Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN...Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.展开更多
目的通过系统评价探讨中国人群2型糖尿病周围神经病变相关危险因素。方法计算机系统检索PubMed、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)和万方科技期刊全文数据库(WanFang)中的中国人...目的通过系统评价探讨中国人群2型糖尿病周围神经病变相关危险因素。方法计算机系统检索PubMed、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)和万方科技期刊全文数据库(WanFang)中的中国人群2型糖尿病周围神经病变危险因素的相关研究,检索时间限定为2000年1月~2020年2月,同时补充检索纳入文献的参考文献。由两名评价者根据纳入、排除标准进行独立选择文献、提取资料、评价质量后,采用Rev Man 5.3软件进行系统评价,用固定效应模型或随机效应模型合并OR值及95%可信区间(CI)分析各个相关危险因素,采用敏感性分析评估结果的稳定性,用漏斗图评估文献的发表偏倚。结果共纳入文献12篇,总样本量为7886例。纳入分析的危险因素共10个,分别为年龄、糖化血红蛋白、糖尿病病程、空腹血糖、餐后2 h血糖、收缩压、舒张压、总胆固醇、三酰甘油、体重指数。结果显示,年龄、糖尿病病程、糖化血红蛋白、空腹血糖是影响糖尿病周围神经病变发生的危险因素。结论初步确定年龄、糖尿病病程、糖化血红蛋白、空腹血糖是影响糖尿病周围神经病变发生的重要独立危险因素,为临床上糖尿病周围神经病变发生的早期防预提供重要依据。展开更多
<strong>Introduction:</strong> <span style="font-family:Verdana;">Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setti...<strong>Introduction:</strong> <span style="font-family:Verdana;">Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setting. Oxaliplatin can cause a chronic peripheral sensory neuropathy which impacts</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">the quality of life and is dose limiting. To date, no therapeutic strategies have proved effective in the treatment of oxaliplatin-induced peripheral neuropathy (OIPN). </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A computerized search of the literature on PubMed database was performed. Publisher original articles were included if they focused on treatment of peripheral neuropathy among patients submitted to oxaliplatin. Eleven out of 242 reviewed papers met our inclusion criteria and were subjected to a 19-item quality checklist. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The included studies differed with respect to study design, patient population and sample size, neuropathic symptoms assessment and efficacy measure. Most studies had an</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">adequate quality. Ten trials tested one drug, and one pilot study tested a non-pharmacological treatment</span><span style="font-family:Verdana;">—</span><span style="font-family:Verdana;">the neurofeedback. Of these, 3 trials included only patients submitted to oxaliplatin-based chemotherapy. Duloxetine showed moderate efficacy in 3 trials. Topical treatment with capsaicin or 10% amitriptyline was promisors in 2 single-arm trials with a </span><span style="font-family:Verdana;">few </span><span style="font-family:Verdana;">sample</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Conclusion展开更多
Neuromuscular ultrasound(NMUS) is a rapidly evolving technique used in neuromuscular medicine to provide complimentary information to standard electrodiagnostic studies. NMUS provides a dynamic, real time assessment o...Neuromuscular ultrasound(NMUS) is a rapidly evolving technique used in neuromuscular medicine to provide complimentary information to standard electrodiagnostic studies. NMUS provides a dynamic, real time assessment of anatomy which can alter both diagnostic and management pathways in peripheral nerve disorders. This review describes the current and future techniques used in NMUS and details the applications and developments in the diagnosis and monitoring of compressive, hereditary, immune-mediated and axonal peripheral nerve disorders, and motor neuron diseases. Technological advances have allowed the increased utilisation of ultrasound for management of peripheral nerve disorders;however, several practical considerations need to be taken into account to facilitate the widespread uptake of this technique.展开更多
<span style="font-family:Verdana;">A-TNF inhibitors are increasingly used in various inflammatory disorders. Multiple side effects have been reported in recent years, particularly peripheral neuropathi...<span style="font-family:Verdana;">A-TNF inhibitors are increasingly used in various inflammatory disorders. Multiple side effects have been reported in recent years, particularly peripheral neuropathies. We report a case of axonal neuropathy occurring after the start of treatment with Infliximab. This is a 47 years old patient, followed for Crohn</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s disease requiring treatment with Infliximab. Twenty-two weeks later, the patient presented a grade 4 of axonal neuropathy. We concluded to a medicinal sensitive neuropathy after elimination of other etiologies.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Given the severity of the neurological symptoms, we decided to change the therapeutic class.展开更多
