Effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy

Objective:To analyze the effect of cinepazide combined with mecobalamine on nerve conduction velocity, vibration perception threshold and serum indexes in patients with diabetic peripheral neuropathy. Methods:90 patients with diabetic peripheral neuropathy treated in our hospital between March 2013 and March 2016 were selected and divided into observation group and control group (n=45) according to random number table, control group received mecobalamine treatment alone and observation group accepted the cinepazide combined with mecobalamine therapy. Differences in nerve conduction velocity, vibration perception threshold as well as serum oxidative stress indexes and nerve injury marker molecules were compared between two groups of patients 2 weeks after treatment. Results:2 weeks after treatment, median nerve, ulnar nerve and peroneal nerve sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) levels of observation group were higher than those of control group (P<0.05) while both lower extremities vibration perception threshold (VPT) levels were lower than those of control group (P<0.05). Serum homocysteine (HCY), advanced glycosylation end products (AGEs), malondialdehyde (MDA), neuron-specific enolase (NSE), high mobility group B1 (HMGB1) and S100βcontent of observation group were lower than those of control group (P<0.05) while reduced glutathione (GSH), superoxide dismutase (SOD), myelin basic protein (MBP) and brain-derived neurotrophic factor (BDNF) content were higher than those of control group (P<0.05). Conclusions:Cinepazide combined with mecobalamine can reduce the nerve injury degree, improve nerve conduction and vibration perception and alleviate the oxidative stress degree in patients with diabetic peripheral neuropathy.

Effects of pestle needle on nerve conduction velocity and inflammatory injury in patients with diabetic peripheral neuropathy

Background:Diabetic peripheral neuropathy(DPN)is one of the most common complications of diabetes mellitus.Impaired neurological function is one of the main characteristics of DPN and is strongly associated with the inflammatory response.Our previous studies have confirmed that pestle needle can improve the nerve function of patients with DPN.But the mechanism of pestle needle treatment of DPN is still unclear.Methods:A total of 70 DPN patients who met the inclusion criteria were randomly divided into two groups.Control group(CG)(n=35)received DPN conventional treatment and the pestle needle group(PNG)(n=35)received pestle needle therapy at Zhiyang(DU09)eight array,Mingmen(DU04)eight array and Heche Road(from Mingmen(DU04)to Changqiang(DU01)),Zusanli(ST36),Sanyinjiao(SP06),Taixi(KI03)and Yongquan(KI01).Patients in the PNG group were required to take this treatment for 4 weeks,5 times a week.Examination indexes were collected before and after treatment,respectively.Nerve function was examined using the Toronto clinical scoring system and nerve conduction velocity detection.Serum inflammatory factors were measured by enzyme linked immunosorbent assay.Results:The Toronto clinical scoring system was significantly reduced in the PNG compared with the CG after treatment.The sensory nerve conduction velocity and motor nerve conduction velocity of the right peroneal and median nerves were significantly faster in the PNG than those in the CG(P<0.05).After treatment,serum interleukin-1 beta,interleukin-6 and tumor necrosis factor-alpha levels decreased in both groups,and the improvement of PNG was better than CG(P<0.05).Conclusion:The pestle needle can significantly improve the symptoms and nerve conduction velocity of DPN,and its mechanism may be related to the reduction of inflammatory factors.

Abnormality of peripheral nerve conduction velocity associated with illness course, symptoms and fasting blood glucose in patients with type 2 diabetes mellitus

