Objective To evaluate the effect of small-dose Lorazepam on residual dizziness in elderly patients with benign paroxysmal positional vertigo (BPPV) after successful particle repositioning maneuver (PRM).Methods A total of 268 patients aged 60 years and over, who were diagnosed as BPPV and underwent successful treatment of PRM, were randomly assigned to medication group and control group.The patients in the medication group were prescribed low-dose lorazepam for 1 week (0.25 mg/time, 3 times/d), whereas the patients in the control group were not prescribed any medication.Hamilton Anxiety Scale (HAMA) was employed to evaluate the anxiety status of patients before and after PRM, and the effect of small-dose lorazepam on residual dizziness was accessed by using the Dizziness Handicap Inventory (DHI) scale and the Activities-specific Balance Confidence (ABC) scale in elderly BPPV patients after PRM.Results No difference in HAMA scores was found between the two groups (t=-0.316, P=0.753) before PRM.The medication group (t=19.931, P=0.000) and the control group (t=26.930, P=0.000) showed a significant improvement in HAMA scores after PRM versus before PRM.However, HAMA scores after PRM was lower in the medication group than in the control group (t=14.967, P=0.000).The medication group had significant improvements after PRM versus before PRM in the following: DHI scores (t=43.661, P=0.000), functional (t=32.326, P=0.000981), emotional (t=31.981, P=0.000), physical (t=14.330, P=0.000) subscale scores, as well as in the ABC scores (t=-23.248, P=0.000).The improvements were also found in the control group in DHI scores (t=46.282, P=0.000), functional (t=32.117, P=0.000), emotional (t=34.563, P=0.000),physical (t=13.182, P=0.000) subscale scores, as well as in the ABC scores(t=-24.536, P=0.000)after PRM versus before PRM.However, after PRM the total DHI score, functional,emotional and physical subscale scores were lower in medication group than in control group (t=5.994, 3.206, 4.757 and 2.851, respectively, P=0.009, 0.002, 0.000 and 0.005).The ABC scores were higher in medication group than in control group (t=2.678, P=0.008) after PRM.Conclusions The elderly patients with BPPV are often accompanied by symptoms of anxiety.The small-dose Lorazepam can alleviate residual dizziness in elderly BPPV patients after successful PRM.

Objective To investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in each ear,and to explore the effect of sleep position in lateral-predominance of ear by PC-BPPV during sleep onset in elderly patients. Methods Totally 114 patients aged (67.4±7.5) years with unilateral PC BPPV confirmed by a positive Dix Hallpike test,were retrospectively reviewed.All patients included in the study were able to define a leteral predominant,favorate head-lying side (right,left or supine position) during sleep onset. Results The Dix Hallpike test was found to be positive on the right side in 72 patients and positive on the left side in 42 cases.During sleep onset,61 patients habitually laid their head on the right side,34 laid their head on the left,and the remaining 19 cases on the supine position.Among 114 cases with positive Dix Hallpike test,there were 78 cases with the same side between affected ear and sleep position (52 cases right,26 cases left),36 cases with different side (9 cases with right position and left positive Dix Hallpike test,8 cases left position and right positive Dix Hallpike test,19 cases slept in a supine position including 12 cases with right positive Dix Hallpike test and 7 cases with left positive).The association between affected ear and head-lying side during sleep onset was statistically significant (x2 =35.737,P＜0.01) and Pearson coefficient of continency was 0.4885. Conclusions Among the elderly,right-sided PC-BPPV is popular,and these patients favorite right head-lying position during sleep.There is association between the affected side by PC-BPPV and the head-lying side during sleep.

