Axiong Powder is a powdered drug applied by Miao people for the treatment and prevention of URI ( upper respiratory infection) , hemorrhoid, carbuncles and boils. Preliminary analysis revealed it to contain some ten kinds of herbs. By clinical analysis, it was shown that the Powder yields rather good therapeutic results on cold, tonsillitis, pyogenic tonsillitis, contusion, sprain. Bacteria strainisolated clinically can be inhibited by Axiong water decoction.

Benign Paroxysmal Positional Vertigo ; complications ; Humans ; Otologic Surgical Procedures ; adverse effects

ObjectiveTo investigate the effects of prenatal taurine supplementation on the Rho-ROCK signaling pathway activity and synaptophysin (Syp) expression in brain tissues of rats with intrauterine growth restriction.MethodsEighteen pregnant Sprague-Dawley rats were randomly divided into control group, fetal growth restriction (FGR) group and taurine group, with six rats in each group. Low-protein diet was given in FGR and taurine groups to establish an FGR model. Taurine 300 mg/(kg·d) was supplemented from gestational day 12 until delivery in taurine group. The mRNA expression levels of neurite growth inhibitor-A(Nogo-A), neurite growth inhibitor receptor (NgR), Rho-A and ROCKⅡin fetal rat brain were detected using reverse transcriptase polymerase chain reaction (n=24), which are the key signaling molecules of the Rho-ROCK signal pathway. The protein expression levels of Nogo-A and NgR were detected by Western blot (n=12). The mean optical density in Nogo-A, NgR and Syp was determined by immunohistochemistry (n=18). One-way analysis of variance and LSD-t test were used for statistical analysis.Results(1) Expression of mRNA: the expression levels of Nogo-A, NgR, Rho-A and ROCKⅡ mRNA in fetal rat brain were 4.09±1.34, 3.01±0.77, 39.89±7.71 and 7.82±1.83, respectively in FGR group, and were significantly higher than in control group (1.00±0.13, 1.00±0.10, 1.02±0.30 and 1.00±0.10) (t=4.735, 5.204, 7.682 and 10.675, allP<0.05). The expressions in taurine group (1.07±0.30, 1.20±0.27, 5.36±0.41 and 1.89±0.43) were significantly lower than in FGR group (t=4.645, 4.690, 6.687 and 9.485, allP<0.05), and there was no statistical difference between taurine group and control group (allP>0.05). (2) Expression of protein by Western blot: the expressions of Nogo-A and NgR protein in fetal rat brain were 1.51±0.09 and 0.31±0.05 in FGR group, 0.82±0.06 and 0.06±0.01 in taurine group, and 1.04±0.10 and 0.09±0.12 in control group. The expression was significantly higher in FGR group than in control group (t=9.644 and 5.285, bothP<0.05). The expression was significantly lower in taurine group than in FGR group (t=14.163 and 5.825, bothP<0.05), and there was no statistical difference between taurine group and control group (allP>0.05). (3) Positive expression of protein: the positive expressions of Nogo-A and NgR protein in fetal rat brain were 0.28±0.06 and 0.11±0.02 in FGR group, 0.10±0.02 and 0.04±0.01 in taurine group, and 0.07±0.01 and 0.04±0.01 in control group. The expression was significantly higher in FGR group than in control group (t=9.778 and 7.645, bothP<0.05). The expression in taurine group was significantly lower than in FGR group (t=8.679 and 7.413, bothP<0.05), and there was no statistical difference between taurine group and control group (bothP>0.05). The positive expression of Syp protein in fetal rat brain was 0.08±0.01 in FGR group, and was significantly lower than in control group (0.16±0.04,t=4.600,P<0.05). The expression in taurine group (0.14±0.36) was significantly higher than in FGR group (t=3.181,P<0.05), and there was no statistical difference between taurine group and control group (P>0.05).ConclusionsPrenatal taurine supplementation can improve neural axon development via down-regulating the expressions of the key molecules of Rho-ROCK signal pathway in fetal rat brain tissue.