BACKGROUND: It has shown that abnormality of peripheral nerve conduction velocity during onset of diabetes mellitus is not related to age and sex, but to symptoms, illness course and level of fasting blood glucose. OBJECTIVE: To measure correlation of abnormality of peripheral nerve conduction velocity with various illness courses, symptoms and levels of fasting blood glucose of patients with type 2 diabetes mellitus. DESIGN: Case analysis. SETTING: Department of Neurology, Central People's Hospital of Huizhou. PARTICIPANTS: A total of 128 patients who were diagnosed as type 2 diabetes mellitus were selected from Central People's Hospital of Huizhou from September 2001 to October 2005. There were 75 males and 53 females aged 32-83 years and the illness course ranged from 1 month to 20 years. METHODS: All 128 patients with type 2 diabetes mellitus received neuro-electrophysiological study and their clinical data were retrospectively analyzed to measure peripheral nerve conduction velocity and fasting blood glucose so as to investigate the correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. MAIN OUTCOME MEASURES: Correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. RESULTS: All 128 patients with type 2 diabetes mellitus were involved in the final analysis. ① Among 128 patients, 114 patients had abnormality of peripheral nerve conduction velocity; 110 patients had clinical symptoms, including 102 patients having abnormality of peripheral nerve conduction velocity; 18 patients did not have clinical symptoms, including 12 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=8.275, P =0.04). ② Among 128 patients, illness course of 75 patients was equal to or less than 5 years, including 27 patients having abnormality of peripheral nerve conduction velocity; illness course of 53 patients was more than 5 years, including 35 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=11.469, P =0.003). ③ Among 128 patients, levels of fasting blood glucose of 75 patients was equal to or lower than 11 mmol/L, including 41 patients having abnormality of peripheral nerve conduction velocity; levels of fasting blood glucose of 53 patients was higher than 11 mmol/L, including 38 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=4.023, P =0.134). CONCLUSION: ① Abnormality of peripheral nerve conduction velocity of patients with type 2 diabetes mellitus is related to illness courses and clinical symptoms. The longer the illness course is, the severer the abnormality of peripheral nerve conduction velocity is. Abnormality of peripheral nerve conduction velocity always occurs on patients who have clinical symptoms. ② Abnormality of peripheral nerve conduction velocity is not related to levels of fasting blood glucose.

Effect of electroacupuncture on conduction velocity of the sciatic nerve in experimental diabetic rats and its mechanisms

Objective To investigate the mechanisms of acupuncture in accelerating regeneration of injured sciatic nerve, the effect of electroacupuncture （EA） at ＂Huantiao （环跳 GB 30）＂ and ＂Zusanli （足三里 ST 36）＂ on conduction velocity and mRNA expression of receptors of advanced glycation end products （RAGE） of the sciatic nerve were observed in experimental diabetic rats. Methods Streptozotocin was injected into the left abdomen in 30 male rats to establish diabetes mellitus （DM） models with hyperglycemia （〉16.7 mmol/L）. Thirty rats with DM were divided into a diabetes model group （group DM）, a Methycobal group （group MET） and an EA group （group EA）. Another 8 rats comparable in body weight and age were used as a normal control group （group NC）. General situation and blood sugar levels of all the rats were recorded, and the conduction velocities of the sciatic nerves were measured. RAGE mRNA expression of the sciatic nerve was detected by means of reverse transcription polymerase chain reaction（RT-PCR）16 weeks after treatment. Results After 16 weeks, the conduction velocities of the sciatic nerves were lowered in group DM, compared with those in group NC, indicating lesion of peripheral nerves. Compared with group DM, the conduction velocities of the sciatic nerves were significantly elevated in both group EA and group MET （P〈0.01 ）, and there was a significant difference between the two groups, showing superiority of EA to Methycobal （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in group DM were significantly higher than those in group NC （P〈0.01）. The RAGE mRNA levels of the sciatic nerves in both group EA and group MET were remarkably lowered than those in group DM （P〈0.01）, and the decrease in group EA was more obviously than that in group MET （P〈0.01）. Conclusion EA may exert its therapeutic effects on diabetic perineuropathy （DPN） by way of regulating abnormal expression of RAGE mRNA in the sciatic nerve and alleviating its injury caused by advanced glycation end products （AGEs） accumulation and diminishing oxidative stress to enhance its conduction velocity.

Efficacy and safety of nerve growth factor for the treatment of neurological diseases:a meta-analysis of 64 randomized controlled trials involving 6,297 patients

OBJECTIVE： China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL： A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were ＂nerve growth factor, randomized controlled trials＂ in Chinese and in English. DATA SELECTION： Inclusion criteria： any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES： The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS： Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group （P 〈 0.0001, RR： 1.35, 95%CI： 1.30-1.40）. The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group （P 〈 0.00001, MD. 4.59 m/s, 95%CI： 4.12-5.06）. The incidence of pain or sclero- ma at the injection site in the nerve growth factor group was also higher than that in the control group （P 〈 0.00001, RR： 6.30, 95%CI： 3.53-11.27）, but such adverse effects were mild. CONCLUSION： Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective.