Objective To compare the short term prognostic values between the four scores including ABCD,ABCD2,ABCD+ low density lipoprotein (ABCD+ LDL),ABCD2 + LDL after transient ischemic attack (TIA).Methods 235 TIA patients were evaluated according to ABCD score,ABCD2 score,ABCD + LDL score and ABCD2 + LDL score.The occurrence of cerebral infarction was observed at day 2 and 7.The predictive value was compared between the four scores by using receiver operating characteristic (ROC) curve.Patients were classified into 3 risk groups:lowrisk group,moderate-risk group and high-risk group according to ABCD2 L score,and the stroke incidence was compared between the 3 groups by using x2 test.Results The area under ROC curves (AUCs) of ABCD、ABCD2、ABCDL and ABCD2L was 0.68 (95％CI:0.59-0.76),0.71 (95％CI:0.62-0.80),0.73 (95％CI:0.65-0.82) and 0.77 (95％CI:0.69-0.84) in predicting the risk of cerebral infarction at day 2,and were 0.73 (95％CI:0.66-0.81),0.77 (95％CI:0.70 0.84),0.80(95％CI:0.74-0.87) and 0.83 (95％CI:0.76-0.89) in predicting the risk of cerebral infarction at day 7 respectively.Patients were divided into 3 groups:low-risk group (score 0-2) (n =28),moderate-risk group (score 3-5) (n=143) and high-risk group (score 6-8) (n=45) according to ABCD2L score.There were significant differences in stroke incidence at day 2 and 7 between the 3groups (0％,9.1％ vs.32.8％,0％,11.9％ vs.56.3％,x2=26.15,58.87,both P＜0.05).Conclusions ABCD2 score is better than ABCD score in predicting the short-term prognosis of transient ischemic attack.Combining ABCD2 score with LDL can significantly increase the predictive value of ABCD2 score.

Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P ＜ 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P ＜ 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.

Objective To investigate the changes in plasma microRNA-126 and microRNA-1 in children with asthma exacerbation and its relationship with bronchial asthma.Methods From October 2012 to December 2013,48 children with asthma exacerbation from the Outpatient Department and the Inpatient Department in Houjie Hospital Affiliated to Guangdong Medical College were enrolled in the study (asthma group).Meanwhile,52 healthy children wcre selected as the healthy control group.The expression levels of plasma microRNA-126 and microRNA-1 were detected by real-time quantitative PCR (RT-PCR).The content of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in plasma was measured by enzyme-linked immunosorbent assay (ELISA).The predictive value of microRNA-126 and microRNA-1 in plasma to bronchial asthma was evaluated by receiver operating characteristic (ROC) curve.Results The relative expression levels of plasma microRNA-126 in the asthma group were upregulated compared with those in the healthy control group [7.36 (0.96-41.21) vs 3.68 (0.75-38.91),Z =3.135,P =0.038],and microRNA-1 relative expression levels in the asthma group were lower than those of the healthy control group [2.17 (0.18-26.97) vs 5.83 (0.82-39.62),Z =2.156,P =0.045].The content of IL-4 in asthma group was higher than those of the control group [(109.98 ± 74.58) ng/L vs (78.50 ± 75.82) ng/L,t =2.122,P =0.036],and the IFN-γ level in the asthma group was lower than those of the healthy control group [(70.49 ± 12.03) ng/L vs (77.03 ± 17.16) ng/L,t =2.270,P =0.025].In the plasma of patients with asthma exacerbation,the sensitivity of microRNA-126 and microRNA-1 was 85.42％ (41/48 cases)and 79.17％ (38/48 cases),respectively.The specificity of microRNA-126 and microRNA-1 in healthy controls was 78.85％ (41/52 cases) and 73.08％ (38/52 cases),respectively.The area under ROC curve of microRNA-126 and microRNA-1 was 0.919 (95％ CI 0.866-0.973),0.867 (95％ CI 0.796-0.939).Conclusions MicroRNA-126 is significantly elevated in plasma of children with asthma exacerbation.The plasma levels of microRNA-1 were significantly downregulated.These results suggest that microRNA-126 and microRNA-1 may be potential markers for the diagnosis of bronchial asthma.

