Peripheral neuropathy

周围神经病变
  • 文章类型: Journal Article
    已发现内脏脂肪面积(VFA)水平与胰岛素抵抗(IR)等各种疾病有很强的相关性,炎症,氧化应激,代谢综合征(MetS),高脂血症,糖尿病,和它的血管并发症。这些并发症包括高血压,心血管疾病,糖尿病视网膜病变(DR),白蛋白尿,和心血管自主神经功能障碍,这被认为是糖尿病神经病变的主要类型之一。本研究旨在探讨2型糖尿病(T2DM)患者内脏脂肪与周围神经病变的相关性。
    对我院收治的2型糖尿病患者的临床资料进行回顾性分析。排除28例之后,共纳入488名患者,分为周围神经病变组(207例)和无周围神经病变对照组(281例)。VFA与DPN的存在之间的相关性使用相关性和多逻辑回归分析进行评估。
    就一般信息而言,与对照组相比,周围神经病变组的BMI较低,但糖尿病病程较长.关于生化指标,周围神经病组的VFA较低,FPG和HbA1c水平较高(均P<0.05)。Spearman相关分析显示VFA、2型糖尿病患者存在周围神经病变(P<0.05)。Logistic回归分析表明,VFA,糖尿病的持续时间,HbA1c水平是2型糖尿病患者周围神经病变发生的影响因素(P<0.05)。
    这项研究揭示了2型糖尿病患者内脏脂肪与周围神经病变之间的相关性,强调监测此类患者内脏脂肪的重要性。除了较低水平的VFA,糖尿病病程和糖化血红蛋白(HbA1c)水平等因素也与T2DM患者的周围神经病变相关.
    UNASSIGNED: Visceral fat area (VFA) levels have been found to exhibit a strong association with various conditions such as insulin resistance (IR), inflammation, oxidative stress, metabolic syndrome (MetS), hyperlipidemia, diabetes, and its vascular complications. These complications include hypertension, cardiovascular disease, diabetic retinopathy (DR), albuminuria, and cardiovascular autonomic dysfunction, which is considered one of the main types of diabetic neuropathy. This study aimed to investigate the correlation between visceral fat and peripheral neuropathy in patients with type 2 diabetes (T2DM).
    UNASSIGNED: A retrospective analysis of clinical data of patients diagnosed with type 2 diabetes admitted to our hospital was conducted. After excluding 28 cases, a total of 488 patients were included, divided into the group with peripheral neuropathy (207 cases) and the control group without peripheral neuropathy (281 cases). The correlation between VFA and the presence of DPN was assessed using correlation and multiple logistic regression analyses.
    UNASSIGNED: In terms of general information, the group with peripheral neuropathy had lower BMI but longer duration of diabetes compared to the control group. Regarding biochemical indicators, VFA were lower in the group with peripheral neuropathy, while FPG and HbA1c levels were higher (all P<0.05). Spearman correlation analysis showed a negative correlation between VFA, and the presence of peripheral neuropathy in patients with type 2 diabetes (P<0.05). Logistic regression analysis indicated that VFA, duration of diabetes, and HbA1c level were influencing factors for the occurrence of peripheral neuropathy in patients with type 2 diabetes (P<0.05).
