Objective: To investigate the application of the calculated electrophysiological parameters in early diagnosis of carpal tunnel syndrome (CTS). Methods: 44 patients (60 hands) with a diagnosis of CTS and 31 healthy volunteers (44 hands) were enrolled. Acquired indicators include median nerve distal motor latency (DML), complex muscle action potential (CMAP) amplitude, conduction velocity (MCV), median nerve sensory nerve action potential (SNAP) amplitude, and conduction velocity (SCV). Then the terminal latency index (TLI), the residual latency (RL), and the difference in peak sensory latencies between the median and ulnar nerves (ΔPSL) were calculated. Results: The two groups were matched in age and gender distribution. The CTS group showed significant difference in SCV, DML, SNAP, and CMAP compared with the control group. The sensitivity, specificity, cutoff value, Youden index, and area under the curve of each indicator are respectively as follows: TLI (0.733, 0.932, 0.622, 0.629, and 0.877), RL (0.750, 0.977, 1.334, 0.727, and 0.907), ΔPSL (0.950, 0.841, 0.150, 0.791, and 0.942), SCV (0.950, 0.796, 56.5, 0.746, and 0.946), DML (0.867, 0.932, 3.55, 0.799, and 0.930), SNAP (0.683, 0.932, 21.68, 0.615, and 0.844), and CMAP (0.683, 0.773, 8.76, 0.456, and 0.758). Conclusion: The calculated electrophysiological parameters have higher sensitivities and specificities relative to a single electrophysiological parameter, which could greatly improve the accuracy of early diagnosis of CTS.

Objective:To investigate the value of growth differentiation factor-15 (GDF-15) and extravascular lung water index (EVLWI) in severity grading and prognosis prediction of patients with acute respiratory distress syndrome (ARDS).Methods:Patients with ARDS aged 18-75 years admitted to the department of respiratory intensive care unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to February 2020 were enrolled. All patients were treated with conventional therapies such as mechanical ventilation, anti-infection, stabilization of water, electrolytes and acid-base environment, blood purification and nutritional support according to their conditions. Besides, the pulse-indicated continuous cardiac output (PiCCO) was performed after admission to the department, and EVLWI before treatment and at 24, 48 and 72 hours of treatment were recorded. Serum GDF-15 level was measured by enzyme linked immunosorbent assay (ELISA) during the same period. Patients were classified as mild, moderate, and severe degree according to the 2012 Berlin Definition of ARDS, and EVLWI and GDF-15 levels in patients with different disease levels before and after treatment were compared. In addition, the length of intensive care unit (ICU) stay, ICU mortality, and 28-day mortality of patients with different GDF-15 or EVLWI levels were analyzed comparatively, with the GDF-15 3 458 ng/L and EVLWI 15 mL/kg as the cut point.Results:A total of 82 patients with ARDS were enrolled, including 22 patients with mild ARDS, 28 patients with moderate ARDS, and 32 patients with severe ARDS. The GDF-15 and EVLWI levels in patients with moderate and severe ARDS at each time point before and after treatment were higher than those in patients with mild ARDS. Both GDF-15 and EVLWI levels in patients with severe ARDS were higher than those in the patients with moderate ARDS. The differences were statistically significant at all the time points except for the difference of GDF-15 levels at 24 hours after treatment (ng/L: 3 900.41±546.43 vs. 3 695.66±604.73, P > 0.05). [GDF-15 (ng/L): 3 786.11±441.45 vs. 3 106.83±605.09 before treatment, 3 895.48±558.96 vs. 3 333.29±559.66 at 48 hours, 3 397.33±539.56 vs. 3 047.53±499.57 at 72 hours; EVLWI (mL/kg): 19.06±1.91 vs. 14.31±1.50 before treatment, 18.56±2.23 vs. 13.26±1.69 at 24 hours, 17.23±1.76 vs. 12.45±1.36 at 48 hours, 15.47±1.81 vs. 11.13±2.19 at 72 hours, all P < 0.05]. According to the cut-off value, there were 23 patients with GDF-15 ≥ 3 458 ng/L and GDF-15 < 3 458 ng/L respectively and there were 23 patients with EVLWI ≥ 15 mL/kg and EVLWI < 15 mL/kg respectively. The length of ICU stay and 28-day mortality in patients with high GDF-15 were significantly higher than those in patients with low GDF-15 [length of ICU stay (days): 21.22±2.69 vs. 15.37±3.14, 28-day mortality: 56.5% vs. 21.7%, both P < 0.05]. The length of ICU stay and 28-day mortality in patients with high EVLWI were also significantly higher than those in patients with low EVLWI [length of ICU stay (days): 18.45±2.61 vs. 14.98±2.75, 28-day mortality: 47.8% vs. 17.4%, both P < 0.05]. Conclusion:To some extent, GDF-15 and EVLWI levels reflect the severity of patients with ARDS, and high GDF-15 and EVLWI levels are significantly associated with poor prognosis in patients with ARDS.