Peripheral Neuropathy (PN) commonly arises as HIV related nerve complication. The study made attempts to assess the underlying factors leading to peripheral neuropathy, the disabling effects of peripheral neuropathy o...Peripheral Neuropathy (PN) commonly arises as HIV related nerve complication. The study made attempts to assess the underlying factors leading to peripheral neuropathy, the disabling effects of peripheral neuropathy on a patient’s life quality and measures which can be implemented to prevent or lessen the burdening effects of these neuropathies. A descriptive design was adopted where cross-sectional data targeting a sample of 100 consenting adult HIV/AIDS clients were collected utilizing structured questionnaires as key instruments of data collection. In this study variables such as age, height, the past and current CD4 lymphocytes, the viral load, the average duration of antiretroviral treatment (ART), use and the presence of certain co-infection, diabetes or alcohol abuse were analyzed to determine their effects of occurrence of peripheral neuropathy. Fifty eight percent (58%) of the clients were classified to be having neuropathic as compared 42% who did not have neuropathic pain. Duration of diagnosis with HIV and previous CD4 count did not significantly determine the occurrence of neuropathic pain. Viral load at time of diagnosis with HIV;nutritional uptake and HAART regimen significantly contribute to occurrence of PN among HIV/AIDS clients. There was no significant association between cases of peripheral neuropathy and demographic factors such as age, gender, height of the respondents and level of education. Clients with peripheral neuropathy were not receiving adequate health talks on peripheral neuropathy. Effect of PN on physical activity was observed. There is need for providing both medical and palliative treatment to HIV/AIDS patients suffering from peripheral neuropathy.展开更多
Parkinson's disease(PD)is a chronic,progressive neurodegenerative disease affecting about 2%-3% of population above the age of 65.In recent years,Parkinson's research has mainly focused on motor and non-motor ...Parkinson's disease(PD)is a chronic,progressive neurodegenerative disease affecting about 2%-3% of population above the age of 65.In recent years,Parkinson's research has mainly focused on motor and non-motor symptoms while there are limited studies on neurodegeneration which is associated with balance problems and increased incidence of falls.Corneal confocal microscopy(CCM)is a real-time,non-invasive,in vivo ophthalmic imaging technique for quantifying nerve damage in peripheral neuropathies and central neurodegenerative disorders.CCM has shown significantly lower corneal nerve fiber density(CNFD)in patients with PD compared to healthy controls.Reduced CNFD is associated with decreased intraepidermal nerve fiber density in PD.This review provides an overview of the ability of CCM to detect nerve damage associated with PD.展开更多
A patient with Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis presented with quadriplegia and multiple peripheral neuropathy with axonal lesion,confirmed by electrophysiological examination.The muscle strength ...A patient with Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis presented with quadriplegia and multiple peripheral neuropathy with axonal lesion,confirmed by electrophysiological examination.The muscle strength in the limbs of the patient gradually recovered almost completely,accompanied by the reversal of neuroelectrophysiological symptoms,and the improvement of clinical manifestations,including consciousness,respiration and cognitive function.It was revealed that the neuropathy in NMDAR encephalitis involved motor or sensorimotor nerves more than pure sensory nerves.No autoantibodies were detectable,in contrast to other anti-NMDAR overlapping syndromes.Although the underlying mechanism remains unclear,it may be associated with autoimmune generalization.In conclusion,when patients with NMDAR encephalitis present with severe limb paralysis,the possibility of peripheral nerve damage should be considered.展开更多