Objective To investigate the reduce of experimental autoirnmune encephalomyelitis(EAE) susceptivity after lipopolysaccharide (LPS) exposure in neonatal rats and its relation with inhibition of macrophage immune function.Methods Litter male neonatal rats were divided into blank control group (n=1 1),phosphate buffer (PBS) group (n=12) and LPS group (n=12);rats in the LPS group were performed intraperitoneal injection of 50 μL LPS on postpartum day 3 and 5.Rats in the PBS group and LPS group were established EAE models by immune induce of spinal cord homogenate of guinea pig with complete Freund's adjuvant at 12 weeks old,while rats in the blank control group were given immune induce of complete Freund's adjuvant.Since the day of induce,the behavioral scale scores of all the rats were assessed.On the 20th d,all rats were sacrificed and paraffin sections were cut and stained with HE to detect inflammatory cell infiltration.The number of infiltrating macrophages and the expressions of CD86,CD80,MHC-Ⅱ were determined by flow cytometry.The transcriptional levels of C-C chemokine receptor type 2 (CCR2),interleukin (IL)-1β and tumor necrosis factor (TNF)-α in macrophages were determined by real-time fluorogenic quantitative PCR.Results As compared with the PBS group,LPS group had significantly lower EAE incidence (11/12 vs.5/12) and higher EAE latency ([10.50±0.71] d vs.[12.17± 1.17] d),and statistically decreased cumulative clinic scores and peak clinic scores (20.00±9.13 vs.5.58±7.12;2.58±1.08 vs.1.03±0.83,P＜0.05).The inflammation in the spinal cord of the PBS group was severer than that in the LPS group (2.83±0.75 vs.1.17±1.17,P＜0.05).The number of infiltrating macrophages of the PBS group was significantly larger than that in the LPS group ([202.70 ±81.89] × 103 cells vs.[92.58 ±42.65] × 103 cells,P＜0.05).The expressions of CD80 and MHC-Ⅱ,and mRNA levels of CCR2,IL-1β and TNF-α in the PBS group were significantly higher than those in the LPS group (P＜0.05).Conclusion Neonatal LPS exposure reduces the severity of EAE,which may relate to impaired macrophage immune function.

Objective:To investigate and analyze the current situation and influencing factors of the establishment demand for electronic health records (EHR) of residents in Sichuan and Hainan Province under the “Internet+healthcare” ecology.Methods:It was a cross-sectional study. A total of 1 200 residents in Sichuan and Hainan Province were selected with convenient sampling method from June to December 2022. A self-designed questionnaire was conducted through the Questionnaire Star online survey, and the survey mainly included general demographic data and basic establishment demands of electronic health records. A total of 1 200 questionnaires were distributed and 1 200 questionnaires returned with 1 170 valid questionnaires (97.5%), including 409 from Sichuan and 761 from Hainan. Chi-square test was used to compare the differences between the two provinces in the demographic characteristics, basic needs, and binary variables of willingness to application file establishment and physical examination file establishment. Kruskal-Wallis test was used to compare the differences in multiple categorical variables between the two provinces. Binary logistic regression was used to analyze the influencing factors of the establishment needs of the electronic health records.Results:The proportions of residents with bachelor degree or above and those with a family population of less than 3 people in Sichuan were both significantly higher than those in Hainan (55.3% vs 47.4%, 38.4% vs 29.2%); but the proportions of mean monthly income ≤10 000 yuan, annual physical examination, self-health management habits, and having children were all significantly lower than those in Hainan (82.2% vs 87.9%, 67.2% vs 74.4%, 78.5% vs 83.7%, 67.2% vs 73.3%) (all P<0.05). The people who were living in the city, having a mean monthly income >10 000 yuan, receiving annual physical examination, not lived alone, having self-health management habits, knowing the electronic health record, willing to manage the electronic health record by themselves, expecting to manage the health record online, needing special assistance to manage the health record, and willing to pay for additional services were more likely to use the application to establish health records (68.7% vs 56.7%, 82.4% vs 63.0%, 72.2% vs 55.3%, 68.8% vs 62.7%, 69.0% vs 60.4%, 73.2% vs 60.4%, 71.9% vs 36.7%, 71.5% vs 45.7%, 76.6% vs 43.3%, 80.1% vs 44.0%) (all P<0.05). Residents who lived in cities, had annual physical examination, had children, and were willing to manage health records by themselves were more likely to establish physical examination files (46.0% vs 32.5%, 47.9% vs 36.2%, 47.1% vs 33.2%, 45.9% vs 34.4%) (all P<0.05). Willing to manage electronic health records by themselves ( OR=3.803, 95% CI: 2.013-6.875), managing electronic health records online ( OR=1.942, 95% CI: 1.110-3.400), managing electronic health records with dedicated person ( OR=3.277, 95% CI: 2.028-5.294), willing to pay for electronic health records ( OR=3.557, 95% CI: 2.182-5.800), having electronic physical examination records ( OR=1.850, 95% CI: 1.191-2.872) were positively correlated with the willingness to use the application to establish health files, and the age ( OR=0.681, 95% CI: 0.469-0.989) was negatively correlated with the willingness to use the application to establish health files (all P<0.05). Having chronic diseases ( OR=1.389, 95% CI: 1.032-1.868) and willing to manage electronic health records by themselves ( OR=1.553, 95% CI: 1.004-2.401) were positively correlated with willingness to set up health files. Receiving annual physical examination ( OR=0.669, 95% CI: 0.497-0.901), willing to pay for electronic health records ( OR=0.576, 95% CI: 0.423-0.783), willing to use the application to establish health files ( OR=0.715, 95% CI: 0.582-0.979) were negatively correlated with willingness to establish files for physical examination (all P<0.05). Conclusion:Residents in Sichuan and Hainan Province have a high demand for electronic health records, which is affected by many factors. Age and chronic diseases are the significant factors influencing residents′ choices of using apps and physical examinations to establish their health records.

