First report of the within-farm prevalence of bovine digital dermatitis in Chinese Holstein dairy cows in Jiangsu, China: A Bayesian modelling approach.

Digital dermatitis is one of the most important causes of lameness in dairy cattle, particularly in housed, intensively-managed cattle. The number of modern intensive dairy farms in China has increased markedly in recent years; however, we lack research on digital dermatitis in Chinese dairy cattle. This preliminary study aimed to estimate the prevalence of digital dermatitis on three conveniently selected farms in Jiangsu, China. The washed hind feet of all lactating cows on all three farms were examined during milking with the aid of a mobile phone light source. True prevalence was then estimated from the apparent prevalence using a Bayesian superpopulation approach to account for the imperfect nature of identifying digital dermatitis in cows during milking. Despite none of the farms having thought it necessary to implement routine digital dermatitis monitoring or control, the disease was found on all three sampled farms. All lesions observed were either chronic M4 or M4.1 type-lesions, with no M2 lesions (i.e. acute ulcerated lesions) observed. The estimated true prevalences on the farms were 7.3% (95% credible interval [CrI]: 5.4%-9.6%), 8.3% (95%CrI: 6.3%-10.8%), and 29.8% (95%CrI: 22.9%-37.2%).

Identification of risk factors for ewe mortality during the pregnancy and lambing period in extensively managed flocks.

BACKGROUND: Ewe mortality during pregnancy and lambing is an issue for sheep producers globally, resulting in reduced productivity and profitability, compromised ewe welfare, and poor consumer perception. Despite these negative consequences, there was little investigation into factors associated with ewe death during this time. Therefore, this study aimed to assess associations between ewe body condition score (BCS), weight, reproductive parameters, and risk of mortality during pregnancy and lambing. METHODS: Four cohorts from three commercial New Zealand farms participated, with 13,142 ewe lambs enrolled and followed over time. Data were collected for five consecutive lambings. Visits aligned with key on-farm management times, specifically: prior to breeding, at pregnancy diagnosis (PD), prior to lambing (set-stocking), and, at weaning of their lambs. At each visit, ewes were weighed, BCS assessed and reproductive status was recorded when relevant (litter size at PD and lactation status after lambing). Ewes that died or were culled were recorded, and any ewes that were absent from consecutive visits were presumed dead. Logistic regressions were developed to assess the relationship between weight and BCS at each visit, PD result (single or multiple-bearing) and lactation status (wet or dry) in each year, and, risk of mortality during the pregnancy and lambing period in each year. RESULTS: In the PD to weaning period, mortality incidence ranged from 6.3 to 6.9% for two-tooth (18-months-old at breeding) to mixed-age (54-months-old at breeding) ewes. For ewe lambs (7 to 8-months-old at breeding), mortality was 7.3% from set-stocking to weaning. Heavier ewe lambs at PD were less likely to die during lambing (OR: 0.978, p = 0.013), as were those with greater set-stocking BCS. In subsequent years, BCS was a predictor of ewe death, with odds of mortality greatest for ewes < BCS 2.5. Additionally, for poorer BCS ewes, increasing weight reduced risk of mortality, but there was no impact of increasing weight in greater BCS ewes. CONCLUSIONS: This study identified risk factors associated with ewe mortality during the pregnancy and lambing period. Flock owners can use these to either cull at-risk ewes or proactively intervene to reduce likelihood of mortality, thereby improving flock productivity, profitability and welfare.

Diagnosing subclinical facial eczema in cattle: does combining liver enzyme tests increase the accuracy of diagnosis?

