OBJECTIVE: To evaluate clinical value of electrocochleography in diagnosing the Meniere's disease. METHOD: Patients were saperated as having definite, probable and possible Meniere's disease according to the 1995 AAOHNS guidelines. Then set the probable and possible Meniere's disease as a suspected group. We used four different stimulus (clicks, 1000 Hz tone burst, 2000 Hz and 4000 Hz tone burst) to record electrocochleo-graphy. Those patients in each group received electrocochleography examination, and summating potential (SP)/action potential (AP) ratios were calculated. A prolonged action potential latency shift (AP shift) evoked by rarefaction and condensation clicks was also measured. RESULT: The click SP/AP positive rate in definite Meniere's disease group was 41.2%, tone burst at 1,000 Hz. 2,000 Hz,4,000 Hz were respectively 80.4%, 72.5%, 37.3%, AP shift positive rate was 45.1%. Using McNemar test, the positive rate of tone burst 1000 Hz (chi2 = 15.04, P < 0.01) and that of tone burst 2,000 Hz (chi2 = 8.65, P < 0.01) were statistically significant different when compared with that of click SP/AP, besides the tone burst at 1,000 Hz yielded has the highest sensitivity. The click SP/AP positive rate in suspected group and definite group were respectively 12% and 45.1% (chi2 = 6.610, P < 0.05) and AP shift positive rate of them were respectively 8.0% and 41.2% (chi2 = 10.460, P < 0.01). By chis-quare test, the positive rates of click SP/AP and AP shift between these two groups were statistically significant different. CONCLUSION Electrocochleography is a reliable test in the diagnosis of Meniere's disease. Compared with clicks, tone burst significantly has a higher sensitivity, especially at 1000Hz and 2000Hz frequencies. A prolonged action potential latency shift evoked by rarefaction and condensation clicks is also a useful addition to diagnosis Meniere' disease.
Adolescent ; Adult ; Aged ; Audiometry, Evoked Response ; Female ; Humans ; Male ; Meniere Disease ; diagnosis ; Middle Aged ; Young Adult

Objective To understand the current status and influencing factors of nursing safety management of geriatric care institutions in Shanghai. Methods Adopted questionnaire and experts spot-supervision to survey 25 geriatric nursing hospitals and 12 community health care centers which had more than 200 beds. The questionnaire had four parts including nature of institutions, general information of the managers, nursing risk management status and nursing safety quality status. Results The average score of nursing safety quality was (14.12 ± 2.03) points, there was no statistical significance in nature of institution, size of the institutions, age, education background, professional title, managerial experience, effect of nursing risk report and assessment and contingency plan (P> 0.05), but there was statistical significance in nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training(F=2.818, 7.768, 3.555, P<0.05 or 0.01). Multiple linear regression showed that nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training were the influence factors of nursing safety quality, and they account for 82.1%, and the regression equation was Y=7.988+0.365X1-0.380X2+0.350X3. Conclusions Strength the construction of nursing management team, perfect nursing management system, regular training could improve nursing safety quality of geriatric institutions in Shanghai.

Objective To compare the significance of two blood glucose monitoring methods of eight-point and five-point after liver transplantation. Methods 160 patients after liver transplantation selected eight-point or five-point blood glucose monitoring methods randomly,each method had 80 patients.Blood glucose value one month after operation,incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection were compared. Results Eight-point and five-point blood glucose monitoring methods showed no difference in incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection.Rate of blood glucose to reach standard level 4 days,1,2,3,4 weeks after operation also showed no difference. Conclusions Comparison of eight-point and five-point blood glucose monitoring methods supply the information needed in clinic,reduce the burden of patients,strengthen the compliance of patients,it has important practical significance for clinical work.