A 11-year old female patient with severe thalassemia, receipt a lentivirus-based cell and gene therapy (CGT) therapy in Shenzhen Children′s Hosptial on July 27th, 2021. At the two follow-up visits after discharge, patient were continuously tested positive for HIV screening through HIV Ag/Ab Combo assay (chemiluminescence Immunoassay), and the viral load results of HIV-1 nucleic acid testing (NAT) were both>5 000 copies/ml. The patient can be diagnosed with HIV infection according to the National Guideline for Detection of HIV/AIDS(2020 Revised Edition). The thorough investigation findings and supplementary experiment results indicated that the false-positive HIV-1 NAT results was caused by cross-reactivity between the target sites detected by conventional HIV-1 NAT reagents and the lentiviral vectors fragments integrated into the genome of patient′s hematopoietic stem/progenitor cells. In conclusion, it is important for laboratories to select appropriate HIV-1 NAT testing platforms which won′t cause cross-reactivity for the testing of samples from patients who have been treated with HIV-derived vectors. It is also recommended to design and develop NAT testing platforms with multiple target regions labeled by different fluorescents for HIV NAT supplementation experiment to reduce the risk of false-positive diagnoses of HIV infection.

OBJECTIVE: To investigate the effect of emergency medical service (EMS) on the prognosis of ischemic stroke patients treated with intravenous thrombolysis. METHODS: Clinical data of 2123 ischemic stroke patients treated with intravenous thrombolysis in 70 hospitals in Zhejiang province were retrospectively analyzed. There were 808 patients sent to the hospital by ambulance (EMS group) and 1315 patients by other transportations (non-EMS group). Good outcome was defined as modified Rankin Scale (mRS) ≤ 2 at 3-month. The onset to needle time (ONT), onset to door time (ODT), door to needle time (DNT) and outcome were compared between EMS group and non-EMS group. Binary logistic regression was used to explore the influencing factors for the outcome at 3-month. RESULTS: Compared with the non-EMS group, patients in the EMS group were older, with higher baseline National Institute of Health Sroke Scale (NIHSS) score, and had a higher proportion of atrial fibrillation (all <0.05), but there were no significant differences in ONT, ODT and DNT between two groups (all >0.05). Binary logistic regression showed that EMS was not independently associated with good outcome (=0.856, 95%:0.664-1.103, >0.05). CONCLUSIONS EMS had not improve the outcome of patients receiving intravenous thrombolysis in Zhejiang province.
Administration, Intravenous ; Brain Ischemia ; drug therapy ; Emergency Medical Services ; Fibrinolytic Agents ; therapeutic use ; Humans ; Prognosis ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; statistics & numerical data ; Treatment Outcome