Inactivation of the skeletal muscle chloride channel ClC-1 results in myotonia congenita (MC), which occur with mutations of CLCN1 gene. However, there is no clear correlation between genotype and phenotype. Clinical data of a patient and his parents with MC were collected retrospectively, including the symptoms and signs, results of blood tests, electromyography, MRI images, and examination results of biceps brachii pathology by histopathology. The patient was diagnosed according to nextgeneration sequencing. Sanger sequencing was then carried out on his parents’ blood samples to verify their mutations. The patient had typical clinical characteristics of Becker myotonia with compound heterozygous mutations of the CLCN1 gene, inherited from his mother (M560T), who showed only mild symptoms and cold induced myotonic motor unit potentials, and from an unaffected father (c.697- 2delA on the intron 5 resulting in exon 6 skipping). In view of the compound heterozygous mutations, he could be classified into Becker myotonia congenita. In conclusion, these results suggested that CLCN1 mutations could lead to atypical myotonic symptoms and abnormities on electromyography (EMG). EMG after muscle cooling test and exercise tests should be completed in the relatives of patients with MC and some patients with atypical syndrome.

Objective To evaluate the value of neurophysiological index ( NI) in evaluating the rate of progression of amyotrophic lateral sclerosis ( ALS ) . Methods Forty-eight patients with ALS were enrolled in Zhongda Hospital of Southeast University from January 2010 to August 2016, of whom 36 patients met the ALS definite diagnostic criteria , 12 patients met the ALS probable diagnostic criteria ( following study confirmed those patients met the ALS definite diagnostic criteria ) , including 8 bulbar-onset and 40 upper extremity onset forms of the disease .Fifty-four age-and sex-matched healthy subjects served as controls.After evaluated by the ALS Functional Rating Scale-revised ( ALSFRS-R) , all subjects underwent electrophysiological examination in the Electromyography Lab of the hospital .The rate of disease progression (ΔFS) =48-total ALSFRS-R score at initial visit/symptom duration (months).The relevance between the complex muscle action potential (CMAP), F frequency, distal motor latency (DML), NI and the ΔFS was investigated respectively.Results In ALS group, the ALSFRS-R score was 14.56 ±10.10, the duration from onset to diagnosis was (14.56 ±10.10) months, and theΔFS was 1.54 ±1.18 per month.The median nerve NI in ALS group was 0.60 ±0.76, in control group was 2.56 ±0.78, with statistically significant difference between two groups (t=-12.5, P<0.01).The ulnar nerve NI in ALS group was 0.70 ±0.55, in control group was 0.96 ±0.10, also with statistically significant difference between two groups (t=-0.31, P=0.003).The median nerve NI and ulnar nerve NI both were negatively correlated withΔFS (r=-0.63, P=0.000; r=-0.506, P=0.007).The ΔFS was exponentially based on median nerve NI (R2 =0.668, P<0.01).Conclusion NI is an objective electrophysiological index , which could be used to evaluate the rate of disease progression in ALS , and to evaluate the prognosis of the disease .

