ObjectiveTo investigate the clinical features and the causes of misdiagnosis of benign paroxysmal positional vertigo (BPPV) in the elderly. Methods21 aged patients diagnosed with BPPV finally were analyzed retrospectively. ResultsBPPV occurred more in female and associated with the posterior semicircular canal. The symptoms of vertigo were obviously improved with the canalith repositioning. With suffering from chronic diseases such as hypertension and cervical spondylosis etc., BPPV in the aged was easily misdiagnosed. ConclusionThe main reason for the misdiagnosis of BPPV in the aged is deficiency of knowledge of vertigo. Canalith repositioning is a safe and effective treatment for the aged with BPPV.

Objective To compare the individual effects of three recruitment maneuvers (RM) in children with congenital heart disease complicated by postoperation acute respiratory distress syndrome (ARDS).Methods A prospective single-blind randomized controlled trial was conducted.Thirty-two children with congenital heart disease complicated with ARDS after open-heart surgery undergoing mechanical ventilation were randomized into three groups,to whom three different RM was respectively performed,namely sustained inflation (SI),progressively increased positive end expiratory pressure (IP) and pressure control ventilation (PCV).Blood gas analysis was done every 6 hours,and the lung RM was performed if oxygenation index (OI) ≤ 300 mmHg (1 mmHg =0.133 kPa).The OI,the dynamic lung compliance (Cdyn),as well as the parameters of hemodynamics before,during and after RM for 15,30,and 60 minutes were recorded and analyzed before and after RM.Results During the treatment process,the OI was significantly increased during the process and 15,30 or 60 minutes after RM compared with that before RM,with no statistical difference among groups (F value was 1.027,0.403,0.264,0.172,0.159,and P value was 0.367,0.671,0.769,0.843,0.853).The Cdyn at all time points in each group was also significantly increased,but there was no statistical difference among groups (F value was 0.009,0.015,0.206,0.010,0.389,and P value was 0.991,0.985,0.814,0.990,0.683).In the process of RM,the heart rate (HR) and mean arterial pressure (MAP) of the children were lowered compared with those before RM [HR (bpm):131.67 ± 9.56 vs.138.93 ± 5.22 in SI group,133.27 ± 9.54 vs.140.33 ± 7.74 in IP group,137.13 ± 7.39 vs.142.40 ± 9.18 in PCV group,all P ＜ 0.01;MAP (mmHg):55.07 ± 4.43 vs.65.87 ± 4.46 in SI group,58.82 ± 6.04 vs.64.02 ± 7.65 in IP group,57.89 ± 4.71 vs.65.36 ± 5.37 in PCV group,all P ＜ 0.01],but it recovered immediately.CVP in all three groups was increased during RM [cmH2O (1 cmH2O =0.098 kPa):11.60±0.99 vs.5.53±0.74 in SI group,10.33± 1.35 vs.5.40±0.74 in IP group,10.20±0.94 vs.5.80±0.68 in PCV group,all P ＜ 0.01].There was significant difference in CVP during RM among three groups (F =7.327,P =0.002),and CVP in SI group was higher than that of other two groups (both P ＜ 0.05).CVP returned to the former level in 15 minutes after RM in IP and PCV groups,and recovered in 30 minutes in SI group.Conclusions All of the RM methods can effectively improve oxygenation and pulmonary compliance of the children with complication of ARDS,and they complement the inadequacy of lung protective ventilation.PCV and IP are more effective than SI in the uniform re-expansion of alveoli after RM and recovery of hemodynamics.

