The datas of epidemiological, clinical, and immunopathology demonstrate there is an important link between upper and lower airways. The upper airways diseases including the allergy rhinitis, the professional rhinitis, the sleep apnea and hypoventilation syndrome, nose polyposis (with/without aspirin sensitive), the chronic rhinosinusitis and so on, have an important contacting with lower airways diseases. Understanding how the upper airway does affect the lower airway disease, has the influential role to diagnosis, the treatment and the prognosis. This article made the brief summary on the important relation about among the nose, the paranasal sinus and the lung recent years.
Asthma ; complications ; Humans ; Lung Diseases, Obstructive ; complications ; Rhinitis ; complications ; Sinusitis ; complications

OBJECTIVE To evaluate facial nerve decompression for Bell’s paralysis. METHODS The reports of facial nerve decompression for Bell’s paralysis were searched in PubMed and CHKD(China hospital knowledge database). Then an include criteria was made, and all the cases included were analyzed all together. The efficiency of different kinds of decompressions and time was discussed, while the steroid therapy was used as the control. RESULTS Five articles were include after search, in these reports there were 147 patients treated by surgery and 105 patients by steroid. The general rate of complete facial nerve recovery by decompression was 57.10 %, and 48.90 % by steroid therapy. The rate of complete recovery of facial nerve was 90.70 % if all segment decompression was done within 14 days after facial nerve paralysis, and it will decrease to 25.00 % if the surgery was done during 15 to 30 days after facial nerve paralysis. If the decompression was done during 15-30 days after facial nerve paralysis, the general recovery rate of mastoid and horizontal segment decompression was 45.70 %, but the all segments decompression was 25.00%. CONCLUSION Facial nerve decompression should be done within 14 days after facial nerve paralysis, the surgery done after 14 days will not improve facial nerve recovery. Till now there are no evidence can prove that all segment decompression be better than mastoid and horizontal segment decompression for Bell's palsy.

OBJECTIVE: To analyze clinical features with benign paroxysmal positional vertigo (BPPV) and discuss the attentions in the canalith repositioning procedures. METHOD: A total of 76 male and female patients aged 80 and over with BPPV (elderly group) and 76 patients aged 60-65 years old with BPPV (older group) was retrospectively analyzed. RESULT: (1)Semicircular canal condition: in elderly group, posterior semicircular canal was involved in 72 cases, whereas the horizontal semicircular 4 cases. In older group, posterior semicircular canal was involved in 70 cases, whereas the horizontal semicircular and multiple canals in 5 cases and 1 case respectively. (2) Precipitating factors: precipitating factors of elderly were variety. Its closely related with emotion, infection, seasonal alternation surgery, and trauma. There were significant differences between the two groups (P<0. 05). (3) The symptoms of undergoing treatment and post-treatment: the duration of dizziness and carebaria were significant difference after canalith repositioning procedure treatment between two groups (P<0. 05), the duration of balance disturbance and symptoms of vegetative nerve functional disturbance like nausea and sweating were significant difference (P<0. 05). (4) Treatment and outcomes: the remission, partial remission rate were 34. 2 %, 81. 6% re- spectively, after the first or second time of repositioning treatment. The efficacy of repositioning treating at the first time was significantly different between two groups (P<0. 05). It was poor efficacy in elderly group. There is no difference in efficacy for repositioning treatment at the second or third time (P>0. 05). (5) The elderly always accompanied with other medical condition and had risk factors of cerebrovascular disease. The efficacy was not associated with the complication(P>0.05). However, it was most likely to overtreatment caused by emphasizing other medical conditions treatment. BPPV was easy to ignore and misdiagnose, meanwhile, delayed the diagnosis and increased the medical costs. (6) Many elderly were accompanied cervical spondylosis, lumbar spondylosis body stiffness and fear of vertigo which increased the difficulty of repositioning treatment. (7) Recurrence: we followed up 2 years after treatment. In older group, 11 patients (14. 5%)were relapsed. In elderly group, 29 patients (38. 2%) relapsed. There were significant differences between the two groups (P<0. 05). CONCLUSION There are various precipitating factors in elderly patients with BPPV, the most frequent precipitating factors were related to psychological factor and overfatigue. The symptoms of the patients attack BPPV was always mask with other diseases, but do not impact on the efficacy of Canalith repositioning at the first time; Even the efficacy of repositioning is poor at the first time, it's effective and safety after multiple treatments of repositioning; It prolonged the symptoms including carenaria, dizziness and nausea after treatment.
Aged ; Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; psychology ; therapy ; Dizziness ; Emotions ; Female ; Humans ; Male ; Masks ; Patient Positioning ; adverse effects ; methods ; Recurrence ; Retrospective Studies ; Semicircular Canals ; Spondylosis ; Vertigo

Objective: To explore the influencing factors for depressive symptoms in adolescents in China, so as to provide insights into promoting mental health of adolescents. Methods: The 2020 follow-up survey data of China Family Panel Studies were collected, including demographic information, lifestyle, family factors and academic factors of adolescents aged 10-19 years. Depressive symptoms were evaluated using the 8-item Center for Epidemiological Studies Depression Scale. The influencing factors for depressive symptoms in adolescents were analyzed using a multivariable logistic regression model. Results: A total of 2 777 adolescents were analyzed, including 1 470 males (52.93%) and 1 307 females (47.07%). There were 1 186 adolescents (42.71%) from urban areas and 1 591 adolescents (57.29%) from rural areas, 106 smokers (3.82%), and 459 adolescents (16.53%) with depressive symptoms. Multivariable logistic regression analysis showed that academic stress (OR=1.268, 95%CI: 1.151-1.396), poor self-rated health (OR=1.255, 95%CI: 1.116-1.411), smoking (OR=1.901, 95%CI: 1.127-3.207), low trust in parents (OR=0.780, 95%CI: 0.729-0.835) and large family size (OR=1.095, 95%CI: 1.035-1.158) were associated with an increased risk of depressive symptoms in adolescents. Conclusion The influencing factors for depressive symptoms in adolescents were academic stress, self-rated health, smoking, trust in parents and family size.

