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Objective:To explore the clinical and electrophysiological characteristics of peripheral neuropathy in prediabetic patients.Methods:Subjects aged 20-65 years with high-risk factors of impaired glycemia enrolled in Beijing Tiantan Hospital, Capital Medical University from 2019 to 2022 were recruited to conduct oral glucose tolerance test, after excluding other causes of neuropathy or radiculopathy. Patients with impaired fasting glucose or impaired glucose tolerance were defined by American Diabetes Association criteria. These patients were divided into clinical polyneuropathy (PN) and clinical non-PN groups, according to the 2010 Toronto consensus criteria and the presence of PN symptoms and signs or not. Nerve conduction studies (NCS), F wave, sympathetic skin response (SSR), R-R interval variation (RRIV) and current perception thresholds (CPT) were performed and the abnormal rate was compared between different electrodiagnostic methods and between clinical subgroups.Results:Among the 73 prediabetic patients ultimately enrolled, only 20 (27.4%) can be diagnosed as clinical PN according to the Toronto consensus criteria. The abnormal rate of CPT (68.5%, 50/73) was significantly higher than those of F wave (2.7%, 2/73), lower limb NCS (0, 0/73), upper limb NCS changes of carpal tunnel syndrome (26.0%, 19/73), SSR (6.8%, 5/73) and RRIV (5.5%, 4/73; McNemar test, all P<0.001). With sinusoid-waveform current stimuli at frequencies of 2 000 Hz, 250 Hz and 5 Hz, the CPT device was used to measure cutaneous sensory thresholds of large myelinated, small myelinated and small unmyelinated sensory fibers respectively. CPT revealed a 21.9% (16/73) abnormal rate of unmyelinated C fiber in the hands of prediabetic patients, significantly higher than that of large myelinated Aβ fibers [8.2% (6/73), χ2=5.352, P=0.021]. Both abnormal rates of small myelinated Aδ [42.5% (31/73)] and unmyelinated C fibers [39.7% (29/73)] in the feet of prediabetic patients were significantly higher than that of large myelinated Aβ fibers [11.0% (8/73), χ2=18.508, 15.965, both P<0.001]. Compared with the clinical non-PN group, the abnormal rates of CPT [90.0% (18/20) vs 60.4% (32/53), χ2=5.904, P=0.015] and SSR [20.0% (4/20) vs 1.9% (1/53), P=0.016) were significantly higher in the clinical PN group. Conclusions:Peripheral neuropathies in prediabetic patients are usually asymptomatic or subclinical, and predispose to affect unmyelinated and small myelinated sensory fibers. Selective electrodiagnostic measurements of small fibers help to detect prediabetic neuropathies in the earliest stages of the disease.
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Objective:To analyze the clinical, electromyographic and tremor characteristics in tremor patients with neuronal intranuclear inclusion disease (NIID).Methods:From May 2018 to April 2023, 34 patients with NIID diagnosed in the Department of Neurology, Beijing Tiantan Hospital of Capital Medical University were retrospectively included. Sixteen patients with tremor of at least one limb and (or) head were in tremor group, and 18 patients without tremor were in control group. The clinical, electromyogram and tremor data of all participants were summarized, the clinical features and electromyogram differences of the 2 groups were compared, and the tremor characteristics of patients with NIID were analyzed.Results:The proportion of female patients in the tremor group was higher than that in the non tremor group (12/16 vs 7/18, P=0.045). The proportion of upper and lower limb peripheral nerve damage in the tremor group was lower than that in the non tremor group (2/16 vs 9/18, P=0.030), with statistical significance. There was no significant difference between the 2 groups in higher cortex and autonomic nervous dysfunction. The