treatment group （40 cases） and a control group （35 cases）. The patients in the treatment group all received acupuncture therapy plus methylcobalamin. In the control group, patients only received methylcobalamin for treatment. The therapeutic effect was evaluated 4 weeks later. Results： Both of the two groups presented improvement in nervous symptoms, signs and nerve conduction, and the improvement of the treatment group was significantly better than that of the control group （P〈0.05）. Conclusion： The therapy of acupuncture in combination with methylcobalamin is more effective than the monotherapy with methylcobalamin in the treatment of diabetic peripheral neuropathy.展开更多
Brachial plexus injury is regarded as one of the most difficult international medical problem. Microsurgery is an advanced technology and has progressed further on the operation, especially on the nerve repair.
基金Supported by Detection Technology Procedures and Normative Research of Priority Species of TCM of National Science and Technology Support Program(No.2006BAI21B11)Scientific Research Innovation Team Project of Beijing University of Chinese Medicine(No.2011-CXTD-14)Postgraduate Independent Topics(No.2014-JYBZZ-XS-078)
文摘OBJECTIVE: To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of diabeticperi pheral neuropathy(DPN).METHODS: Randomized controlled trials investigating the efficacy of puerarin injection on DPN were searched for in China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, and Cochrane Library from establishment to April 30.Two reviewers independently retrieved and extracted the information.The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.2 software.RESULTS: Twenty-two studies involving 1664 participants were included. The quality of the studies was found to be relatively low. Meta-analysis showed that puerarin injection combined with western medication was more effective than conventional therapy for rate, nerve conduction velocity(NCV), and hemorheology index. Six adverse drug reactions(ADRs) from puerarin injection were reported in two studies. Reactions included facial flushing, palpitations, and pain at infusion locations. However,noserious ADRs were reported.CONCLUSION: Puerarin injection was effective for the treatment of DPN. Puerarin can improve the total effective rate, correct NCV that was decreased by diabetes, and improve the hemorheology index.Puerarin was also relatively safe clinically. However,since the articles included in the study were not high-quality, more studies should be conducted to strengthen their findings.
文摘Diabetic neuropathy (DN) is the most commonly seen complication in diabetes mellitus (DM), and can occur in its early stage. With the prolongation of the course of the disease, the incidence of DN can reach 90％. The lesion can involve any location of neural system, it can occur
文摘Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.
基金Supported by the National High Technology Research and Development Program of China(863 Program,No.2015AA020511)
文摘AIM：To evaluate the structural injure patterns in peripapillary retinal fiber layer （pRNFL）, retinal ganglion cell layer （RGCL） and their correlations to visual function in various mitochondrial optic neuropathies （MON） to offer help to their differential diagnosis.METHODS：Totally 32 MON patients （60 eyes） were recruited within 6mo after clinical onsets, including 20 Leber hereditary optic neuropathy （LHON） patients （37eyes）, 12 ethambutol-induced optic neuropathy （EON）patients （23 eyes）, and 41 age-gender matched healthy controls （HC, 82 eyes）. All subjects had pRNFL and RGCL examinations with optic coherence tomography （OCT） and visual function tests.RESULTS：In the early stages of MON, the temporal pRNFL thickness decreased （66.09±22.57μm）, but increased in other quadrants, compared to HC （76.95±14.81μm）. The other quadrants remaining stable for LHON and EON patients besides the second hour sector of pRNFL thickness reduced and the temporal pRNFL decreased （56.78±15.87μm） for EON. Total macular thickness in MON reduced remarkably（279.25±18.90μm; P=0.015）, which mainly occurring in the inner circle （3 mm diameter of circle） and the nasal temporal sectors in the outer circle （5.5 mm diameter of circle）, in contrast to those in HC. RGCL thickness reduced in each sector of the macula （61.90±8.73μm; P≤0.001）. It strongly showed the correlationship of best corrected visual acuity （R=0.50, P=0.0003） and visual field injury （R=0.54,P=0.0002） in MON patients.CONCLUSION：OCT is a potential tool for detecting structural alterations in the optic nerves of various MON. Different types of MON may have different damage patterns.
文摘AIM To investigate the causes of the recurrent carpal tunnel syndrome(CTS) and implemented surgical interventions.METHODS Four hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.RESULTS Thirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center. CONCLUSION We concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.
基金Supported by The Iran University of Medical Sciences,No.54-1
文摘AIM To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. METHODS The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists' perspectives(n= 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system.RESULTS The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease,(the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net(Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity(true positive rate)(89%), specificity(true negative rate)(98%), and accuracy(a proportion of true results, both positive and negative)(93%).CONCLUSION The system designed in this study can help specialistsand general practitioners to diagnose the disease more quickly to improve the quality of care for patients.
