摘要
It is presented as an innovative technique in the treatment of atrial fibrillation, with the aim of improving the quality of life of affected patients. OBJECTIVES: The study aims to describe the ablation procedure using the Boston Scientific System Farapulse medical equipment and analyze the results in a specific clinical case. METHODS: A pulmonary vein ablation procedure was performed using the aforementioned equipment. Details of the procedure were recorded, including catheter placement and applications performed in each pulmonary vein. RESULTS: Good tolerance was observed by the patient during the procedure, with an adequate number of applications in each pulmonary vein. Postablation electrocardiogram showed no significant abnormalities, suggesting electrical stability of the heart. It is concluded that the pulsed field pulmonary vein ablation technique using the Boston Scientific System medical equipment is safe and effective in the treatment of atrial fibrillation.
Se presenta como una técnica innovadora en el tratamiento de la fibrilación auricular, con el objetivo de mejorar la calidad de vida de los pacientes afectados. OBJETIVOS: El estudio tiene como objetivo describir el procedimiento de ablación utilizando el equipo médico Boston Scientific System Farapulse y analizar los resultados en un caso clínico específico. Métodos: Se realizó un procedimiento de ablación de venas pulmonares utilizando el equipo mencionado. Se registraron los detalles del procedimiento, incluyendo la colocación de catéteres y las aplicaciones realizadas en cada vena pulmonar. RESULTADOS: Se observó una buena tolerancia por parte del paciente durante el procedimiento, con un número adecuado de aplicaciones en cada vena pulmonar. El electrocardiograma postablación no mostró anomalías significativas, lo que sugiere una estabilidad eléctrica del corazón. Se concluye que la técnica de ablación de venas pulmonares con campo pulsado utilizando el equipo médico Boston Scientific System es segura y eficaz en el tratamiento de la fibrilación auricular.
Subject(s)
Humans , Male , Middle Aged , Pulmonary Veins/surgery , Atrial Fibrillation/surgery , Catheter Ablation/methods , Reproducibility of Results , Treatment Outcome , Catheter Ablation/adverse effects摘要
The brain’s neural circuits consist of a large number of highly unstable networks. Despite the existence of many internal and external factors that continuously disturb the balance, our brains employ an array of homeostatic mechanisms that allow neurons or neural circuits to sense how active they are, and when they deviate from a target value, whereby a force must be generated to move neuronal activity back toward this target. Sleep is one of the well-known physiological states in the regulation of homeostasis. Sleep pressure increases during wakefulness and decreases during sleep. When sleep is lost (e.g., sleep deprivation), this loss is compensated by extending or strengthening subsequent sleep. These phenomena are known as sleep homeostasis. The dysregulation of sleep homeostasis accompanies brain-related diseases such as schizophrenia, bipolar disorder, major depressive disorder, and autism spectrum disorder. More importantly, it can significantly undermine the basis of traditional sleep hygiene practices for these diseases. Therefore, clarifying the mechanisms of sleep homeostasis is important for therapy, but it remains an unsolved mystery. In addition to pharmacological treatment, non-invasive brain stimulation has become one of the most promising tools for clinical treatment in recent years due to its low cost, portability and low incidence of side effects. In order to promote relevant technologies, this review will focus on the electrophysiological mechanisms of sleep homeostasis. We first discuss the electrophysiological marker of sleep homeostasis, slow-wave activity, then move to the neuronal firing rates, finally discuss more aspects of sleep homeostasis, including differences in brain area, sleep stages, learning and individual differences.