amplitude of composite muscle action potential and sensory nerve action potential in all patients was normal or slightly decreased; some patients experienced a decrease in motor and sensory fiber conduction velocity. The proportion of motor and sensory nerve conduction velocity slowing in the non tremor group was higher than that in the tremor group [motor nerve:41.7%(30/72) vs 17.2%(11/64), χ 2=9.64, P=0.002;sensory nerve:38.9% (35/90) vs 20.0%(16/80), χ 2=7.19, P=0.007]. The number of cases of postural tremors in different parts among the 16 patients was as follows: 13 in the upper limbs, 7 in the lower limbs, and 6 in the head; static tremor: 8 cases in the upper limbs, 3 cases in the lower limbs, and 5 cases in the head. At rest, the frequency of tremors in different parts of the body was as follows: upper limb (5.3±1.1) Hz, lower limb (4.2±0.4) Hz, and head (3.9±0.6) Hz. The difference in tremor frequency among the 3 parts was statistically significant ( F=3.92, P=0.047); Pairwise comparison showed that the frequency of head tremor was lower than that of upper limb tremor, with a statistically significant difference ( P=0.020). In a postural state, tremor frequency in different parts was as follows: upper limb (5.4±0.9) Hz, lower limb (5.0±0.7) Hz, head (3.9±0.7) Hz. There was a statistically significant difference in tremor frequency among the 3 parts ( F=6.65, P=0.005). Further pairwise comparison revealed statistically significant differences in tremor frequency between the patient′s head, upper and lower limbs ( P=0.001, P=0.022). Synchronous tremor rhythm was predominant, with occasional alternations or synchronous+alternations. There was no harmonic tremor spectrum was observed. Conclusions:NIID patients with tremors were more common in female patients.The degree of peripheral nerve damage was milder than those without tremors. The site and form of tremor were diverse, with a dominant frequency of 4-6 Hz, mainly synchronous rhythm, and no harmonic spectrum. Postural tremors were common in the limbs.
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@#Abstract: Objective To compare the mosquito trapping effect of BG-trap mosquito trap using carbon dioxide versus BG-lure attractant under filed conditions. Methods In August and September 2020, two areas were set with a distance of 100 m. Two sites were set at each area, and one mosquito trap BG trap was set with a distance of 5 m. Each site was set with different flow of CO2 and different amount of BG-lure attractants. The BG-trap mosquito traps on the same area would exchange positions every other day. The mosquitoes captured by each mosquito trap was collected and classified. and the species, sex and number of mosquitoes captured were recorded and counted. Results The densities of Aedes albopictus captured by BG+/CO2-and BG-/CO2+were 14 and 31, and that of Culex pipiens pallens were 2 and 16, respectively. The differences were statistically significant (Aedes albopictus, t=-2.675, P<0.05; Culex pipiens pallens, t=-4.873, P<0.05). With BG-lure attractant, the females of Aedes albopictus and Culex pipiens pallens in the CO2+group were 2.6 (25/9.5) and 12.0 (12 /1) times higher than those in the CO2-group, and the differences were statistically significant (female Aedes albopictus, t=-4.119, P<0.01; female Culex pipiens pallens, t=-4.592, P<0.01), suggesting that the most important attractant to female mosquitoes is CO2. With BG-lure attractant, the male Aedes albopictus in the CO2+ group was 3.0 (12/4) times higher than that in the CO2-group, and the difference was statistically significant (male Aedes albopictus, t=-3.284, P<0.01). Without BG-lure attractant, female Aedes albopictus and female Culex pipiens pallens in the CO2 + group were 1.8 (18 / 10) and 15.5 (15.5/1.0) times higher than those in the CO2-group, and