Objective To explore the role of somatosensory evoked potentials elicited by paraspinal stimulation in the detection of spinal cord lesions.Methods Patients with clinically suspected spinal cord lesions underwent somatosensory evoked potentials(SEPs)and spinal cord conduction velocity(SCCV)test using paraspinal stimulating method.96 patients aged 15 to 75 years old with suspected spinal cord lesions of various aetiologies were tested.36 patients had demyelinating disease of the spinal cord,26 had sub-acute combined degeneration of the spinal cord,19 had myelopathy,10 had acute myelitis,5 had spinal cord corhpression.Results Paraspinal stimulation elicited somatosensory evoked potentials were Performed on all 96 patients,68 of whom underwent spinal MRI as well.SEPs and SCCV were found abnormal in a high ratio in all kinds of spinal cord lesions ; in general,78 among the 96 patients had abnormal SEPs with a sensitivity of 81.25%.27 out of 36 with demyelinating disease of the spine had abnormal SEPs with a sensitivity of 75.00%,23 out of 26 with subacute combined degeneration of the spinal cord had abnormal SEPs with a sensitivity of 88.46%,8 out of 10 with acute myelitis had abnormal SEPs,15 patients with myelopathy having abnormal findings,all 5 patients with spinal cord compression had abnormal SEPs.42 of 68 patients undergoing MRI revealed to be abnormal,in which 35 patients also had abnormal SEPs.The other 26 patients had normal spinal MRI,in which 21 patients had abnormal SEPs.Conclusions Paraspinal stimulation somatosensory evoked potentials and spinal cord conduction velocity may objectively document the abnormalities of electrophysiology,which occurs earlier than those of anatomy and radiological finds, therefore it may detect the dysfunction of spinal cord at an early stage.It is even more useful in the detecting of the metabolic myelopathy,which can hardly be detected by MRI.This technique is simple,inexpensive, and maybe useful in the diagnosis for patients with suspected spinal cord lesions.

Adult ; Burns ; etiology ; Humans ; Male ; Middle Aged ; Paraquat ; adverse effects ; Scrotum ; injuries

BACKGROUNDCubital tunnel syndrome is a well-recognized clinical condition and is the second most common peripheral compression neuropathy. This study was designed to investigate the causes of cubital tunnel syndrome by surgical means and to assess the clinical value of the neurophysiological diagnosis of cubital tunnel syndrome.

METHODSTwenty-one patients (involving a total of 22 limbs from 16 men and 5 women, aged 22 to 63, with a mean age of 49 years) with clinical symptoms and signs indicating a problem with their ulnar nerve underwent motor conduction velocity examinations at different sites along the ulnar nerve and examinations of sensory conduction velocity in the hand, before undergoing anterior transposition of the ulnar nerve.

RESULTSElectromyographic abnormalities were seen in 21 of 22 limbs [motor nerve conduction velocity (MCV) range (15.9 - 47.5) m/s, mean 32.7 m/s] who underwent motor conduction velocity examinations across the elbow segment of the ulnar nerve. Reduced velocity was observed in 13 of 22 limbs [MCV (15.7 - 59.6) m/s, mean 40.4 m/s] undergoing MCV tests in the forearms. An absent or abnormal sensory nerve action potential following stimulation was detected in the little finger of 14 of 22 limbs. The factors responsible for ulnar compression based on observations made during surgery were as follows: 15 cases involved compression by arcuate ligaments, muscle tendons, or bone hyperplasia; 2 involved fibrous adhesion; 3 involved compression by the venous plexus or a concurrent thick vein; 2 involved compression by cysts.

CONCLUSIONSFactors inducing cubital tunnel syndrome include both common factors that have been reported and rare factors, involving the venous plexus, thick veins, and cysts. Tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis cubital tunnel syndrome, especially MCV tests indicating decreased velocity across the elbow segment of the ulnar nerve.

Adult ; Cubital Tunnel Syndrome ; etiology ; physiopathology ; surgery ; Electromyography ; Evoked Potentials, Motor ; Evoked Potentials, Somatosensory ; Female ; Humans ; Male ; Middle Aged

Adult ; Female ; Humans ; Inhalation Exposure ; Male ; Middle Aged ; Paraquat ; poisoning

Objective To study effect of excessive iodine intake on sodium-iodide symporter(NIS)mRNA and protein expression of breast in lactating rats.Methods60 Wistar rats,having been weaned for one month,were randomly divided into three groups according to their body weights,I.e,①normal iodine(NI,30 rats);②ten fold high iodine(10 HI,15 rats);③one hundred fold high iodine(100 HI,15 rats).Eating food containing iodine of 300μg/L and drinking water of iodine at 5,1845,20 295μg/L,respectively.After fed for 3 months,the rats mated and had offspring,and urine and milk iodine of lactating rats were determined by As-Ce-catalytic spectrophotometric method.Their marmnary glands were sampled at lactation day 10.Then NIS mRNA expression by RT-PCR was determined and NIS protein by immunohistochemistry(SABC)was observed.Results The urine iodine of 10 HI group(3597.5μg/L)and 100HI group(25 404.3μg/L)increased obviously compared with that of NI group(344.7μg/L).The milk iodine of 10HI group(27.1×103μg/L)and 100HI group(191.0×1μg/L)was higher than that of NI group(6.0×103μg/L),but the increased fold of milk iodine was not paralleled with that of urine iodine.Difference of NIS mRNA expression was significant(F=24.19,P＜0.01)among the groups,and the NIS mRNA expression in 10HI(1.250±0.034)and 100HI(1.272±0.039)group were less than that in NI (1.532±0.044)group(P＜0.01).The breast NIS mRNA expression in lactating rats(1.532±0.044)was significantly higher than that in unlactating rats(0.879±0.018,P＜0.01).With the increasing iodine uptake,NIS protein expression decreased.Conclusions The NIS mRNA and protein in rat breasts is down-regulated by excessive iodine intake.So increasing extent of milk iodine concentration is inhibited,which is important to prevent off-spring from getting excessive iodine intake from parental generation.

