OBJECTIVE:To observe the efficacy and safety of mirtazapine in the treatment of perimenopausal syndrome with sleep disorders. METHODS:100 perimenopausal patients with sleep disorders were randomly divided into study group(52 cases) and control group(48 cases). Study group was given Mirtazapine tablet with initial dose of 15 mg,once a day,taking 1-2 hours before going to bed,increased and maintained to 30 mg after 1 week. The control group was given Oryzanol tablet 10 mg after meals,3 times a day. Both groups were treated for 8 weeks. Scores of HAMD-17 and PSQI before and after treatment were ob-served,efficacy of depression and sleep were evaluated and and incidence of adverse reactions in 2 groups was observed. RE-SULTS:After treatment,HAMD-17 scores and PSQI scores in 2 groups were significantly lower than before,and study group was lower than control group,8 weeks<4 weeks<2 weeks,the differences were statistically significant(P<0.05 or P<0.01). Total ef-fective rates of depression and sleep in study group were significantly higher than control group(P<0.05). There was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Mirtazapine can improve the sleep disorders of peri-menopausal syndrome with rapid onset,but the adverse reactions need futher observation.

To assess the clinical application of video head impulse test (vHIT) for vestibular function in vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) patients.Thirty-three patients with VN and 43 patients with BPPV were enrolled from Sir Run Run Shaw Hospital and Ningbo Second Hospital from March 15 to September 10, 2015; and 50 healthy controls were also enrolled in the study. vHIT was used to quantitatively test the vestibulo-ocular reflex (VOR) gains of a pair of horizontal semicircular canals. VOR gains two pairs of vertical semicircular canals, and the corresponding asymmetrical value of three VOR gains. The saccades information was also recorded.Compared with the healthy control group and BPPV patients, the affected horizontal and vertical VOR gains were declined and the corresponding asymmetries were increased in VN patients (all<0.01). BPPV group also showed higher vertical VOR gain asymmetries compared with the healthy control group (all<0.01), but no significant difference was observed in VOR gains and horizontal VOR gain asymmetry (all>0.05). The sensibility of vHIT in diagnosis of VN was 87.9%. Among 33 VN patients, 22 were diagnosed with superior vestibular nerve dysfunction, 7 were found with inferior vestibular nerve dysfunction and 3 were with both dysfunction; and 1 case was not distinguished.Video head impulse test can quantitatively evaluate the vestibular dysfunction of VN and can help early diagnosis of VN, which may be widely used in clinic.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Impulse Test ; Humans ; Reflex, Vestibulo-Ocular ; physiology ; Saccades ; physiology ; Semicircular Canals ; innervation ; physiopathology ; Sensitivity and Specificity ; Vestibular Diseases ; classification ; diagnosis ; Vestibular Nerve ; pathology ; Vestibular Neuronitis ; classification ; diagnosis