    UNASSIGNED: This study revealed a correlation between visceral fat and peripheral neuropathy in patients with type 2 diabetes, highlighting the importance of monitoring visceral fat in such patients. In addition to lower levels of VFA, factors such as duration of diabetes and glycated hemoglobin (HbA1c) level were also associated with peripheral neuropathy in patients with T2DM.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    IgLON5自身免疫是一种新型抗体介导的疾病,其特征是血清和/或脑脊液(CSF)对IgLON5抗体呈阳性。抗IgLON5疾病主要表现为睡眠障碍,运动障碍和脑干综合征。在这项研究中,我们报告了一例抗IgLON5疾病的患者,他表现为腹胀,腹痛,间歇性排尿困难和便秘,四肢间歇性闪电疼痛,抗IgLON5病不典型,易导致误诊。在进行自身抗体筛查后,我们考虑抗IgLON5病。患者开始接受静脉注射地塞米松的免疫治疗,静脉注射免疫球蛋白(IVIG)和口服硫唑嘌呤。治疗后,这些表现几乎解决了。抗IgLON5疾病的临床表现是多样的,可能存在不同的组合,这很容易导致误诊。早期识别和使用免疫抑制剂治疗这种自身免疫性疾病可能会导致更好的结果。
    IgLON5 autoimmunity is a novel antibody-mediated disorder characterized by serum and/or cerebrospinal fluid (CSF) positivity for IgLON5 antibody. Anti-IgLON5 disease mainly manifests as sleep disturbances, movement disorders and brainstem syndromes. In this study, we report the case of a patient with anti-IgLON5 disease who presented with abdominal distension, abdominal pain, intermittent dysuria and constipation, and intermittent lightning pain in the extremities, which are atypical of anti-IgLON5 disease and could easily lead to misdiagnosis. After performing autoantibody screening, we considered anti-IgLON5 disease. The patient was started on a course of immunotherapy with intravenous dexamethasone, intravenous immunoglobulin (IVIG) and oral azathioprine. Following treatment, the manifestations nearly resolved. The clinical manifestations of anti-IgLON5 disease are diverse and may present in different combinations, which can easily lead to misdiagnosis. Early recognition and treatment of this autoimmune disease with immunosuppressive agents may lead to better outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    化疗与免疫疗法的组合已逐渐显示出增加T细胞浸润和抗肿瘤功效的实质性希望。然而,紫杉醇联合免疫检查点抑制剂靶向PD-1/PD-L1仅用于治疗一小部分转移性三阴性乳腺癌(TNBC),临床结局非常有限.此外,该方案不能预防紫杉醇诱导的周围神经病变.因此,迫切需要一种新的靶点来增强紫杉醇的抗肿瘤活性,并缓解化疗引起的乳腺癌周围神经病变.这里,我们发现,在紫杉醇为基础的化疗后,Dickkopf-1(DKK1)在人乳腺癌多重亚型中的表达上调.机制研究显示紫杉醇通过诱导乳腺癌细胞EGFR信号通路促进DKK1表达,DKK1的上调可能通过抑制肿瘤微环境中CD8+T细胞的浸润和活性而阻碍紫杉醇的疗效。此外,紫杉醇在荷瘤小鼠中的治疗还通过激活原发性感觉背根神经节(DRG)神经元中的EGFR信号来增加DKK1的表达,导致周围神经病变的发展,其特征是坐骨神经的髓鞘损伤,神经性疼痛,和后爪皮肤的皮肤神经支配丧失。抗DKK1抗体的加入不仅改善了紫杉醇在乳腺癌的两种鼠亚型模型中的治疗功效,而且减轻了紫杉醇诱导的周围神经病变。一起来看,我们的研究结果提供了一种具有低神经毒性的潜在化学免疫治疗策略,该策略可使多种亚型乳腺癌患者受益.
    Chemotherapy in combination with immunotherapy has gradually shown substantial promise to increase T cell infiltration and antitumor efficacy. However, paclitaxel in combination with immune checkpoint inhibitor targeting PD-1/PD-L1 was only used to treat a small proportion of metastatic triple-negative breast cancer (TNBC), and the clinical outcomes was very limited. In addition, this regimen cannot prevent paclitaxel-induced peripheral neuropathy. Therefore, there was an urgent need for a novel target to enhance the antitumor activity of paclitaxel and alleviate chemotherapy-induced peripheral neuropathy in breast cancer. Here, we found that Dickkopf-1 (DKK1) expression was upregulated in multiply subtypes of human breast cancer specimens after paclitaxel-based chemotherapy. Mechanistic studies revealed that paclitaxel promoted DKK1 expression by inducing EGFR signaling in breast cancer cells, and the upregulation of DKK1 could hinder the therapeutic efficacy of paclitaxel by suppressing the infiltration and activity of CD8+ T cells in tumor microenvironment. Moreover, paclitaxel treatment in tumor-bearing mice also increased DKK1 expression through the activation of EGFR signaling in the primary sensory dorsal root ganglion (DRG) neurons, leading to the development of peripheral neuropathy, which is charactered by myelin damage in the sciatic nerve, neuropathic pain, and loss of cutaneous innervation in hindpaw skin. The addition of an anti-DKK1 antibody not only improved therapeutic efficacy of paclitaxel in two murine subtype models of breast cancer but also alleviated paclitaxel-induced peripheral neuropathy. Taken together, our findings providing a potential chemoimmunotherapy strategy with low neurotoxicity that can benefit multiple subtypes of breast cancer patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    一名19岁男子反复出现间歇性发烧,进行性四肢无力,麻木,萎缩了5年.腓肠神经活检,脾,脾淋巴结,骨髓和唇腺显示单形小淋巴细胞弥漫性浸润,并且有大量有髓神经纤维严重丧失。免疫组织化学,这些细胞主要是CD8阳性T细胞,对CD3和CD57呈阳性。该患者被诊断为惰性CD8阳性T淋巴细胞增生性疾病(惰性CD8阳性T-LPD),强调在这些条件下需要广泛的鉴别诊断,并进行神经活检。
