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Small cell lung cancer with peripheral neuropathy as the first symptom:Two case reports

World Journal of Clinical Cases 2025年第9期13卷 30-40页

作者： Man Luo Xiao-Xi Lu Dan-Yang Meng Jin Hu Department of Neurology Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Department of Information Technology Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina

BACKGROUND Small cell lung cancer(SCLC)is the most malignant type of lung *** in the latent period and early stage of the tumor,SCLC is prone to produce distant metastases with complex and diverse clinical *** is most closely related to paraneoplastic syndrome,and some cases present as paraneoplastic peripheral neuropathy(PPN).PPN in SCLC appears early,lacks specificity,and often occurs before diagnosis of the primary *** is easy to be misdiagnosed as a primary disease of the nervous system,leading to missed diagnosis and delayed diagnosis and *** SUMMARY This paper reports two cases of SCLC with limb weakness as the first *** first symptoms of one patient were rash,limb weakness,and abnormal *** patient was repeatedly referred to the hospital for limb weakness and rash for>1 year,during which time,treatment with hormones and immunosuppressants did not lead to significant improvement,and the condition gradually *** patient was later diagnosed with SCLC,and the dyskinesia did not worsen as the dermatomyositis improved after antineoplastic and hormone *** second case presented with limb numbness and weakness as the first symptom,but the patient did not pay attention to ***,the patient was diagnosed with SCLC after facial edema caused by tumor thrombus invading the ***,he was diagnosed with extensive SCLC and died 1 year after *** The two cases had PPN and abnormal electromyography,highlighting its correlation with early clinical indicators of SCLC.

关键词： Paraneoplastic peripheral neuropathy Small cell lung cancer peripheral neuropathy Electromyography Dermatomyositis Case report

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Efficacy of Wen-Luo-Tong on peripheral neuropathy Induced by Chemotherapy or Target Therapy: A Randomized, Double-Blinded, Placebo-Controlled Trial

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Chinese Journal of Integrative Medicine 2022年第7期28卷 579-585页

作者： DENG Bo JIA Li-qun WAN Dong-gui WANG Bao-yi CHENG Zhi-qiang DENG Chao Center of Science and Technology China-Japan Friendship HospitalBeijing 100029China Integrative Oncology Department of Chinese Medicine and Western Medicine China-Japan Friendship HospitalBeijing 100029China

Objective: To evaluate the efficacy of Wen-Luo-Tong Granules(WLT) local administration in the treatment of patients with peripheral neuropathy(PN) induced by chemotherapy or target therapy. Methods: This study is a randomized, double-blinded, and placebo-controlled trial. Seventy-eight patients with PN induced by chemotherapy or target therapy were enrolled from China-Japan Friendship Hospital between July 2019 and January 2020. They were randomly assigned to WLT(39 cases) and control groups(39 cases) using a block randomization method. The WLT group received WLT(hand and foot bath) plus oral Mecobalamin for 1 week, while the control group received placebo plus oral Mecobalamin. The primary endpoint was PN grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events(NCI-CTCAE). The secondary endpoints included quantitative touch-detection threshold, neuropathy symptoms, Quality of Life QuestionnaireChemotherapy Induced peripheral neuropathy(QLQ-CIPN20), and Quality of Life Questionnaire-Core30(QLQ-C30). Results: After treatment, the PN grade in the WLT group was significantly lower than that in the control group(1.00±0.29 vs. 1.75±0.68, Pneuropathy symptom score, QLQ-CIPN 20(sensory scale, motor scale, autonomic scale, and sum score), and QLQ-C30(physical functioning, role functioning, emotional functioning, and global health) in the WLT group significantly improved after treatment(P<0.01 or P<0.05). Conclusion: WLT local administration was significantly effective in the treatment of patients with PN induced by chemotherapy or target therapy.(Trial registration No. ChiCTR1900023862)

关键词： peripheral neuropathy chemotherapy target therapy Chinese medicine Wen-Luo-Tong randomized controlled trial

