1.The value of sympathetic skin response for early diagnosis of diabetic neuropathy
Zhirong JIA ; Xin SHI ; Yining HUANG
Chinese Journal of Neurology 2001;0(03):-
Objective To study the association between sympathetic skin response (SSR) and diabetic neuropathy,and explore its use as the objective base for its early diagnosis. Methods The latencies and amplitudes of the initiation,waves N and P in SSR of the extremities in 80 diabetic patients and 30 healthy controls were determined using electrophysiological measurements. Results The latencies of the initiation,waves N and P of SSR test were prolonged significantly in the diabetic patients as compared to the controls ( P 0.05). All but two patients (97.5%) demonstrated abnormal SSR in at least one limb. Seven patients (8.8%) had no responses in SSR in both the feet and hands. The frequency of abnormality in the latency of initiation and waves N and P was 86.9%(139/160)in the upper limbs,and 89.4%(143/160)in the lower limbs. Conclusions The SSR can detect the early dysfunction of the small sympathetic fibers in diabetes millitus and may be a useful electrophysiologic testing for the early diagnosis of diabetic neuropathy.
2.Pathogenesis and electrodiagnosis of cubital tunnel syndrome
Zhirong JIA ; Xin SHI ; Xiangru SUN ;
Chinese Journal of Neurology 2001;0(02):-
Objectives To determine the causes of cubital tunnel syndrome by performing operation,and to assess the clinical value of neurophysiologic diagnosis in cubital tunnel syndrome Methods Twenty one patients (22 limbs from 16 men and 5 women, aged from 22 to 63 years, with mean age of 49 years)suspected of ulnar nerve involved in clinical symptoms and the signs of ulnar distribution were recorded with motor conduction velocity at different sites along with the ulnar nerve and sensory conduction velocity in the hand,and underwent anterior transposition of the ulnar nerve Results Electromyographic abnormality was seen in 21/22 (range MCV 15.9~47.5 m/s,mean 32.7 m/s) of patients with motor conduction velocity in across elbow segment of the ulnar nerve. And slowing was seen in 13/22 (MCV 15.7~59.6 m/s, mean 40.4 m/s )patients with MCV in the forearms. The absent or abnormal evoked sensory nerve action potential was seen in 14/22 patients in the little finger. The factors of ulnar compressed in this study by operation were:15 ulnar nerves compressed by arcuate ligaments, or muscle tendons, or bone hyperplasia; two were involved in fibrous by adhesion;three compressed by venous plexus or concurrent thick vein;two compressed by cysts Conclusions The factors of cubital tunnel syndrome include either the common factors reported or the rare factors, such as the venous plexus, thick vein and cysts. The tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis of cubital tunnel syndrome, especially the slowing velocity of MCV across the elbow segment.
3.Application of short-segment nerve conduction studies in the cubital tunnel syndrome
Zhirong JIA ; Zhu LIU ; Tingting WANG ; Xin SHI ; Wei LIANG
Chinese Journal of Neurology 2014;(6):403-407
Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.
4.Paroxysmal diagonistic ideomotor apraxia in ischemic infarction of the corpus callosum
Tingting WANG ; Zhirong JIA ; Wei SUN ; Tao PAN
Chinese Journal of Neurology 2011;44(7):479-481
Objectives To report the clinical features and treatment in a case with paroxysmal diagonistic ideomotor apraxia after ischemic infarction of the corpus callosum.Methods The neuropsychological tests,brain MRI,the TCD and carotid duplex sonography were carried out in the patient who is right handed and had had presentation of paroxysmal diagonistic ideomotor apraxia for ten days.Results Neuropsychological tests confirmed the diagnosis of paroxysmal diagonistic apraxia in this patient.MRI showed ischemic infarction in the right corpus callosum.The symptomsin the patient were improved after the treatment with aspirin for three months.Conclusion The infarction of corpus callosum may induce paroxysmal diagonistic apraxia.
5.Paraspinal elicited somatosensory evoked potentials in the detection of spinal cord lesions
Zhirong JIA ; Xin SHI ; Xiang-Ru SUN ; Yi-Ning HUANG ;
Chinese Journal of Neurology 2005;0(09):-
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.