    A 19-year-old man presented with recurrent intermittent fever, progressive limbs weakness, numbness, and atrophy for 5 years. Biopsy of the sural nerve, spleen, lymph nodes, bone marrow and labial gland revealed that monomorphic small lymphoid cells infiltrated diffusely and that there was severe loss of large myelinated nerve fibers. Immunohistochemically, these cells were mainly CD8-positive T cells and were positive for CD3 and CD57. This patient was diagnosed as indolent CD8-positive T lymphoproliferative disorder (indolent CD8-positive T-LPD), emphasizing the need for a broad differential diagnosis under these conditions, and nerve biopsy should be performed.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    由于有效药物的可获得性有限,耐多药结核病(MDR-TB)和广泛耐药前结核病(Pre-XDR-TB)的治疗仍然具有挑战性。利奈唑胺已成为这些病例的有希望的治疗选择。然而,它的长期使用会导致并发症,如周围和视神经病变。针灸,中国传统医学的基石,已被证明是有效的治疗周围神经病变(PN)。这项研究探讨了针灸治疗利奈唑胺引起的周围神经病变(LIPN)的潜在益处。
    四个病人,年龄27至60岁,诊断为LIPN,接受每日针灸治疗。主要终点是评估针灸在减轻患者与LIPN相关的神经性疼痛中的功效。这主要是使用针灸治疗前后的简短形式McGill疼痛问卷(SF-MPQ)得分的变化来测量的。
    其中三名患者症状明显缓解,而一个人经历了边际改善。治疗范围为7至18个疗程。具体来说,第一例患者报告实质性缓解,得分从33降低到13;第二例患者观察到最小变化;第三例患者在八次治疗后得分从10急剧下降到2;最后一例患者在五次治疗后得分从21降低到12,但未继续治疗进行第二次评估.
    针灸是治疗LIPN的一种有前途的方法。然而,需要进行更大,更彻底的研究来确定其全部潜力。
    UNASSIGNED: The treatment of multidrug-resistant tuberculosis (MDR-TB) and pre-extensively drug-resistant tuberculosis (pre-XDR-TB) remains challenging due to the limited availability of effective drugs. Linezolid has emerged as a promising therapeutic option for these cases. However, its long-term use can lead to complications such as peripheral and optic neuropathies. Acupuncture, a cornerstone of traditional Chinese medicine, has been shown to be effective in the treatment of peripheral neuropathy (PN). This study examines the potential benefits of acupuncture in the treatment of linezolid-induced peripheral neuropathy (LIPN).
    UNASSIGNED: Four patients, aged 27 to 60 years, diagnosed with LIPN, underwent daily acupuncture treatments. The main endpoint was to assess the efficacy of acupuncture in reducing neuropathic pain associated with LIPN in patients. This was primarily measured using changes in the Short Form McGill Pain Questionnaire (SF-MPQ) scores before and after acupuncture treatment.
    UNASSIGNED: Three of the patients experienced significant symptom remission, while one experienced marginal improvement. Treatments ranged from 7 to 18 sessions. Specifically, the first patient reported substantial relief with a score reduction from 33 to 13; the second patient observed minimal change; the third patient\'s score decreased dramatically from 10 to 2 after eight sessions; the last patient had a score reduction from 21 to 12 after five sessions, but did not continue treatment for a second assessment.
    UNASSIGNED: Acupuncture is a promising therapeutic approach for LIPN. However, larger and more thorough studies are needed to determine its full potential.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:本研究探讨了胰岛α细胞功能与胰岛细胞功能,正如血浆胰高血糖素水平所反映的那样,2型糖尿病(T2DM)患者的糖尿病周围神经病变(DPN)。
    方法:回顾性纳入358例T2DM患者,分为非DPN组(n=220)和DPN组(n=138)。所有患者均接受口服葡萄糖耐量试验以检测血糖水平,胰岛素和胰高血糖素,和胰高血糖素的曲线下面积(AUC)(AUCglu)用于估计总胰高血糖素水平。周围神经传导速度(PNCV),振幅(PNCA)和延迟(PNCL)通过肌电图获得,并计算了他们的Z分数。
    结果:年龄存在显著差异,疾病持续时间,血清丙氨酸转氨酶水平,天冬氨酸转氨酶,尿素氮,高密度脂蛋白,和2h-C肽在这两组之间(p<0.05)。NDPN组在30、60和120分钟时具有较高的胰高血糖素水平和AUCglu(p<0.05)。PNCV和PNCA的Z得分呈增加趋势(p<0.05),PNCL的Z评分呈下降趋势(p<0.05)。胰高血糖素水平与PNCV、PNCA呈正相关,但与PNCL呈负相关,与Gluca30min的相关性最强(p<0.05)。Glucoa30min与PNCV独立相关,PNCL,PNCA和DPN,分别为(p<0.05)。胰岛α细胞的功能,正如血浆胰高血糖素水平所反映的那样,与T2DM患者DPN的发生密切相关。
    结论:Glucoa30min可能是DPN发生的潜在有价值的独立预测因子。
    This study explored the correlation between pancreatic islet α cell function, as reflected by the plasma glucagon levels, and Diabetic Peripheral Neuropathy (DPN) in patients with Type 2 Diabetes Mellitus (T2DM).