AIMS: To assess whether adding glutamate dehydrogenase (GDH) activity measurements to measurements of gamma-glutamyl transferase (GGT) activity appreciably increases the accuracy of diagnosis of subclinical facial eczema (FE) in cattle. METHODS: As part of a larger study on the impact of FE on productivity, GGT and GDH activities were measured in serum samples collected from 426 cattle from one dairy farm in the Taranaki region in April 2018. Bayesian latent class analysis was then used to estimate herd prevalence of subclinical FE as well as the specificity and sensitivity of the activity in serum of GGT or GDH alone, and of GGT and GDH activities combined, as diagnostic tests for subclinical FE. RESULTS: The latent class analysis estimated the true prevalence of subclinical FE in the study population as 47.5 (95% probability interval (PI) = 38.3-55.3)%. There was no evidence of any clinically relevant difference between GGT and GDH activities as predictors of subclinical FE; the difference between the areas under the receiver operating characteristic curves for the two measures was 0.005 (95% PI = -0.02 to -0.03). Using the two tests in parallel, with a threshold of 50 IU/L for GGT and 225 IU/L for GDH resulted in specificity and sensitivity of >95%, markedly increasing the accuracy of diagnosis of subclinical FE compared to using GGT or GDH alone at any threshold. CONCLUSIONS AND CLINICAL RELEVANCE: In this herd, combining the two tests resulted in a clinically relevant improvement in the accuracy of diagnosis of subclinical FE compared to using either test alone, which if used at the individual level will result in fewer cattle being assigned the wrong FE status. This will also apply at the herd level, with combined testing producing fewer false-positive herd test results than using one enzyme alone. This is particularly important for monitoring the efficacy of FE control measures when the expectation should be that the proportion of cattle with FE is very low.

The prevalence of gross pathological damage in the livers of dairy cattle at processing plants in autumn in the North Island of New Zealand and an assessment of the gross liver pathology score as a method for estimating the prevalence of facial eczema.

AIM: To measure the prevalence of gross pathological damage in the livers of dairy cows at slaughter in the North Island of New Zealand in 2018 and 2019 and to determine, using Bayesian latent class analysis, the specificity and sensitivity of gross liver pathology score (GLS) as a method for detecting moderate to severe facial eczema (FE) at processing plants. METHOD: Meat inspectors at four processing plants located in the Northland, Waikato, Bay of Plenty and Taranaki regions of New Zealand graded all dairy cattle livers on particular days in April and May of 2018 and 2019 using a gross liver pathology score (GLS) from 0-5 (0 = no damage, 1= fatty liver, 2 = cholangitis and early cirrhosis, 3 = cirrhosis, 4 = extensive cirrhosis, 5 = regeneration). Forty livers from each grade were selected for histopathology. Sections from the apical margin of the right and the left lobes were scored using a histology biliary score (HBS; scored from 1-16) based on the classical histological lesions of FE focussing on changes that differentiate FE from fasciolosis. Mean HBS was collapsed into scores 2-6 (no and mild damage) and score 7-12 (moderate and severe) and GLS was collapsed into grades 0-2 (no or mild damage) and grades 3-5 (moderate, severe and chronic damage). A Bayesian latent class model was developed to estimate sensitivity and specificity of HBS and GLS. The diagnostic target was moderate or severe, gross and/or histological changes in the liver consistent with FE. RESULTS: A total of 2,899 dairy cow livers were graded at the four plants over the two study periods. There were 700/2,899 (24.1%) livers with at least some form of gross pathology damage (GLS≥1) and 130/2,899 (4.5%) livers with moderate, severe or chronic gross pathology damage (GLS≥3). The estimates (posterior median) for the sensitivity and specificity of GLS to liver damage were 0.844 (95% credible interval (CrI) = 0.757-0.905) and 0.932 (95% CrI = 0.866-0.973) respectively. Estimates for HBS were 0.834 (95% CrI = 0.765-0.892) and 0.778 (95% CrI = 0.707-0.854), respectively. CONCLUSION AND CLINICAL RELEVANCE: GLS is a useful means of estimating liver damage consistent with FE at slaughter. Increased use of liver scoring at slaughter could be useful for monitoring the likely impacts of FE at the country and regional levels.

Effects of a topically applied anaesthetic on the behaviour, pain sensitivity and weight gain of dairy calves following thermocautery disbudding with a local anaesthetic.