摘要
A 76-year-old woman was found unconscious in her home one morning in August. She was subsequently diagnosed and treated for heat stroke by her physician. However, 55 days later, she was transferred to our hospital presenting with symptoms of dementia, dysarthria, dysphagia, moderate bilateral upper extremity paralysis, severe lower extremity paraplegia, and loss of deep tendon reflexes. Cerebellar ataxia in her upper extremities and no sensory disturbance in her extremities were also noted. She required assistance when eating and upon excretion, as well as the use of a wheelchair. She was rehabilitated for one month and was subsequently able to urinate on her own. However, her physical function and ability to carry out daily activities did not improve. As a result, she was evaluated further using nerve conduction studies and needle electromyography, the results of which suggested spinal cord lesions (anterior horn cells or ventral roots). In 1985, Delgado et al. reported a case of central nervous system sequelae after heat stroke. In their case, flaccid quadriplegia, bladder-rectal disorder, and sweating dysfunction were observed, but no sensory disturbance was detected. They described pathological findings of lesions in the anterior horn, the medial lateral horn, and the ventral root of the spinal cord. Based on this, it is highly likely that spinal cord lesions were also caused by heat stroke in our case. Although there are few reports of spinal cord lesions as a sequela of heat stroke, this case highlights the need to carefully monitor patients of heat stroke for such pathological conditions.
摘要
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.
摘要
Abstract Introduction Auditory evoked potentials are widely used in clinical practice to complement the assessment of central auditory processing. However, it is necessary to understand whether these potentials are highly accurate, to assist in the diagnosis of auditory processing disorder. Objective To measure the accuracy of middle and long latency auditory evoked potentials in the diagnosis of auditory processing disorder in adults. Methods This is a case-control study, formed by a control group of 30 individuals with normal auditory processing assessment, and a case group composed of 43 individuals with altered auditory processing assessment. Their sensitivities, specificities, accuracies, positive and negative predictive values for the diagnosis of alterations were measured and compared between the potentials. Results The accuracies of the middle and long latency potentials were 51% and 67%, respectively. The P1-N1-P2 and N2-P300 complexes had an accuracy of 57.5% and 58.9%, respectively. The cognitive potential P300 showed an accuracy of 55%. There was no significant result for the middle-latency potential (OR = 1.8; 95% CI: 0.6-5.4, p > 0.42) and for P300 (OR = 2.63, 95% CI: 0.85-8.43, p > 0.11). However, the result was significant for the long-latency potential (OR = 6.3; 95% CI: 2-19.6, p < 0.01). There was a significant result for the P1-N1-P2 complexes (OR = 6.76, 95% Cl:1.4-32.5, p = < 0.010) and N2-P300 (OR = 3.60; 95% CI: 10.16-11.20, p < 0.039). Conclusion Individuals with altered long-latency auditory evoked potential are more likely to have auditory processing disorder and, as such, this test can be used as a complementary tool to confirm the diagnosis.
摘要
Abstract Introduction Noise obscures speech signal, causing auditory masking. The effects of this masking can be observed through the cortical auditory evoked potentials (CAEPs). White noise, in turn, has an effect on the auditory cortex, interfering, for example, with lexical decision making. Objective To analyze the effect of simultaneous masking by contralateral white noise on CAEPs elicited by speech stimuli. Methods Cross-sectional observational analytical study carried out with 15 participants of both sexes, who were submitted to CAEPs in two conditions: 1) without noise; 2) with white noise at 100 dBSPL intensity, contralaterally and simultaneously. To compare these conditions, the Student t test or the Wilcoxon test were used, depending on the sample normality. Differences with p values < 0.05 were considered significant. Results: When white noise was presented contralaterally and simultaneously to the CAEPs with speech stimulus, an increase in P1, N1 and P2 wave latencies was observed. P1 and P2 amplitudes and N1-P2 peak to peak amplitude also increased, unlike N1 amplitude, which decreased. The differences were significant for P1 and P2 wave latencies and for P2 wave amplitude. Conclusion The simultaneous masking effect was observed from the morphological alterations of the CAEPs with speech stimulus when white noise was presented in the contralateral ear. There was a significant increase in P1 and P2 wave latencies, as well as in P2 wave amplitude.