6.The study of somatosensory evoked potential of the upper limbs in subacute combined degeneration
Tingting WANG ; Zhirong JIA ; Tao PAN ; Zhu LIU ; Xin SHI ; Wei LIANG
Chinese Journal of Neurology 2013;(5):308-312
Objective To analyze the features of the latency and interval in somatosensory evoked potentials (SEP) of the upper limbs in subacute combined degeneration(SCD),and evaluate the SEP of the upper limbs in the diagnosis of SCD.Methods Thirty-four defined SCD patients and 22 healthy controls were included in this study.The patients underwent the SEP test and the magnetic resonance imaging(MRI)of spinal cord.The SEP results of the patients were compared with those of the controls.The results of the SEP,which were divided into the peripheral part and central part to be evaluated,were also compared with the related results of the SEP and MRI.Results Compared with the controls,the N9 ((10.80 ± 1.07) ms vs (10.23 ± 0.64) ms,t =3.223),P14 ((17.28 ± 2.56) ms vs (14.62 ± 0.84) ms,t =6.643),N9-P14 ((6.48±2.27) ms vs(4.40-0.58) ms,t =5.951) in the upper limbs and N9((12.11 ±0.83) ms vs (10.93±0.56) ms,t=5.690),P30((36.96±5.56) ms vs(30.37±2.20) ms,t=7.217),P38 ((46.94 ±5.83) ms vs(39.80 ±2.54) ms,t =7.353) in the lower limbs of SCD patients were prolonged (all P <0.01),however,the P14-N20 was prolonged without statistical significance.The abnormality of SEP was 80.9% (110/136),in which the abnormality of the upper limbs was 85.3% (58/68)while that of the lower limbs was 76.5% (52/68).N9-P14 had the highest abnormality rate which was 72.1% (49/68).The patients with SCD with normal N9 had prolonged N9-P14 ((5.98 ± 1.90) ms vs(4.40 ± 0.58) ms,t =5.267,P < 0.01).Conclusions Subacute combined degeneration can involve not only the peripheral part of the somatosensory pathway but also the central part including the brainstem and brain.In the SEP of upper limbs,N9-P14 has the highest abnormality rate which suggests that the part from cervical spinal cord to the brainstem may be the most vulnerable in SCD.The test of SEP in the upper limbs may provide evidence for the damage in the central part in SCD.
7.Electrophysiological characteristics in patients with early Guillain-Barré syndrome
Tao PAN ; Zhirong JIA ; Tingting WANG ; Hongxia WANG ; Xin SHI ; Wei LIANG
Chinese Journal of Neurology 2011;44(11):735-738
Objective To analyze the characteristics of the F waves,H-reflex and nerve conductions and its diagnostic value in the patients with Guillain-Barré syndrome(GBS)onset within 4 weeks.Methods The electrophysiological data of the 40 patients with GBS were analyzed retrospectively.These patients were divided into 2 groups according to the duration of illness including in 2 week' s group and over 2 week' s group.The results of the F waves,H-reflex,the motor nerve conduction velocity (MCV),and the sensory nerve conduction velocity(SCV)of these patients were analyzed.Results The abnormality rate of the F waves was 17/20 and 7/18 respectively in less 2 week' s group and over 2 week' s.The H-reflexes were 13/20 and 12/19.The MCV was 28.4%(25/88)and 32.9%(26/79).The distal motor latency was 40.9%(36/88)and 36.7%(29/79).The compound muscle action potential amplitude was 35.2%(31/88)and 32.9%(26/79)respectively in these two groups.The abnormality rate of the SCV was 11.2%(10/89)and 25.2%(24/95)respectively in the two groups.The higher abnormality rate of these tests was the F waves and H-reflex in both the groups.The abnormality rates of the F waves(x2 =8.657,P =0.003)and SCV(x2 =6.002,P =0.014)were significantly different between the two groups.There were no significant differences in the other tests.Conclusion The electrophysiological tests are valuable in the diagnosis of GBS.The F waves and H-reflex are more significant for early diagnosis of GBS.