12E7 Antigen ; Adult ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Hemangiopericytoma ; pathology ; Humans ; Lymphoma ; pathology ; Male ; Nasal Cavity ; Neuroectodermal Tumors, Primitive ; pathology ; Nose Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

Adult ; Bronchoalveolar Lavage ; nursing ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; nursing ; therapy ; Retrospective Studies

Two new sesquiterpenoids, named as tyromols A and B (1 and 2), were isolated from cultures of basidiomycete Tyromyces chioneus, along with two previously reported 15-hydroxy-6 α, 12-epoxy-7β, 10αH, 11βH-spiroax-4-ene (3) and agripilol C (4). Compounds 1-4 were separated and purified by silica gel, RP-18, Sephadex LH-20 column chromatography. Their structures were elucidated on the basis of extensive spectroscopic analysis including IR, MS, 1D and 2D NMR experiments.
Basidiomycota ; chemistry ; Magnetic Resonance Spectroscopy ; Sesquiterpenes ; chemistry ; isolation & purification ; Sesterterpenes

Objective:To construct the lentiviral-vector encoding human interleukin-10 protein(LV-hIL-10) and to observe the effect of LV-hIL-10 on controlling neuropathic pain via intrathecal administration in CCI rats. Methods:hIL-10 gene fragment was isolated and amplified from pCYIL-10 plasmid by PCR, and was cloned into pWPXL. The recombinant plasmid pWPXL-IL-10,envelope plasmid pMD2.G and packaging plasmid psPAX2 were cotransfected into 293T cells, LV-hIL-10 is prepared by concentrating the collected supernatant .At the same time, the empty plasmid pWPXL-GFP,pMD2.G and psPAX2 were cotransfected into 293T cells, LV-GFP is prepared for contrast.135 sheer breed pathogen-free adult male Sprague-Dawley rats divided into 9 arrays at random: CCI models 4 arrays (C0,C1,C2,C3), sham operatived rats 4 arrays (S0,S1,S2,S3) and a normal contrast array (N), each respectively intrathecal injection LV-hIL-10 (C1,S1)、LV-GFP (C2, S2),isotonic Nachloride (C3,S3) and control (no implanted catheters and no administration, C0,S0), the pain threshold of each array and the expression of mRNA and protein of IL-10 in spinal cord,pallium and hippocampus on different time were observed after intrathecal administration LV-hIL-10 in successful CCI model rats . Results:The hIL-10 gene fragment was obtained from pCYIL-10 plasmid, pWPXL-hIL-10 was recombinated successfully. the cloned gene segment was validated by DNA sequencing .High titer(2?1010)and highly purified LV-hIL-10 particles were obtained by three plasmids were cotransfected into 293T cells. The mechanical allodynia and thermal hyperalgesia were alleviated via intrathecal injection LV-hIL-10 in CCI rats. The overexpression of IL-10 were detected in spinal cord,pallium and hippocampus , especially in the spinal cord .Conclusions:The mechanical allodynia and thermal hyperalgesia can be relieved by intrathecal injection LV-hIL-10 in CCI rats.

Objective To analyze the test results of persons with noise -induced hearing loss using disyllabic Mandarin speech test materials (MSTMs) .Methods 57 subjects with noise -induced hearing loss (noise group) were divided into three groups according to the duration of noise exposure :less than 10 years ,between 11 and 20 years and more than 20 years ,and also separated into 2 groups in terms of the degrees of hearing loss (group A :pure tone average thresholds of 0 .5 ,1 ,2 ,and 4 kHz less than or equal to 30 dB HL ,group B:pure tone average threshold of 0 .5 ,1 ,2 ,and 4 kHz greater than 30 dB HL) .66 subjects with normal hearing were in the control group .All the subjects enrolled in this study could speak Mandarin well in their daily life .Nine lists of disyllabic Mandarin speech test materials were utilized to test SRT and P -I function for these groups respectively .Results PTA and SRT in the noise group were much higher than the control group ,the average slope of P -I function was 5 .94% /dB ,and the curve of P-I function moved to the right side .SRT showed obvious changes as the increase of the years of noise exposure and especially in the group which had more than 20 years noise exposure (P<0 .01) . SRT of group B which had more hearing loss were greater than that of group A (P<0 .01) .Conclusion SRTs in the noise group are much higher than the control group with the average slope of P -I functions decreasing and the curve moving to the right side .As the years of noise exposure increase and the degrees of hearing loss become more severe ,SRT rise more apparently .