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HLA class Ⅱ alleles and risk for peripheral neuropathy in type 2 diabetes patients

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Neural Regeneration Research 2016年第11期11卷 1839-1844页

作者： Ahmad Marzban Javad Kiani Mehrdad Hajilooi Hamzeh Rezaei Zohreh Kahramfar Ghasem Solgi Division of Endocrinology Department of Internal MedicineSchool of MedicineHamadan University of Medical Sciences Department of Immunology School of MedicineHamadan University of Medical Sciences Psoriasis Research Center Department of DermatologyFarshchian HospitalHamadan University of Medical Sciences

The potential impact of human leukocyte antigen （HLA） genotype variations on development of diabetic peripheral neuropathy （DPN） is not well determined. This study aimed to identify the association of HLA class II alleles with DPN in type 2 diabetes （T2D） patients. Totally 106 T2D patients, 49 with DPN and 57 without DPN, and 100 ethnic-matched healthy controls were analyzed. Both groups of the patients were matched based on sex, age, body mass index （BMI） and duration of T2D. Polyneuropathy was diagnosed using electrodiagnostic methods. HLA-DRB1 and DQB1 genotyping was performed in all subjects by the polymerase chain reaction with sequence-specific primers （PCR-SSP） method. T2D patients with DPN showed higher frequencies of HLA-DRB1＊10 and DRB1＊12 alleles compared to control group （P = 0.04）. HLA-DQB1＊02 allele and HLA-DRB1＊07-DQB1＊02 haplotype were associated with a decreased risk for developing DPN in T2D patients （P = 0.02 and P = 0.05 respectively）. Also, patients with severe neuropathy showed higher frequencies of DRB1＊07 （P = 0.003） and DQB1＊02 （P = 0.02） alleles than those with mild-to-moderate form of neuropathy. The distribution of DRB 1 and DQB 1 alleles and haplotypes were not statistically different between all patients and healthy controls. Our findings implicate a possible protective role of HLA-DQB1＊02 allele and HLA-DRB1＊07-DQB1＊02 haplotype against development of peripheral neuropathy in T2D patients. Therefore, variations in HLA genotypes might be used as genetic markers for prediction and potentially management of neuropathy in T2D patients.

关键词： nerve regeneration HLA-DRB1 HLA-DQB1 alleles genotypes haplotypes peripheral neuropathy type 2 diabetes neural regeneration

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A genetic variant study of bortezomib-induced peripheral neuropathy in Chinese multiple myeloma patients

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Oncology Research 2024年第5期32卷 955-963页

作者： YAN ZHANG HEYANG ZHANG JING WANG XIN WEI YI QU FENG XU LIJUN ZHANG Department of Hematology The First Affiliated Hospital of China Medical UniversityShenyang110001China

Background:Bortezomib results in peripheral neuropathy(PN)in approximately 50%of patients,during multiple myeloma(MM)treatment,a complication known as Bortezomib-induced peripheral neuropathy(BIPN).The drug response varies among *** factor may play an important role in ***:A nextgeneration sequencing(NGS)panel containing 1659 targets from 233 genes was used to identify risk variants for developing BIPN in 204 MM patients who received bortezomib *** expression of MTHFR and ALDH1A1 in 62 peripheral blood samples was detected by real-time quantitative PCR(RT-qPCR).Serum homocysteine(Hcy)levels were detected in 40 samples by chemiluminescent microparticle immunoassay(CMIA).Results:Compared with the non-BIPN group(n=89),a total of 8 significantly associated single nucleotide polymorphisms(SNPs)were identified in the BIPN group(n=115):MTHFR(rs1801131,rs1801133,rs17421511),EPHX1(rs1051740),MME(rs2016848),ALDH1A1(rs6151031),HTR7(rs1935349)and CYP2A6(rs8192720).The mRNA expression level of MTHFR in newly diagnosed patients with peripheral neuritis after treatment(NP group)was lower than that of newly diagnosed patients without peripheral neuritis after treatment(NnP group)(1.70±0.77 vs.2.81±0.97,p=0.009).Serum Hcy levels were significantly higher in BIPN group than in non-BIPN group(11.66±1.79μmol/L vs.8.52±3.29μmol/L,p=0.016)and healthy controls(11.66±1.79μmol/L vs.8.55±2.13μmol/L,p≤0.001).Conclusion:CYP2A6,EPHX1,MTHFR,ALDH1A1,HTR7,MME and BIPN are linked in Chinese MM *** is more likely to occur in patients with lower MTHFR mRNA expression,which might result in higher serum Hcy levels.