Objective To investigate the effects of using a catheter balloon to treat crieopharyngeal achala-sia in patients with brainstem lesions. Methods Thirty cases of dysphagia caused by brainstem lesions were diag-nosed as crieopharyngeal achalasia through videofluoroscopy of swallowing.The cases were divided into a treatment group and a control group randomly.The treatment group was treated with balloon dilatation and routine dysphagia re-habilitation training once daily,while the control group was treated with routine dysphagia rehabilitation training only.The treatment end point was either the patient resuming an oral diet or after 4 weeks of treatment.All eases were evaluated videofluoroscopically with a drinking test pre-and pest-treatment.Results After 10 to 24 balloon dilata-tions,10 of the 15 patients in the treatment group regained the ability to take solid food and water orally,thoush 2 of them could take pasty food only.Only 2 of the 15 patients in the control group regained the ability to take common food by mouth,though 5 of them could take pasty food.The other patients had no improvement.There wag a signifi-cant difference between the two groups.The cricopharyngeal aehalasia of 12 patients in the ffeatment group improved from incomplete relaxation/opening to complete relaxation/opening.Pooling and residue in the pyriform sinus or val-leculae was reduced and no misaspiration was observed.In the control group only 7 patients had some improvement.The mesn time for the bolus passing the pharynx after treatment was significantly shortened from 0.23 s to 0.15 s in the treatment group,but not significantly in the control group.Conclusions Catheter balloon dilatation is effective for cricopharyngeal achalasia caused by brainstem injury and is helpful for relieving the symptoms in the pharynx phase and the esophagus phase of dysphagia.

Objective To compare 76% meglucamine diatrizoate solution with 60%barium sulphate suspen-sion for use in videofluoroscopic swallowing studies(VFSSs).Methods Forty-nine cases of dysphagia caused by brain injury.brainstem lesion ir nasopharyngeal carcinoma(NPC)were recruited for this study.They were divided into a meglucamine diatrizoate group of 22 patients who were administered 76% meglucamine diatrizoate solution as a contrast agent,and a barium sulphate group of 27 patients with whom 70%barium sulphate suspension was used.All the Datients were treated by balloon dilatation and other routine dysphagia rehabilitation procedures.The treatment end point was either the patient's resuming an oral diet or after 4 weeks of treatment. All cases were evaluated by VFSS pre-and post-treatment.Results The patients in the meglucamine diatrizoate group showed significant pre-and post-treatment differences in terms of the pharynx transit times of brain injury and brainstem lesion victims.NPC patients showed no significant differences.In the barium sulphate group there were significant pre-and post-treatment differences in Dharynx transit time for patients with all three conditions. Conclusions Using 76%meglucamine di-atrizoate solution as a contrast agent decreases the sensitivity of VFSS. Using 60% barium sulphate suspension in VFSS is recommended.

Objective To analyse clinical application of reversed anterolateral thigh adipefascial flap in repair of defects around the knee. Methods Reversed anterolateral thigh adipofascial flap was employed to repair defects of knee and upper shank in five patients from July 2006 to April 2007. The perforator arteries were detected and labelled with a hand held Doppler flowmeter before operation. The size of flaps containing perforator artery ranged from 6 cmx 8 cm to 12 cm×13 cm. After the descending branch was severed at the bifurcation of the lateral circumflex femoral artery, the flaps were elevated distal-ly to cover the defects of the knee and upper part of the shank. A split thickness graft was harvested to cover the flap. Results All the reversed anterolateral thigh adipofascial flaps survived well, with no complications occurred in donor site. Partial graft necrosis occurred in one patient and healed after conser-vative wound dressing change. Conclusion The reversed anterolateral thigh adipofascial flap is a good choice for repair of defects around the knee, for it can provide long thin vascular pedicle and maintain contour of the donor cite.

Objective To explore the significance of urodynamics detection in benign prostatic hyperplasia (BPH) patients with cerebral vascular accident. Methods The results of urodynamics were detected in 60 BPH patients with cerebral vascular accident (research group) and 60 simple BPH patients (control group), and the results were compared. Results The levels of bladder compliance (BC), maximum bladder capacity (MCC), maximum urinary flow rate (Qmax), detrusor pressure before voiding (Pdet), maximal urethral closure pressure (MUCP), functional urethral length (FUL) in research group were significantly lower than those in control group:(25.0 ± 4.4)ml/cmH2O (1 cmH2O=0.098 kPa) vs. (34.0 ± 5.9) ml/cmH2O, (203.0 ± 16.8) ml vs. (256.0 ± 20.3) ml, (6.70 ± 0.25) ml/s vs. (11.10 ± 0.43) ml/s, (81.0 ± 13.6) cmH2O vs. (108.0 ± 20.2) cmH2O, (60.0 ± 9.8) cmH2O vs. (88.0 ± 12.2) cmH2O, (3.0 ± 0.5) cm vs. (5.2 ± 0.8) cm, P < 0.05. The level of postvoid residual volume (PRV) in research group was significantly higher than that in control group:(83.0 ± 9.4) ml vs. (48.0 ± 8.3) ml, P<0.05. The rate of low compliance bladder and unstable bladder in research group were significantly higher than that in control group:63.3%(38/60) vs. 25.0%(15/60), 66.7%(40/60) vs. 28.3%(17/60), P<0.01. Conclusions Cerebral vascular accident can increase the bladder dysfunction of patients with BPH .