Objective To analyze reasons of open operation after percutaneous vertebroplasty.Methods From January 2008 to January 2012,516 patients (587 vertebrae) underwent percutaneous vertebroplasty in our hospital.Among them,13 patients occurred serious complications after operation:9 cases of spinal cord injury and 4 cases of nerve root injury.There were 5 males and 9 females,aged from 53 to 72 years (average,64.5 years).There were 10 cases of osteoporotic fracture,2 cases of vertebral metastases and 1 case of vertebral hemangioma.The lesion segments were as follows:T7 in 1 case,T8 in 1 case,T9 in 2 cases,T10 in 1 case,T11 in 1 case,T12 in 2 cases,L1 in 3 cases,L3 in 1 case and L4 in 1 case.According to the American Spinal Injury Association (ASIA) classification,9 patients with spinal cord injury were rated as follows:grade A in 2 cases,grade B in 1 case and grade C in 6 cases.Four patients with nerve root injury had skin hypesthesia,and the muscle strengths of them were grade Ⅱ.All patients underwent posterior open operation 4-12 h after definite diagnosis.Results Thirteen patients were followed up for 3 to 47 months (average,14.1 months).The reasons of open operation were as follows:bone cement leakage in 6 cases (46.2％,6/13),puncture failure in 3 cases (23.1％,3/13) and indication select error in 4 cases (30.8％,4/13).All 6 cases of bone cement leakage were non vascular leakage,including 2 cases of leakage into the spinal canal and 4 cases of leakage into the nerve root canal.At final follow up,the muscle strength was improved to grade V in 3 patients with nerve root injury and grade Ⅳ in remaining 1 patient.And skin sensation was also improved.The ASIA grade of 7 patients with spinal cord injury was improved:grade D in 4 cases and grade E in 3 cases.For remaining 2 patients,there was no change in ASIA grade.Conclusion The reasons of open operation after percutaneous vertebroplasty include bone cement leakage,puncture failure,and indication select error.And bone cement leakage is the most common.

As pioneer of tumor stem cell research, leukemia stem cell research has not only important theoretical significance, but also clinical application potential. The survival and development of stem cells are directly impacted by their microenvironment. The research on leukemia stem cells and their microenvironment are now becoming a hot topic. The author presumes that stem cells are a population with heterogenecity and hierarchy; any single cell from the population is difficult to form a clone; the interaction between the leukemia stem cell and its microenvironment can be described by the concept of leukemia stem cell niche. In this article, the leukemia cell population with heterogenecity and hierarchy as well as leukemia stem cell niche were summarized and discussed.
Cell Line, Tumor ; Humans ; Leukemia ; genetics ; pathology ; Neoplastic Stem Cells ; metabolism ; pathology ; Stem Cell Niche ; cytology ; Stromal Cells ; cytology ; immunology

Relapse, which puzzled several generations of hematologists, is the bottle-neck of radical treatment for leukemias. The progress of Human Microbiome Project at the beginning of 21st century suggested that human body was a super-organism constituted by the core of human cells and symbiotic microorganisms. The elucidation and characterization of endogenous retrovirus and prion protein suggested the possible effects of co-evolutional microorganisms on human health. Recently, the elucidation of the roles of tunneling nanotubes in intercellular communication and transportation suggested a novel way for cellular communication and transport of oncogenic materials. The role and significance of in vivo cell fusion have been studied in more detail. On the other hand, donor cell leukemia was reported. All of these approaches provide novel insights for studying the mechanism of leukemia relapse. Based on previous work, the authors suggest the hypothesis: there are two possible mechanisms for the relapse of leukemias: the minimal residual disease (MRD) and intercellular transportation of oncogenic materials.
Cell Fusion ; Humans ; Leukemia ; pathology ; Neoplasm, Residual ; pathology ; Recurrence