关键词： Multiple Myeloma peripheral neuropathy Bortezomib Bortezomib-induced peripheral neuropathy Next-generation sequencing MTHFR Serum Hcy

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Advances in the treatment of diabetic peripheral neuropathy by modulating gut microbiota with traditional Chinese medicine

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World Journal of Diabetes 2024年第8期15卷 1712-1716页

作者： Ye-Yao Li Rui-Qian Guan Zhi-Bo Hong Yao-Lei Wang Li-Min Pan Department of Endocrinology The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin 150001Heilongjiang ProvinceChina Department of Tuina The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin 150001Heilongjiang ProvinceChina

Diabetic peripheral neuropathy(DPN)is one of the strongest risk factors for diabetic foot ulcers(neuropathic ulcerations)and the existing ulcers may further deteriorate due to the damage to sensory ***,the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short *** is associated with gut microbiota *** Chinese medicine(TCM)compounds such as Shenqi Dihuang Decoction,Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut *** current review discusses whether TCM compounds can reduce the risk of DPN by improving gut microbiota.

关键词： Diabetes peripheral neuropathy Traditional Chinese medicine Gut microbiota Diabetic foot ulcer Treatment

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peripheral neuropathy under Infliximab Therapy: About One Case

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Open Journal of Gastroenterology 2020年第9期10卷 242-246页

作者： Fatima-Zahra Hamdoun Hakima Abid Nada Lahmidani Mounia El Yousfi Dafr-Allah Benajah Mohammed El Abkari Adil Ibrahimi Department of Hepato-Gastroenterology Hassan II University Hospital of Fez Faculty of Medicine University Sidi Mohammed Ben Abdelalh Fez Morocco

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’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. Given the severity of the neurological symptoms, we decided to change the therapeutic class.

关键词： Crohn’s Disease Infliximab peripheral neuropathy

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Efficacy of combining traditional Chinese medicine fumigation with Western medicine for diabetic peripheral neuropathy:A systematic review and meta-analysis

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International Journal of Nursing Sciences 2015年第3期2卷 295-303页

作者： Lei Zhang Xu Tian Yue Ma Ying-Hui Jin Fan-Jie Meng Graduate College Tianjin University of Traditional Chinese MedicineTianjin 300193China Department of Nursing Shijiazhuang College of MedicineShijiazhuang 050061China School of Nursing Tianjin University of Traditional Chinese MedicineTianjin 300193China Department of Teachers'Development and Evaluation Tianjin University of Traditional Chinese MedicineTianjin 300193China

Objective:A systematic review and meta-analysis was conducted to evaluate the effectiveness of supplementing Western medicine with Traditional Chinese medicine(TCM)fumigation in patients with diabetic peripheral ***:The China Biomedical Literature,Chinese full-text periodical,China National Knowledge Infrastructure,WanFang,PubMed,EMbase,and Cochrane Library databases were searched for relevant randomized controlled trials published from inception through May *** methodological quality of eligible studies was evaluated using the Cochrane Risk Bias Assessment tool,and summarized effects were calculated using Reviewer Manager 5.1 *** analysis was conducted based on the duration of ***:The initial search identified 312 relevant studies,of which 40 randomized controlled trials involving 3497 patients were eligible for *** results indicated that TCM fumigation significantly improved the curative effects[risk ratio(RR)=1.34,95%CI(confidence interval):1.29e1.39],common peroneal motor nerve conduction velocity[standard mean difference(SMD)=2.93,95%CI:2.26e3.61],common peroneal sensory nerve conduction velocity(SMD=2.23,95%CI:1.46e3.01),and plasma viscosity(SMD=1.02,95%CI:1.35e0.69)compared to Western medicine alone(all p<0.01).A subgroup analysis indicated that the curative effects were significant after 15 days(RR=1.31,95%CI:1.21e1.42),30 days(RR=1.33,95%CI:1.26e1.40),and 60 days(RR=1.50,95%CI:1.32e1.71)of combined treatment(all p<0.01).