Acoustic Stimulation ; Evoked Potentials, Auditory, Brain Stem ; Humans ; Speech

Objective To explore whether the changes of sound source in the horizontal azimuth can induce mismatch negativity (MMN) ,and quantify the minimal audible angle which could elicit the MMN and to find effec‐tive way to test human's ability of sound localization in the horizontal plane .Methods With the self developed sound localization device and Bio - logic auditory evoked potentiometer ,in the free field hearing tests were performed on 30 healthy young volunteers according to oddball stimulation sequence .We adopted 1 000 Hz pure tone as the stand‐ard stimuli , the change of sound source location as experimental models ,using minimum audible angle (MAA ) measure procedure ,sound localization test was conducted at 0° ,± 45° ,± 90°standard positions in the horizontal plane .MMN was obtained by subtracting the ERP of deviant stimuli from the ERP of standard stimuli .The latency and amplitude of each MMN were recorded .Results The MMAs of normal young people were recorded and normal values of latency and amplitude of MMN were obtained .The results of the sound localization test for the youth were :MAA(0°)= 2 .09 ± 1 .81° ,MAA( - 45°)= 3 .84 ± 1 .61° ,MAA (45°) = 3 .69 ± 2 .39° ,MAA ( - 90°) = 4 .41 ± 1 . 41° ,MAA(90°)= 4 .23 ± 3 .22° ,separately .There was a significant effect of the location of the deviant stimulus , with those presented at 90° eliciting larger peaks and longer latency period than those presented at 0° .Conclusion Our findings suggest that changes of sound position in the horizontal azimuth can induce mismatch negative waves , and MMN on the basis of MAA test procedure could be used to evaluate the ability of sound localization .

Bone Conduction ; Hearing Aids ; Humans

Objective To investigate the correlation between the degree of pathogenetic condition and cogni-tive impairment in young OSAHS patients. Methods Sixty-three patients (18～44 years old) were divided into 3 groups according to the assessment criteria regarding the degrees of pathogenetic conditions of hypoxemia and its persistence time: mild group(the lowest SaO2 ≥ 85 %, n = 20 ), moderate group (the lowest SaO2 : 65 ～ 84 %, n =24), and severe group (the lowest SAO2<65%, n= 19). Twenty-five healthy young adults were selected as the control group. All the subjects were tested with event-related potential, namely P300, the polysomnogram and the mini-mental state examination scale(MMSE). Results P300 latency in patients of three OSAHS groups was sig-nificantly prolonged as 326.1±12.7, 346.9±19.1, and 34.9±18.3 ms, as compared with those of control group: 311.9±18.3 ms (P< 0.05, respectively). In severe group, P300 latency was markedly increased compared with mild and moderate groups(P<0.01, P<0.05, respectively). No obvious differences were observed between mild and moderate groups(P=0. 095). The difference of hypoxemia lasting time could influence the P300 latency, such as when the hypoxemia lasting time was 4～60 seconds, the latency was 338. 12±13.7 ms, and when the hypoxemia lasting time increased to 60 ～ 140 s, the latency was prolonged to 354.74±16.7 ms(P = 0. 031 ). There was no difference among all groups in the P300 amplitudes. The MMSE scores for all patients were within normal limits andthere were differences between serve and control group(RA -RB=9. 91, P= 0. 003). Conclusion Among patients with OS-AHS, the impairment of cognitive function is con'anon. The degrees of pathogenetic conditions of hypoxemia and its lasting time may be used to evaluate the impairment degree of cognitive function in patients with OSAHS.

Objective To investigate the role of sonic hedgehog (Shh) signal transduction pathway in the expression of vascular endothelial growth factor (VEGF) under hypoxia in cultured human retinal pigment epithelial (hRPE) cells.Methods ARPE-19 were cultured and divided into normal ARPE-19 (Cont) and hypoxia group (100 μmol/L CoCl2 Cobalt Chloride +-ARPE-19);hypoxia group was further divided into CoCl2 group,cyclopamine group (CYA) and dimethyl sulfoxide (DMSO) group.20 μmol/L cyclopamine was added to the CYA group 1 hour before hypoxia,1‰ DMSO was added into DMSO group at the same time.The hRPE cells were cultured under hypoxia for 4,8,12,24 hours.The expression of Shh and VEGF were determined by Real-time fluorescent quantitate PCR (RT-PCR).The amount of VEGF in the hRPE-conditioned supernatant was measured using enzyme linked immunosorbent assay (ELISA) at 4,8,12,24 hours,respectively.Results RT-PCR tests showed that the level of Shh and VEGF of hRPE was time dependently increased (Shh:F=45.260,P=0.001;VEGF:F=264.938,P=0.001).The level of Shh and VEGF of hRPE in the group treated with cyclopamine was decreased (P＜0.01).ELISA tests showed that the amount of VEGF in hRPE supernatant was significantly increased in time-dependent manner (F =3 156.676,P =0.001),and it was down-regulated by cyclopamine under hypoxia (P＜0.01).Conclusion Shh signal transduction pathway could play a role in the VEGF expression induced by hypoxia in hRPE cells.