Aims: To compare the effect of a topically applied anaesthetic to no pain relief or meloxicam on the behavioural responses, pain sensitivity and weight gain of calves following disbudding with or without sedation. Methods: A total of 364, 2-6 week-old calves from three commercial farms were systematically allocated to one of six treatment groups. All calves received a cornual nerve block prior to disbudding, with half restrained in a crate and half sedated with xylazine. Within these groups one third received no further treatment (control), one third were treated with meloxicam >10 minutes prior to disbudding and one third received a topical anaesthetic applied to the horn bud wounds following disbudding. The frequency of ear flicks, head shakes, head scratches and pain sensitivity of the wound were recorded on up to eight occasions over 24 hours after disbudding. Calves were weighed before, and 7 and 28 days after, disbudding to determine average daily weight gain (ADG). Results: Compared to calves in the crate-control group, all other groups had reduced ear flicks at all times following disbudding (p < 0.01). Treatment with meloxicam and topical anaesthesia in addition to sedation reduced head scratches compared to calves in the crate-control group (p ≤ 0.013). At 22 hours after disbudding head shakes were reduced in sedated calves treated with topical anaesthetic compared to calves in the crate-control group (p < 0.001). Pain sensitivity was lower in all sedated calves than unsedated calves (p < 0.001). The ADG between Days 0-7 was 0.14 (95% CI = 0.015-0.274) kg/day greater in sedated calves treated with meloxicam than calves in the crate-control group (p = 0.03), and the ADG between Days 0-28 tended to be 0.06 (95% CI=-0.01-0.13) kg/day greater in sedated calves treated with topical anaesthetic than calves in the crate-control group (p = 0.09). Conclusion and clinical relevance: Sedation of calves for disbudding reduced the pain experienced in the following 24 hours. There was a benefit to providing calves with topical anaesthetic following disbudding on behavioural responses and pain sensitivity, which was similar to that of treating calves with meloxicam.

Interobserver agreement of digital dermatitis M-scores for photographs of the hind feet of standing dairy cattle.

Digital dermatitis (DD) is the leading infectious cause of lameness in dairy cattle, and it affects their welfare and productivity worldwide. At the herd level, DD is often assessed while cows are standing in a milking parlor, and lesions are most commonly evaluated using the M-score. The objective of this study was to examine the interobserver agreement for M-scores of the feet of standing cattle, based on digital color photographs of dairy cattle hind feet. A total of 88 photographs and written descriptors of the M-score were sent to 11 scorers working at 10 different institutions in 5 countries. The scorers received no formal training immediately before scoring the photographs; however, all regularly used the M-score to score DD. The answers for 36 photographs were excluded from the analysis because the photograph either had more than 1 M-stage as mode or not all scorers assigned an M-score to it. The M-scores of the 11 scorers from 52 photographs were available for analysis. Interobserver agreement was tested using Gwet's agreement coefficient (AC1) and the mode was assumed correct. Overall, moderate agreement emerged for the M-score (AC1 = 0.48). For the individual M-stages, almost perfect agreement existed for M0 (AC1 = 0.99), M1 (AC1 = 0.92), and M3 (AC1 = 0.82), and substantial agreement for M2 (AC1 = 0.61), M4 (AC1 = 0.65), and M4.1 (AC1 = 0.71). This outcome indicates the degree of individual variation in M-scoring in this context by unstandardized, experienced European observers, particularly for the M2, M4, and M4.1 stages. Standardized training is likely to improve the consistency of M-scoring and thus the generalizability of future DD research results on this important endemic disease.

Detecting bovine digital dermatitis in the milking parlour: To wash or not to wash, a Bayesian superpopulation approach.

Visual assessment in the milking parlour is a commonly used method to determine the prevalence and severity of bovine digital dermatitis (BDD). It is generally suggested that cows' feet are washed prior to examination to maximise the sensitivity of the assessment, but concern has been expressed that washing cows' feet could contaminate the teats and lead to intramammary infection. Furthermore, the evidence for washing cows' feet is equivocal, as some studies have reported similar sensitivities for detecting BDD without washing as that reported by studies which used washing. Furthermore most of these studies have used data from housed cattle. The findings from these studies may not be applicable to cattle at pasture where feet are often contaminated with mud rather than faeces and lesions may be smaller and less severe. The aim of this study was to compare, in cattle at pasture, the sensitivities of BDD examinations before and after washing. Two herds known to have BDD were enrolled and approximately half of each herd was screened for BDD by examining the cows' hind feet before and after washing. The sensitivities of these examinations were estimated using a Bayesian superpopulation approach, and were found to be 0.34 (95% credible interval [CrI]: 0.088-0.69) and 0.63 (95%CrI: 0.46-0.78) for pre- and post-washing, respectively. There was a 93.95% probability that the sensitivity of examination post-washing was greater than that pre-washing. These results suggest that in pasture-based herds, many BDD lesions will be missed if cattle are examined without their feet being washed.