Objective To investigate why benign, paroxysmal positional vertigo (BPPV) recurs.Methods Three hundred persons diagnosed with BPPV who had been treated at Tongji Hospital of Huazhong University of Science and Technology between April 2012 and April 2014 were given a telephone follow-up at least one year after their manual repositioning treatment.The respondents were divided into a healthy group and a recurrence group according to whether they said their vertigo had recurred.The age and gender distributions of the two groups were compared, along with their underlying diseases and living-related factors.Causes of the recurrence were then hypothesized.Results Single factor analysis and binary logistic regression analysis showed that overwork, an age over 45, travelling frequently, long use of computers, sleep disorders, oral intake of calcium tablets, posterior circulation ischemia and hyperlipidemia were all closely related to the BPPV recurrence.Age over 45 showed the strongest correlation.Conclusion Aging is the greatest risk factor for the recurrence of BPPV.Posterior circulation ischemia, hyperlipidemia, overwork, sleep disorders, long use of computers and being on business frequently are also predictors of relapse.

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment.

Objective: To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). Methods: Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. Results: A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. Conclusions The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium.

Objective:To investigate the effect of high-frequency repetitive transcranial magnetic stimulation combined with sertraline on depressive symptoms and self-injurious behaviors in adolescents with depression and non-suicidal self-injury.Methods:This study was a prospective study. A total of 112 adolescent patients with depression and non-suicidal self-injury who received treatment at the Third Hospital of Quzhou from January 2021 to September 2023 were included in this study. These patients were divided into a control group and a study group, with 56 patients per group, using the random digital table method. The control group was treated with sertraline, while the study group was treated with high-frequency repetitive transcranial magnetic stimulation combined with sertraline. The depression scores [assessed using the 24-item Hamilton Depression Scale (HAMD-24) and the Self-Rating Depression Scale (SDS)], self-injury status, and inflammatory factor levels (tumor necrosis factor-α, interleukin-10, and interleukin-1β levels) were compared before and after the intervention.Results:Before intervention, there were no statistically significant differences in HAMD-24 scores and SDS scores between the two groups (both P > 0.05). After intervention, both HAMD-24 scores and SDS scores decreased significantly in both groups (both P < 0.05). Additionally, the HAMD-24 scores [(13.46 ± 3.98) points] and SDS scores [(50.28 ± 5.13) points] in the study group were significantly lower than those in the control group [(19.89 ± 4.23) points, (71.62 ± 6.88) points, t = -8.28, -18.61, both P < 0.05]. Before intervention, there were no statistically significant differences in the number of self-injury incidents and self-injurious behavior scores between the two groups (both P > 0.05). After intervention, the number of self-injury incidents and the score of self-injurious behaviors significantly decreased in the study group compared with before intervention (both P < 0.05). After intervention, the number of self-injury incidents in the control group was decreased compared with before intervention ( P < 0.05), while the score of self-injurious behaviors did not differ significantly compared with before intervention ( P > 0.05). After intervention, the number of self-injury incidents [(2.15 ± 1.06) times] and the score of self-injurious behaviors [(2.41 ± 0.65) points] in the study group were significantly lower than those in the control group [5.43 ± 3.61) times, (12.04 ± 3.01) points, t = -7.78, -23.40, both P < 0.05]. Before intervention, there were no statistically significant differences in interleukin-1β, tumor necrosis factor-α, and interleukin-10 levels between the two groups (all P > 0.05). After intervention, interleukin-1β and tumor necrosis factor-α levels in the study group were significantly lower than those before intervention (both P < 0.05), while interleukin-10 levels in the study group were significantly higher than those before intervention ( P < 0.05). There were no statistically significant differences in the levels of interleukin-1β, tumor necrosis factor-α, and interleukin-10 between the pre- and post-intervention measurements in the control group (all P > 0.05). After intervention, interleukin-1β levels [(57.15 ± 6.33) ng/L] and tumor necrosis factor-α levels [(13.87 ± 5.91) ng/L] in the study group were significantly lower than those in the control group [(73.61 ± 8.52) ng/L, (17.12 ± 5.28) ng/L], while interleukin-10 levels [(1.62 ± 0.66) ng/L] were significantly higher than those in the control group [(1.19 ± 0.63) ng/L, t = -11.60, 3.53, -3.07, all P < 0.05]. Conclusion:High-frequency repetitive transcranial magnetic stimulation combined with sertraline can significantly reduce depressive symptoms and self-injurious behaviors in adolescents with depression and non-suicidal self-injury. The reason may be due to the decrease in inflammatory factor levels in patients.