Objective:To investigate protective effects of hirudin on oxidative stress and apoptosis of spinal dorsal root ganglion cells in high-glucose rats at the cellular and molecular level.Methods:Dorsal root ganglion neuro...Objective:To investigate protective effects of hirudin on oxidative stress and apoptosis of spinal dorsal root ganglion cells in high-glucose rats at the cellular and molecular level.Methods:Dorsal root ganglion neurons(DRGn)were harvested from embryonic day in 15 SD rats,purified and identificated after primary culture.They were divided into the normal control group,high-glucose(HG)group,positive control(alpha-lipoic acid,ALA)group,low-dose hirudin group(H1),medium-dose hirudin group(H2)and high-dose hirudin group(H3).The control group was cultured by neuron specific culture medium,while the HG group was cultured by neuron specific culture medium and 20 mmol/L glucose(HG medium).The hirudin groups were cultured by HG medium+0.25 IU/mL hirudin(H1),HG medium+0.5 IU/mL hirudin(H2)and HG medium+1 IU/mL hirudin(H3).The ALA group was cultured by HG medium +100μmol/L ALA.3-(4,5-dimethylthiazol-2-yl)-2,5-diphenylt etrazolium bromide(MTT)assay was used to explore the optimum concentration and intervention time.Flow cytometry assay was used to detect the level of reactive oxygen series(ROS).Western blot and quantificational realtime polymerase chain reaction(qRT-PCR)were used to detect the expression of protein and mRNA of nuclear factor erythroid 2-related factor 2(Nrf-2),hemeoxygence-1(HO-1),nuclear factor-κB(NF-κB)and Caspase-3.TUNEL assay was used to test the apoptosis rate of different groups.Results:After 24 h of culture,the cell activity of hirudin and ALA groups were higher than that of HG group,and there was a statistical difference between the H1 group and HG group(P<0.05).In hirudin groups,the apoptosis rate of cells,the expression of activated Caspase-3 protein and Caspase-3 mRNA were lower than those of HG group(P<0.01),higher than those of ALA group(P<0.01 or P<0.05).The ROS level of hirudin groups was higher than that of ALA group(P<0.01),lower than that of HG group(P<0.01 or P<0.05).The expression of NF-κB(P65)protein in H3 group were lower than those of HG group(P<0.05).The expression of Nrf-2 protein展开更多
基金Supported by Zhejiang Province Traditional Chinese Medicine Scientific Research Fund Project(No.2015ZA094)。
文摘Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.
文摘目的通过系统评价探讨中国人群2型糖尿病周围神经病变相关危险因素。方法计算机系统检索PubMed、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)和万方科技期刊全文数据库(WanFang)中的中国人群2型糖尿病周围神经病变危险因素的相关研究,检索时间限定为2000年1月~2020年2月,同时补充检索纳入文献的参考文献。由两名评价者根据纳入、排除标准进行独立选择文献、提取资料、评价质量后,采用Rev Man 5.3软件进行系统评价,用固定效应模型或随机效应模型合并OR值及95%可信区间(CI)分析各个相关危险因素,采用敏感性分析评估结果的稳定性,用漏斗图评估文献的发表偏倚。结果共纳入文献12篇,总样本量为7886例。纳入分析的危险因素共10个,分别为年龄、糖化血红蛋白、糖尿病病程、空腹血糖、餐后2 h血糖、收缩压、舒张压、总胆固醇、三酰甘油、体重指数。结果显示,年龄、糖尿病病程、糖化血红蛋白、空腹血糖是影响糖尿病周围神经病变发生的危险因素。结论初步确定年龄、糖尿病病程、糖化血红蛋白、空腹血糖是影响糖尿病周围神经病变发生的重要独立危险因素,为临床上糖尿病周围神经病变发生的早期防预提供重要依据。
文摘<strong>Introduction:</strong> <span style="font-family:Verdana;">Oxaliplatin is a platinum-derivative chemotherapeutic agent used in digestive tumours, in the adjuvant and metastatic setting. Oxaliplatin can cause a chronic peripheral sensory neuropathy which impacts</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">the quality of life and is dose limiting. To date, no therapeutic strategies have proved effective in the treatment of oxaliplatin-induced peripheral neuropathy (OIPN). </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A computerized search of the literature on PubMed database was performed. Publisher original articles were included if they focused on treatment of peripheral neuropathy among patients submitted to oxaliplatin. Eleven out of 242 reviewed papers met our inclusion criteria and were subjected to a 19-item quality checklist. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The included studies differed with respect to study design, patient population and sample size, neuropathic symptoms assessment and efficacy measure. Most studies had an</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">adequate quality. Ten trials tested one drug, and one pilot study tested a non-pharmacological treatment</span><span style="font-family:Verdana;">—</span><span style="font-family:Verdana;">the neurofeedback. Of these, 3 trials included only patients submitted to oxaliplatin-based chemotherapy. Duloxetine showed moderate efficacy in 3 trials. Topical treatment with capsaicin or 10% amitriptyline was promisors in 2 single-arm trials with a </span><span style="font-family:Verdana;">few </span><span style="font-family:Verdana;">sample</span><span style="font-family:Verdana;">s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Conclusion
文摘Neuromuscular ultrasound(NMUS) is a rapidly evolving technique used in neuromuscular medicine to provide complimentary information to standard electrodiagnostic studies. NMUS provides a dynamic, real time assessment of anatomy which can alter both diagnostic and management pathways in peripheral nerve disorders. This review describes the current and future techniques used in NMUS and details the applications and developments in the diagnosis and monitoring of compressive, hereditary, immune-mediated and axonal peripheral nerve disorders, and motor neuron diseases. Technological advances have allowed the increased utilisation of ultrasound for management of peripheral nerve disorders;however, several practical considerations need to be taken into account to facilitate the widespread uptake of this technique.
文摘<span style="font-family:Verdana;">A-TNF inhibitors are increasingly used in various inflammatory disorders. Multiple side effects have been reported in recent years, particularly peripheral neuropathies. We report a case of axonal neuropathy occurring after the start of treatment with Infliximab. This is a 47 years old patient, followed for Crohn</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s disease requiring treatment with Infliximab. Twenty-two weeks later, the patient presented a grade 4 of axonal neuropathy. We concluded to a medicinal sensitive neuropathy after elimination of other etiologies.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Given the severity of the neurological symptoms, we decided to change the therapeutic class.
文摘Peripheral Neuropathy (PN) commonly arises as HIV related nerve complication. The study made attempts to assess the underlying factors leading to peripheral neuropathy, the disabling effects of peripheral neuropathy on a patient’s life quality and measures which can be implemented to prevent or lessen the burdening effects of these neuropathies. A descriptive design was adopted where cross-sectional data targeting a sample of 100 consenting adult HIV/AIDS clients were collected utilizing structured questionnaires as key instruments of data collection. In this study variables such as age, height, the past and current CD4 lymphocytes, the viral load, the average duration of antiretroviral treatment (ART), use and the presence of certain co-infection, diabetes or alcohol abuse were analyzed to determine their effects of occurrence of peripheral neuropathy. Fifty eight percent (58%) of the clients were classified to be having neuropathic as compared 42% who did not have neuropathic pain. Duration of diagnosis with HIV and previous CD4 count did not significantly determine the occurrence of neuropathic pain. Viral load at time of diagnosis with HIV;nutritional uptake and HAART regimen significantly contribute to occurrence of PN among HIV/AIDS clients. There was no significant association between cases of peripheral neuropathy and demographic factors such as age, gender, height of the respondents and level of education. Clients with peripheral neuropathy were not receiving adequate health talks on peripheral neuropathy. Effect of PN on physical activity was observed. There is need for providing both medical and palliative treatment to HIV/AIDS patients suffering from peripheral neuropathy.