Effects of climate and farm management practices on bovine digital dermatitis in spring-calving pasture-based dairy farms in Taranaki, New Zealand.

To investigate the effect of climate and farm management practices on prevalence of bovine digital dermatitis (BDD) in spring-calving farms in Taranaki, New Zealand, whole herd assessments of BDD were made on 57 farms which had been previously identified as having cows with BDD. Assessments of BDD lesions were made on five occasions between early lactation (September 2015) and drying-off (May 2016; at approximately 6-week intervals). Along with the clinical assessment, data on farm management practices were collected using questionnaires. In addition, climate data including rainfall and soil/air temperature were obtained from a local weather station. The raw temporal pattern was analysed using a generalised estimating equation method, followed by a mixed effects negative binomial model which modelled the associations between prevalence and the covariates including management practices, rainfall and soil temperature. The highest farm and cow level prevalences were seen on the second visit (27/Oct/2015-11/Dec/2015) and were lowest on the fourth visit (29/Jan/2016-10/Mar/2016). Farms with a higher prevalence at the first visit tended to have a higher prevalence at later visits, even though the affected individuals were often different. There was thus a strong correlation (0.94) between prevalence (proportion of cows affected at each time point) and incidence (proportion of cows with new affections at each time point). Two climate measurements were found to have associations with BDD prevalence. Firstly, increased rainfall in the previous month was associated with decreased cow level prevalence; secondly, there was a quadratic relationship between prevalence and soil temperature, with prevalence increasing as soil temperature increased from 11.8 °C to approximately 18 °C and then decreasing as soil temperature increased from approximately 18 °C to 23.9 °C. In addition to the effect of climate, using outside staff to perform hoof trimming was found to increase the risk of BDD affection (risk ratio [RR]: 2.06, 95% confidence interval [CI]: 1.05-4.06).

Estimating the herd and cow level prevalence of bovine digital dermatitis on New Zealand dairy farms: A Bayesian superpopulation approach.

A cross-sectional study of 127 dairy herds distributed across four regions of New Zealand (NZ) was conducted to estimate the regional herd-level prevalence of bovine digital dermatitis (BDD) and the prevalence of cows with BDD lesions within affected herds. Each herd was visited once during the 2016-2017 lactating season and the rear feet of all cows in the milking herd were examined to detect the presence of BDD lesions. Of the 127 herds examined, 63 had at least one cow with a detected BDD lesion. Of the 59 849 cows observed, 646 cows were observed with BDD lesions. All of the herds in which BBD was detected were located in three of the four regions (Waikato, Manawatu and South Canterbury). No convincing lesions were observed on the West Coast. The probability of BDD freedom on the West Coast was predicted to be 99.97% using a Bayesian latent class model. For the three regions where BDD lesions were observed, the true herd level and cow level prevalences were estimated using a Bayesian superpopulation approach which accounted for the imperfect diagnostic method. Based on priors obtained from previous research in another region of NZ (Taranaki), the true herd level prevalences in Waikato, Manawatu and South Canterbury were estimated to be 59.2% (95% probability interval [PI]: 44.3%-73.9%), 43.3% (95%PI: 29%-59%) and 65.9% (95%PI: 49.5%-79.9%), respectively, while the true median within-herd prevalences were estimated as 3.2% (95%PI: 2%-5%), 1.7% (95%PI: 0.9%-3.1%) and 3.7% (95%PI: 2.4%-5.5%), respectively. All of these estimates except for the true herd level prevalence in Manawatu were fairly robust to changes in the priors. For Manawatu region, changing from the prior obtained in Taranaki (the best estimate of the herd level prevalence = 60%, 95% sure > 40%) to one where the mode was 50% (95% sure < 80%) reduced the posterior from 43.3% to 35.2% (95%PI: 20.1%-53.5%). The marked variation in BDD prevalence between regions and between farms highlights the need for further exploration into risk factors for disease.