关键词： Fumigation Diabetic peripheral neuropathy Traditional Chinese medic

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Lysosomal dysfunction in Schwann cells is involved in bortezomib-induced peripheral neuropathy

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中国药理学与毒理学杂志 2021年第9期35卷 683-684页

作者： WU Zhan-xun YAN Wen-ping CHEN Zhong WU Jia-ying ZHANG Xiang-nan Institute of Pharmacology&Toxicology Col-lege of Pharmaceutical SciencesKey Laboratory of Medical Neurobiology of the Ministry of Health of ChinaZhejiang UniversityHangzhou 310058China Department of Pharmacy the First Affili-ated HospitalSchool of MedicineZhejiang Univer-sityHangzhou 310003China

OBJECTIVE The proteasome inhibitor bortezomib(BTZ)is a first-line anti-multi⁃ple myeloma ***-induced peripheral neu⁃ropathy(BIPN)is a main adverse effect that char⁃acterized by neuropathic *** is still no strategy to prevent or treat BIPN,attributed to the unidentified mechanisms underlying *** studies suggested that BTZ impairs Schwann cells and thus leads to axonal demye⁃lination,whereas it remained not fully understood how BTZ cause Schwann cell *** was observed that BTZ upregulates the autophagy marker LC3-Ⅱprotein in Schwann ***,it remains unclear whether BTZ causes autopha⁃gy-lysosome dysfunction in Schwann *** The male C57BL/6 mice were intra⁃venous injection of BTZ(1 mg·kg-1 per day,twice weekly for a total of 4 weeks).The paw withdraw⁃al latency was tested by the Von Frey test and Hargreaves test to reflect the neuropathic *** conduction velocity and the action potential amplitude of the tail nerve were tested by neuro⁃physiological assessment to reflect peripheral nerve *** histomorphology of the sciat⁃ic nerves was detected by immunofluorescence and transmission electron microscopy to reflect the demyelination and axonal *** RSC96 cells,the Schwann cell-like immortal cells,were cultured and exposed to *** lysosomal function was determined by Lyso⁃Tracker and DQ-BSA ***-relat⁃ed proteins,including p62 and LC3,and lysosom⁃al hydrolase cathepsin B were determined by Western ***①BTZ induced mechano-allodynia,neurological conduction abnormalities of the tail nerve,demyelination and axonal degeneration of the sciatic nerves.②BTZ caused lysosomal dysfunction,resulting in the blockade of autophagy flux in Schwann cells and sciatic nerves.③The lysosomal activator Torin1 reversed lysosomal dysfunction caused by BTZ in Schwann cells.④Torin1 improved BTZ-induced mechano-allodynia and demyelination of sciatic *** BTZ led to lyso⁃somal dysfunction in

关键词： bortezomib peripheral neuropathy sciatic nerves demyelination Schwann cells lysosome

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Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2020年第11期21卷 911-920页

作者： Xiao-hong WU Jing-wen FANG Yin-qiong HUANG Xue-feng BAI Yong ZHUANG Xiao-yu CHEN Xia-hong LIN Department of Endocrinology the Second Affiliated Hospital of Fujian Medical UniversityQuanzhou 362000China Department of Endocrinology the First Hospital of QuanzhouQuanzhou 362000China