Qian-Zheng-San promotes regeneration after sciatic nerve crush injury in rats

Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San(1.75 g/mL) daily as systemic therapy for 1, 2, 4, or 8 weeks. Rats in the control group were not administered Qian-Zheng-San. Rats in sham group did not undergo surgery and systemic therapy. Footprint analysis was used to assess nerve motor function. Electrophysiological experiments were used to detect nerve conduction function. Immunofluorescence staining was used to assess axon counts and morphological analysis. Immunohistochemical staining was used to observe myelin regeneration of the sciatic nerve and the number of motoneurons in the anterior horn of the spinal cord. At 2 and 4 weeks postoperatively, the sciatic nerve function index, nerve conduction velocity, the number of distant regenerated axons and the axon diameter of the sciatic nerve increased in the Qian-Zheng-San treatment group compared with the control group. At 2 weeks postoperatively, nerve fiber diameter, myelin thickness, and the number of motor neurons in the lumbar spinal cord anterior horn increased in the Qian-Zheng-San treatment group compared with the control group. These results indicate that QianZheng-San has a positive effect on peripheral nerve regeneration.

Transdermal delivery of 4-aminopyridine accelerates motor functional recovery and improves nerve morphology following sciatic nerve crush injury in mice

Oral 4-aminopyridine(4-AP)is clinically used for symptomatic relief in multiple sclerosis and we recently demonstrated that systemic 4-AP had previously unknown clinically-relevant effects after traumatic peripheral nerve injury including the promotion of re-myelination,improvement of nerve conductivity,and acceleration of functional recovery.We hypothesized that,instead of oral or injection administration,transdermal 4-AP(TD-4-AP)could also improve functional recovery after traumatic peripheral nerve injury.Mice with surgical traumatic peripheral nerve injury received TD-4AP or vehicle alone and were examined for skin permeability,pharmacokinetics,functional,electrophysiological,and nerve morphological properties.4-AP showed linear pharmacokinetics and the maximum plasma 4-AP concentrations were proportional to TD-4-AP dose.While a single dose of TD-4-AP administration demonstrated rapid transient improvement in motor function,chronic TD-4-AP treatment significantly improved motor function and nerve conduction and these effects were associated with fewer degenerating axons and thicker myelin sheaths than those from vehicle controls.These findings provide direct evidence for the potential transdermal applicability of 4-AP and demonstrate that 4-AP delivered through the skin can enhance in-vivo functional recovery and nerve conduction while decreasing axonal degeneration.The animal experiments were approved by the University Committee on Animal Research(UCAR)at the University of Rochester(UCAR-2009-019)on March 31,2017.

Intraoperative single administration of neutrophil peptide 1 accelerates the early functional recovery of peripheral nerves after crush injury

Neutrophil peptide 1 belongs to a family of peptides involved in innate immunity. Continuous intramuscular injection of neutrophil peptide 1 can promote the regeneration of peripheral nerves, but clinical application in this manner is not convenient. To this end, the effects of a single intraoperative administration of neutrophil peptide 1 on peripheral nerve regeneration were experimentally observed. A rat model of sciatic nerve crush injury was established using the clamp method. After model establishment, a normal saline group and a neutrophil peptide 1 group were injected with a single dose of normal saline or 10 μg/mL neutrophil peptide 1, respectively. A sham group, without sciatic nerve crush was also prepared as a control. Sciatic nerve function tests, neuroelectrophysiological tests, and hematoxylin-eosin staining showed that the nerve conduction velocity, sciatic functional index, and tibialis anterior muscle fiber cross-sectional area were better in the neutrophil peptide 1 group than in the normal saline group at 4 weeks after surgery. At 4 and 8 weeks after surgery, there were no differences in the wet weight of the tibialis anterior muscle between the neutrophil peptide 1 and saline groups. Histological staining of the sciatic nerve showed no significant differences in the number of myelinated nerve fibers or the axon cross-sectional area between the neutrophil peptide 1 and normal saline groups. The above data confirmed that a single dose of neutrophil peptide 1 during surgery can promote the recovery of neurological function 4 weeks after sciatic nerve injury. All the experiments were approved by the Medical Ethics Committee of Peking University People's Hospital, China(approval No. 2015-50) on December 9, 2015.

