Objective To investigate motor nerve function status in rats with diabetes mellitus by motor unit number estimation (MUNE), and discuss it′s early diagnostic value in diabetic peripheral neuropathy (DPN). Methods Diabetic rat model (DM group) was induced by streptozotocin. The MUNE of gastrocnemius muscle and motor nerve conduction (MCV, CMAP) of the sciatic nerve were measured at the 4th, 8th and 12th week after onset of hyperglycemia in the DM group and the control group (normal SD rats). The ultrastructure of sciatic nerve was observed by electron microscope. Results At the 4th week, MUNE of gastrocnemius muscle was significantly decreased in DM group compared to that of the control group (275.88 ± 87.87 vs 369.71 ± 75.64,P<0.05). There were no significant differences in MCV and CMAP of sciatic nerve be?tween two groups. The electron microscopy observation showed that most nerve fibers were normal;a small amount of axonal atrophy, and myelin lamellar structure was separated in DM group. At the 8th week, compared with the control group, MUNE were reduced in gastrocnemius muscle in DM group (357.49±72.68 vs 221.26±92.41, P<0.01). There were no significant dif?ferences in MCV and CMAP of the sciatic nerve between DM group and control group. The electron microscope observation showed that part of nerve fibers were normal, the myelin focal plate layer was loose and separated, axonal atrophy, the axonal membrane and myelin sheath inner layer was separated with big gap. At the 12th week, MUNE of gastrocnemius muscle (127.87±19.80 vs 366.85±51.25), sciatic nerve MCV [(35.06±4.43) m/s vs (50.47±6.07) m/s] and CMAP [(2.91±1.37) mV vs (5.98±2.14) mV] were significantly decreased in DM group than those of control group (P<0.01). The electron microscopy observation showed severely damaged myelin flex and axonal squeeze. Conclusion MUNE is much earlier in detecting ear?ly motor nerve dysfunction in DM than conventional motor nerve conduction test.

Objective To assess the function of motor nerve fiber in patients with diabetic peripheral neuropathy (DPN) by single-fiber conduction studies.Methods According to the diagnostic standard of DPN issued in Toronto meeting in 2009,on the basis of the result of peroneal nerve conventional conduction study,a total of 65 patients with DPN in the Department of Endocrinology and the Department of Neurology of Tianjin Third Central Hospital from October 2012 to October 2013 were enrolled into the study,from whom 33 had abnormal sensory conduction (sensory-diabetic peripheral neuropathy group,S-DPN group),32 had abnormal sensory motor conduction (sensory motor-diabetic peripheral neuropathy group,SM-DPN group).Single-fiber conduction velocity (SF-CV) and single-fiber distal motor latency (SF-DML)were detected in all subjects.The obtained results were compared with the data from 34 healthy volunteers (control group).The relationship of SF-CV,SF-DML and the duration of diabetes mellitus,fasting glucose,HbA1 c was also studied in DPN patients.Results The SF-CV ((43.1 ± 3.6) m/s) was decreased in S-DPN group compared with control group ((47.5 ± 3.3) m/s,t =5.077,P ＜ 0.01).There were no significant differences in SF-DML ((3.6 ± 0.7) ms),motor nerve conduction velocity (MCV (49.5 ± 2.6)m/s) and DML ((3.4 ± 0.6) ms) in S-DPN group compared with that of control group ((3.4 ± 0.5) ms,(50.9 ± 3.5) m/s,(3.2 ± 0.5) ms,respectively).SM-DPN group had lower SF-CV ((35.2 ± 3.6)m/s,t =9.119,14.219),MCV ((40.9 ± 3.2) m/s,t =11.131,13.025) and increased SF-DML ((4.5±0.7) ms,t=5.692,7.231),DML ((4.2 ±0.7) ms,t=5.561,6.975) compared with the other two groups (P ＜0.01).SF-CV in DPN patients was negatively related to the diabetic duration (r =-0.340,P =0.006),while SF-DML had no correlation with duration of DM,fasting blood glucose and HbAlc.Conclusions Detection of SF-CV is easy to find early motor nerve dysfunction in DPN patients.SF-CV is decreased with the increasing duration of diabetes.

OBJECTIVE: To summarize the clinical experience with endoscopic transnasal resection of nasal skull- base neoplasms, which involved anterior skull base, pterygopalatine fossa, nfratemporal fossa. METHOD: Clinical data from 73 patients performed on endoscopic transnasal resection of nasal skull-base neoplasms were analyzed retrospectively. RESULT: Total tumor removal was obtained in 54 cases, subtotal removal in 19 cases. In 16 cases of benign tumor, the postoperative survival rate was 100%; Malignancy in 57 cases, of which 16 patients were died, and half-year survival rate was 71.9%. CONCLUSION Endoscopic endonasal approach be able to fully reveal and re- moval of lesions involving the anterior skull base, pterygopalatine fossa and infratemporal fossa. The approach is feasible and safe.
Endoscopy ; Humans ; Nose ; surgery ; Postoperative Period ; Pterygopalatine Fossa ; Retrospective Studies ; Skull Base ; Skull Base Neoplasms ; surgery