Objective:To investigate the value of optic disc retinal nerve fiber layer(RNFL)thickness in the diagnosis of diabetic peripheral neuropathy(DPN).Methods:Ninety patients with type 2 diabetes,including 60 patients without DPN(NDPN group)and 30 patients with DPN(DPN group),and 30 healthy participants(normal group)were *** coherence tomography(OCT)was used to measure the four quadrants and the overall average RNFL thickness of the optic *** receiver operator characteristic curve was drawn and the area under the curve(AUC)was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for ***:The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average((101.07±12.40)μm vs.(111.07±6.99)μm and(109.25±6.90)μm),superior quadrant((123.00±19.04)μm vs.(138.93±14.16)μm and(134.47±14.34)μm),and inferior quadrant((129.37±17.50)μm vs.(143.60±12.22)μm and(144.48±14.10)μm),and the differences were statistically *** diagnostic efficiencies of the overall average,superior quadrant,and inferior quadrant RNFL thicknesses,and a combined index of superior and inferior quadrant RNFL thicknesses were similar,and the AUCs were 0.739(95%confidence interval(CI)0.635–0.826),0.683(95%CI 0.576–0.778),0.755(95%CI 0.652–0.840),and 0.773(95%CI 0.672–0.854),*** diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%.Conclusions:The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

关键词： Type 2 diabetes peripheral neuropathy Retinal nerve fiber layer thickness Optical coherence tomography Diagnosis

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A ＂Triple Trouble＂ Case of Facioscapulohumeral Muscular Dystrophy Accompanied by peripheral neuropathy and Myoclonic Epilepsy

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Chinese Medical Journal 2018年第18期131卷 2164-2171页

作者： Xiao-Dan Lin Jun-Jie He Feng Lin Hai-Zhu Chen Liu-Qing Xu Wei Hu Nai-Qing Cai Min-Ting Lin Ning Wang Zhi-Qiang Wang Guo-Rong Xu Department of Neurology and Institute of Neurology First Affiliated Hospital Fujian Medical University Fuzhou Fujian 350005 China Fujian Key Laboratory of Molecular Neurology Fuzhou Fujian 350005 China

Background： Facioscapulohumeral muscular dystrophy （FSHD） is characterized by asymmetric muscular deficit of facial, shoulder-girdle muscles, and descending to lower limb muscles, but it exists in several extramuscular manifestations or overlapping syndromes. Herein, we report a ＂complex disease plus＂ patient with FSHD1, accompanied by peripheral neuropathy and myoclonic epilepsy. Methods： Standard clinical assessments, particular auxiliary examination, histological analysis, and molecular analysis were performed through the new Comprehensive Clinical Evaluation Form, pulsed-field gel electrophoresis-based Southern blot, Multiplex Ligation-dependent Probe Amplification （MLPA）, whole exome sequencing （WES）, and targeted methylation sequencing. Results： The patient presented with mild facial weakness, humeral poly-hill sign, scapular winging, peroneal weakness, drop foot, pes cavus, and myoclonic epilepsy. Furthermore, electrophysiology revealed severely demyelinated and axonal injury. The muscle and nerve biopsy revealed broadly fiber Type II grouping atrophy and myelinated nerve fibers that significantly decreased with thin myelinated fibers and onion bulbs changes. Generalized sharp and sharp-slow wave complexes on electroencephalography support the diagnosis toward myoclonic epilepsy. In addition, molecular testing demonstrated a co-segregated 20-kb 4q35-EcoRI fragment and permissive allele A, which corresponded with D4Z4 hypomethylation status in the family. Both the patient＇s mother and brother only presented the typical FSHD but lacked overlapping syndromes. However, no mutations for hereditary peripheral neuropathy and myoclonic epilepsy were discovered by MLPA and WES. Conclusions： The present study described a ＂tripe trouble＂ with FSHD, peripheral neuropathy, and myoclonic epilepsy, adding the spectrum of overlapping syndromes and contributing to the credible diagnosis of atypical phenotype. It would provide a direct clue on medical care and genetic counseli

关键词： Facioscapulohumeral Muscular Dystrophy Myoclonic Epilepsy Overlapping Syndromes peripheral neuropathy TripleTrouble

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