the difference was statistically significant (female Aedes albopictus, t=-2.868, P<0.05; female Culex pipiens pallens, t=-5.259, P<0.05). Without BG-lure attractant, the male Aedes albopictus in the CO2+group was 2.0 (9.0/4.5) times higher than that in the CO2-group, with a statistically significant difference (t=-2.508, P<0.05). With CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.4 (43.5/31) and 0.78 (12.5/16.0) times higher than those in the BG-attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.943, P>0.05 ; Culex pipiens pallens, t=0.709, P>0.05). Without CO2, Aedes albopictus and Culex pipiens pallens in the BG + attractant group were 1.0 (14/14) and 2.0 (2.0/1.0) times higher than those in the BG + attractant group, and the differences were not statistically significant (Aedes albopictus, t=-0.500, P>0.05; Culex pipiens pallens, t=-1.000, P>0.05). Without BG-lure attractant, the densities of female Aedes albopictus captured by adding 0, 1 and 2 parts of dry ice were 10, 17.5 and 18 respectively, and the difference was statistically significant among the three groups (F=3.942, P<0.05). The densities of female Culex pipiens pallens captured were 1, 13 and 18 respectively, and the difference was statistically significant among the three groups (F=13.881, P<0.05). However, there was no significant difference between the capture of female Aedes albopictus and female Culex pipiens pallens by adding 1 part of dry ice and 2 parts of dry ice (female Aedes albopictus, t=0.112, P>0.05; female Culex pipiens pallens, t=-0.540, P>0.05). Without CO2, 10, 10, 9.5 and 1, 1 and 1.5 female Aedes albopictus and Culex pipiens pallens were captured by adding 0, 1 and 2 portions of BG-lure attractants, respectively. There were no significant differences between the three groups (female Aedes albopictus, F=0.120, P>0.05; female Culex pipiens pallens, F=0.477, P>0.05). Conclusions In the monitoring of BG-trap mosquito trap, the mosquito trapping effect of CO2 is better than that of BG-lure attractant. When the same monitoring effect is obtained, the use of CO2 (100 mL/min) can save the use cost.
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Objective To optimize the method to elicit the facial nerve F wave and to establish its reference values and its related parameters, in order to provide an electrophysiological basis for facial nerve assessment in patients with hemifacial spasm (HFS). Methods Thirty-six healthy volunteers and 22 patients with HFS underwent this project. Compound muscle action potentials (CAMP, or M waves) and F waves were elicited by stimulating the marginal mandibular branch of the facial nerve and recorded with needle electrodes placed in the mentalis muscle. The association between F parameters and Cohen Grading of the HFS patients were analyzed. Results There were no significant differences in F parameters between men and women or between the two sides in control subjects. Minimal latency of F wave (Fmin) and mean latency of F wave (Fmean) had positive correlations with head circumference (Fmin r=0.449, P=0.013; Fmean r=0.391, P=0.033), but had no correlations with age nor height. Patients with HFS had prolonged duration of F wave (Fdura) in spasm side, compared with normal side (13.1 ms vs. 9.5 ms, P<0.01) and healthy subjects (13.1 ms vs. 9.7 ms, P<0.001), and increased ratio of F-wave amplitude and M-wave amplitude (F/M) in spasm side, compared with normal side (6.9% vs. 3.8%, P<0.001) and healthy subjects (6.9% vs. 3.7%, P<0.001). F/M exhibited a positive correlation with Cohen Grading (r=0.538, P=0.001). Conclusion A clear facial nerve F wave can be achieved by stimulating the marginal mandibular branch of the facial nerve, which provides an objective basis for evaluation of the facial nerve function in HFS patients with increased F/M and prolonged Fdura.