文摘OBJECTIVE： The present study was undertaken to evaluate the effect of diosmin in diabetic neuropathy in type 2 diabetic rats. METHODS： Type 2 diabetes was induced in male Sprague-Dawley rats by single intraperitoneal injection of streptozotocin （35 mg/kg） and high-fat diet. Four weeks after the confirmation of diabetes, diabetic rats were treated with diosmin （50 and 100 mg/kg, p.o.） for next 4 weeks. Rats were evaluated for biochemical, behavioral and oxidative stress parameters. Eddy＇s hot plate and tail immersion test were performed on 6th, 7th, 8th, 9th and 10th weeks of experiment to assess thermal hyperalgesia and cold allodynia respectively. Further, the walking function test was performed for assessing the motor responses at the end of the treatment schedule. RESULTS： Rats were fed with high-fat diet throughout the experiment schedule and administration of low-dose streptozotocin induced significant elevation in blood glucose level and insulin resistance which was confirmed by oral glucose tolerance test. Treatment with diosmin at doses of 50 and 100 mg/kg significantly restored the reduced body weight, elevated blood sugar and lipid profiles. Further the dose-dependent improvement was observed in thermal hyperalgesia, cold allodynia and walking function in diabetic rats treated with diosmin. Elevated levels of malondialdehyde, and nitric oxide and decreased glutathione levels and superoxide dismutase activity in diabetic rats were restored significantly after the 4 weeks of diosmin treatment. CONCLUSION： Diosmin has shown beneficial effect in preventing the progression of early diabetic neuropathy in rats.
文摘Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.
文摘Herpes zoster(HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. Peripheral neuropathy may reveal segmental motor paresis of either upper or lower limbs, the abdominal muscles or the diaphragm. We report the case of a 62-year-old male patient who presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall. Plain X-rays and computed tomography scan showed distended small bowel. A diagnosis of intestinal pseudo-obstruction was made secondary to segmental paresis of the small intestine and visceral neuropathy. Conservative management was successful and the patient was discharged uneventfully. Intestinal pseudo-obstruction ought to be consideredwhen dealing with non-obstructive(adynamic) conditions of the digestive tract associated with HZ infection; since early recognition may help to avoid unnecessary surgery.
基金Supported by the National Fund of Natural Sciences(No.81173445)
文摘OBJECTIVE:To study the features of the distribution and differentiation ofTraditional Chinese Medicine(TCM)syndromes in patients with diabetic peripheral neuropathy(DPN).METHODS:We collected clinical data on illness course,age,fasting blood glucose,saccharogenic hemoglobin,TCM syndromes,tongue,and pulse of238 DPN patients.Differentiated main syndromes(Yin deficiency and exuberant heat,invasion of spleen by damp-heat,deficiency of both Qi and Yins,and deficiency of both Yin and Yang)and accompanying syndromes(blood stasis and phlegm-dampness)of diabetes were also recorded.The features of DPN syndromes were then analyzed.RESULTS:Among the four main syndromes of diabetes,deficiency of both Yin and Yang was the most common in the 238 DPN patients,of which89%-96%had blood stasis.CONCLUSION:The method of differentiating syndromes of diabetes can be applied to DPN patients.Deficiency of both Yin and Yang,often accompanied by blood stasis,is commonly seen.
基金Supported by the National Natural Science Foundation Project of China and Shaanxi Province:the Inhibitory Effects of Tangzhoutong on the Metabolic Memory Associated with Diabetic Peripheral Neuropathy via Cross-Talk Between Apoptosis and Autophagy Based on the Theory of Incubative Pathogen(No.81673785)The Inhibitory Effects of Salvianolic Acid B on The Metabolic Memory Associated With Diabetic Peripheral Neuropathy via Cross-Talk Between Apoptosis and Autophagy(No.2015JZ023)The Inhibitory Effect of Tanshinone IIA in Diabetic Peripheral Neuropathy via Apoptosis-Autophagy Cross-Talk(No.2014JM4118)
文摘OBJECTIVE: To investigate the effects of ginsenoside Rb1 on high glucose-induced neurotoxicity and the underlying molecular mechanism in primary cultured Schwann cells(SCs).METHODS: Cultured SCs were divided into six groups that received(a) normal glucose,(b) osmotic control,(c) high glucose,(d) high glucose plus 1μM ginsenoside Rb1,(e) high glucose plus 10 μM ginsenoside Rb1, or(f) high glucose plus 100 μM alpha lipoic acid(ALA). Intracellular reactive oxygen species(ROS) generation and mitochondrial transmembrane potential(ΔΨm) were detected by flow cytometric analyses. Apoptosis was confirmed by the annexin V-FITC/propidium iodide(PI) method,and the concentration of 8-hydroxy-2-deoxy guanosine(8-OHd G) was detected by an enzyme-linked immunosorbent assay. Western blotting was performed to analyze the expression levels of important transcription factors such as cytochrome c, bcl-2, bax, activated caspase-3, and activated poly(ADP-ribose) polymerase(PARP).RESULTS: Ginsenoside Rb1 inhibited high glucose-induced oxidative stress by decreasing ROS and 8-OHd G levels as well as mitochondrial depolarization in SCs. 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide and annexin V-FITC/PI assays showed that incubating SCs with high glucose decreased cell viability and increased the number of apoptotic cells, whereas treatment with ginsenoside Rb1 protected SCs against high glucose-induced cell damage. Furthermore, ginsenoside Rb1 down-regulated the expression of high glucose-induced bax and cytochrome c release but up-regulated bcl-2 expression. In addition, ginsenoside Rb1 attenuated high glucose-induced activation of caspase-3 and minimized cleavage of PARP in SCs.CONCLUSION: These results suggest that ginsenoside Rb1 antagonizes high glucose-induced oxidative stress and activation of the mitochondrial apoptosis pathway in SCs.