Objective:To investigate the effect of high-frequency repetitive transcranial magnetic stimulation combined with fluvoxamine treatment on improving depression, impulsivity, and self-injury levels in adolescent patients with depression.Methods:A total of 124 adolescent patients with depression who received treatment at the Department of Psychiatry, The Third Hospital of Quzhou, China from January 2022 to November 2023 were included in this study. The patients were randomly divided into a control group and an observation group, with 62 patients per group, using the random number table method. Patients in the control group received treatment with fluvoxamine, while patients in the observation group underwent high-frequency repetitive transcranial magnetic stimulation and treatment with fluvoxamine. Clinical efficacy and the scores of the Hamilton Depression Scale, Hamilton Anxiety Scale, the Barratt Impulsiveness Scale-ll revised version, and the Non-Suicidal Self-Injury Assessment Tool revised version were compared between the two groups.Results:The total response rate in the observation group was 90.32% (56/62), which was significantly higher than that in the control group [72.58% (45/62), χ2 = 6.46, P < 0.05]. After treatment, scores of the Hamilton Depression Scale and Hamilton Anxiety Scale in the observation group were (12.08 ± 1.97) points and (11.58 ± 1.59) points, respectively, which were significantly lower than those in the control group [(16.42 ± 2.33) points, (14.42 ± 1.94) points, t = -8.28, -18.61, both P < 0.05]. After treatment, the scores of the Barratt Impulsiveness Scale-ll revised version and Non-Suicidal Self-Injury Assessment Tool revised version in the observation group were significantly lower than those in the control group [(28.25 ± 3.91) points, (9.23 ± 2.12) points, t = 5.42, 9.44, both P < 0.05]. Conclusion:High-frequency repetitive transcranial magnetic stimulation combined with fluvoxamine treatment can significantly reduce depressive symptoms, impulsivity, and self-injury levels in adolescent patients with depression.