Saikosaponin a increases interleukin-10 expression and inhibits scar formation after sciatic nerve injury

Nerve scarring after peripheral nerve injury can severely hamper nerve regeneration and functional recovery.Further,the anti-inflammatory cytokine,interleukin-10,can inhibit nerve scar formation.Saikosaponin a（SSa） is a monomer molecule extracted from the Chinese medicine,Bupleurum.SSa can exert anti-inflammatory effects in spinal cord injury and traumatic brain injury.However,it has not been shown whether SSa can play a role in peripheral nerve injury.In this study,rats were randomly assigned to three groups.In the sham group,the left sciatic nerve was directly sutured after exposure.In the sciatic nerve injury（SNI） ＋ SSa and SNI groups,the left sciatic nerve was sutured and continuously injected daily with SSa（10 mg/kg） or an equivalent volume of saline for 7 days.Enzyme linked immunosorbent assay results demonstrated that at 7 days after injury,interleukin-10 level was considerably higher in the SNI ＋ SSa group than in the SNI group.Masson staining and western blot assay demonstrated that at 8 weeks after injury,type I and III collagen content was lower and nerve scar formation was visibly less in the SNI ＋ SSa group compared with the SNI group.Simultaneously,sciatic functional index and nerve conduction velocity were improved in the SNI ＋ SSa group compared with the SNI group.These results confirm that SSa can increase the expression of the anti-inflammatory factor,interleukin-10,and reduce nerve scar formation to promote functional recovery of injured sciatic nerve.

A novel chronic nerve compression model in the rat

Current animal models of chronic peripheral nerve compression are mainly silicone tube models. However, the cross section of the rat sciatic nerve is not a perfect circle, and there are differences in the diameter of the sciatic nerve due to individual differences. The use of a silicone tube with a uniform internal diameter may not provide a reliable and consistent model. We have established a chronic sciatic nerve compression model that can induce demyelination of the sciatic nerve and lead to atrophy of skeletal muscle. In 3-week-old pups and adult rats, the sciatic nerve of the right hind limb was exposed, and a piece of surgical latex glove was gently placed under the nerve. N-butyl-cyanoacrylate was then placed over the nerve, and after it had set, another piece of glove latex was placed on top of the target area and allowed to adhere to the first piece to form a sandwich-like complex. Thus, a chronic sciatic nerve compression model was produced. Control pups with latex or N-butyl-cyanoacrylate were also prepared. Functional changes to nerves were assessed using the hot plate test and electromyography. Immunofluorescence and electron microscopy analyses of the nerves were performed to quantify the degree of neuropathological change. Masson staining was conducted to assess the degree of fibrosis in the gastrocnemius and intrinsic paw muscles. The pup group rats subjected to nerve compression displayed thermal hypoesthesia and a gradual decrease in nerve conduction velocity at 2 weeks after surgery. Neuropathological studies demonstrated that the model caused nerve demyelination and axonal irregularities and triggered collagen deposition in the epineurium and perineurium of the affected nerve at 8 weeks after surgery. The degree of fibrosis in the gastrocnemius and intrinsic paw muscles was significantly increased at 20 weeks after surgery. In conclusion, our novel model can reproduce the functional and histological changes of chronic nerve compression injury that occurs in humans and it will be a useful new tool for investigating the mechanisms underlying chronic nerve compression.

