Objective To study the diagnostic value of single fiber electromyography (SFEMG) in diabetic peripheral neuropathy (DPN).Methods The values of jitter and fiber density (FD) in 36 patients with diabetes mellitus of 2 type were determined by Viking Ⅳ, while conventional nerve conduction studies (NCS) were performed,and the fasting blood glucose and glycosylated hemoglobin A 1C (HbA 1C ) were measured.Results The values of jitter were associated with FD, and both jitter and FD were positively related to HbA 1C .18 cases with abnormal NCS showed increased jitter(11 cases with block),and increased FD in 14 cases; the remaining 18 cases with normal NCS,7 cases with increased jitter(3 cases with block),the increased FD in 5 cases.Conclusion Denervation reinnervation reflected by jitter and FD was associated with the metabolic status. SFEMG could be served as sensitive means to early diagnosis of DPN, and might detect subclinical peripheral neuropathy of diabetes.

Objective To investigate the diagnostic value of F wave in diabetic peripheral neuropathy (DPN).Methods F and M wave parameters were measured in 106 patients with diabetes mellitus and 75 normal persons, including the minimum latency, duration, amplitude and area of F wave, and the amplitude and the area of M wave.Results (1) In the 30 patients with diabetes mellitus without peripheral neuropathy, there were 8 cases with prolonged the duration of F wave, 4 cases with prolonged the minimum latency of F wave, 2 cases with increased in the ratio of the area of F/M wave. (2) The minimum latency prolonged of F wave, the ratio of the amplitude of F/M wave and the ratio of the area of F/M wave significantly increased in the 76 patients with DPN, the duration of F wave prolonged in the mild DPN but no one revealed remarkable abnormal. (3) In the controls, the function of upper limit of the minimum latency of F wave (Y) and leg length (X) was Y=12.3+48.8X 2. Conclusion (1) F wave could be served as sensitive index to the early diagnosis of DPN, and might detect subclinical DPN. (2) The proximal nerve segment could be affected without the lesions of the distal nerve segment in patients with DPN, and it suggested that vascular factor plays an important role in the mechanism of DPN.

The total ascorbic acid contents of 21 kinds of vegetables and melons in Ch'angsha within the later 3 seasons of 1955 and the spring time of 1957 were determined with the 2,4-dinitrophenylhydrazine coloremetric method (Roe and Kuether, as well as its modification by Schaffert and Kingsley).From the result obtained, it is found that throughout the four seasons in Ch'angsha, there were many vegetables and melons rich in vitamin C. The antiscorbutic potency of the same species of vegetables showed seasonal variations.

Objective To evaluate the feasibility of repair of full-thickness skin defects in nude mice with tissue-engineered skin which was constructed by culture of human amniotic epithelial cells (hAECs) and fibroblasts on human de-epidermized dermis (DED).Methods Healthy human amniotic tissues were treated with trypsin at a low concentration in multi-steps to prepare hAECs,and a two-step collagenase digestion was used to treat healthy children's prepuce tissues to prepare fibroblast suspensions.When fibroblasts were cultured in vitro up to passage 3-5 and hAECs up to passage 2,they were seeded on the reticular dermal surface and basement membrane surface of the DED respectively to construct the tissueengineered skin.A total of 20 heahhy male nude mice aged 3-4 weeks were enrolled into this experiment,and full-thickness skin defects were made on the middle of the back of mice.Then,these mice were randomly divided into 2 groups by using a lottery method,and reconstructed full-thickness tissueengineered skin grafts and vaseline oil gauze were used to cover the wounds in the tissue-engineered skin group and control group respectively.The whole body and transplantation sites of the nude mice were observed on day 7,14,21 and 28 after transplantation,the wound healing time and rate were compared between the above two groups,and skin tissues at the transplantation site were harvested at 4 weeks after transplantation and subjected to histological examination.Results HAECs had stem-cell characteristics and expressed octamer-binding protein-4 (OCT-4) and embryonic marker stage-specific embryonic antigen4 (SSEA-4).After 2-week organ culture,the in vitro reconstructed tissue-engineered skin showed 4-9 continuous layers of stratified epithelium,and the histological structure of the epidermis was similar to that of the normal human skin.Compared with the control group,the tissue-engineered skin group showed significantly higher wound healing rates on day 7,14 and 21 after transplantation (57.49％ ± 6.11％ vs.22.93％ ± 4.26％,92.80％ ± 3.10％ vs.54.57％ ± 7.94％,98.83％ ± 0.25％ vs.91.16％ ± 4.79％,respectively;n =10,t =27.36,32.23,11.80,respectively,all P ＜ 0.001),shorter wound healing time [(21.51 ± 1.51) d vs.(28.80 ± 1.14) d,n =10,t =42.23,P ＜ 0.001],with the color of skin grafts closer to that of autologous skin on day 28 after transplantation.Histological examination revealed distinct stratification of the epithelium,obvious keratinization and favorable growth of cells in the dermis in the tissue-engineered skin group,but thin epithelium with some defects,indistinct stratification of the dermis,and inflammatory cell infiltration in the control group.Condusion Tissue-engineered skin constructed by the culture of hAECs and fibroblasts on human DED can survive in nude mice after transplantation,resulting in a more favorable healing of wounds,and is expected to serve as a kind of ideal tissue-engineered skin.