    A total of 358 patients with T2DM were retrospectively enrolled in this study and divided into the Non-DPN (NDPN) group (n = 220) and the DPN group (n = 138). All patients underwent an oral glucose tolerance test to detect levels of blood glucose, insulin and glucagon, and the Area Under the Curve (AUC) for Glucagon (AUCglu) was used to estimate the overall glucagon level. The Peripheral Nerve Conduction Velocity (PNCV), Amplitude (PNCA) and Latency (PNCL) were obtained with electromyography, and their Z scores were calculated.
    There were significant differences regarding the age, disease duration, serum levels of alanine aminotransferase, aspartate aminotransferase, urea nitrogen, high-density lipoprotein, and 2h-C peptide between these two groups (p < 0.05). The NDPN group had higher glucagon levels at 30, 60 and 120 min and AUCglu (p < 0.05). The Z-scores of PNCV and PNCA showed an increasing trend (p < 0.05), while the Z-score of PNCL showed a decreasing trend (p < 0.05). The glucagon levels were positively correlated with PNCV and PNCA, but negatively correlated with PNCL, with Gluca30min having the strongest correlation (p < 0.05). Gluca30min was independently related to PNCV, PNCL, PNCA and DPN, respectively (p < 0.05). The function of pancreatic α islet cells, as reflected by the plasma glucagon level, is closely related to the occurrence of DPN in T2DM patients.
    Gluca30min may be a potentially valuable independent predictor for the occurrence of DPN.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    在标准条件下,一氧化二氮(N2O)表现为无色,具有温和甜味的无臭气体。该化合物在各个领域都有应用,包括它用作气溶胶推进剂,赛车中的促进剂,以及外科手术和牙科的麻醉剂。不幸的是,N2O的娱乐性滥用由于其欣快感和致幻作用而在年轻人中普遍存在。使这个问题更加复杂的是,一氧化二氮可以很容易地从非处方家庭用品中获得,促进其非医疗用途。近年来,全球社会目睹了一氧化二氮气体娱乐利用的激增。尽管N2O的非医疗滥用普遍存在,对暴露于它可能产生的不利影响的理解仍然不足。本文概述了管理发现,实验室和电诊断特性,以及与一氧化二氮使用引起的神经系统疾病相关的临床表现。
    Under standard conditions, nitrous oxide (N2O) manifests as a colorless, odorless gas with a mildly sweet taste. The compound finds applications in various fields, including its use as an aerosol propellants, an accelerant in motor racing, and an anesthetic in surgical procedures and dentistry. Unfortunately, the recreational misuse of N2O has become prevalent among young individuals due to its euphoric and hallucinogenic effects. Compounding this issue is the fact that nitrous oxide can be easily obtained from over-the-counter household items, facilitating its non-medical use. The global community has witnessed a surge in the recreational utilization of nitrous oxide gas in recent years. Despite the widespread non-medical abuse of N2O, there remains inadequate understanding of the potential adverse effects resulting from exposure to it. This paper provides an overview of management findings, laboratory and electrodiagnostic characteristics, as well as clinical presentations associated with neurological disorders induced by nitrous oxide usage.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    抗中性粒细胞胞浆抗体(ANCA)相关的系统性血管炎(AASV)是一种罕见的全身免疫疾病,主要影响小动脉,静脉,和毛细血管,常导致肾损伤和肺损伤。值得注意的是,主要表现为周围神经病(PN)的个体在AASV中并不常见,这可能导致严重的误诊或未诊断的病例。PN的严重程度和位置可因患者而异。在这篇文章中,我们介绍一例AASV患者最初出现PN征象.此案例强调了将AASV视为无法解释的神经系统症状的潜在原因的重要性。及时的识别和正确的治疗对于提高AASV患者的生存率和功能预后至关重要。