Boric acid reduces axonal and myelin damage in experimental sciatic nerve injury

The aim of this study was to investigate the effects of boric acid in experimental acute sciatic nerve injury. Twenty-eight adult male rats were randomly divided into four equal groups （n = 7）： control （C）, boric acid （BA）, sciatic nerve injury （I） , and sciatic nerve injury ＋ boric acid treatment （BAI）. Sciatic nerve injury was generated using a Yasargil aneurysm clip in the groups I and BAI. Boric acid was given four times at 100 mg/kg to rats in the groups BA and BAI after injury （by gavage at 0, 24, 48 and 72 hours） but no injury was made in the group BA. In vivo electrophysiological tests were performed at the end of the day 4 and sciatic nerve tissue samples were taken for histopathological examination. The amplitude of compound action potential, the nerve conduction velocity and the number of axons were significantly lower and the myelin structure was found to be broken in group I compared with those in groups C and BA. However, the amplitude of the compound action potential, the nerve conduction velocity and the number of axons were significantly greater in group BAI than in group I. Moreover, myelin injury was significantly milder and the intensity of nuclear factor kappa B immunostaining was significantly weaker in group BAI than in group I. The results of this study show that administration of boric acid at 100 mg/kg after sciatic nerve injury in rats markedly reduces myelin and axonal injury and improves the electrophysiological function of injured sciatic nerve possibly through alleviating oxidative stress reactions.

Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients（65 elbows） diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the Mc Gowan scale as modified by Goldberg： 18 patients（28%） had grade IIA neuropathy, 20（31%） had grade IIB, and 27（42%） had grade III. Postoperatively, according to the Wilson ＆ Krout criteria, treatment outcomes were excellent in 38 patients（58%）, good in 16（25%）, fair in 7（11%）, and poor in 4（6%）, with an excellent and good rate of 83%. A negative correlation was found between the preoperative Mc Gowan grade and the postoperative Wilson ＆ Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

通络糖泰方对糖尿病周围神经病变患者SNCV影响的临床研究

目的:观察通络糖泰方对早期糖尿病周围神经病变(DPN)患者SNCV的影响,并探讨其作用的可能机制。方法:将40名气阴两虚兼瘀血阻络的DPN患者,随机分为治疗组(20例)和对照组(20例),两组患者都给予糖尿病基础治疗,对照组加弥可保口服,每次0.5mg,每日3次,治疗组在保持原糖尿病基础治疗的同时使用以益气养阴、化瘀通络为主要功效的通络糖泰方中药汤剂,每次150mL,每日3次,两组患者疗程均为8周;观察治疗前后患者临床症状体征、空腹血糖、餐后2h血糖、糖化血红蛋白、感觉神经传导速度等指标的变化,并对综合疗效进行评价。结果:本研究显示入选DPN患者中,治疗组显效11例,有效8例,无效1例,显效率为55%,总有效率为95%,对照组显效5例,有效10例,无效5例,显效率为25%,总有效率为75%,患者症状明显改善。治疗组患者FPG、2hPG、HbA1c、SNCV等指标有所下降,较治疗前有显著差异(P<0.05)。对照组无明显改变,两组治疗前后SNCV没有显著改变。结论:通络糖泰方通过整体调节,能够有效改善DPN患者临床症状和体征,改善糖脂代谢,改善神经传导速度,从而起到早期防治DPN的作用,其综合疗效优于对照组。

探讨F波联合SSR和NCV在糖尿病周围神经病早期的诊断价值

目的探讨F波联合皮肤交感反应(SSR)和常规神经传导检测(NCV)对糖尿病周围神经病(DPN)早期的诊断价值。方法对324例2型糖尿病患者,根据有无周围神经症状分为无症状组(103例)、有症状组(221例)及同期对照组(100例),均行正中神经和胫神经F波,四肢感觉、运动神经传导检测(NCV)和SSR检查。分析比较组间F波、NCV和SSR指标的临床特点。结果糖尿病患者下肢运动、感觉神经损害程度重于上肢,且四肢感觉神经异常比例高于运动神经(P<0.05);对糖尿病有症状组、无症状组进行SSR和NCV联合检测,总异常率为90.1%,明显高于单独应用NCV异常率,差异有统计学意义(P<0.05)。与对照组比较,糖尿病(DM)有症状组上肢正中神经F波出现率减少,F波传导速度减慢,下肢胫神经F波出现率减少,F波潜伏期延长。无症状组仅上肢正中神经F波出现率减少。与DM无症状组比较,有症状组上肢正中神经F波传导速度减慢,下肢F波出现率减少,F波潜伏期延长(P<0.05),而上肢F波出现率差异无统计学意义(P>0.05)。对糖尿病组进行NCV、SSR和F波联合检测异常率为93.2%,明显高于单纯NCV检测(P<0.05)。结论糖尿病在早期无症状时即存在周围神经损害,以小纤维受累为主,F波、SSR联合NCV检测能有效弥补NCV不能反映自主神经小纤维和运动神经近端功能的不足,提高对DPN的早期诊断。

