Objective To evaluate the efficacy of intratympanic steroid therapy compared with systemic ster‐oid therapy on the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with damaged glu‐cose tolerance .Methods Fifty first -diagnosed unilateral ISSNHL patients with damaged glucose tolerance were randomized devided equally to the intervention group (intratympanic steroid therapy) or the control group (systemic steroid therapy) ,all patients received conventional drug therapy simultaneously .Pure-tone hearing threshold tests were performed in all patients every 3 days after the first time ,and repeated measures anova was used to assess effects of hearing recovery accompanied with time .Results The mean hearing threshold in the control group de‐creased from 85 .4 ± 5 .6 dB to 48 .2 ± 4 .9 dB ,while in the intervention group it decreased from 84 .8 ± 5 .6 dB to 31 .7 ± 4 .6 dB .Total effective rate in the intervention group (84 .00% ,21/95) was higher than that in the control group (68 .00% ,17/25)(P<0 .05) .Conclusion The intratympanic steroid therapy is more effective than systemic steroid therapy in the treatment of ISSNHL patients with damaged glucose tolerance .

Background Influence of weightlessness on visual function has been a hot topic in aerospace medicine field.Electroretinography (ERG) is valuable tool of evaluating visual function.Objective This study aims to observe the influence of head down tilt simulated weightlessness on ERG.MethodHead down tilt for 6° was adopted in 6 healthy volunteers.Flash ERG,including rod response,maxium response,cone response,oscillatory potentials (OPs) and 30 Hz flicker was recorded,and the latency and amplitude from each wave were analyzed before,two days and five days after trial.The record procedure followed the ISCEV standard for full field clinical electroretinography (2008 update).Oral informed consent was obtained from all the subjects prior to the trail.Results No significant differences were detected in the latencies and amplitudes of a,b waves of cone response and 30 Hz flicker among various time points(P＞0.05).The latencies were significantly prolonged in b wave of rod and a,b waves of maxim responses(P＜0.01),but no obvious change was found in amplitudes (P＞0.05).Both the latency and amplitude of all of the wavelets of OPs were considerably among the different time points(P＜0.05-0.01),and the ∑OPs was evidently different among the different time points(P＜0.05).Conclusion Head down tilt simulated weightlessness induce the abnormality of visual function in the early stage.

Objective To evaluate the efficiency of long-term video electro-encephalography(VEEG) monitoring in neonatal seizure.Methods The medical records of 36 neonates recruited and performed with long-term VEEG in the neonatal intensive care units in hospital from Jun.2011 to Jun.2012 were collected.The medical records included age,gender,diagnosis,VEEG background,epileptiform activity,epileptic seizures (electrographic seizures,electroclinical seizures or both),and nonepilepic events.Informations on prognosis and therapy was also obtained.Results Among the 36 neonates,the neonates with normal,or mildly,moderately,and severely abnormal VEEG were 3 (8.3％),9 (25.0％),16 (44.4％) and 8 (22.2％) neonates,respectively.Children with normal electro-encephalography (EEG) developed normally.The percentage with developmental delay in children with mildly,moderately,and severely abnormal EEG were 1 1.1％,37.5％ and 62.5％,respectively and abnormal VEEG was significantly associated with developmental delay(x2 =13.8,P =0.003).Among these 36 neonates,21 cases had neonatal seizures (58.3％),including 14 (66.7％) cases with epileptic seizures and 6(28.6％) cases with nonepileptic seizures and 1 case with both.In addition,13 (61.9％) cases out of 21 cases with neonatal seizures developed abnormally (including developmental delay and death),and there was no significant association between neonatal seizure and development (x2 =0.206,P =0.65).Conclusions Neonatal seizure is very common,but electroclinical dissociation is an outstanding feature of neonatal seizures.Long-term VEEG monitoring is a valuable tool and may aid in the early identification and management of patients who are more likely to develop epilepsy.

A high-speed counter-current chromatography (HSCCC) method was successfully developed for the preparative separation and purification of deoxyschizandrin from Schisandrae Sphenantherae Fructus in one step. The purity of deoxyschizandrin was 98.5%, and the structure was identified by MS, UV and NMR. This method was simple, fast, convenient and appropriate to prepare pure compound as reference substances for related research on Schisandrae Sphenantherae Fructus.