Inter-observer agreement between two observers for bovine digital dermatitis identification in New Zealand using digital photographs.

AIMS: To assess the inter-observer agreement for detecting bovine digital dermatitis (BDD) lesions in digital colour photographs of the hind feet of cows, which had been taken while the animals were standing to be milked, between two trained observers. METHODS: Thirty-six photographs were selected from a total of 184 photographs held by the first author (R1), who had classified them as negative (n=11) or positive (n=25) for BDD. They were delivered to a technician (R2) who had previously visually inspected cattle for BDD lesions, and who then recorded the photographs as being either BDD-positive or BDD-negative. The percentage agreement between R1 and R2, and two other inter-observer agreement statistics, Cohen's κ and Gwet's first-order chance correction agreement coefficient (AC1), were calculated. The cumulative membership probabilities of Cohen's κ and Gwet's AC1 were then calculated for different benchmark ranges of κ. RESULTS: The percentage agreement between R1 and R2 was 33/36 (92%), Cohen's κ was 0.80 (95% CI=0.57-1.0) and Gwet's AC1 was 0.86 (95% CI=0.69-1.0). Based on the cumulative membership probabilities for Gwet's AC1, there was 75% probability that the two observers had almost perfect agreement (κ≥0.81). For both Cohen's κ and Gwet's AC1, there was >95% probability that the two observers had at least substantial agreement (κ≥0.61). CONCLUSIONS: The two trained observers had at least substantial agreement in identifying from a digital photograph as to whether BDD lesions were present or absent. Therefore results from the two could be used interchangeably. CLINICAL RELEVANCE: Visual assessment for BDD lesions in the milking parlour can be subjective. However a high agreement between these two trained BDD inspectors means BDD prevalence reported from different regions in New Zealand by these two can be directly compared.

Farm level risk factors for bovine digital dermatitis in Taranaki, New Zealand: An analysis using a Bayesian hurdle model.

As part of a cross-sectional study of bovine digital dermatitis (BDD) in 60,455 cows across 224 herds, in Taranaki, a region of the North Island of New Zealand, from September 2014 to February 2015, questionnaires from 114 farms were analysed to identify the key management practices which affect the probability of a farm being affected by BDD and the prevalence of an individual cow being affected on affected farms. The data from the questionnaires were analysed using a Bayesian hurdle model. Two factors were identified as being associated with farm level infection status: (1) milking parlour type; farms which had rotary platforms were more likely to be recorded as having BDD than those which had herringbone parlours (odds ratio, OR, 3.19; 95% probability interval, PI, 1.31-8.51); and (2) young stock movement; farms whose young stock were reared on farms alongside heifers from other farms had a higher odds of being BDD positive than farms where heifers were kept separate (OR 4.15; 95% PI 1.39-15.27). Two factors were associated with an increase in the prevalence of BDD within affected farms: (1) farms which used outside staff to trim feet had a higher prevalence of BDD (prevalence ratio, PR, 3.13; 95% PI 1.25-7.29) than farms which did not use outside staff; and (2) farms examined in spring (September to November) had a higher prevalence of BDD (PR 2.16; 95% PI 1.05-4.43) than farms examined in summer (December to February).

Estimating the true prevalence of bovine digital dermatitis in taranaki, New Zealand using a bayesian latent class model.

A Bayesian latent class model was developed to estimate the true prevalence of bovine digital dermatitis (BDD) in Taranaki, New Zealand. This model allowed farms to have zero prevalence as well as also accounting for between farm heterogeneity that was conditional on whether a farm was positive for bovine digital dermatitis. The estimated true farm level prevalence was 68.9% (95% credible interval [CrI]: 50.0%-85.7%), while on infected farms the overall cow level prevalence (number of infected cows/total number of cows on infected farms) was 2.9% (95%CrI: 2.1%-4.3%). The sensitivity analyses suggested that the prevalence estimates were reasonably robust when the variation of the priors fell within the biologically plausible range. These results indicated that visual inspection of standing animals during milking was sufficiently accurate to identify infected farms. However, for every 100 animals identified through visual inspection, 84 animals with lesions were missed. In other words, 46% (calculated as 84/184) of true positives at the animal level could be missed by visual inspection. The high and robust specificity (99.9%, 95%CrI: 99.8%-99.9%) suggested that lesions reported as BDD were very unlikely to be false positives.