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Objective To investigate the diagnostic value of spontaneous activities in genioglossus of amyotrophic lateral sclerosis (ALS).Methods A retrospective analysis of 79 patients diagnosed with ALS from January 2014 to December 2015 in Beijing Tiantan Hospital Affiliated to Capital Medical University was made.The patients were divided into two groups according to the clinical examination:with (44 patients) or without bulbar symptoms (35 patients).The course of disease,spontaneous potentials and ALS-Functional Rating Scale (ALS-FRS) scores were discussed,together with the association between semi-quantitative evaluation of spontaneous potential of the genioglossus and ALS-FRS score.Results In ALS patients,the overall positive rate of glossal spontaneous potentials was 69.6％ (55/79),among which the positive rate was 82.9％ (29/35) in patients with bulbar symptoms and 59.1％ (26/44) in patients without bulbar symptoms,with statistically significant differences between the two groups (x2=5.206,P＜0.05).While the positive rate in sternocleidomastoid was only 13.9％ (11/79),and there was no statistically significant difference between patients with or without bulbar symptoms.Semi-quantitative evaluation of fibrillation potentials in genioglossus muscle was correlated with ALS-FRS score (r=-0.258,P＜0.05).Conclusion Compared with sternocleidomastoid muscle,genioglossus muscle has a higher positive rate of spontaneous potentials and a higher diagnostic value in patients with subclinical bulbar symptoms.
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Objective To summarize the characteristics of tremor peak frequency,power and harmonics occurrence rate between Parkinson's disease (PD) and multiple system atrophy-parkinsonism (MSA-P).Methods From January to December in 2016,48 PD patients and 22 MSA-P patients were enrolled in Beijing Tiantan Hospital.Upper limb tremor patients got tremor analysis test in rest,posture and holding 1 000 g states,while lower limb tremor patients in rest and posture states.Peak frequency,power and harmonics occurrence rate of tremor were compared between PD and MSA-P patients in different states.Results Peak frequency of PD and MSA-P patients in upper rest ((4.76± 0.82) Hz vs (6.03 ± 0.25)Hz,t=-2.161,P=0.037),posture ((5.25 ±0.88) Hz vs (7.66 ±1.90) Hz,t=-4.266,P=0.001),holding 1 000 g ((5.80 ± 1.28) Hz vs (8.32 ± 1.51) Hz,t =-6.436,P =0.000) and lower posture ((4.85 ±0.78) Hz vs (6.42 ± 1.13) Hz,t =-3.001,P =0.012) showed statistically significant difference.Half-width power of PD and MSA-P patients in upper rest (extensor:15.70 (5.82,32.96)mg2/μV2 vs 3.14 (1.69,4.60) mg2/μV2,Z =-2.008,P =0.037),in posture (extensor:33.14(20.46,64.27) mg2/μV2 vs 10.02 (7.11,14.60) mg2/μV2,Z =-3.627,P =0.000;flexor:27.49(9.48,41.74) mg2/μV2 vs 5.97 (4.41,15.59) mg2/μV2,Z =-2.336,P =0.019),in holding 1 000g (flexor:17.80 (9.40,36.60) mg2/μV2vs8.15 (5.32,17.65) mg2/μV2,Z=-2.494,P=0.013),and in lower posture (flexor:26.63(7.09,85.84) mg2/μV2 vs 3.78 (2.51,7.12) mg2/μμV2,Z=-2.049,P =0.045) showed statistically significant difference.Harmonics occurrence rate of PD and MSAP patients in rest (82.5％ vs 5.9％,χ2 =29.096,P =0.000),posture (80.0％ vs 5.9％,χ2 =26.884,P=0.000) and holding 1 000 g (65.0％ vs 0,χ2 =20.318,P=0.000) had statistically significant difference.Conclusions Tremor peak frequency in PD patients was lower than that in MSA-P patients,while power and harmonics occurrence rate in PD patients were higher than in MSA-P patients.