BACKGROUND:Atorvastatin has been shown to reduce bone loss and fracture, but its effects on implant osseointegration remain unknown.
OBJECTIVE:To investigate the effects of atorvastatin on implant osseointegration in osteoporotic rats and the underlying mechanisms.
METHODS:Forty-eight Sprague-Dawley rats were randomized into sham-surgery, ovariectomy, and atorvastatin (10 and 20 mg/kg per day) treatment groups, respectively. Al rats received ovariectomy and implant surgery except those in the sham-surgery group. Bone mineral density of the lumbar vertebra, osseointegration ratio and pul-out strength of implants were measured after 12-week treatment.Levels of bone formation and resorption markers in osteoblasts treated with atorvastatin were determined by ELISA. Wnt pathway-relatedgene expression was detected by RT-PCR.
RESULTS AND CONCLUSION:Bone mineral density, osseointegration ratio and pul-out strength of implants were significantly increased in 20 mg/kg per day of atorvastatin treatment group compared with ovariectomy group (P< 0.05). Levels of alkaline phosphatase, osteocalcinand osteoprotegerinwere significantly increased in osteoblasts treated with atorvastatinin vitro(P<0 .05), and the level of osteoclast differentiation factor RANKL was significantly inhibited (P< 0.05). Meanwhile, atorvastatin significantly promoted the mRNA expression of low-density lipoprotein associated protein 5and β-catenin, and inhibited the mRNA expression of dickkopfWnt signal pathway inhibitor 1and sclerostin. Our results suggest that atorvastatin promotes implant osseointegration in osteoporotic rats by activating Wnt/β-catenin signal pathway.

Objective To approach the methods and effects of internal fixation for Hoffa fracture. Methods A total of 26 patients with 26 condylar Hoffa fractures ( medial condylar fractures in 13patients and lateral condylar fractures in 13) treated from August 1993 to February 2010 were retrospectively analyzed.According to the Letenneur classification,there were 16 patients with type Ⅰ fractures,four with type Ⅱ fractures and six with type Ⅲ fractures.Among them,two patients were with open fractures and 24 with closed fractures.Surgical approaches including screw fixation in 21 patients and lateral support plate fixation in five were selected based on the fracture types and affected sides. Results All patients were followed up for 12.5-48 months (average 18 months),which showed fracture healing in all the patients within 3-4 months (average 3.5 months).Two patients had slight shift together with knee joint pain,ie,one patient had ROM of knee for 95 °,and one failed the functional exercise because of pain and had ROM of knee for 60° during follow up.No complications including infection,delayed union or bone necrosis occurred.According to Letenneur' s functional assessment system,the postoperative outcomes were excellent and good in 24 condyles,fair in one and poor in one. Conclusions Surgical treatment for Hoffa fractures is safe and effective,but the key point is to choose correct screw fixation position and orientation according to the fracture types and fracture fragment size.

Objective To observe the influence of head-down tilt on visual evoked potential.Methods Six healthy volunteers were exposed to-6? head-down tilt.The visual evoked potential were measured before the test,the second day and the fifth day of the test under different space frequency.Results No significant difference was found in the latency of P100 before and after the test.The amplitude of P100 had significant change under high space frequency.But not the same happened on middle and low space frequency.Conclusion head-down tilt can induce the change of visual evoked potential under high space frequency,which means the weightlessness may influent the visual function.