摘要
Abstract Introduction NB CE-Chirp LS was developed to improve the audiogram estimation by auditory brainstem response (ABR) thresholds during audiological assessment of infants and difficult to test children. However, before we know how the stimulus behaves in several types of hearing loss, it is important we know how the stimulus behaves in normal hearing infants. Objective To describe ABR thresholds with NB CE-Chirp LS stimulus for 500, 1,000, 2,000, and 4,000 Hz, as well as the amplitude and absolute latency for ABR thresholds. Methods Auditory brainstem response thresholds were evaluated with the Eclipse EP25 system. NB CE-Chirp LS was presented using an ER-3A insert earphone. EEG filter was 30 Hz high-pass and 1,500 Hz low-pass. The ABR threshold was defined as the lowest intensity capable of clearly evoke wave V, accompanied by an absent response 5 dB below. Results Eighteen normal hearing infants were evaluated. The mean and standard deviation (SD) of the ABR threshold (dB nHL) were: 23.8 (±4.2); 14.4 (±5.7); 6.0 (±5.0); and 7.0 (±5.9). The mean and SD of the absolute latency (ms) were: 8.86 (±1.12); 9.21 (±0.95); 9.44 (±0.78); and 9.64 (±0.52). The mean amplitude (nV) and SD were: 0.123 (±0.035); 0.127 (±0.039); 0.141 (±0.052); and 0.105 (±0.028), respectively, for 500, 1,000, 2,000 and 4,000 Hz. Conclusion Auditory brainstem response threshold with NB CE-Chirp LS reaches low levels, in special for high frequencies. It provides absolute latencies similar between frequencies with robust amplitude. The results obtained brings to the examiner more confidence in the results registered.
摘要
Abstract Introduction The P300 auditory evoked potential is a long-latency cortical potential evoked with auditory stimulation, which provides information on neural mechanisms underlying the central auditory processing. Objectives To identify and gather scientific evidence regarding the P300 in adult cochlear implant (CI) users. Data Synthesis A total of 87 articles, 20 of which were selected for this study, were identified and exported to the Rayyan search software. Those 20 articles did not propose a homogeneous methodology, which made comparison more difficult. Most articles (60%) in this review compare CI users with typical hearing people, showing prolonged P300 latency in CI users. Among the studies, 35% show that CI users present a smaller P300 amplitude. Another variable is the influence of the kind of stimulus used to elicit P300, which was prolonged in 30% of the studies that used pure tone stimuli, 10% of the studies that used pure tone and speech stimuli, and 60% of the studies that used speech stimuli. Conclusion This review has contributed with evidence that shows the importance of applying a controlled P300 protocol to diagnose and monitor CI users. Regardless of the stimuli used to elicit P300, we noticed a pattern in the increase in latency and decrease in amplitude in CI users. The user's experience with the CI speech processor over time and the speech test results seem to be related to the P300 latency and amplitude measurements.
摘要
This article presents our historical research regarding Charles Brown-Séquard, a famous scientist with important contributions to the medical field, in particular for neurology, and endocrinology, and his relationship with Dom Pedro II, the second and last Brazilian Emperor, and an enlightened ruler. The Emperor contacted several illustrious personages in support of State policy, such as for the development of experimental physiology at the Imperial Museum of Natural History, but also for personal purposes given his health problems and those of the Empress. Charles Brown-Séquard and his pilgrimage between different worlds as a physician and physiologist are presented until his definitive establishment in Paris, where he replaces Claude Bernard in the chair of experimental medicine at the Collège de France. Jacques-Arsene d'Arsonval took over after this chair, and together with Brown-Séquard, he electrophysiologically examined the Emperor's diabetic peripheral neuropathy. In this article, the Emperor´s relationship with Brown-Séquard was studied mainly from the correspondence sent to Dom Pedro II and retrieved from the Imperial Museum in Petrópolis, Brazil, and from the accounts of his meetings that included scientific sessions and clinical consultations. This article can be used to understand the progress of knowledge in the field of neurology/clinical neurophysiology, the tracking of emerging ideas in the field of science in the past and the threat to the credibility of researchers.