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Objective To evaluate the diagnostic accuracy of diffusion tensor imaging (DTI) of corticospinal tract in amyotrophic lateral sclerosis (ALS) and find optimal testing strategies and optimal cutoff values of DTI indices for individual patient discrimination.Methods Thirty-three ALS patients and 34 healthy controls,collected at Peking Union Medical College Hospital from June 2004 through July 2005,undergoing brain DTI studies and fractional anisotropy (FA) examinations along the corticospinal tract,were analyzed by receiver operating characteristic (ROC) curves.Results Compared with the controls,ALS group had significantly decreased FA values in subcortical white matter of the precentral gyrus,the posterior limb of the internal capsule and the cerebral peduncle.In ROC analysis,the average FA value of the former two positions showed the best performance with an area under the curve of 0.917,an optimal cut-off value of 0.604,a sensitivity of 0.759 and a specificity of 0.912.The corresponding data for the average FA of all the three positions and each single position were listed as follows:average of three 0.914,0.648,0.759,0.912; precentral gyrus 0.875,0.509,0.733,0.824; internal capsule 0.845,0.692,0.656,0.941 ; and cerebral peduncle 0.752,0.742,0.656,0.735.Conclusions FA values of the corticospinal tract have a good accuracy in detecting upper motor neuron involvement in ALS.Precentral gyrus and posterior limb of the internal capsule and the average FA values of these two positions were suggested as the preferred testing places and DTI indices for clinical use.
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To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12-13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98.The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12-13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need.
الموضوعات
Adolescent , Child , Female , Humans , Male , China , Epidemiology , Cross-Cultural Comparison , Data Collection , Dental Health Surveys , Methods , Reference Standards , Health Services Needs and Demand , Malocclusion , Diagnosis , Epidemiology , Needs Assessment , Observer Variation , Orthodontics, Corrective , Reference Standards , Reference Values , Reproducibility of Results , Sensitivity and Specificityالملخص
<p><b>OBJECTIVE</b>To evaluate and analyze mechanism of Pizhen for the treatment of pain in patients with knee osteoarthritis.</p><p><b>METHODS</b>Eighty-five patients (85 knees) were divided into two groups according to random number table method. Among 35 patients in the experimental group, 6 patients were male and 29 patients were female, 1 patient lost follow-up, the average age was (56.65 +/- 4.89) years, and the patients were treated with Pizhen. Among 50 patients in the control group,there were 6 males and 44 females, the average age was (57.54 +/- 4.91) years, and the patients were treated with intra-articular injection with sodium hyaluronate. The VAS score and the data of algometer from the most obvious tenderness around the knee were used to evaluate the clinical effects.</p><p><b>RESULTS</b>There were significant differences of scores in the experimental group before and after treatment (P<0.01). There were significant differences of scores in the control group before and after treatment (P<0.01). After treatment, there were no statistical differences of VAS score and the data of algometer between experimental and control groups ( P>0.01). There was negative correlation between VAS score and the data of algometer.</p><p><b>CONCLUSION</b>The Pizhen is an effective method to treat pain in patients with knee osteoarthritis by relaxing tendon of soft tissue around pain point of knee joint, and relaxing compress and stimulation of nerves.</p>
الموضوعات
Aged , Female , Humans , Male , Middle Aged , Acupuncture Analgesia , Case-Control Studies , Osteoarthritis, Knee , Therapeutics , Pain Measurementالملخص
