OBJECTIVE: To compare the effectiveness of sequential treatment for subjective and objective benign paroxysmal positional vertigo(BPPV). METHOD: The efficacy of sequential treatment for nineteen vertical semicircular canal S-BPPV patients(Group A) and forty-five vertical semicircular canal O-BPPV patients(Group B) who were admitted to our hospital between January 2014 and July 2015 was retrospectively analyzed and compared, treatment of five cases with horizontal semicircular canal S-BPPV was reported here as well. RESULT: The number of repositioning maneuver for Group A was 2 - 6 times (average: 4. 21±1. 18) while 2 - 3 times (average: 2. 29 ± 0. 46) for Group B. There was significant difference between the two groups(P<0. 01). The effective rate of initial treatment for Group A was 78. 9%(15/19) while 82. 2%(37/45)for Group B. After one weeks treatment, the effective rate for Group A changed to be 89. 5% (17/19)while 88. 9% (40/45) for Group B. Non-significant difference was found in the two groups neither in the initial nor one weeks treatment. On three months' follow-up, one in Group A and two in Group B relapsed, and they were cured after treated in the initial treatment. The recurrence for Group A was 5. 3%(1/19) while 4. 4%(2/45) for Group B and there was non-significant difference. The five cases with horizontal semicircular canal S-BPPV were completely free of disease after undergoing treatment. CONCLUSION The sequential treatment is effective for both vertical semicircular canal S-BPPV and vertical semicircular canal O-BPPV, but the former needs more repositioning maneuver times. The repositioning maneuver, combined with drug therapy and head-shake-in-supine-position method is recommended for horizontal semicircular canal S-BPPV.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Patient Positioning ; Recurrence ; Retrospective Studies ; Semicircular Canals ; physiopathology ; Treatment Outcome

OBJECTIVETo explore the expression of p-p38 MAPK protein and the number of astrocytes expressing p-p38 MAPK in CA1 hippocampus in rats during the induction of brain ischemic tolerance induced by intermittent hypobaric hypoxia (IH) preconditioning.

METHODSThirty healthy adult male Wistar rats were randomly divided into 6 groups (n = 5 in each group): sham 0 min group, IH + sham 0 min group, sham 7 d group, IH + sham 7 d group, Ischemia (Is) 7 d group, and IH + Is 7 d group. Neuropathological evaluation was performed by thionine staining in CA1 hippocampus in rats. The expression of p-p38 MAPK in CA1 hippocampus was observed by immunohistochemical staining. And the number of astrocytes expressing p-p38 MAPK was observed by immunofluorescent double labeling.

RESULTSThe results showed that IH preconditioning induced brain ischemic tolerance successfully. At the same time, IH preconditioning obviously up-regulated the expression of p-p38 MAPK protein in CA1 hippocampus, and also increased the number of astrocytes expressing p-p38 MAPK.

CONCLUSIONIt might be concluded that IH preconditioning induced brain ischemic tolerance by up-regulating the expression of p-p38 MAPK protein in pyramidal neurones and astrocytes.

Animals ; Astrocytes ; enzymology ; pathology ; Brain Ischemia ; enzymology ; pathology ; Disease Models, Animal ; Hippocampus ; enzymology ; Hypoxia ; Ischemic Preconditioning ; methods ; Male ; Phosphorylation ; Pressure ; Rats ; Rats, Wistar ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To evaluate the efficacy of pedicle screw fixation combined with bucking bar technique in treatment of C2 pedicle fractures.Methods A retrospective case series study was conducted for 26 cases of C2 pedicle fractures undergone posterior pedicle screw fixation after putting the bucking bar on the anterior surface of C2 via oral cavity from April 2004 to April 2014.There were 19 males and 7 females,with a mean age of 42 years (range,27-71 years).Bilateral C2 pedicle screw placement status,operation time and intraoperative blood loss were recorded.American Spinal Injury Association (ASIA) impairment scale and Visual Analogue Scale (VAS) were used for outcome evaluation.Fracture reduction and symptoms such as sore throat,expectoration,hoarse voice,dysphagia and condition of posterior pharyngeal wall were detected after operation.Results Pedicle fixation of C2 pedicle fractures was completed successfully in 21 cases,repeat C2 pedicle fixation took place in three,and C1-3 fixation was conducted for two.Operation time was (83.2 ± 16.6) min and blood loss was (171.2 ± 115.5)ml.One of the cases experiencing repeat manipulation for screw insertion had transient body balance disorder caused by cerebellar ischemia and recovered within 2 days.X-ray and CT showed complete reduction in 17 cases and incomplete reduction in nine cases.Bony fusion was obtained 6 months after operation.Twenty cases were followed up for 3-46 months (mean,26 months).Final follow-up showed anatomical reduction and bony healing in 19 cases,while malunion in other three cases.ASIA grade improved from C to D in one case,whereas the rest showed a complete neurological recovery (ASIA grade E).VAS improved from preoperative 3-8 points [(5.2 ± 2.5) points] to 0-4 points [(1.6 ±1.5) points] at the final follow-up (P ＜ 0.05).Mild swollen sore throat occurred in four cases after operation.Laryngoscopy showed injury to the posterior pharyngeal wall mucosa (Grade Ⅰ in six cases and Grade Ⅱ in two cases),which were healed within 5-7 days after operation.Conclusion For C2 pedicle fractures,pedicle screw fixation combined with bucking bar technique via oral cavity benefits fracture reduction and stability without apparent impairment to the soft tissue of pharyngeal mucosa.