Este artigo apresenta nossa pesquisa histórica a respeito de Charles Brown-Séquard, famoso cientista com importantes contribuições para a área médica, em especial para a neurologia e endocrinologia, e sua relação com Dom Pedro II, segundo e último Imperador brasileiro, e governante esclarecido. O Imperador contactou várias personalidades ilustres no apoio à política de Estado, como para o desenvolvimento da fisiologia experimental no Museu Imperial de História Natural, mas também para fins pessoais dados os seus problemas de saúde e os da Imperatriz. Charles Brown-Séquard e sua peregrinação entre diferentes mundos como médico e fisiologista são apresentados até seu estabelecimento definitivo em Paris, onde substitui Claude Bernard na cadeira de medicina experimental no Collège de France. Jacques-Arsene d'Arsonval assumiu após esta cadeira e, juntamente com Brown-Séquard, examinou eletrofisiologicamente a neuropatia periférica diabética do imperador. Neste artigo, a relação do Imperador com BrownSéquard foi estudada principalmente a partir da correspondência enviada a Dom Pedro II e recuperada no Museu Imperial de Petrópolis, Brasil, e dos relatos de seus encontros que incluíam sessões científicas e consultas clínicas . Este artigo pode ser usado para entender o progresso do conhecimento no campo da neurologia/neurofisiologia clínica, o rastreamento de ideias emergentes no campo da ciência no passado e a ameaça à credibilidade dos pesquisadores.
摘要
Abstract Introduction Auditory-evoked potentials are influenced by several factors, including polarity, filter, stimulus intensity and stimulation rate. The presentation of higher rates of stimuli per second enables the collection of a greater number of responses in a given period of time, promoting a shorter testing time; however, the collected recordings are subject to changes related to wave morphology. Objectives To compare the brainstem auditory-evoked-potential responses with click stimulus with the most commonly used stimulation rates in the clinical practice. Methods The present cross-sectional analytical study was performed with fifteen participants of both genders and normal hearing thresholds. The brainstem auditoryevoked potential was performed at four different stimulation rates (21.1, 26.7, and 27.7 stimuli/s, and a rate determined based on a mathematical calculation using the a measurement of the transmission frequency of the power grid at the time of the examination). Results We observed that the rate of 21.1 stimuli/s showed the highest amplitudes for waves I, III, and V when compared with the other rates. The rate of 26.7 stimuli/s, when compared with 27.7 stimuli/s, showed a higher amplitude for wave V. The latency if wave V was significantly lower with the rate of 21.1 stimuli/s than with 27.7 stimuli/s. Conclusions The stimulation rate interferes with wave latencies and amplitudes; its decrease from 27.7 to 21.1 stimuli/s decreases the latency of wave V and increases the amplitues and improves the morphology of waves I, III and V. In addition, we found evidence that suggests an improvement in the visualization of wave III by adjusting the stimulation rate based on a measurement of the local transmission frequency of the power grid.
摘要
Abstract Introduction Auditory processing refers to the efficiency and effectiveness with which the central auditory nervous system uses auditory information. Middle- and long-latency auditory evoked potentials are objective electrophysiological tests that can complement the diagnosis of alterations involving central auditory processing. Objectives To standardize latency and amplitude values for short-, middle-, and long-latency auditory evoked potentials in adults with normal hearing thresholds. Methods This is a cross-sectional study. Thirty-three adults with normal hearing thresholds, without hearing complaints, and with normal central auditory processing were evaluated. All underwent basic audiological evaluation, central auditory processing assessment, and short-, middle-, and long-latency auditory evoked potentials. Results Absolute latency and interpeak values for middle- and long-latency auditory evoked potentials were lower than internationally suggested. However, for the brainstem auditory evoked potential, the means were within the range considered as normal, as suggested in the equipment. Conclusions The present study provided measurements of normal latencies and amplitudes for short-, middle-, and long-latency auditory evoked potentials in adults.
摘要
Abstract Introduction Individuals with autism spectrum disorder (ASD) have abnormalities in auditory perception and sensitivity. The mismatch negativity (MMN) component of the evoked potential demonstrates a brain detection response to an auditory change due to memory, and enables the identification of changes in the auditory system. Objectives To analyze MMN responses in children and adolescents with ASD and compare them with those of a control group. Methods Cross-sectional and comparative study. The sample was composed of 68 children and adolescents, divided into study group (SG), which contained those diagnosed with ASD, and the control group (CG), which contained those with typical development, normal hearing thresholds, and without hearing complaints. All participants were submitted to peripheral and central electrophysiological auditory evaluations. For the electrophysiological auditory evaluation and MMN recording, the electrodes were fixed in the following positions: Fz (active electrode), M1 and M2 (reference electrodes), and on the forehead (ground electrode). Auditory stimuli were presented in both ears simultaneously, with a frequency of 1,000 Hz for the frequent stimulus, and of 2,000 Hz for the rare stimulus, in an intensity of 80 dBNA. Results Latency and amplitude values were increased in the SG, with a statistically significant difference in comparison with the CG. In the MMN analysis, there was no statistically significant difference in the comparison between right and left ears and between genders. Conclusions Children and adolescents with ASD had higher latency and amplitude values in the MMN component than the individuals in the CG.