MEP、NCV、FW在突眼性甲状腺肿中的应用

目的:了解突眼性甲状腺肿患者感觉传入神经以及运动传出通路(包括运动中枢、脊髓、神经根和远、近端周围神经)的功能状态。方法:对44例突眼性甲状腺肿患者采用表面电极法常规顺向检测正中神经和胫后神经共88条神经感觉传导速度(SCV)、运动末端潜伏期(DL)及波幅,F波(FW)潜伏期及出现率。并在88条尺神经和腓总神经从中枢至外周传出通路不同部位予以磁刺激,分别在小指展肌和胫前肌记录复合肌肉动作电位,分别测定各段潜伏期和中枢运动传导时间(CMCT)。结果:88条正中神经和胫后神经中有16条(18%)SCV减慢或波幅降低,12条(14%)ML延长或波幅降低。4条FW潜伏期延长,4条FW出现率降低。88条尺神经和腓总神经运动诱发电位(MEP)检查中有34条(39%)波幅降低,各节段潜伏期和CMCT均未见异常。结论:NCV、FW、MEP联合检测对判断突眼性甲状腺肿是否合并神经病变具有较重要作用。

Effects of Head-down Tilt on Nerve Conduction in Rhesus Monkeys

Background： Few studies have focused on peripheral nerve conduction during exposure to microgravity. The -6° head-down tilt （HDT） comprises an experimental model used to simulate the space flight environment. This study investigated nerve conduction characteristics of rhesus monkeys before and alter prolonged exposure to H DT. Methods： Six rhesus monkeys （3-4 years old） were tilted backward 6° from the horizontal. Nerve conduction studies （NCSs） were performed on the median, ulnar, tibial, and fibular motor nerves. Analysis of variance with a randomized block design was conducted to compare the differences in the NCS belbre and 7, 2 l, and 42 days alter the 6° HDT. Results： The proximal amplitude of the CMAP of the median nerve was significantly decreased at 21 and 42 days of HDT compared with the amplitude before HDT （4.38 ± 2.83 vs. 8.40 ±2.66 mV, F = 4.85, P = 0.013 and 3.30± 2.70 vs. 8.40± 2.66 mV, F = 5.93, P = 0.004, respectively）. The distal amplitude of the CMAP of the median nerve was significantly decreased at 7, 21, and 42 days of HDT compared with the amplitude before HDT （7.28 ± 1.27 vs. 10.25 ± 3.40 mV, F= 4.03, P = 0.039; 5.05 ± 2.01 vs. 10.25 ± 3.40 mV, F = 6.25, P = 0.04; and 3.95 ± 2.79 vs. 10.25 ± 3.40 mV, F = 7.35, F=- 0.01; respectively）. The proximal amplitude of the CMAP of the tibial nerve was significantly decreased at 42 days of HDT compared with the amplitude betbre HDT （6.14± 1.94 vs. 11.87± 3.19 mV, F = 5.02, P = 0.039）. Conclusions： This study demonstrates that the compound muscle action potential amplitudes of nerves are decreased under simulated microgravity in rhesus monkeys. Moreover, rhesus monkeys exposed to HDT might be served as an experimental model for the study of NCS under microgravity.