<p><b>OBJECTIVE</b>To investigate the mutation characteristics of paired box homeotic gene 9 (PAX9) and muscle segment homeobox gene 1 (MSX1) of patients with congenital oligodontia.</p><p><b>METHODS</b>Clinical manifestations were recorded by taking complete oral examinations in patients with congenital nonsyndromic oligodontia and some of his normal family members. Pedigree information was confirmed by extended interviews and a pedigree was constructed. Inheritance mode and clinical features were analyzed. Assessment of crown width compared to normal value of crown width in Chinese people was based on the registrations and measurements of study cast. Comparison of craniofacial form, malocclusion types and characteristics were conducted via cephalometric analysis by taking lateral cephalometric radiographics. Venous blood samples were collected and DNA was extracted from leukocytes. DNA sequencing and mutation analysis were analyzed in exon 1, 2, 3, 4 of PAX9 and exon 1, 2 of MSX1 coding region by polymerase chain reaction (PCR).</p><p><b>RESULTS</b>The teeth shape abnormality of the patient was noticed by a measured smaller crown width compared to normal values of crown width in Chinese people. The result of cephalometric analysis indicated no obvious inherited tendency in the proband in terms of facial osseo type and jaw bone pattern. One mutation was found in the proband and his mother in exon 3 of PAX9, the missense mutation G718C causing a conservative change A240P was present. Mutation was not found in MSX1.</p><p><b>CONCLUSION</b>These findings suggest that the missense mutation G718C in exon 3 of PAX9 is likely the cause of oligodontia.</p>
الموضوعات
Adolescent , Female , Humans , Male , Anodontia , Asian People , DNA Mutational Analysis , Mutation , PAX9 Transcription Factor , Pedigree , Polymerase Chain Reaction , Sequence Analysis, DNAالملخص
Objective To investigate the diffusion tensor imaging(DTI)and magnetic resonance spectroscopy(MRS)changes in amyotrophic lateral sclerosis(ALS)and to study on the physiopathology of ALS.Methods Thirty-eight AIS patients,8 patients with pure lower motor neuron involvement and 5 patients with mixed-type cervical spondylosis and 34 healthy controls were enrolled and examined with the conventional brain MRI,DTI and 1H-MRS.Results T2-weighted and T2 FLAIR images revealed abnormal high signals in bilateral pyramidal tract positions in 21%(8/38)of ALS patients,which was higher than that in the coaex When compared with the control group,the values of FA in the precentral gyms(0.492±0.059 vs 0.552±0.045,F=17.150,P<0.01),the posterior limb of the internal capsule(0.679±0.048 vs 0.727 4-0.031.F=19.481.P<0.01)and the cerebral peduncle(1eft:0.740 4-0.038 vs 0.761 4±0.024.F=4.290;right:0.720 ±0.044 vs 0.746 ±0.034,F=3.264,both P<0.01)of the ALS group were decreased significantly.so were the values of NAA/Cr.And the FA reduction rate was 10.9%,6.6% and 2.8%-3.5% respectively.There was also a significant decrease in FA in the anterior limb of the internal capsule and the occipital lobe in the ALS group.Conclusion Not only does the application of DTI and MRS help to demonstrate upper motor neuron involvement in the brain and facilitate the diagnosis and differential diagnosis of ALS,but also increases the understanding of the lesion distribution and physiopathology in ALS.
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<p><b>OBJECTIVE</b>To assess the significance of single fiber electromyography (SFEMG) in diagnosis of inflammatory myopathies and the correlation with other assistant examination findings.</p><p><b>METHODS</b>SFEMG were recorded from the extensor digitorum communis of 34 patients with polymyositis or dermatomyositis and compared with the findings of routine electromyography (EMG), serum creatine kinase (CK) determination, and muscle biopsy.</p><p><b>RESULTS</b>SFEMG recordings in 34 patients were all abnormal. The prominent feature was markedly increased fiber density (FD) with normally or mildly increased jitter. FD ranged from 1.0 to 6.0 (2.34 +/- 0.43). Jitter ranged from 5 to 78 micros (41.6 +/- 10.3 micros). The potential pairs with jitter values greater than 55 micros ranged from 0% to 55% (7.7% +/- 11.8%). Block was detected at one recording site in only one patient. Routine EMG demonstrated myogenic lesions in only 24 patients (70.6%). FD was a little higher in the normal-EMG subgroup or the neurogenic-EMG subgroup than myogenic-EMG subgroup but without statistical significance. Elevated CK levels were found in 75% patients (24/32). FD in the normal CK subgroup was significantly higher than that in the elevated CK subgroup (2.62 +/- 0.40 vs. 2.28 +/- 0.40, P < 0.05). Muscle pathologies were consistent with the diagnosis of myositis in 75% (15/20).</p><p><b>CONCLUSION</b>SFEMG is of great value in the diagnosis and disease process understanding of inflammatory myopathies for the clinically suspected patients with normal routine EMG, CK levels, and muscle biopsies.</p>