摘要
Understanding the mechanism of information processing in plants remains a challenging task even in the era of machine learning and artificial neural networks. Sir J.C. Bose had demonstrated through his experiments that the various modes of stimulation which effectively initiated nervous impulse in animals led to impulse generation in the excitable plant Mimosa pudica as well. In order to localize the tissue responsible for conduction of excitation in the petiole of Mimosa, Bose had constructed a specialized ‘Electric Probe’ (glass tip electrode). From this experiment, Bose found that there were different intensities of transmitted excitation in different tissue layers of the petiole. In this backdrop, an experimental research has been conducted to comparatively study the pattern of spatial voltage distribution across different tissue layers in both, a non-excitable plant Alternanthera philoxeroides (in stem) and an excitable plant Mimosa pudica (in petiole), by following experimental principles similar to that of Sir J. C. Bose. For the present experimental study, the electrical probes (glass tip electrode), similar to the one designed by J.C. Bose and the whole experimental setup has been constructed and developed completely in the laboratory. The results indicated a striking difference in the spatial voltage distribution pattern between the non-excitable and the excitable plant. Since Mimosa is an excitable plant having specialized mechanoreceptor cells, the change in spatial voltage distribution in the different layers of petiole, following excitation (uniform electrical stimuli) of a sub-petiole has been also studied, as an additional segment of the present research. In the present study a notable difference in the intensities of the transmitted excitation was also found upon electrical stimulation of one of the sub-petioles of the excitable plant M. pudica.
摘要
@#Objective To describe the neuroelectrophysiological findings and genetic alteration of a patient with hereditary neuropathy with liability to pressure palsies (HNPP) who first presented with posterior interosseous nerve damage,and to improve clinicians'understanding of this disease. Methods We analyzed the clinical data of the patient and his families,and conducted a literature review on this disease. Results The 15-year-old male patient presented to the clinic complaining of weakness in the right forearm and inability to lift his fingers for more than one month. Electrophysiological examination demonstrated multiple peripheral nerve damage. Gene testing revealed large-fragment loss of heterozygosity in the exon region of the PMP22 gene. Conclusion HNPP is clinically heterogeneous,which should be considered when mild pressure can trigger nerve paralysis and electrophysiology indicates multiple peripheral nerve damage. Early diagnosis and symptomatic treatment can improve the quality of life and prognosis of the patients.
摘要
@#Objective To analyze the electrophysiological characteristics of patients with severe Guillain-Barré syndrome and the related factors causing poor prognosis,and evaluate the value of neuroelectrophysiology in predicting poor prognosis. Methods The clinical data of 78 GBS patients admitted to our hospital from March 2020 to May 2022 were selected,divided into mild (n=52) and severe (n=26) according to the severity of the disease,and the good group (n=45) and bad group (n=33) according to the prognosis;Compare the clinical data of different groups,compare the neuroelectrophysiological characteristics of patients in different disease groups,analyze the relevant factors causing poor prognosis,build a line chart prediction model and verify it;analyze the value of electrophysiological characteristics for poor prognosis through the subject's working characteristics (ROC) curve. Results A comparison of the clinical data of two groups of patients with different severity found that the incidence of facial paralysis,chest tightness,diarrhea,mechanical ventilation,autonomic nervous dysfunction and other autoimmune diseases in the severe group was significantly higher than that of patients in the mild group (P<0.05). By comparing the electrophysiological characteristics of the two groups,it was found that the total peroneal nerve conduction rate and tibia motor conduction rate of the severe severe group were significantly lower than that of the mild group,while the F-wave abnormality rate and dCMAP wave amplitude abnormality rate were significantly higher than that of the mild group (P<0.05);single-factor and multi-factor results showed that the pre-hospital course of hospitalization was >2 weeks,elevated cerebrospinal fluid protein,and MRC score ≤30 at hospital,mechanical ventilation,combined with other autoimmune diseases,slowing of the total peroneal nerve conduction rate,slowing down the tibial motion conduction rate,increased F-wave abnormality rate,increased amplitude abnormality of dCMAP and axial cord injury are all risk factors affecting poor prognosis (OR values are greater than 1,P<0.05);the total score of the line chart prediction model is 613 points,and the corresponding adverse prognosis probability is 74.56%,which has good distinction,accuracy and effectiveness;the ROC curve obtains the total peroneal nerve conduction rate,tibial nerve motion conduction rate,F-wave abnormality,dCMAP wave amplitude abnormality four the area,positive/negative prediction value,sensitivity and specificity under the ROC curve of the joint prediction are significantly higher than that of individual predictions,with better prediction performance. Conclusion Analyzing the electrophysiological characteristics of severe GBS patients is conducive to a clearer understanding of the severity of patients' condition. It has a very important predictive value for poor prognosis,and is worth popularizing and applying in clinic.
