ObjectiveTo investigate the dynamic change of cerebral aquaporin 4 (AQP4) expression level during traumatic brain injury (TBI) in rats and the relationship between AQP4 expression and traumatic brain injury and edema. MethodsThe experimental TBI model was established by bumpiness of free falling body according to Feeney's. The changes of brain water content (BWC) and permeability of blood-brain barrier (BBB) were measured by the methods of wet and dry weight and Evans blue fluorometry. Immunohistochemistry was used to determine the change of expression of AQP4 during different periods after TBI. Results6 h after TBI, water content of brain tissue and EB content in the contusion side significantly increased, and the protein expression of AQP4 in contusion marginal region began to increase. They reached summit 24 h after operation and did not come back normal level 5 d after operation. There was significantly positive correlation between protein expression of AQP4 and change of EB content (r=0.957486,P<0.05). ConclusionThe dynamic change of cerebral AQP4 expression level closely related to the destruction of BBB and the formation of cerebral edema during traumatic brain injury.

ObjectiveTo observe the protective effects of Chinese medicine Naoshuning on neurological deficits following traumatic brain injury (TBI) in rats.MethodsCerebral contusion was produced by dropping weight,the beam-walking task was employed to observe neurological functional changes,water content in the brain tissue and neuropathological changes were also evaluated.ResultsWithin one week the ability to process in beam-walking task was significantly lessened,the outcome of beam-walking task of Naoshuning group was significantly better than that of the model group.Water content in the brain tissue and neuropathological changes were also alleviated in Naoshuning group compared with that in model group.ConclusionEarly alleviating brain edema,protecting brain tissue may be one of the mechanism of Chinese medicine to ameliorate the behavior deficits following TBI in rats.

Objective To investigate audiological characteristics of patients with intact tympanic membranes and conductive or mixed hearing loss .Methods A retrospective study was carried out among 30 patients (42 ears) with intact tympanic membranes and conductive or mixed hearing loss who underwent exploratory tympanotomy . The preoperative outcomes of pure tone audiometry ,tympanometry ,resonant frequency of middle ear and temporal bone CT scan were analyzed .Results Among 42 ears ,30 ears with otosclerosis and 12 ears with ossicular chain dis-ruption were confirmed in exploratory tympanotomy ,but only 5 ears showed positive findings in CT scan .The mean thresholds of bone conduction ,air conduction and air -bone gap at frequencies of 0 .5 ,1 and 2 kHz were 27 .5 ± 1 .3 dB HL ,67 .0 ± 1 .8 dB HL ,39 .5 ± 1 .1 dB HL ,respectively .An analysis of tympanometric data of all patients re-vealed that 50% of all ears (21/42) were type A tympanograms ,42 .9% (18/42) were type As tympanograms ,and 7 .1% (3/42) were type Ad tympanograms .The mean of the resonant frequency of the middle ear in otosclerositic patients (1 079 .0 ± 67 .4 Hz) was significantly higher than ossicular chain disruption patients (633 .3 ± 43 .6 Hz) . Conclusion Otosclerosis is the most common in the patients with intact tympanic membranes and conductive or mixed hearing loss .The middle ear resonant frequency of otosclerositic patients is significantly higher than that of ossicular chain disruption patients .

Objective:To explore the effect of Naoshuning on the protein expression of Matrix metalloproteinases(MMPs) in experimental injuried brain tissue of rats. Methods:Immunohistochemistry was used to determine the changes of protein expression of MMPs. Brain tissue water content,permeability and ultramicrostructure of blood-brain barrier(BBB) were also observed. Results:Compared with the sham group,the brain tissue water and EB content of injured side and the level of MMP-2 and MMP-9 protein expression in brain tissue around contusion in model group increased obviously(all P

Objective To investigate the characteristics of auditory brainstem response (ABR) in autistic children of 6 years or younger .Methods A total of 98 children with normal hearing and 22 autistic children were en‐rolled in this study .They were divided into 3 groups :1~2 years age group ,2< ~3 years age group ,and 3< ~6 years age group .The thresholds ,wave latencies and interpeak intervals of ABR were statistically analyzed .Results The ABR thresholds in normal hearing children (and autistic children) in 1~2 years age group ,2< ~3 years age group ,and 3< ~6 years age group were 15 .64 ± 5 .02 (17 .50 ± 5 .35) ,14 .73 ± 4 .85 (17 .81 ± 6 .58) ,and 15 .57 ± 5 .62 (17 .25 ± 6 .97) dB nHL ,respectively .There were no significantly statistical difference between the normal hearing children and autistic children (P>0 .05) .In 80 dB nHL click sound stimulus ,there was also no statistical difference in the values of peak latencies or interpeak intervals of ABR between normal hearing children and autistic children (P> 0 .05) ,whereas ,prolongation of peak latencies or interpeak intervals of ABR occurred in 36 .36%(25 .00% ears) autistic children .The ratio of prolongation of peak latencies of I ,III ,V waves and interpeak inter‐vals of I-III ,III-V ,I-V occurred in 4 .54% ,6 .82% ,13 .64% ,18 .18% ,6 .83% and 15 .91% ,respectively . Conclusion The ABR in some autistic children present abnormality and occur in various forms with the prolongation of interpeak intervals of I -III as the most common .