双黄通络饮对糖尿病周围神经病变及其NCV的影响

目的:观察双黄通络饮对气虚血瘀型糖尿病周围神经病变(DPN)患者神经传导速度(NCV)的影响以及临床疗效。方法:将68例DPN患者随机分为两组,对照组(34例):硫辛酸注射液300mg加入250ml生理盐水静脉滴注,每日一次;治疗组(34例):口服双黄通络饮汤剂,日1剂,疗程均为2周。观察两组治疗前后症状的改善以及患者NCV指标变化情况。结果:治疗组总有效率分别为85.3%、79.4%,治疗组显著高于对照组(P<0.05)。组间比较NCV改善基本相当(P>0.05)。结论:双黄通络饮治疗DPN疗效肯定,对患者神经传导速度的影响与硫辛酸一致。

硫辛酸注射液联合二甲双胍缓释片对糖尿病周围神经病患者NCV及氧化应激反应的影响

目的：观察硫辛酸注射液联合二甲双胍缓释片对糖尿病周围神经病（DPN）患者神经传导速度（NCV）及氧化应激反应的影响。方法：选择2013年4月～2015年4月收治的110例DPN患者为研究对象，采用随机数字表法分为观察组和对照组各55例。在常规控制血糖的同时，对照组给予二甲双胍缓释片治疗，观察组采用硫辛酸注射液联合二甲双胍缓释片治疗，比较两组临床症状改善情况、NCV变化。结果：治疗效果：观察组总有效率96％明显高于对照组85％（x2=3．960，P〈0．05）；临床症状：观察组下肢与足部疼痛、感觉异常、灼热感评分明显低于对照组（t=3．245～5．638，P〈0．05）；NCV：观察组正中神经、腓总神经MCV、SCV均明显快于对照组（t=4．126～7．325，P〈0．05）。结论：硫辛酸注射液联合二甲双胍缓释片能有助于缓解患者的临床症状，促进MCV和SCV的恢复，减轻氧化应激反应，提高治疗效果。

应用MEP、NCV联合诊断糖尿病性神经病

目的 :探讨运动诱发电位 (MEP)、神经传导速度 (NCV)检测对糖尿病 (DM)运动神经中枢及神经根、周围神经病变的诊断价值。方法 :检测 5 0例DM病人的MEP及NCV。结果 :MEP异常率 82 %(4 1/ 5 0 )。表现皮层、脊髓刺激MEP潜伏期延迟、波形分化欠佳 ,部分伴有中枢运动传导时间 (CMCT)异常。MEP异常率与病程长短呈正相关 ;空腹血糖水平对MEP结果无明显影响。NCV异常率 70 % ,主要表现运动神经传导速度 (MCV)、感觉神经传导速度 (SCV)减慢。结论 :MEP、NCV检查对诊断DM的锥体束功能损害及神经根、周围神经病变有重要价值 ,二者结合可对DM的神经系统功能提供全面客观指标。

依帕司他联合丁苯酞软胶囊对痛性糖尿病周围神经病变患者的影响

目的:分析依帕司他联合丁苯酞软胶囊对痛性糖尿病周围神经病变(PDPN)患者的影响。方法:选取2021年2月—2022年2月通城县人民医院收治的80例PDPN患者作为研究对象,根据掷硬币法将患者分为对照组和研究组,各40例。对照组给予依帕司他,研究组在对照组基础上给予丁苯酞软胶囊,比较两组临床疗效、不良反应、疼痛程度[视觉模拟评分法(VAS)]、正中神经、腓总神经、尺神经的感觉神经传导速度(SNCV)、运动神经传导速度(MNCV)及氧化应激指标[超氧化物歧化酶(SOD),丙二醛(MDA)]水平。结果:研究组临床总有效率高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);治疗1个月后,两组VAS评分低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗1个月后,两组正中神经、腓总神经、尺神经的SNCV和MNCV较治疗前提高,且研究组高于对照组,差异有统计学意义(P<0.05);治疗1个月后,两组SOD和MDA水平较治疗前改善,且研究组SOD水平高于对照组,MDA水平低于对照组,差异有统计学意义(P<0.05)。结论:依帕司他与丁苯酞软胶囊联合治疗PNDN,临床疗效好,不良反应发生率较低,能显著降低疼痛程度,提高正中神经、腓总神经、尺神经SNCV和MNCV,改善SOD和MDA水平。