摘要
Objective:To investigate the clinical and electrophysiological characteristics of facial onset sensory motor neuronopathy (FOSMN) syndrome.Methods:Ten patients diagnosed with FOSMN syndrome in Peking Union Medical College Hospital from January 2012 to December 2022 were included. The clinical and electrophysiological characteristics of patients were analyzed and summarized, and the genetic testing was also performed in these patients.Results:The age of onset was (56.6±6.5) years, and the longest survival duration of disease was 10 years. All patients had numbness around the face and mouth as the first symptom and abnormal blink reflex. A total of 52 sensory nerve conduction nerves were detected, among which 2 median nerves and 2 μlnar nerves showed decreased amplitude of sensory nerve action potential. Needle electromyography showed neurogenic lesions, with both progressive and chronic denervation. Whole exome sequencing identified the heterozygous variant c.272A>C in the exon 4 of the SOD1 gene resulting in the amino acid change p.Asp90Ala in 1 patient. In all patients, the disease progressed relentlessly and eventually led to involvement of respiratory muscle. Conclusion:FOSMN syndrome is characterized by abnormal blink reflex and sometimes abnormal sensory nerve conduction may be shown on electrophysiologic testing.
摘要
Objective:To explore the risk factors of bortezomib-related peripheral neuropathy (BIPN) and the clinical and electrophysiological characteristics of patients in treatment of multiple myeloma (MM).Methods:The clinical data of 71 newly diagnosed MM patients treated with BD (bortezomib + dexamethasone) regimen in Yancheng First People's Hospital from March 2016 to December 2019 were retrospectively analyzed. The bone marrow morphology, immunology, cytogenetics, molecular biology (MICM), routine electrophysiological examination before and after treatment were performed. All patients were divided into the peripheral neuropathy (PN) group and the non-PN group according to the presence or not of BIPN, and the clinicopathological differences of both groups were also compared; a binary logistic regression model was used to analyze the factors affecting the occurrence of PN. The electrophysiological characteristics were summarized and fluorescence in situ hybridization (FISH) was used to detect karyotype of BIPN patients.Results:Among 71 MM patients, there were 40 cases (56.3%) of PN and 31 cases (43.7%) of non-PN. The proportion of patients at international staging system (ISS) staging Ⅲ, and the levels of IgA, IgG, IgM, serum creatinine, β 2-microglobulin (β 2-MG) in the PN group were higher than those in the non-PN group, and hemoglobin (Hb) level in the PN group was lower than that in the non-PN group, and the differences were statistically significant (both P < 0.05). Binary logistic regression analysis showed that increased IgA ( OR = 1.151, 95% CI 1.012-1.309, P = 0.033), increased IgG ( OR = 1.055, 95% CI 1.000~1.112, P = 0.049), increased IgM ( OR = 1.010, 95% CI 1.001-1.018, P = 0.022), increased serum creatinine ( OR = 1.037, 95% CI 1.011~1.065, P = 0.005), increased β 2-MG ( OR = 1.564, 95% CI 1.039-2.354, P = 0.032) were risk factors for BIPN. Among 40 patients with BIPN, 33 cases (82.5%) of sensory nerve conduction velocity (SCV) were abnormal, 23 cases (57.5%) of motor nerve conduction velocity (MCV) were abnormal; 31 cases (77.5%) showed demyelination damage, 9 cases (22.5%) had axonal damage. Among 40 patients with BIPN, 24 cases underwent FISH detection, including 19 cases (79.2%) with chromosomal mutations, of which 12 cases (50.0%) were mixed subtype abnormal. Conclusions:MM patients with high levels of β 2-MG, IgA, IgG, IgM and serum creatinine are more prone to PN when treated with bortezomib. The electrophysiology of patients with BIPN is mainly characterized by demyelination of sensory nerves.