8.Significance of quantitative thermal testing in the diagnosis of diabetic peripheral neuropathy
Zhirong JIA ; Hongxia WANG ; Xin SHI ; Wei LIANG ; Xiangru SUN ; Yining HUANG
Chinese Journal of Neurology 2008;41(10):661-665
Objective To investigate the significance of quantitative thermal testing (QTT) in the diagnosis of diabetic peripheral neuropathy. Methods One hundred and sixty-nine diabetic patients with neurological deficit (DM group) and 53 age-matched healthy controls underwent the determination of cold threshold (CT), warm threshold (WT), clod pain threshold (CPT), warm pain threshold (WPT) in both dorsum of hand and dorsum of foot. DM group were divided into subgroups with a course of disease > 5 years or with a course of disease ≤ 5 years, or divided into subgroups with normal or abnormal nerve conduction study (NCS). Results CT and WT of DM group with a course of disease ≤ 5 years ((29.6 ± 1.4), (26. 5±4. 3) ℃ ; (35.9±3.0), (41.3±4. 0) ℃) were higher than the health controls' ((30. 2±1.2), (29.1±1.5) ℃; (35.0±1.9), (36.5±1.5) ℃, respectively; t=3.27, 6.63, 2.80, 8.61, all P< 0. 05). The CT and WT of DM group with a course of disease > 5 years' ((28. 2±4. 0), (23. 1 ±7.9) ℃ ; (37.0±4. 7), (42. 6±4. 2) ℃, respectively) were higher than the DM group with course of disease≤ 5 years(t =4. 09, 4.63, 2.55, 2. 68 ,all P <0. 05). CT and WT of the normal NCS group((29. 5 ± 1.8), (27.0±4. 6) ℃ ; (35.0±1.9), (40. 9±3. 8)℃, respectively) were higher than the healthy controls' , and the difference was significant(t =3.22, 4. 17, 3.51,9. 95,all P<0.01). The frequency of abnormal QTT in DM group was higher than that of NCS in DM group. The QTT and NCS of DM group with a course of disease >5 years were higher than these in DM group with a course of disease ≤5 years; the frequency of abnormal WT in DM group(86. 4% ,146/169)was higher than that of CT in DM group(68. 1% ,115/169,x2=15.49, P<0.01), the frequency of abnormal QTT in the dorsum of foot in DM group was higher than that in the dorsum of hand in the DM group. PT of diabetic patients were higher than that in the healthy controls. Condusions QTT is more sensitive than NCS in the diagnosis diabetic peripheral neuropathy, which is neeossary to assist NCS when diabetic peripheral neuropathy is suspected, WT in dorsum of foot is a sensitive parameter in the diagnosis of diabetic peripheral neuropathy.
9.Evaluation of Education about Nosocomial Infection of AIDS and Professional Postexposure Prophylaxis
Lan LIU ; Xu FANG ; Yingchun CHU ; Jia HE ; Zhirong WANG ; Qiang GUO
Chinese Journal of Nosocomiology 2006;0(05):-
OBJECTIVE To analyze the reason of cause of nosocomial infection of AIDS and the events of medical staff exposed to the virus of HIV,to explore the role of activity in the education program and put in practice the education.METHODS To analyze the activity of education about prevention of nosocomial infection of AIDS and postexposure prophylaxis.RESULTS Having practiced the education,all of medical staffs increased the consciousness to prevent the AIDS,there was not a case of exposed to virus of HIV in the first half of year of 2007.CONCLUSIONS Leaders pay attention to and practice the education activity about NI and prevent the staff from exposure to virus of HIV,especially,to realize a series of rules and counter measures,it is key links to prevent AIDS among medical staffs in hospital.
10.Prevention against and treatment of doxorubicin-induced acute cardiotoxicity by dexrazoxane and schisandrin B.
Kaiyong HU ; Yong YANG ; Lihua HE ; Duowei WANG ; Zhirong JIA ; Shuran LI ; Wei TIAN ; Jie MAO ; Xianjing LI ; Wei ZHANG
Acta Pharmaceutica Sinica 2014;49(7):1007-12
In this study, it is to compare the effectiveness of prevention against and treatment of doxorubicin (DOX) induced cardiotoxicity by dexrazoxane and schisandrin B (Sch B) in rats. Sprague-Dawley (SD) rats were randomly divided into the following 6 groups: normal saline group, DOX group, DOX+DEX group, DOX+Sch B (80 mg x kg(-1)) group, DOX+Sch B (40 mg x kg(-1)) group and DOX+Sch B (20 mg x kg(-1)) group. The results showed that Sch B could combat the increase of myocardial enzymes in peripheral blood, decrease of the enzyme activity of myocardial tissue antioxidant enzymes and disorders of systolic and diastolic function of heart in rats intravenously injected with doxorubicin (15 mg x kg(-1)). Sch B was better than DEX in protecting rat against DOX-induced the symptoms. Sch B could protect rat against DOX-induced acute cardiomyopathy and has clinical potential applications.