Objective To observe the imaging features of partiallythreaded screw fixation using in various kinds of C2 pedicel fracture.Methods CT image materials of 160 Chinese Han patients who suffered from atlantoaxial injury without vertebral body and pedicle fracture of C2 was included in this study,including 120 males and 40 females.Pedical trajectory selected according to Ebraheim method in threedimensional CT reconstruction was analyzed in ADW 4.4 workstation.The posterior wall fracture of C2 vertebral body,isthmus fracture and fractures under C2 laminar were simulated according to clinical observation.The trajectory length (partiallythreaded screw length) from entry point to anterior cortical bone of C2,bolt shank length from entry point to fracture line and fillet of screw length from fracture line to anterior cortical bone of C2 were measured.Relations between height,gender and partiallythreaded screw length bolt shank and fillet of screw length was evaluated.Results Male height was 167±7.9 cm on average,and female was 156±6.6 cm.The length of partiallythreaded screw was 29 mm in male and 25 mm in female on average.Height and gender was positively correlated with partiallythreaded screw length.In posterior wall fracture of C2 vertebral body,length of bolt shank was an average of 17 mm in male and 15mm in female,while fillet of screw length was 12 mm in male and 10 mm in female.The mean length of bolt shank was 14mm in male and 13 mm in female,while mean fillet of screw length was 15 mm in male and 12 mm in female in isthmus fracture.In fractures under C2 laminar,length of bolt shank was 10 mm in male and 9 mm in female on average,while mean fillet of screw length was 18 mm in male and 15mm in female.Conclusion The length of partiallythreaded screw used in posterior axial pedicle fracture may have a close correlation to length and height.The length of bolt shank and fillet of screw was different according to the position of the fracture.

Objective: To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium (NVM) and dilated cardiomyopathy (DCM) combining hypertrabeculation in order to distinguish NVM from DCM.
Methods: Our research included 2 groups of patients: NVM group,n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.
Results:①Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classiifcation, higher plasma levels of BNP (P<0.05) and more obvious cardiac dilatation.②The patients in NVM group had the most trabeculation segments (9.82 ± 2.02) and the apical (17th segment) was involved, patients had the higher ratio of noncompacton/compaction (NC/C) as (2.84 ± 0.61), there were (4.12 ± 2.68) segments with NC/C > 2.③The patients in DCM combining hypertrabeculation group had the less trabeculation segments (5.56 ± 1.56) and the apical was seldom involved, patients had the lower ration of NC/C as (1.91± 0.42), there was at most 1 segment with NC/C > 2. All P<0.05.
Conclusion: Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C >2 in at least 2 segments of free ventricular walls.

Objective To determine the pharmacokinetic parameters of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats by HPLC. Methods Gavage and intravenous injection were employed for administration. HPLC was used to determine the concentrations of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats in different time points. The pharmacokinetic parameters were computed by DAS3.0. Results The linear range of P-methoxybenzyl alcohol in plasma was 0.63-321.17 μg/mL, r 2=0.994 5. Intra-day accuracy, inter-day accuracy, absolute recovery and stability were in specified range. Conclusion The method is simple and accurate for the determination of the pharmacokinetic parameters of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats.

Purpose Sustained attention dysfunction is a common symptom of patient with attention-deficit/hyperactivity disorder (ADHD).To reveal the neural mechanism of the abnormality of sustained attention of patients with ADHD,the cerebral blood flow (CBF) abnormalities in patients were studied by perfusion imaging.Materials and Methods Sixteen children with ADHD and twenty normal controls treated at the 401st Hospital of PLA from June 2013 to September 2015 underwent 3D arterial spin labeling (3D-ASL)scanning with GE 3.0T MRI scanner.The participants were performed four continuous sections of sustained attention to response task (SART) for 20 minutes in the scanner.Using SPM 8 toolkit,the local CBF values of both groups were compared in a voxel-wise manner,and their correlations with response time and target accuracy of SART were analyzed.Results When performing the SART,the patients with ADHD showed significantly inhibited trend of increasing CBF in the anterior cortex like dorsal cortex,medial prefrontal cortex,and motor area;however,they presented enhanced trend of increasing CBF in the posterior cortex such as posterior cingulate cortex and parietooccipital sulcus (P＜0.01);the change of CBF in the dorsal prefrontal cortex and that in the precentral and postcentral gyrus had significant correlation with response time of SART task and targeting ratio (dorsal prefrontal cortex:r=0.745,P＜0.001;r=0.591,P＜0.001;r=-0.521,P＜0.001.Precentral and postcentral gyrus:r=0.579,P＜0.001).Conclusion Patients with ADHD show different CBF redistribution between anterior and posterior cerebral cortex in performing SART,and the abnormal CBF shows significant correlations with behavioral metrics,which reflects the mechanism of sustained attention dysfunction of patients with ADHD.

