1.The value of multiple neurophysiological tests in the early diagnosis of diabetic peripheral neuropathy
Yunqian ZHANG ; Hong XU ; Yingqiu CHENG ; Yi ZHOU ; Xiaolei SHENG ; Yunhu FAN
Chinese Journal of Physical Medicine and Rehabilitation 2013;(5):351-355
Objective To investigate the value of nerve conduction studies (NCSs),F wave analysis,somatosensory evoked potential (SEP) and skin sympathetic response (SSR) in the early diagnosis of diabetic peripheral neuropathy (DPN).Methods A total of 110 patients with diabetes mellitus were recruited as the diabetic group and another 50 well-matched healthy volunteers as the normal controls.Sensory and motor NCSs of the median,ulnar,posterior tibial and common peroneal nerves were performed.F waves were recorded from the median and posterior tibial nerves.SEPs elicited by stimulation to nerves of both the upper and lower limbs as well as SSRs were measured,all in both the diabetic group and the normal controls.Results The total rate of nerve conduction abnormality was 74.5% in the diabetic group,with sensory nerve conduction abnormalities more frequent and more severe among motor nerves in the extremities.The total rate of F wave abnormalities was 57.3% in the diabetic group.The rate in patients with normal distal motor conduction in their median and posterior tibial nerves was 50.7%.The total SEP abnormality rate was 70.0% with regard to the proximal peripheral nerve potentials in the diabetic group,but there was no obvious abnormality of the supraclavicular electrical potential in the upper limbs for those with normal sensory nerve conduction in the median nerve.The rate of occurrence of abnormality in the gluteus point potential in the lower limbs of those with normal posterior tibial sensory conduction was 62.5%.The total rate of SSR abnormalities was 80.0% in the diabetic group but 72% among those with normal nerve conduction in their extremities.Combining the NCS,SSR,SEP and F wave results,the total abnormality rate was 90.9% in the diabetic group,which was much higher than with any single test used alone.Conclusion NCS is essential for diagnosing DPN.Early diagnosis of subclinical diabetic neuropathy will be significantly enhanced when nerve conduction,SSRs,SEPs and F waves are tested together.
2.Effects of growth hormone on serum albumin levels and intestinal mucosal morphology in rats with intracerebral hemorrhage
Zhixiu YANG ; Jianlin WANG ; Lihua LUO ; Xiaomin ZHANG ; Yunhu FAN ; Yang ZHANG
International Journal of Cerebrovascular Diseases 2009;17(12):913-917
Objecthe To equate the effects of recombinant human growth hormone (rhGH) on serum albumin lewis and intestinal mucosal morphology in rats with intracerebral hemorrhage. Methods A rat model of intracerebral hemorrhage was induced by autologous blood injection. Fifty-six SD rats were divided into sham-operation group (n =8), rhGH group (n =24; intraperitoneal injection of rhGH, 1 U/kg, once a day), and saline control group (n =24; intraperitoneal injection of equivalent normal saline, once a day). The rhGH and saline control groups were redivided into 1-, 7- and 14-day groups (n =8 in each group) after the procedure. The serum albumin concentration was detected at different time points in all groups. The changes of intestinal mucosal morphology were observed with Hematoxylin and Eosin (HE)staining and image analysis. Results Hie serum albumin lewis at all time points of intracerebral hemorrhage in the saline control group were all significantly lower than those in the sham-operation group (all P < 0. 01); The serum albumin level was increased gradually with the treatment process in the rhGH group, however, it was only significantly higher than the saline control group at day 14 (39.93 ±1.98 g/L νs. 37. 93 ±1.57 g/L) (P<0. 01). There were no significant differences between the rhGH group and the saline group in intestinal villus height and mucosal thickness at day 1 and 7 after intracerebral hemorrhage, however they were increased significantly at day 14 (P <0.01). The area of intestinal villi was reduced progressively at day 1, 7 and 14 after intracerebral hemorrhage, and with the treatment process the rhGH group was increased more progressively than the saline control group (P <0. 01). The depth of intestinal glands in the rhGH group was increased significantly than that in the saline control group (P <0. 01), but there was no significant difference at day 14; the density of glands in the rhGH group was significantly increased than that in the saline group at day 1 after intracerebral hemorrhage (P < 0. 01), and it was not increased significantly at day 7, however, it was not increased but decreased slightly at day 14. Conclusions The serum albumin level in rats with intracerebral hemorrhage was decreased significantly than that in the sham-operation group, and intracerebral hemorrhage could cause intestinal mucosal injury. rhGH increased the serum albumin level in rats with intracerebral hemorrhage. It might reduce intestinal mucosal injury to different degrees whether it was in the early or late intracerebral hemorrhage, and the late improvement was more significant. The improvement degree of rhGH on intestinal mucosal injury was positively correlated with the increased degrees of the serum albumin level.
3.Correlation between serum albumin level and intestinal mucosa change in rats with cerebral hemorrhage
Jianlin WANG ; Suming ZHANG ; Zhixiu YANG ; Xiaomin ZHANG ; Yunhu FAN ; Jingmei WANG
Chinese Journal of Neurology 2010;43(11):801-804
Objective To explore the correlation between the serum albumin level and the jejunal mucosal morphology in rats with cerebral hemorrhage and to find out the mechanism of the resulting hypoproteinemia.Methods A rat model of cerebral hemorrhage was used to detect the serum albumin level and the morphologic parameters of jejunal mucosa on day 1,7 and 14 after the hemorrhage.The results were compared to the normal control group and the sham-operated group. The correlation between the serum albumin level and the parameters of the jejunal mucosal morphology was explored.Results The serum albumin level was positively correlated with the small intestinal villous height(r =0.869,P<0.01),villous area(r=0.659,P<0.01),mucosal thickness (r=0.915,P<0.01),depth of intestinal glands(r=0.545,P<0.05)and density of intestinal glands(r=0.475,P<0.05).Conclusion The serum albumin level is closely related to the morphologic changes of the jejunal mucosa.
4.Clinical Trial on the Role of Tuina in Rehabilitation Therapy Following Total Hip Replacement
Li GONG ; Juntao YAN ; Zhenan ZHU ; Yuanzhi FAN ; Yin SUN ; Yunhu XI ; Rude HUANG ; Chouping HAN
Journal of Acupuncture and Tuina Science 2010;08(6):384-389
Objective: To observe the clinical effect of tuina in rehabilitation following total hip replacement. Methods: 60 cases were randomly allocated into a treatment group and control group, 30 cases in each group. Cases in the treatment were treated with combined mina and rehabilitation, while cases in the control group were treated with rehabilitation alone. All treatment retained for two weeks. The results were observed 7 d, 2 weeks and 6 weeks following the total hip replacement using Harris scale and Hamilton Anxiety Rating Scale (HAMA).Results: For Harris scale, there were significant intra-group differences in different time frames (P<0.05); there were no statistical differences between the two groups 1 d, 7 d and 6 weeks following the total hip replacement (P>0.05); and there were statistical differences between the two groups 2 weeks following the total hip replacement. For HAMA scale, there were significant intra-group differences in different time frames (P<0.05); there were no significant differences between the two groups 1 d following the total hip replacement; and there were substantial differences between the two groups 7 d, 2 weeks and 6 weeks following the total hip replacement. Conclusion: In a given unit time, combined mina and rehabilitation is superior to rehabilitation alone in improving the patients' post-operative pain, articular range of motion and anxiety.