Objective To investigate the minimal invasive management of cystitis glandularis with invasion of the ureteric meatus.Methods The clinical data of 18 cases were reviewed.Among the 18 cystitis glandularis patients,12 cases were invasion of bilateral ureteric meatus and 6 of unilateral ureteric meatus.Operation or drug treatment was performed on the diseases that can cause cystitis glandularis such as bladder stone,bladder neck stegnosis,external urethral meatus stegnosis and benign prostate hyperplasia.Sensitive antibiotic was administrated in all cases.After placing ureter catheter,transurethral plasma electro-resection was carried out in five patients whose ureteric meatus could be identified.In addition,of thirteen patients with ureteral orifice unable to be identified,there were ten cases with normal renal function,mitomycin was injected under affected membrana mucosa,and then the patient with ureteral orifice identified underwent transurethral plasma electro-resection after placing ureter catheter.On the other hand,the patient whose ureteral orifice still could not be recognized undertaken transurethral electro-resection at first,during which the ureter catheter was put once ureteral orifice had been detected,otherwise,the ureter catheter should be placed through cystoscope if nephritic colic emerged and hydronephrosis aggravated after operation.In those patients with kidney dysfunction,the ureter catheter was put by ureter discission or ureter replantation at first,the transurethral electro-resection could not be executed until the renal function recovered.Following all these procedure above,bladder instillation of drugs regularly,anti-infection and symptomatic treatment were administrated.Results One patient combined with bladder adenocarcinoma received cystectomy,of the other patients,six cases recurred and underwent electrotomy again resulting in no relapse.All nephrohydrops vanished or relieved obviously,nevertheless,urinary tract infection,haematuria and bladder-ureter backstreaming as the cardinal complication developed in some cases.Conclusion In the management of cystitis glandularis encroaching ureteric meatus,total or partial cystectomy can be avoided if ureter draining freely can be ensured,motivation removal,antiinfection,injection of drug under mucosa and preoperative diuresis conduce to the achievement of ureter catheter placing,transurethral plasma electro-resection is still effective methods in treating these cystitis glandularis.

Objective To explore the effects of modified balloon dilatation therapy for treating upper esophageal sphincter dysfunction after a brainstem stroke.Methods Ten healthy adult volunteers and 20 dysphagic patients with upper esophageal sphincter dysfunction after a brainstem stroke were recruited.The 20 patients were divided into a balloon dilatation therapy group of ten who were treated with catheter balloon dilatation therapy, and a control group of ten who received conventional therapy.All were given block-designed task fMRI scans guided by a matched visual presentation system before and after the treatment.Results Widespread activation was observed in both hemispheres, including the bilateral cerebral cortex, the brainstem and the cerebellum, but the activated areas were significantly smaller in the stroke patients before treatment.After the treatment, seven patients in the balloon dilatation group were totally orally fed, while only three patients in the control group recovered totally oral intake.After dilatation, significantly more regions were activated, including the anterior cingulate, insula, supplementary motor area, precuneus and the frontal lobe.They were activated with relatively low voxels in the treatment group, while in the control group significant activation was observed only in the precuneus after treatment.Conclusion Modified balloon dilatation therapy can increase activation of the cortex and subcortical structures related to swallowing, promoting better swallowing function.

Objective To assess the neurophysiological effects of transcranial direct current stimulation (tDCS) of the motor cortex when swallowing.Methods Twenty healthy volunteers had anodal tDCS (a-tDCS), cathodal tDCS (c-tDCS) or sham tDCS applied over the hemisphere with stronger suprahyoid projections, effortful swallowing was performed simultaneously.Suprahyoid motor-evoked potentials (MEPs) on both the stimulated and non-stimulated contra-lateral hemisphere were examined immediately before stimulation and 5,30, 60 and 90 minutes later.The MEPs were normalized and analyzed using two-way repeated measures analysis of variance.Results The tDCS had long-lasting effects on the suprahyoid MEPs bilaterally.There were significant changes in the effect over time.Sham tDCS showed no significant effect.Compared with sham tDCS, a-tDCS significantly increased the excitability of the stimulated hemisphere, but not the non-stimulated projection.Compared with sham tDCS, c-tDCS induced decreased cortical excitability in the stimulated hemisphere but an increase in the non-stimulated projection.Conclusions tDCS during swallowing can alter bilateral swallowing activity in the motor cortex in a polarity-dependent and site-dependent way.A-tDCS enhances the excitability of the stimulated hemisphere while c-tDCS inhibits it ipsilaterally but increases it contralaterally.