Farm and cow-level prevalence of bovine digital dermatitis on dairy farms in Taranaki, New Zealand.

AIMS: The aims of this cross-sectional study were to investigate the herd and cow-level prevalence of bovine digital dermatitis (BDD) in dairy farms in the northern Taranaki region of New Zealand, and to identify whether there was any spatial clustering of herds with the disease. METHODS: A survey of 224 dairy farms in the northern Taranaki region of New Zealand was undertaken from September 2014 to February 2015. Following training in robust criteria to confirm BDD visually, a technician inspected the rear feet of every milking cow on the farms during milking. The identity of cows with lesions and the feet involved were recorded. The proportion of cows affected among the inspected population (cow-level prevalence), the proportion of a herd affected (farm-level prevalence), and proportion of farms with ≥1 cow with lesions, were calculated. A bivariate K function analysis was then used to assess whether farms with ≥1 cow with lesions were clustered, after accounting for the distribution of the farms involved in the study. RESULTS: Bovine digital dermatitis lesions were observed on 143/224 (63.8 (95% CI=57.5-70.1)%) farms. Within-farm prevalence was 0% on 81 (36.2%) farms, between >0 and <3% on 120 (53.5%) farms, with a maximum prevalence of 12.7% on one farm. Overall, cow-level prevalence was 707/60,455 (1.2 (95% CI=0.9-3.0)%), and on affected farms was 707/41,116 (1.7 (95% CI=1.4-2.1)%). In affected cows, 268/707 (37.9%) had a lesion on left foot only, 262/707 (37.1%) on the right foot only and 177/707 (25.0%) on both feet. The K function analysis showed no evidence of clustering of farms with BDD. CONCLUSIONS: Bovine digital dermatitis was widespread among the survey farms, but there was no evidence that there was any clustering of herds with BDD. The cow-level prevalence on affected farms was much lower than reported elsewhere. CLINICAL RELEVANCE: Although the prevalence at the cow level was low, if these data are representative of other regions of New Zealand, BDD could easily become a major problem on dairy farms in New Zealand, as has been observed in other countries.

Spatial distribution analysis on climatic variables in northeast China.

Information ecology is a new research area of modern ecology. Here describes the spatial distribution analysis methods of four sorts of climatic variables, i.e. temperature, precipitation, relative humidity and sunshine fraction in Northeast China. First, digital terrain models was built with large-scale maps and vector data. Then trend surface analysis and interpolation method were used to analyze the spatial distribution of these four kinds of climatic variables at three temporal scale: (1) monthly data; (2) mean monthly data of thirty years, and (3) mean annual data of thirty years. Ecological information system were used for graphics analysis on the spatial distribution of these climatic variables.

The cause of slowed forearm median conduction velocity in carpal tunnel syndrome.