Objective To study the roles of the contact heat evoked potential (CHEP) in evaluating the small nerve fibers of cranial and spinal in elderly diabetic patients,and to analyze the feature of the small fibers in order to provide scientific foundations for early diagnosis of diabetic neuropathy (DN).Methods Totally 50 diabetic patients and 40 healthy subjects were included in this study.The diabetic patients were divided into the normal nerve conduction group (n=17) and the abnormal nerve conduction group (n=33).CHEP was determined and thermal stimuli was given to the area of eyelid,forearm and peroneal.Sensory and motor nerve conduction velocity in the upper and lower limbs were tested in all diabetic patients.Results Compared with the healthy group,the N wave latencies were prolonged and the N-P amplitudes were reduced in the area of eyelid,forearm and peroneal in diabetic patients (all P＜0.01).Compared with the healthy group,the logarithm of N-P amplitudes were reduced in areas of forearm and peroneal [(1.70±0.10) vs.(1.60±0.14),(1.65±0.078) vs.(1.54±0.15),both P＜0.05] and N wave latencies were prolonged in eyelid area [(343.1±18.2) ms vs.(385.4±26.5) ms,P＜0.05] in normal nerve conduction group.Compared to group with normal nerve conduction velocity,the logarithm of N-P amplitudes was reduced in peroneal area [(1.54±0.15) vs.(1.44±0.15),P＜0.05] in abnormal nerve conduction group.Conclusions CHEP can detect the early impairment of the small fibers in elderly diabetic patients.The early smallfiber impairments in diabetic neuropathy may be axon-oriented in spinal nerves and myelin-oriented in cranial nerves.

Objective To study the influencing elements in x-Gal staining method and optimize the reactive conditions so that nonspecific background can be eliminated and grafted exogenous cells carrying LacZ gene can be discerned correctly. Methods C17 2 cells (carrying lzcZ gene) were injected into the right lateral ventricle both in the adult and newborn animals. After one week they were perfused using two methods, then the slices were stained at different pH and incubating time respectively. The X-gal positive cells in hippocampus were counted under light microscope. Results Background staining in this method has close correlation with the species and age of the host animals and it decreases when pH is higher or incubating time is shorter. The results are the best when pH 9 5 and the incubating time is 1*!h.Conclusion The reliability of X-gal staining method depends on optimization of several parameters, including pH, incubating time, perfusion etc. It is necessary to establish the correspondent controls.;

BACKGROUND:Using experimental animals to simulate diseases of human being is the basis of studying etiology and treatment of the diseases, so the diseases of nasal cavity and sinus need suitable experimental animals as models.
OBJECTIVE:To observe the regional anatomy of rhino-sinus in rabbits and its performance through CT imaging, and to discuss the feasibility of applying a rabbit model to the study of animal rhino-sinusitis.
METHODS:Routine coronal and axial scanning images of rhino-sinus of New Zealand rabbits were performed through Discovery CT750 HD. The rhino-sinus anatomy was then observed.
RESULTS AND CONCLUSION:The nasal septum is located on both sides of the nasal cavity. The lateral wal of rabbit nasal is composed of maxil ary turbinate, middle turbinate, the inside of the middle turbinate and inferior turbinate. The maxil ary sinus cavity is the largest one and ethmoid sinus, sphenoid sinus and frontal sinus are relatively much smal er. Al these sinuses are paired and symmetrical. The rhino-sinus in rabbit is displayed clearly in CT scan. The anatomical location of rabbit is similar to that of human;however, the maxil ary sinus of rabbit is greater than that of human correspondingly, which is suitable for operating and applying to surgical anatomy and imaging analysis. The rabbit model of rhino-sinus can be applied to simulate human rhino-sinusitis.

Objective To evaluate the function of motor nerve in patients with diabetic sensory neuropathy (DPN) by estimating the motor units.Methods Fifty-four patients with DPN were divided into two groups according to the nerve conduction abnormality of ulnar nerve.The paresthosia group only included patients of 33 patients (20 male, 13 female) with abnormal sensory conduction.The admixture group included 21 patients (13 male, 8 female) with abnormal motor sensory conduction.The control group included 42 healthy people.A Keypoint4 electromyogram device was used to estimate the motor units of hypothenar muscle, and the fasting blood glucose and the duration of diabetes mellitus were documented.Results The motor units of hypothenar muscle in paresthesia group, admixture group and control group was 97.1±47.6, 63.3±22.3, 173.0±75.5 (F=21.259, P=0.000) respectively.The hypothcnar muscle motor units(84.0±42.8) in 54 patients with DPN had negative correlation (r=-0.414, P=0.002) with the duration of diabetes mellitus (1 month to 26 years) and had no evident correlation with fasting blood glucose (5.0-20.4 mmol/L).Conclusion There is clinical motor nerve damage in patients with diabetic sensory neuropathy, and the loss of motor units is impacted by the duration of diabetes mellitus.