Objective:To investigate the expression of microRNA (miR) -26a in human skin fibroblasts during photoaging induced by ultraviolet A (UVA) , and to evaluate the effect of up-or down-regulation of miR-26a expression on the methylation level of the whole genome, the target gene enhancer of zeste homolog 2 (EZH2) and cell aging.Methods:Some human skin fibroblasts were irradiated with 10 J/cm 2 UVA once a day for 7 consecutive days, RNA was extracted on days 0, 3 and 7, and real-time quantitative reverse PCR (RT-PCR) was performed to determine the expression of miR-26a; miR-26a mimics and inhibitors were transfected into fibroblasts to up-or down-regulate the expression of miR-26a respectively, and fluorescence microscopy and RT-PCR were performed to determine the expression of miR-26a and evaluate the transfection efficiency. Some human skin fibroblasts were divided into 6 groups: blank control group receiving no treatment, UVA group treated with UVA irradiation according to the above method, miR-26a mimic group transfected with miR-26a-mimics, UVA+miR-26a mimic group transfected with miR-26a-mimics followed by UVA irradiation, miR-26a inhibitor group transfected with miR-26a inhibitors, UVA+miR-26a inhibitor group transfected with miR-26a inhibitors followed by UVA irradiation. On day 7, cells in each group were collected after the end of UVA irradiation. Then, flow cytometry was performed to detect cell cycle, DNA methylation quantitative detection kit was used to detect the methylation level of whole genome, RT-PCR was conducted to determine the mRNA expression of EZH2 (a histone-lysine N-methyltransferase enzyme) , DNA methyltransferase 1 (DNMT1) and miR-26a, and Western blot analysis was performed to determine the protein expression of EZH2 and DNMT1. Statistical analysis was carried out by using one-way analysis of variance and least significant difference- t test. Results:Compared with the unirradiated control group, the expression of miR-26a gradually increased in the UVA irradiation group over time during the culture, and there was a significant difference in the expression of miR-26a between the two groups after 7 days of UVA irradiation ( t=5.295, P < 0.05) . Strong fluorescence signals were observed in the miR-26a mimic-or miR-26a inhibitor-transfected fibroblasts, suggesting a high transfection efficiency. Flow cytometry showed that the proportion of cells at G1 phase significantly differed among the blank control group, UVA group, miR-26a mimic group, UVA+miR-26a mimic group, miR-26a inhibitor group, and UVA+miR-26a inhibitor group (52.82% ± 2.56%, 78.56% ± 4.34%, 53.63% ± 3.13%, 89.52% ± 4.17%, 54.39% ± 3.86%, 65.34% ± 4.78%, respectively; F=46.728, P < 0.01) , and significantly higher in the UVA group than in the blank control group ( t=8.848, P < 0.01) , higher in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group ( t=11.922, 3.154, P < 0.01, < 0.05, respectively) , and higher in the UVA+miR-26a inhibitor group than in the miR-26a-inhibitor group ( t=3.087, P < 0.05) , but significantly lower in the UVA+miR-26a inhibitor group than in the UVA group ( t=3.547, P < 0.05) . Detection of the genome-wide methylation level showed that the methylation level ( A450 value) significantly differed among the above groups (0.676 ± 0.024, 0.323 ± 0.043, 0.506 ± 0.035, 0.169 ± 0.024, 0.602 ± 0.036, 0.422 ± 0.029, respectively, F=97.402, P < 0.01) , and significantly lower in the UVA group than in the blank control group ( P < 0.01) , lower in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group (both P < 0.01) , and lower in the UVA+miR-26a inhibitor group than in the miR-26a inhibitor group ( P < 0.01) , but significantly higher in the UVA+miR-26a inhibitor group than in the UVA group ( P < 0.05) . RT-PCR and Western blot analysis showed significant differences in the mRNA and protein expression of EZH2 and DNMT1 respectively among the 6 groups (both P < 0.05) , which were significantly lower in the UVA group than in the blank control group ( P < 0.05) , lower in the UVA+miR-26a mimic group than in the miR-26a mimic group and UVA group (both P < 0.05) , and lower in the UVA+miR-26a inhibitor group than in the miR-26a inhibitor group ( P < 0.05) , but significantly higher in the UVA+miR-26a inhibitor group than in the UVA group ( P < 0.05) . Conclusion:In the UVA irradiation-induced photoaging of skin fibroblasts, miR-26a expression was up-regulated, cellular proliferative activity and genome-wide methylation level decreased; up-regulation of miR-26a expression could down-regulate the expression of its target gene EZH2 and methylation-related gene DNM1, and promote cell photoaging, while down-regulation of miR-26a expression could up-regulate the expression of EZH2 and DNMT1, and inhibit cell photoaging.

Objective To analyze the ‘late diagnoses’ (LD) phenomena among newly identified HIV/AIDS cases in China from 2010 to 2014.Methods Newly identified HIV/AIDS cases from 2010 to 2014 were selected from the National HIV/AIDS comprehensive information system.Rates related to LD were stratified according to the demographic indicators.Results From 2010 to 2014,numbers of newly identified HIV/AIDS cases were reported as 64 338,74 517,82 434,90 119 and 103 501 in China.Among them,proportions of LD were 41.8％,42.1％,38.1％,36.8％ and 35.5％ respectively.LD proportions appeared high in medical settings,with the minimum proportion as 45％ (x2=5 174,P＜0.000 1).Proportion of LD among patients who were heterosexually transmitted appeared over 40％,which was significantly higher than that seen among men who have sex with men or injecting drug users (x2=3 066,P＜0.000 1).Proportion of LD showed more than 39％ in those newly identified cases,and was seen higher in permanent residents than in floating population (less than 30％) (x2=5 265,P＜0.000 1).Conclusion With the expansion testing coverage on HIV,newly identified HIV/AIDS increased year by year.Among the newly identified cases,late diagnosis was high,especially in medical institutions.More effective strategies and measures are needed to promote the early detection of HIV in high risk population.