    Anti-neutrophil cytoplasmic antibodies (ANCA)-associated systemic vasculitis (AASV) is a rare systemic immunological condition that predominantly impacts small arteries, veins, and capillaries, often leading to kidney damage and pulmonary injury. It is important to note that individuals primarily presenting with peripheral neuropathy (PN) are uncommon in AASV, which can result in significant misdiagnosis or undiagnosed cases. The severity and location of PN can vary among patients. In this article, we present a case of an AASV patient initially showing signs of PN. This case highlights the significance of considering AASV as a potential cause of unexplained neurological symptoms. Timely identification and proper treatment are essential for improving the survival rate and functional prognosis of AASV patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    由于体感神经系统损伤或疾病,神经性疼痛通常与化疗有关,称为化疗引起的周围神经病变(CIPN)。然而,由于检测手段有限,CIPN诱导的神经元细胞蛋白质组聚集的机制仍然难以捉摸.在这里,我们提供了用于荧光成像(AggStain)和蛋白质组学分析(AggLink)的系列传感器,以可视化和捕获CIPN神经元细胞模型中聚集的蛋白质组。环境敏感的AggStain成像传感器选择性结合并检测具有12.3倍荧光增强的蛋白质聚集。Further,共价AggLink蛋白质组传感器通过LC-MS/MS分析捕获细胞聚集的蛋白质并描述其组成。该集成传感器平台揭示了CIPN细胞模型中蛋白质组聚集的存在,并强调了其在各种细胞应激条件下评估蛋白质组稳定性的更广泛应用的潜力。
    As a consequence of somatosensory nervous system injury or disease, neuropathic pain is commonly associated with chemotherapies, known as chemotherapy-induced peripheral neuropathy (CIPN). However, the mechanisms underlying CIPN-induced proteome aggregation in neuronal cells remain elusive due to limited detection tools. Herein, we present series sensors for fluorescence imaging (AggStain) and proteomics analysis (AggLink) to visualize and capture aggregated proteome in CIPN neuronal cell model. The environment-sensitive AggStain imaging sensor selectively binds and detects protein aggregation with 12.3 fold fluorescence enhancement. Further, the covalent AggLink proteomic sensor captures cellular aggregated proteins and profiles their composition via LC-MS/MS analysis. This integrative sensor platform reveals the presence of proteome aggregation in CIPN cell model and highlights its potential for broader applications in assessing proteome stability under various cellular stress conditions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    一氧化碳(CO)是一种没有气味或颜色的气体,在暴露导致昏迷或死亡之前很难发现。一氧化碳中毒是世界上最常见和最致命的中毒之一。一氧化碳中毒是全球常见且通常致命的中毒形式。CO的毒性作用是组织缺氧,导致全身并发症.此外,一氧化碳中毒后可能出现严重的神经系统症状和迟发性并发症.然而,CO中毒后周围神经病变相对罕见。以前,只有一例一氧化碳中毒后的单侧神经丛病变,伴有横纹肌溶解和认知功能障碍,已被报道。在这份报告中,描述了一氧化碳中毒后孤立的单侧臂丛神经病变。这种情况下的关键机制可能是CO诱导的脊髓缺血。立即给予高压氧治疗(HBOT)对于预防急性CO中毒后的周围神经病变至关重要。急性CO中毒后应立即进行高压氧治疗(HBOT),以预防周围神经病变。此外,急性一氧化碳中毒后的周围神经病变可能受益于持续的康复训练.
    Carbon monoxide (CO) is a gas that has no odor or color, making it difficult to detect until exposure leads to coma or death. CO poisoning is one of the most common and deadly poisonings around the world. CO poisoning is a common and often fatal form of poisoning worldwide. A toxic effect of CO is tissue hypoxia, which leads to systemic complications. Additionally, there may be severe neurological symptoms and delayed complications following CO poisoning. However, peripheral neuropathy is relatively rare after CO poisoning. Previously, only one case of unilateral plexopathy after CO poisoning, accompanied by rhabdomyolysis and cognitive dysfunction, has been reported. In this report, an isolated unilateral brachial plexopathy following CO intoxication is described. A key mechanism in this case may be CO-induced spinal cord ischemia. Immediate administration of hyperbaric oxygen therapy (HBOT) is crucial to prevent peripheral neuropathy after acute CO intoxication. Hyperbaric oxygen therapy (HBOT) should be administered immediately after acute CO intoxication to prevent peripheral neuropathy. Additionally, peripheral neuropathy following acute CO intoxication may benefit from consistent rehabilitation training.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号