Carcinoma, Hepatocellular ; diagnosis ; surgery ; therapy ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; therapy

10.3969/j.issn.1008-9691.2013.03.011

Objective To investigate the relationship between the cerebral circulation time and disease condition and prognosis in patients with acute subarachnoid hemorrhage. Methods DSA were performed to determine the cerebral circulation time (CCT) in 60 patients who had subarachnoid hemorrhage (SAH) within 3 days. The patients were divided into different groups according to the severity of the disease condition,patients with CSC score as 13-15 were assigned as group Ⅰ ,whose CCT was (13.45 ± 1. 89) s. Twenty two patients with GSC score as 3-12 were assigned as group Ⅱ ,whose CCT was (16.79 ± 2. 07) s. There were significant difference between the CCT of the two groups (t =3. 76,P = 0. 001). (2)Twenty-nine patients with Hunt-Hess grade as 1-2 were assigned as group 1,whose CCT was (13.06 ± 1. 83) s. Thirty one patients with Hunt-Hess grade as 3-5 were assigned as group 2, whose CCT was (15. 89 ± 2.06) s. There were significant difference between the CCT of the two groups (t = 3. 39, P =0. 003). (3) Seventeen patients with delayed ischemic damage were assigned as group A, whose CCT was (16. 84 ±1.91) s. Forty three patients without delayed ischemic damage were assigned as group B, whose CCT was (12.94 ± 1. 67) s. There were significant difference between the CCT of the two groups (t = 2. 23, P =0.025). (4)Forty-six patients with GOS score as 4-5 were assigned as group a,whose CCT was (13.07 ±1. 89)s. Fourteen patients with GSC score as 1-3 were assigned as group b,whose CCT was (17.11 ± 1. 71)s. There were significant difference between the CCT of the two groups (t = 3. 27, P = 0.008). Conclusion CCT may reflect the severity of the SAH in early onset patients and has prognostic value.

Objective To compare the clinical application of FACS analysis indicators and traditional infection indicators in early diagnosis of infection in premature infants .Methods 60 premature infants were divided into the infected group (n=29) and non-in-fected group(n=31) according to their clinical symptoms and laboratory results .BD FACSCanto Flow Cytometry was employed to detect CD11b ,CD64 and CD45RO ,BACTEC 9120 Automated Blood Culture System was used to conduct body fluids and secretions culture .Sysmex XE-5000 Automated Hematology Analyzers and i-CHROMA Reader Immunofluorescence Analyzer were adopted to conduct the complete blood count test and hypersensitive C-reactive protein (hs-CRP) detection ,respectively .Receiver operator characteristic(ROC) curve was used to analyze the diagnostic value of indexes above in preterm infants with infection ,and their sen-sitivity ,specificity ,positive predictive value and negative predictive value were calculated .Results On the first day after birth ,neu-trophil CD11b ,CD64 ,monocyte CD64 and hs-CRP levels of preterm infants in infection group were obviously higher than those in non-infection group(P<0 .05) .Differences of CD45RO ,WBC ,neutrophil absolute and percentage between the two groups showed no statistical significance(P>0 .05) .ROC area under the curve(AUC)>0 .7 was found in Neutrophil CD64 ,monocyte CD64 and hs-CRP ,which had higher value in early diagnosis of infection in premature infants .The highest sensitivity ,specificity ,positive pre-dictive value and negative predictive value were 79 .31% ,96 .78% ,83 .34% and 75 .00% ,respectively .Conclusion FACS analysis indicators has better clinical value in the early diagnosis of infection in premature infants .