ObjectiveTo investigate the relationship between e-cigarette use and subjective cognitive decline. MethodsThis study included survey participants aged ≥45 years from the US Behavioral Risk Factor Surveillance System. The prevalence of subjective cognitive decline in people with different tobacco use conditions was estimated. Multivariate logistic regression was employed to determine the relationship between e-cigarette use and subjective cognitive decline， as well as the relationship between co-use of e-cigarette and combustible tobacco and subjective cognitive decline. ResultsA total of 204 032 participants were included in the study. The total prevalence of subjective cognitive decline was 11.46%， whereas among current e-cigarette users， the prevalence was 19.92%. After accounting for confounding factors， current e-cigarette use was identified as a risk factor for subjective cognitive decline compared to individuals who had never used e-cigarettes， with an OR of 1.46 （95%CI： 1.20‒1.77）. Meanwhile， occasional e-cigarette use showed a higher risk， with an OR of 1.54 （95%CI： 1.22‒1.95）. The highest risk was observed with the co-use of e-cigarette and combustible tobacco， with an OR of 1.69 （95%CI： 1.32‒2.16）， followed by current e-cigarette use and former combustible tobacco use， with an OR value of 1.38 （95%CI： 1.08‒1.78）. ConclusionThe use of e-cigarettes increases the risk of subjective cognitive decline， with occasional use demonstrating a more pronounced negative impact. In general， the risk of cognitive decline is greater among e-cigarette users compared to combustible tobacco users. Controlling the use of combustible tobacco， especially e-cigarette， will help reduce the incidence of subjective cognitive decline. Individuals currently using combustible tobacco are advised to explore smoking cessation methods other than transitioning to e-cigarettes.

Objective To investigate the role of network platform for treatment and rescue of acute and severe cerebrovascular diseases in improving treatment level of patients with acute ischemic stroke.Methods The differences of number of patients accepted venous thrombolysis, number of patients accepted emergency intravascular interventional treatment, and time from admission to intravenous thrombolysis (door to needle time [DNT]) were analyzed in patients with acute ischemic stroke admitted to our hospital in the first year (2016) and the second and third years (2017 and 2018) of construction of network platform for treatment and rescue of acute and severe cerebrovascular diseases in Yunfu city. The National Institutes of Health Stroke Scale (NIHSS) scores were compared in 120 patients selected randomly from online referral (study group,n=60) and non-online referral (control group,n=60) within the same time periods in 2018.Results In 2017 and 2018, the number of patients accepted intravenous thrombolysis was 85 and 103, respectively, and the rate of intravenous thrombolysis was 9.92％ and 9.83％; they were all significantly larger/higher than those in 2016 (n=50, 6.97％,P<0.05). In 2017 and 2018, the number of patients accepted emergency endovascular treatment was 56 and 129, respectively, and the emergency endovascular treatment rate was 6.53％ and 12.31％; they were all higher than those in 2016 (n=44 and 6.14％), and the differences between those in 2018 and 2016 were statistically significant (P<0.05). The DNT ([82.00±18.75] min in 2017 and [77.00±32.17] min in 2018) was significantly shorter than that in 2016 ([109.00±30.58] min,P<0.05). The NIHSS scores of the study group and control group were 4.70±3.64 and 8.90±5.62, respectively, after one week of treatment, both of which were lower than those before treatment (14.30±6.29 and 13.60±6.37); and after treatment, the NIHSS scores of the treatment group were statistically lower than those of the control group (P<0.05). Conclusion Construction and effective operation of network platform for treatment and rescue of acute and severe cerebrovascular diseases is an effective guarantee to improve the success rate of treatment for patients with acute ischemic stroke.

Objective To explore the prognostic factors in Guillain Barre syndrome (GBS) in children. Methods A total of 125 children with GBS were included and grouped according to their independent walking at two and six months after discharge, and their clinical data were analyzed. Results In 125 children (74 males, 51 females) the average age was 84.49±25.32 months, and 41 were under 6 years old. 102 children had a history of prodromal infections. 32 children had cranial nerve involvement and 35 had autonomic nerve involvement. 12 children need assisted respiration. At 2 and 6 months after discharge, when compared with children who could walk independently, the rates of functional score > 3, cranial nerve involvement, and neuroelectrophysiology as denervation potential were higher in children who could not walk independently, and the differences were statistically significant (P all<0.05). Conclusions The factors that affect the short-term prognosis are denervation potential in neuroelectrophysiology, cranial nerve involvement, and functional score > 3. Early identification of uniqueness in patients and subsequent development of targeted rehabilitation training should be carried out to improve the prognosis.