Objective:To investigate the characteristics of phrenic nerve motor conduction (PNC)and motor evoked potentials of diaphragm elicited through magnetic stimulation (dMEP)in mechanical ventilation of patients with chronic obstructive pulmonary disease(COPD).Methods:PNC and dMEP were performed in 10 COPD patients with regular mechanical ventilation(the duration of mechanical ventilation≤7 d),10 COPD patients with prolonged mechanical ventilation(the duration of mechanical ventilation＞7 d),and 10 healthy subjects(control group).Results:There were significant differences in the latency and the common logarithm of the amplitude of PNC,cervical dMEP and cortical dMEP between three groups before and after weaning(P＜0.01 or P＜0.05).There were significant differences in central motor conduction time(CMCT)in three groups before and after weaning(P＜0.01).There was longer CMCT before weaning in two COPD groups than that of control group(P＜0.01).It showed no statistical difference in CMCT before weaning between two COPD groups(P＞0.05).There was a longer CMCT after weaning in prolonged mechanical ventilation than that of regular mechanical ventilation(P＜0.01).However,there was no statistical difference in CMCT after weaning between the regular mechanical ventilation group and the control group(P＞0.05).Conclusion:There were dysfunctions in the cortico-diaphragmatic pathway in COPD patients with mechanical ventilation,which may be aggravated by the prolonged mechanical ventilation.PNC and dMEP may help to define the cause of respiratory dysfunction in COPD patients with mechanical ventilation.

Objective To observe the clinical efficacy of acupoint sticking plus hot compress by moxa-salt bag in treating constipation after acute cerebral stroke.Method Eighty patients with constipation after cerebral stroke were randomly allocated to a treatment group and a control group by using random number table method according to registration order, 40 cases each. The control group was intervened by acupoint sticking at umbilicus with rawDa Huang (Rheum Officinale), and the treatment group was additionally given hot compress using moxa-salt bag. The treatment was given once a day, for consecutive 3 days in total. The first defecation time, stool shape and defecation sensation were observed in the two groups. The clinical efficacies were compared between the two groups.Result The total effective rate was 90.0％ in the treatment group versus 72.5％ in the control group, and the difference was statistically significant (P<0.05). After the treatment, there was statistically significant difference in comparing the first defecation time between the two groups (P<0.05). After the treatment, the incidence rate of soft stool was 85.0％ and that of hard stool was 15.0％ in the treatment group versus 40.0％ and 60.0％ in the control group, and the differences were statistically significant (P<0.05). The incidence rate of pleasant defecation sensation was 80.0％ and that of difficult defecation was 20.0％ in the treatment group versus 35.0％ and 65.0％ in the control group after the treatment, and the differences were statistically significant (P<0.05).Conclusion Acupoint sticking plus hot compress by moxa-salt bag is an effective method in treating constipation after acute cerebral stroke.

This study retrospectively reviewed 75 patients with impaired glucose tolerance(IGT)admitted in our hospital from March 2015 to October 2015.All patients underwent Toronto clinical scoring system(TCSS) evaluation.Patients with IGT were further divided into normal score group(TCSS-N, n=50)and abnormal score group(TCSS-A, n=25)according to their scoring results, and 30 healthy volunteers were served as control group.All patients and controls underwent motor and sensory nerve conduction studies, as well as sympathetic skin response(SSR)test using the Keypoint.Net(Medoc Ltd)electromyogram device.The results showed that the SSR amplitude of lower limbs was reduced [(0.61±0.44 vs 1.00±0.33)mv, P<0.05]andlatencyoflowerlimbswas extended [(1 880±282 vs 1 642±256)ms, P<0.05]in IGT group compared with control group.But median, ulnar, tibial, and peroneal nerve sensory and motor conduction revealed no difference between two groups.In TCSS-A group, the SSR amplitude of lower limbs was reduced [(0.47±0.39)mv, P<0.05], latency of lower limbs was extended [(2 062±291)ms,P<0.05]and the sensory nerve action potential(SNAP)amplitude of the tibial nerve was significantly lower compared with control group [(1.83±0.37 vs 2.07±0.30)μv, P<0.05].Compared to TCSS-N group, latency of lower limbs was extended [(2 062±291 vs 1 808±246)ms, P<0.05]in TCSS-A group.The SSR amplitude of lower limbs were reduced[(0.66±0.44)mv,P<0.05]and latency were prolonged(P<0.05)in TCSS-N group compared with control group.Pearson correlation analysis showed that the SSR amplitude and latency of the lower limbs were correlated with the postprandial blood glucose, blood glucose fluctuation, body weight, as well as body mass index.These results suggest that there exists peripheral nerve damage in the patients with IGT, mainly involving the small fiber nerve of the lower limbs.Large fibers may also be mildly affected as the disease progresses.