基金This study was supported by Henan Medical Science and Technology Project(201503153)Talent project of Henan Provincial People's Hospital(23456-4).
文摘Parkinson's disease(PD)is a chronic,progressive neurodegenerative disease affecting about 2%-3% of population above the age of 65.In recent years,Parkinson's research has mainly focused on motor and non-motor symptoms while there are limited studies on neurodegeneration which is associated with balance problems and increased incidence of falls.Corneal confocal microscopy(CCM)is a real-time,non-invasive,in vivo ophthalmic imaging technique for quantifying nerve damage in peripheral neuropathies and central neurodegenerative disorders.CCM has shown significantly lower corneal nerve fiber density(CNFD)in patients with PD compared to healthy controls.Reduced CNFD is associated with decreased intraepidermal nerve fiber density in PD.This review provides an overview of the ability of CCM to detect nerve damage associated with PD.
文摘A patient with Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis presented with quadriplegia and multiple peripheral neuropathy with axonal lesion,confirmed by electrophysiological examination.The muscle strength in the limbs of the patient gradually recovered almost completely,accompanied by the reversal of neuroelectrophysiological symptoms,and the improvement of clinical manifestations,including consciousness,respiration and cognitive function.It was revealed that the neuropathy in NMDAR encephalitis involved motor or sensorimotor nerves more than pure sensory nerves.No autoantibodies were detectable,in contrast to other anti-NMDAR overlapping syndromes.Although the underlying mechanism remains unclear,it may be associated with autoimmune generalization.In conclusion,when patients with NMDAR encephalitis present with severe limb paralysis,the possibility of peripheral nerve damage should be considered.
基金the National Natural Science Foundation of China(No.81473639)Beijing Natural Science Foundation(No.7122147)the Special Scientific Research Fund for Doctoral Subjects in Universities and Colleges(No.20121106110003)。
文摘Objective:To investigate protective effects of hirudin on oxidative stress and apoptosis of spinal dorsal root ganglion cells in high-glucose rats at the cellular and molecular level.Methods:Dorsal root ganglion neurons(DRGn)were harvested from embryonic day in 15 SD rats,purified and identificated after primary culture.They were divided into the normal control group,high-glucose(HG)group,positive control(alpha-lipoic acid,ALA)group,low-dose hirudin group(H1),medium-dose hirudin group(H2)and high-dose hirudin group(H3).The control group was cultured by neuron specific culture medium,while the HG group was cultured by neuron specific culture medium and 20 mmol/L glucose(HG medium).The hirudin groups were cultured by HG medium+0.25 IU/mL hirudin(H1),HG medium+0.5 IU/mL hirudin(H2)and HG medium+1 IU/mL hirudin(H3).The ALA group was cultured by HG medium +100μmol/L ALA.3-(4,5-dimethylthiazol-2-yl)-2,5-diphenylt etrazolium bromide(MTT)assay was used to explore the optimum concentration and intervention time.Flow cytometry assay was used to detect the level of reactive oxygen series(ROS).Western blot and quantificational realtime polymerase chain reaction(qRT-PCR)were used to detect the expression of protein and mRNA of nuclear factor erythroid 2-related factor 2(Nrf-2),hemeoxygence-1(HO-1),nuclear factor-κB(NF-κB)and Caspase-3.TUNEL assay was used to test the apoptosis rate of different groups.Results:After 24 h of culture,the cell activity of hirudin and ALA groups were higher than that of HG group,and there was a statistical difference between the H1 group and HG group(P<0.05).In hirudin groups,the apoptosis rate of cells,the expression of activated Caspase-3 protein and Caspase-3 mRNA were lower than those of HG group(P<0.01),higher than those of ALA group(P<0.01 or P<0.05).The ROS level of hirudin groups was higher than that of ALA group(P<0.01),lower than that of HG group(P<0.01 or P<0.05).The expression of NF-κB(P65)protein in H3 group were lower than those of HG group(P<0.05).The expression of Nrf-2 protein