文摘Objective： To evaluate the clinical efficacy of moxibustion plus Mecobalamin in treating diabetic peripheral neuropathy. Methods： Eighty subjects were equally allocated into combination and control groups. On the basis of the same basic treatment, the combination group was treated by moxibustion plus Mecobalamin and the control group simply by Mecobalamin. Treatment lasted 3 months. Nerve conduction velocity and symptom severity were compared between pre-treatment and post-treatment. Results： Nerve conduction velocity was improved in both combination and control groups and more obviously in the combination group. The marked effective rate, effective rate and ineffective rate were respectively 52.5%, 32.5% and 15.0% in the combination group and 35.0%, 27.5% and 37.5% in the control group. There were statistically significant differences between the two groups （P〈0.01 or P〈0.05）. Conclusion： Based on a basic treatment, moxibustion plus Mecobalamin is superior to simple Mecobalamin in treating diabetic peripheral neuropathy.
基金the Scientific Research Program of China-Japan Friendship Hospital, Ministry of Health, No. 20053055
文摘BACKGROUND： Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy （DPN）. Microsurgical decompression of peripheral nerve maybe effectively releases the symptoms of DPN. OBJECTIVE： To investigate the curative effects of microsurgical decompression of median nerves for treatment of DPN in upper limbs. DESIGN： Case-follow up observation. SETTING： Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Health. PARTICIPANTS： Twelve patients with DPN in upper limbs （19 hands） who received treatment in the Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Public Health between March 2004 and July 2006 were involved in this experiment. The involved patients, 5 male and 7 female, were aged 44 to 77 years, with DPN course of 6 months to 16 years. They all met 1999 WHO diabetic diagnosis criteria. Both two hands had symptom in 7 patients, and only one hand had symptom in 5 patients. Informed consents of detected items were obtained from all the patients, who also received 21 months of follow-up treatment. METHODS： （1）Operation was carried out under the anesthetic status of brachial plexus. Under an operating microscope, transverse carpal ligament was exposed. Subsequently, transverse carpal ligament, forearm superficial fascia and palmar aponeurosis were fully liberated, and then part of them was cut off. Connective tissue around median nerve, superficial flexor muscle of fingers, radial flexor, palmaris longus and other flexor tendons were completely loosened. Finally, epineurium was opened with microinstrument for neurolysis. After tourniquet was loosened, and bipolar coagulator was used to stop bleeding, and the incision was closed. （2） In postoperative 21 months, the subjective symptom, two-point discrimination （The smallest distance of two normal points was 3 to 6 mm）, nerve conduction velocity and acti
基金the National Research Foundation of Korea Grant funded by the Korean government(MSIT)(2020R1A2C1100891 and 2021R1G1A1008337)the Soonchunhyang University Research Fund.
文摘BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.
文摘Objective： To observe the clinical efficacy of warm acupuncture in the treatment of diabetic peripheral neuropathy and its effects on the conduction velocity of the tibial nerve and common fibular nerve. Methods： Fifty-two subjects were evenly randomized into two groups and treated by conventional therapy; in addition, the control group was given mecobalamin injection at 500μg, once a day for four weeks, and treatment group was given warm acupuncture, 6 times a week for 4 weeks. The clinical efficacy and the conduction velocity of the tibial nerve and common fibular nerve were observed and compared between the two groups. Results： After four-week treatments, the total effective rate was 88.5% in the treatment group and 61.5% in the control group, with a higher rate in the treatment group than in the control group （P〈0.05）; the conduction velocity of tibial nerve and common fibular nerve was higher in both groups （P〈0.05）, with higher conduction velocity in the treatment group than in the control group （P〈0.05）. Conclusion： Warm acupuncture is quite effective to treat diabetic peripheral neuropathy and to improve nerve velocity.
文摘Objective： To study the clinical effect of acupuncture combined with methylcobalamin in the treatment of diabetic peripheral neuropathy. Methods： Seventy-five diabetic patients complicated with peripheral neuropathies were included and randomly allocated into a treatment group （40 cases） and a control group （35 cases）. The patients in the treatment group all received acupuncture therapy plus methylcobalamin. In the control group, patients only received methylcobalamin for treatment. The therapeutic effect was evaluated 4 weeks later. Results： Both of the two groups presented improvement in nervous symptoms, signs and nerve conduction, and the improvement of the treatment group was significantly better than that of the control group （P〈0.05）. Conclusion： The therapy of acupuncture in combination with methylcobalamin is more effective than the monotherapy with methylcobalamin in the treatment of diabetic peripheral neuropathy.
文摘Brachial plexus injury is regarded as one of the most difficult international medical problem. Microsurgery is an advanced technology and has progressed further on the operation, especially on the nerve repair.