Objective To explore the immunogenicity of recombinant chimeric 6Aβ15-T including the Aβ1-15 epitope and a T-helper epitope formulated with different adjuvants and to evaluate its feasibility as a candidate vaccine for Alzheimer disease (AD).Methods The recombinant chimeric antigen 6Aβ15-T formulated with Al adjuvant, Freund′s adjuvant or MF59 adjuvant was administered to two strains of mice .The 6Aβ15-T-immunized group without adjuvants ( Mock) and non-immunized group (Control) were included in this study as control groups .The specific antibody and cellular immune response of the chimeric antigen were evaluated .Results In BALB/c strain mice, three types of adjuvants could substan-tially boost the immunogenicity of chimeric antigen 6Aβ15-T and produce a high level of specific-Aβ(β-amyloid) antibod-ies.In C57BL/6 strain mice, the existence of adjuvants enhanced the immune response of 6Aβ15-T antigen, but the mice in Mock group also produced a strong antibody response .In two strains of mice, prevalence of anti-AβIgG1, which was an indicator of Th2 polarization, was observed in the 6Aβ15-T-immunized mice.Additionally, the Al adjuvant induced a high-er level of IgG1 antibody titers, and the ratio of IgG1/IgG2a was the largest.As expected, the 6Aβ15-T antigen formulated with or without adjuvants induced PADRE-specific, but not Aβ42-specific T cellular immune response .Conclusion The 6Aβ15-T antigens formulated with different types of adjuvants could induce strong Th 2-polarized Aβ42-specific antibody re-sponses without activating self-reactive Aβ42-specific T cells in two strains of mice .The results suggested that the recombi-nant chimeric antigen 6Aβ15-T is a good candidate vaccine for AD .

Objective To estimate the difference of PS、CBV/CBF in the evaluation pf angiogenesis and growth behavior of the C6 glioma.Methods Sixty adult Wistar rats were divided into 3 groups randomly.CT perfusion were performed at the time of 5,13,20 d after the rats were inoculated C6 glioma cells.Permeability surface(PS),cerebral blood volume(CBV),cerebral blood flow(CBF)of different part of the tumor(central part,peripheral part,adjacent part and contralateral normal parenchyma)were measured at different time.Results At the central parts of the lesions,there were obvious difference between different time of tumor growth among PS[(3.94?0.15),(8.47?0.34),(5.20?0.65)ml? 100g~(-1)?min~(-1)],CBF[(280.33?8.82),(388.33?14.00),(116.16?11.54)ml? 100g~(-1)?min~(-1)],CBV[(7.75?0.27),(12.73?0.98),(5.14?0.66)ml?100g~(-1)](F=4.421,P= 0.013;F=11.370,P=0.000;F=15.789,P=0.000).There were statistical difference of PS at the different time in both the peripheral and adjacent parts of the glioma.(F=13.567,P=0.000;F=12.470, P=0.000).No difference were detected in CBF or CBV at different time of the peripheral parts of the tumors(F=1.176,P=0.336;F=0.148,P=0.710).there were significant difference between different time of tumor growth among CBF[(175.33?12.95),(275.50?13.76),(246.33?12.81)ml? 100g~(-1)?min~(-1)],CBV[(4.15?0.47),(8.05?0.30),(7.54?0.89)ml?100g~(-1)]at the adjacent parts of the tumors(F=24.176,P=0.000;F=17.148,P=0.000;F=15.791,P=0.000). Coneluslon CBV,CBF can reflect the number and volume of the tumor vessels,while PS can directly reflect the function of the angiogenesis and the behavior of the glioma.

OBJECTIVETo evaluate the craniofacial characteristics of the Class II malocclusion patients with mouth-breating by posteroanterior cephalometry.

METHODSTo measure craniofacial width of the 12 Class II malocclusion patients with mouth-breathing, and to compared these measures with corresponding measures in a group of normal children.

RESULTSThe width of the maxillary base bone (J-J) was less than that in normal children significantly (P < 0.01). The mouth-breathing children's upper and lower arch width (at first molar and cuspid) were comparatively narrower, and lateronasal width (Lap-Lap) was narrower too.

CONCLUSIONMouth breathing may lead to craniofacial morphological abnormal development in craniofacial transverse structures.

Adolescent ; Cephalometry ; Child ; Cuspid ; Dental Arch ; Face ; Humans ; Male ; Malocclusion ; Malocclusion, Angle Class II ; Maxilla ; Molar