Objective To evaluate the post-operative glucose level and insulin dose of patients undergoing total pancreatectomy.Methods From September 1980 to September 2014, 21 patients underwent total pancrea-tectomy in Peking Union Medical College Hospital, who were enrolled in our study.We reviewed the changes in their insulin dosage and glucose levels after operation, also summarized type and dose of insulin as well as glucose level in stable period.Results The required insulin dose reached peak within 4 days after surgery ( maximum dose 300 U/d).The average dose was (143.5 ±62.8) U/d and decreased gradually.During the perioperative period (needing parenteral nutrition), the blood glucose level fluctuated markedly (1.52-29.06 mmol/L) and the average level was (11.18 ±0.95) mmol/L.During the stable period ( without parenteral nutrition) , patients on average had (5.3 ±2.0) U of preprandial rapid-acting insulin and (8.1 ±2.9) U of long-acting insulin be-fore sleeping;the average fasting blood glucose was (6.69 ±1.48) mmol/L, 2 h postprandial blood glucose was (9.08 ±2.84) mmol/L, bedtime blood glucose was (9.66 ±2.49) mmol/L, and blood glucose level at night was (8.15 ±2.78) mmol/L.67%of the patients had 13 hypoglycemic episodes monthly on average.For those five followed-up patients, the average hemoglobin A1c was (6.15 ±1.20)%.Conclusions Patients undergoing total pancreatectomy may experience marked fluctuation of blood glucose level and short-term increase of insulin need which gradually decreases afterwards.After entering the stable period, the glucose level could be well-con-trolled but with frequent hypoglycemia.There is no diabetic ketoacidosis.

Objective:To investigate the clinical efficacy of qualitative and staging diagnosis of rectal tumors with dual contrast-enhanced ultrasonography and interventional biopsy.Methods:A total of 300 patients with rectal tumors who received treatment in The First People's Hospital of Huzhou from December 2019 to March 2022 were included in this study. All patients underwent dual contrast-enhanced ultrasonography and interventional biopsy followed by focus resection. Taking the postoperative histopathological test results as the gold standard, the efficacy of dual contrast-enhanced ultrasonography and interventional biopsy in the localization, qualitative analysis, and staging of rectal tumors was analyzed.Results:The compliance rate of dual contrast-enhanced ultrasonography and interventional biopsy in the localization of rectal tumors was 100%. The sensitivity, specificity, and accuracy of the dual contrast-enhanced ultrasonography and interventional biopsy for qualitative diagnosis of rectal tumors were 94.8%, 97.8%, and 96.7%, respectively. The Kappa value used for assessing agreement in the qualitative diagnosis of rectal tumors between dual contrast-enhanced ultrasonography and interventional biopsy and postoperative tissue pathological examination results was 0.947. The area under the curve plotted for qualitative diagnosis of rectal tumors was 0.974. The sensitivity, specificity, and sensitivity of dual contrast-enhanced ultrasonography and interventional biopsy for diagnosis of stage I-III rectal cancer were 94.1%-97.8%. The Kappa values used for assessing agreement in staging diagnosis of stage I-III rectal cancer between dual contrast-enhanced ultrasonography and interventional biopsy and postoperative tissue pathological examination results were 0.923, 0.912, and 0.927, respectively. The areas under the curve plotted for staging diagnosis of rectal cancer were 0.961, 0.955, and 0.970, respectively.Conclusion:Dual contrast-enhanced ultrasonography and interventional biopsy have a high efficacy in the localization, qualitative diagnosis, and staging diagnosis of rectal tumors.