OBJECTIVES: Attempting to answer a debate concerning the etiopathogenesis of the decreased forearm median motor conduction velocity (FMMCV), we tried to use proximal stimulation at the wrist, elbow, mid-arm and axillary regions to determine segmental median motor conduction velocity (MMCV). We also correlated the FMMCV with median motor distal latency (MMDL) and compound muscle action potential (CMAP) amplitudes of the abductor pollicis brevis (APB) muscle in order to assess whether the conduction block of large myelinating fibers or retrograde axonal atrophy was the major cause of the decreased FMMCV. BACKGROUND: The cause of the decreased FMMCV resulting from either the conduction block of the large myelinating fibers at the wrist or distal compression with retrograde axonal atrophy remains an unresolved issue at the moment. Animal models have supported the hypothesis that the retrograde axonal atrophy might also occur in humans. Other authors believe the standard FMMCV is calculated by subtracting the distal latency which may not represent an exact assessment of FMMCV but rather the velocity of small fibers that persist through the carpal tunnel. SUBJECTS AND METHODS: Patients with the clinical symptoms and signs of carpal tunnel syndrome (CTS) confirmed using standard electrodiagnosis were included. The patients were arbitrarily divided into two groups based on the FMMCV, one with reduced FMMCV (n = 20, FMMCV < 50 m/s) and the other with normal FMMCV (n = 35, FMMCV> or =50 m/s). Age-matched volunteers served as controls. We explored motor conduction proximally at wrist, elbow, mid-arm and axillary stimulation, and recorded at the APB muscles. Based on the latency differences, we calculated the FMMCV, distal arm MMCV (DAMMCV) and proximal arm MMCV (PAMMCV), and compared the conduction velocity (CV) differences of DAMMCV-FMMCV, PAMMCV-FMMCV and PAMMCV-DAMMCV in the two patient groups and the control. Furthermore, we correlated FMMCV with MMDL and CMAP amplitudes of APB muscle because MMDL and CMAP amplitudes might reflect the integrity of the large myelinating fibers. RESULTS: CMAP amplitudes of APB muscle at wrist stimulation and MMDL were not correlated with FMMCV in either of the two patient groups; however, the CMAP amplitude was markedly decreased and MMDL was significantly prolonged when compared with normal controls. The significant increase of CV gradient of DAMMCV-FMMCV and PAMMCV-FMMCV without an equal increase of CV gradient of PAMMCV-DAMMCV only occurred in the reduced FMMCV patient group, suggesting that the conduction block is not the primary cause. The CV gradient of DAMMCV-FMMCV and PAMMCV-DAMMCV did not show any significant difference between patients with the normal FMMCV and the control group. CONCLUSION: The retrograde axonal atrophy, not selective damage of the large fibers at the wrist, was the direct cause of the decreased FMMCV.

[Prophylactic effects of zhuling and BCG on postoperative recurrence of bladder cancer].

The prophylactic effects of Chinese herbal medicine Zhuling (Grifola umbellata pilat) and BCG on bladder cancer after TURBT and partial cystectomy were evaluated. 146 patients with bladder cancer were divided into 3 groups, Zhuling, BCG, and control group. Follow-up for 48-124 months (average 70.8 months) showed that the tumor recurrence rate was 33.3%, 34.3% and 65.1%, respectively. Compared to the control group, the recurrence rate of Zhuling group and BCG group was significantly decreased (P < 0.01). The effect of Zhuling was similar to that intravesical BCG. Zhuling was cheaper and convenient in usage, and no side effects.

[Double J stent for pelvis-ureter junction stricture].

Twenty-one patients (27 ureters) with pelvis-ureter junction stricture were treated by persistent dilatation with indwelling double J stent in the ureter. The double J stents were inserted by means of retrograde cystoscopic approach. The duration of stents left in the ureters was 3 approximately 12 months. Follow-up for 5 approximately 36 months after removed the double J stents showed the extinction of the symptoms, remission of the hydropyonephrosis and improvement of the renal function. The excretion urography and retrograde pyelography showed improvement of stricture in 25 ureters. We suggest that persistent dilatation with double J stent be used as first choice for treatment of pelvis-ureter junction stricture.

[Squamous cell carcinoma of urinary epithelia: report of 15 cases].

From May 1983 to 1992, 15 patients with urinary epithelial squamous cell carcinoma in renal pelvis (7) and in bladder (8) were treated. Eleven of them were complicated by urinary tract stone. Of the 15 patients, 8 were misdiagnosed as having simple urinary stone and 1 renal tuberculosis. It is suggested that active treatment for urinary stones be used to prevent the occurrence of squamous cell carcinoma and that possibility of concomitant epithelial tumor in patients with long-term and large urinary stones be considered.

[Inhibitory effect of Chinese herb medicine zhuling on urinary bladder cancer. An experimental and clinical study].

Inhibitory effect of Zhuling (Grifola umbellata pilat) on urinary bladder cancer was determined experimentally and clinically. The results showed that zhuling inhibited significantly the induction of bladder cancer in rats exposed to N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), decreasing from 100% (18/18) in control group to 61.1% (11/18) in zhuling (P less than 0.01). Zhuling was given to 22 patients with recurrent bladder cancer after TUR or partial cystectomy. The patients were followed up for 12 to 38 months (average 26.5 months). Bladder cancer recurred in seven of the patients with a longer recurrence interval (19.2 months) after medication than before medication (P less than 0.05). The remaining 15 patients had no recurrence. The mechanism of Zhuling is discussed.