OBJECTIVE: To explore the effect of masking therapy for the early stage of the patients with noise-induced tinnitus,and imply the treatment for patients with noise-induced tinnitus. METHOD: Sixty-eight cases with tinnitus were studied. All the patients took the audiological examinations and tinnitus tests firstly, and accepted the masking therapy for 6 months. The therapeutic effiency was evaluated according to tinnitus handicap inventory (THI) and subjective visual-analogue scale (VAS). The minimum masking intensity was also evaluated. RESULT: The majority of the patients with noise-induced tinnitus (59 cases, 86. 8%) had tinnitus frequency of 4 kHz,and most of them (44 cases, 64. 7%) had positive residual inhibition tests. Tinnitus completely disappeared in 3 cases after masking therapy, and the efficiency of this treatment is 83. 8%. There was significant difference in the scores of THI and VAS before and after therapy(P<0. 01), and there was also significant difference in the minimum masking intensity (P<0. 01). CONCLUSION Masking therapy is the most important treatment for the patients in the early stage of noise-induced tinnitus. The therapeutic effiency is significant and should be promoted.
Humans ; Noise ; adverse effects ; Tinnitus ; etiology ; therapy

OBJECTIVE: To analyze and summarize nystagmus of patients with posterior canal benign paroxysmal positional vertigo (BPPV) in positioning test,and to improve the diagnosis and treatment of posterior canal BPPV (PSC-BPPV). METHOD: The present study was conducted on 175 patients who had unilateral BPPV of the posterior semicircular canal (PSC). Their positional nystagmus recorded by videnonystagmography in Dix-Hallpike test,roll test and roll over test were analyzed to summarize the characteristics of nystagmus on nystagmograph of PSC-BP-PV. RESULT: Of the 175 patients, lesion was located in the left PSC in 69 (39.4%) patients,the right PSC in 106 (60. 6%)patients. The nystagmus of patients with PSC-canalithiasis showed upward on the vertical phase of nystagmograph and orientated the different side on horizontal phase in the head hangging position. The horizontal phase pointed to the contralateral side in 47(26. 9%) patients, the ipsilateral contralateral side in 100(57. 1%) patients,no significant reverse ingredients in 28(16.0%) patients. When these patients returned to sit,139(79.4%) patients showed down beating positioning nystagmus, whereas 36 (20. 6%) patients with no nystagmus only had a short vertigo or dizziness. The horizontal phase of the 139 patients pointed to the contralateral side in 40(22. 9%) patients,the ipsilateral contralateral side in 68(38. 9%) patients,no significant reverse ingredients in 31(17. 7%) patients. In roll test,12 patients of the right PSC-BPPV presented an up-beating rotatory nystagmus when the head turned to right,and 5 patients of the left PSC-BPPV presented a down-beating rotatory nystagmus when the head turned to left. When the patients changed body from the left lateral position to the right lateral position in the roll over test, 74(42. 3%) patientsshowed vertical positioning nystagmus. In 30 patients who presented an up-beating nystagmus, there were 25(83. 3%) patientscame from the right PSC-BPPV. In 44 patients who presented a down-beating nystagmus, there were 36(81. 8%) patientscame from the left PSC-BPPV. The direction of the vertical nystagmus was highly correlated with the judgment about the side of the PSC-BPPV in roll over test (P<0. 01). CONCLUSION The patient with PSC-canalithiasis showed an uncertain direction in torsional nystagmus in Dix-Hallpike test,the diagnosis was mainly concern with the vertical nystagmus. When we found a rotatory nystagmus with much more up-beating nystagmus in roll test, it might be PSC-BPPV. We also can use the roll over test to diagnose the location of the otolith in which side of the PSC-BPPV.
Benign Paroxysmal Positional Vertigo ; complications ; Dizziness ; Electronystagmography ; Face ; Head ; Humans ; Nystagmus, Physiologic ; Otolithic Membrane ; Patient Positioning ; Semicircular Canals ; Vertigo ; Vestibular Function Tests

Bilateral inferior petrosal sinus sampling(BIPSS), with or without desmopressin stimulation, is the gold standard in the diagnosis of Cushing′s disease. A few of patients with Cushing′s disease present a false negative result in BIPSS. These patients are often misdiagnosed as ectopic adrenocorticotropin(ACTH) syndrome(EAS). Here we report a case of Cushing′s disease with a false negative BIPSS, in the hope to aid clinical physicians in the differential diagnosis and treatment of ACTH-dependent Cushing′s syndrome.

Gallbladder carcinoma is a common malignant tumor of the biliary system characterized by poor specificity of early symptoms， a high degree of malignancy， and rapid progression， and it is difficult to make an early diagnosis. Gallstones and gallbladder polyps are considered the most common risk factors for gallbladder carcinoma. Ultrasound is the preferred examination， while CT， MRI， and PET also have their own advantages. There is a lack of radical treatment methods for gallbladder carcinoma， and surgical operation remains the preferred treatment method for gallbladder carcinoma； however， due to the rapid progression of this disease， most patients have lost the opportunity for surgery at the time of diagnosis. A combination of various treatment modalities， such as radiochemotherapy， targeted therapy， and immunotherapy， has improved the prognosis of patients to a certain extent， but with an unsatisfactory long-term therapeutic effect. Therefore， it is of particular importance to give priority to prevention rather than treatment and emphasize early identification and treatment.