Objective To investigate clinical nursing pathway management combined with nurse hierarchical system so as to promote the smooth implementation of clinical pathways.Methods The process of clinical nursing pathway was distributed into the work of nurses at different levels by using the present available resources; their process quality was quantitatively evaluated, which was closely related to their achievements, with the aim of making the nursing activity procedurized and standardized.Results Patients' satisfaction before and after implementing the clinical care pathway management combined with nurse hierarchical system was significantly different (P<0.01); the average hospital stay for a single disease was decreased after its implementation (P<0.05).Conclusions Implementing clinical nursing pathway management combined with nurse hierarchical system could effectively control the health care costs, improve quality of care and achieve the best possible care and management objectives.

Objective To investigate the methods for establishment of evaluation index system of clinical nursing pathway management.Methods Delphi method was used to screen evaluation indexes of clinical nursing pathway management and three rounds of expert consultation was carried out to establish the clinical nursing pathway management evaluation system. Analytic hierarchy process and comprehensive evaluation method was used to determine the levels of the index weight,and finally the establishment of weight factors at all levels.Results Aiming at the process of clinical nursing pathway management and following the principle of continuous improvement,an evaluation index system of clinical nursing pathway management was established.Conclusions The evaluation index system of clinical nursing pathway management provides a feasible and effective evaluation tool for the application and improvement of clinical nursing pathway and guides the promotion of application and development of clinical nursing pathway.

OBJECTIVETo investigate the efficacy of combined modality therapy for small cell lung cancer (SCLC) patient with limited stage disease (LD).

METHODSThe data of 122 SCLC patients with limited stage disease treated by surgery combined with chemotherapy and radiotherapy were analysed retrospectively.

RESULTSThe median survival time (MST) of the 122 patients was 38 months, the 1-, 3-, 5-year survival rate was 83.6%, 50.0% and 38.0%, respectively. If stratified the patients by TNM stage, the MST of stage I was not reached yet, it was 52 months for stage II and 22 months for stage III (P = 0.001); the 5-year survival rate was 57.1%, 43.1% and 28.3%, respectively. For stage III, the MST and 5-year survival rate was 40 months and 45.3% for the patients who received postoperative chemoradiotherapy, and only 20 months and 26.1% for those who were treated with postoperative chemotherapy alone (P = 0.071).

CONCLUSIONCombined modality therapy can improve the survival of small cell lung cancer patient with limited stage disease, and TNM stage is still a significant prognostic factor.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Radiotherapy, Adjuvant ; Retrospective Studies ; Small Cell Lung Carcinoma ; pathology ; therapy ; Survival Rate

OBJECTIVETo analyze the clinical feature and the value of chemotherapy for advanced stage bronchioloalveolar carcinoma (BAC) of the lung.

METHODSThe clinical data of 53 advanced stage BAC patients treated from Jan. 1999 to Dec. 2004 was collected and reviewed. Most of the patients received more than 2 cycles of the combined chemotherapy with platinum-based regimen.

RESULTSOf these 53 eligible patients in this series, 34 (64.2%) were women, 42 (79.2%) never smoked any cigarette, 29 (54.7%) originated from the right lung, and 12 patients (22.6%) showed bilateral multi-lobular or multi-central lesions or diffusive pulmonary involvement. The objective response rate was 17.0% (2 complete response, 7 partial response). 30 (56.6%) patients demonstrated stable disease and 14 (26.4%) patients showed progression of the disease. The median progression-free and overall survivals were 6.1 and 16.0 months, respectively. The 1-year survival rate was 71.7%. Grade 3 or severer toxicities included neutropenia (34.0%), thrombocytopenia (15.1%), anemia (22.6%), nausea and vomiting (39.6%), alopecia (30.2%), constipation (17.0%) and peripheral neurotoxicity (13.2%).

CONCLUSIONAdvanced bronchioloalveolar carcinoma is likely to occur in woman, nonsmoker and the right lung, frequently with bilateral diffuse pulmonary involvement. The platinum-based combined chemotherapy regimen is modestly effective with tolerable toxicity. Compared with the historical data of lung adenocarcinoma of the same stage, bronchioloalveolar carcinoma has a longer overall survived.

Adenocarcinoma, Bronchiolo-Alveolar ; drug therapy ; pathology ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Remission Induction ; Retrospective Studies ; Sex Factors ; Smoking ; Vinblastine ; administration & dosage ; analogs & derivatives

BACKGROUNDDiabetic neuropathy is common in diabetes mellitus. The early stage of diabetic neuropathy is often symptomless and difficult to be treated. The aim of this study was to assess the correlation between the results of the sympathetic skin response (SSR) test and the development of diabetic neuropathy, and explore the use of SSR as an objective basis for the early diagnosis of diabetic neuropathy.

METHODSThe latencies and amplitudes of initiation and of the N and P waves were determined by SSR testing of the extremities of 80 diabetic patients and 30 healthy controls.

RESULTSThe latencies of initiation and of the N and P waves were significantly (P <0.001) longer in diabetic patients than in the controls, while there was no significant difference in the amplitudes (P >0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb.

CONCLUSIONSSSR can detect early dysfunction of the small sympathetic fibers in people affected by diabetes mellitus, and may be a useful electrophysiological test for the early diagnosis of diabetic neuropathy.

Adult ; Aged ; Diabetic Neuropathies ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Reaction Time ; Skin ; innervation ; Sympathetic Nervous System ; physiology