Objective To analyze features of clinical manifestation, electrophysiology, imageology and molecular ge?netics of familial carpal tunnel syndrome (FCTS), especially research progress in genetics. Methods Clinical data, labo?ratory and electrophysiologyical results as well as medical images were collected from the propositus. In addition, genetic analysis around peripheral neuropathy was performed on the proband, son of the proband and the affected relatives in the family. Result Patients showed a typical bilateral CTS with early onset. The mode of inheritance in this family was auto?somal dominant.. Gene sequencing revealed point mutations in INF2, KIF1B, TRPV4 and SCN9A. Besides, the possibili?ty of having hereditary neuropathy with liability to pressure palsy(HNPP)or familial amyloidosis (FAP) was excluded by the molecular genetic studies. Conclusion Primary FCTS exists as a separate autonomic entity, which may be caused by other unknown genes and therefore warrants further exploration.

Objective To explore the effect of morning nursing round and direction for key patients in geriatric comprehensive surgery department.Method Four hundred and twenty-six patients from January to December,2012 were assigned to control group,where routine morning nursing round was carried out.Another 453 patients from January to December in 2013 were assigned to observation group,where the morning nursing round and direction for key patients was carried out.The two groups were compared in terms of the general nursing quality,the rate of nurses knowing the disease condition and the rate of professional knowledge acquisition. Result After the application of morning nursing round for key patients,the general nursing quality,the rate of nurses knowing disease conditions and the rate of professional knowledge acquisition in the observation group were all significantly higher than those the control group(all P<0.05).Conclusion The morning nursing round and directions for key patients may remarkably improve the rate of nurses’knowing the disease conditions and professional knowledge acquisition and general nursing quality so that their professional skills and comprehensive quality can be further upgraded.

The incidence of dysphagia after stroke is high.It may affect the rehabilitation of patients and increase mortality.The assessment is of great significance for early objective examination of dysphagia,in which the bedside screening tests are the most common assessment methods in the routine clinical work.This article reviews the advances in research on the commonly used bedside screening tests of dysphagia.

OBJECTIVE The aim of this study is to investigate the correlation between the spontaneous otoacoustic emission(SOAE)and transient evoked otoacoustic emission(TEOAE)in neonate. METHODS The subjects were 224 ears of 112 newborns(59 females, 53 males). The age of subjects ranged from 2 to 4 days (mean?SD: 2.68?0.74 day years). SOAE and TEOAE were measured with ILO96. RESULTS The correlation between SOAE number and TEOAE level were found (r=0.43, P

Objective: To optimize the expression of recombinant human monocyte chemoattractant protein (rhuMCP-1) in E.coli DE3. Methods:With NBS-MICROS 15 L T.DR fermentor, pGEX-IN/huMCP-1 was constructed by our laboratory. Four parameters including pH,temperature,agitation rate and concentration of IPTG were studied by orthogonal experimental design. Results: It was found that the expression level was greatly affected by the amount of dissolved oxygen. This indicated that the agitation rate and ventilation amount were the most important parameters during fermentation. Examined by SDS-PAGE and gel scanning, the expression level of total protein was over 40% when agitation rate was 300 r/min and ventilation amount was 10 L/min. Conclusion: A method for high-level expression of huMCP-1 on pilot-scale is established, and it will be useful for large-scale industrial production of target protein.

Objective.To study the changes of microcirculation in patients with diabetic retinopathy(DR).Methods.Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them,72 cases were male,81 cases were female,mean age 57.0±10.0 years, mean disease course 8.2±7.5 years.All cases were examined fundi by ophthalmologist,urinary albumin excretion rate (UAE)in 24 hours was measured by radioimmunoassay.Moreover,we examined the blood glucose,blood pressure,blood viscosity and observed the changes of naifold microcirculation.Results.It was found that there were more evident disturbance of microcirculation,markedly slowed velocity of blood flow(P＜0.05),significantly increased aggregation of blood cells(P＜0.05)and exudation around the loop(P＜0.05)in the group with DR,compared with the group without DR.Conclusion.It was more evident disturbance of nailfold microcirculation in patients with diabetic retinopathy.