摘要
Objective:To explore the common causes and solutions for artifacts in clinical visual electrophysiological examination.Methods:A cross-sectional study was performed.The clinical visual electrophysiological examination results of 25 001 cases were collected from 2012 to 2020 at the Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University). Artifacts were identified and analyzed according to the standard waveform provided by the International Society for Clinical Electrophysiology of Vision.The characteristics and causes of the artifact were analyzed.The solutions to reduce and eliminate the artifact were proposed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University) (No.KY2020053).Results:There were 60 typical artifacts identified among the 25 001 cases.Common causes of the artifacts were classified as three categories, the factors related to subjects, environment, or instruments.Among the 60 cases, 42(70.0%) were caused by tension in head and facial muscles of patients, 9(15.0%) due to blinking of patients, 4(6.7%) resulted from 50 Hz power frequency artifact, 2(3.3%) arisen from abnormal amplifier, and 3(5.0%) for other reasons.The strategies to avoid artifact were as follows.First, examiners could inform patients of the examination process in advance to help patients to relax and avoid the influencing factors, such as muscle tension in head and face, blinking, inattention and so on; second, high-quality 50 Hz hardware wave trap was recommended to reduce 50 Hz artifact, with good ground connection and removing of the high-power electrical appliances near the visual electrophysiological instrument; third, clean the skin sufficiently to reduce the reference electrode impedance to less than 1 kΩ.Conclusions:There is a variety of artifact waveforms and causes.The technicians should make correct judgments and handle the artifact in time to provide more accurate examination results.The doctors should know about artifact, which is helpful for better interpretation of visual electrophysiological examination reports.
摘要
Visual electrophysiological examination has strict standards and quantitative methods for stimulating light, which involves the concepts of photopic and scotopic vision of human eyes.Photopic vision is a visual perceptual activity mainly involving cones in a bright environment, while scotopic vision is a visual perceptual activity mainly involving rod cells in a dark environment.Even if the rated power of the light source is the same, the brightness (luminous flux) perceived by human eyes is different for different spectral light sources in the same or different visual environments.To enable ophthalmologists and clinical visual electrophysiological examination technicians to accurately understand the setting mechanism and recording results of stimulating light in the international standard of visual electrophysiology, this paper introduced the basic concepts such as the concept of human eye photopic and scotopic vision, the measurement and expression of brightness in different visual environments, and the luminous flux of light sources under photopic and scotopic vision in detail, and interpreted the application of the concept of photopic and scotopic vision in clinical visual electrophysiology.
摘要
Depressive disorder seriously affects people's physical and mental health.Acupuncture is a safe and effective treatment for depression,yet,its mechanism is unclear.Therefore,acupuncture's action mechanism in intervening depression was summarized from several perspectives,including morphology and ultrastructure of neurons in depression-related brain areas,function and structure of glial cells,brain functional and structural connectivity,and neuroelectrophysiology.It's discovered that acupuncture can repair the morphological and ultrastructural damage of neurons in the hippocampus and prefrontal lobe,mitigate the functional and structural injuries of glial cells in the hippocampus and prefrontal lobe,strengthen functional connectivity and heal structural connection,and promote neuroelectrophysiological activities,which possibly are the principal mechanisms of how acupuncture works in intervening depressive disorder.