Objective To study the development of research about benign paroxysmal positional vertigo (BP-PV) in China and summarize certain characteristics and hot spots ,so as to provide a basis and direction for further relevant research .Methods CNKI ,CQVIP and wanfang database were used to search relevant literatures published before 2015 .The period sequence ,journal distribution ,productive authors ,research institutions ,high -frequent key words and hot spots were analyzed through bibliometric method and visualization method .Results There were 922 literatures about BPPV research from 1981 to 2015 in China ,involving 2021 authors and 309 research institu-tions ,published in 297 kinds of journal .The literature quantity showed a gradual upward trend on the whole and journals were widely distributed ;core journal group had not yet formed .Top 13 journals (4 .38% ,13/297) had published 292 relevant literatures (31 .67% ,292/922) ,major journals were relatively concentrated ;top 17 authors had published 222 relevant literatures (24 .08% ,222/922) ,top 12 research institutions had published 137 relevant literatures (14 .86% ,137/922);high productive authors mostly came from high productive authority .Through an analysis of keywords ,it is found that BPPV researches mainly focus on pathogenesis ,diagnostic method and treat-ment .New directions have emerged in recent years ,like comparative analysis of drug treatment and manual reduc-tion ,study on the secondary BPPV of sudden deafness and Meniere'sdisease .Conclusion The publishing of 2016 re-vised edition of the guidelines for BPPV diagnosis and treatment will further deepen relevant researches ;literature quantity is expected to continue to grow ;study on the secondary BPPV of sudden deafness and Meniere's disease will be a focus .

The neurosurgery clinical practice is difficult and important for most undergraduate. The reasons come not only from the development of neurosurgical science,but from shortage of contents in basic peviod,so in clinical education the re-teaching of basic neurosurgical knowledge is important. Teachers should make full use of clinical resources to fulfill this teaching aim and the emphasis should be neuroanatomy and neurophysiology.

[Objective]To analyze and compare the results of the posterolateral entrance and posterior laminectomy in treating thoracic disc herniation.[Method]From Nov.1998 to Feb.2006,fifty-one cases were treated with posterolateral entrance combined with the facet disectomy(Group A),and 26 patients were treated with the vertebral disectomy instead of the thoracic disc tissue disectomy.Complications occurring in the follow-up time were investigated and the improving rates were calculated.Otanni Systems was used to evaluate the clinical results.The SPSS 13.0 was used for statistic work.[Result]The operation time was 130～185 min(mean 162 min) for Group A,145～205 min(mean 168 min) for Group B.No difference existed(P=0.062).The blood lost was 400～600 ml(mean 485 ml),while in group B,it was 500～800 ml(mean 646 ml),tbere was significant difference(P=0.013).The clinical satisfaction rate of group A was 86.3%,26 patients returned to perfect results,with 18 in good,6 in fair and 1 in poor results.In group B,the clnical satisfaction rate was 69.2%.There was significant difference between 2 groups(P=0.025).Seven out of the 51 patients had complications in group A.Two patients of neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 2 patients because of loosening and paresthesia.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 1 patient.While in the Group B,six patients neurological dysfunction showed no improvement.One patient was found having spinal cord reactive edema.Internal fixation system was removed in 1 patient.Anterior spinal artery syndrome was found in 1 patient.Leakage of CSF was observed in 2 patients.There were obvious difference(P=0.034).[Conclusion]Posterolateral entrance is effective in treating thoracic disc herniation.Comparing with the posterior laminectomy,this operation method is safer,more effective and has less complications.

Attentions have been paid to teaching Nepal students in English in our university,and many problems need to be analyzed and solved.Selection and application of appropriate teaching material,sufficient preparation before class and applying nimble teaching style have received satisfactory results.

The knowledge absence of neurosurgical regional anatomy is the major shortcoming which makes seven-year program medical students feel difficult in studying neurosurgical special course.The reasons for this phenomenon include the limited teaching time for basic medical course and the continuous progress in the field of neurological anatomy.The teacher should make good use of clinical resources to carry on the additional teaching of neurosurgical regional anatony.The detailed plans include small-class teaching and individual case analysis using the data of neuroimaging and angiography of the brain and spinal cord.All these measures are intend to let the students grasp of the basic knowledge clinical neurosurgery during the internship and make the smooth transition from interns to doctors,providing references for other department.

Fresh subcutaneous tissue from the rabbit's ear was processed with copper ferrocyanide method (Karnovsky and Roots, 1964) for demonstrating acetylcholinesterase. The arterio-venous anastomoses were revealed by the abundant "cholinergic" nerve fibers present around its arterial and intermediate segments. These nerves formed a dense network around these segments of AVA which gives AVA a conspicuous and outstanding picture under the microscope. 262 AVA were identified and their length and outer diameter of the intermediate segment were measured. The longest was 620.6 ?m, the shortest 81.9 ?m, and the averaging length was 254.8 ?m. Their outer diameters fell between 109.2～20?m, with an average of 52.2 ?m. The authors condered the measurements of the intermediate segment of the AVA give more significant information than the total length of the AVA.The AVA were classified into the following types according their morphological characteristics: the simple type (including the long and thin type, and short and thick type) and the complex type (including bifurcate, trifurcate, quarifurcate, compound, and circular types). This method of demonstrating AVA morphology was compared with former observations made directly in vivo or by histological methods and it serves as an new tool for the investigation of AVA.

BACKGROUND: At present, traditional modalities of neuroimaging, such as CT and MRI, is very limited in the diagnosis and severity estimation of diffuse axonal injury (DAI).OBJECTIVE: To investigate the value of proton magnetic resonance spectroscopy (1HMRS) in the diagnosis and prognosis of DAI.DESIGN, TIME AND SETTING: Prospective clinical controlled observation. The study was performed at the Department of Neurosurgery, and Department of Radiology, First Affiliated Hospital of Chongqing Medical University between October 2002 and September 2007.PARTICIPANTS: A total of 63 subjects with traumatic brain injury were enrolled and divided into DAI group (n=27) and non-DAI group (n=36) according to the result of MRI. In addition, 20 healthy persons were served as control group.METHODS: Demographic and clinical data were recorded on admission and neuroimaging examinations including fluid attenuated inversion recovery were carried on according to carefully designed procedures, in addition, 1HMRS was performed and the data were analyzed in combination with clinical condition.MAIN OUTCOME MEASURES: The ratios of N-acetyl aspartate (NAA)/creatine (Cr) and creatine phosphate (Cr), Choline compound (Cho)/Cr, myoinositol (mlNs)/Cr, and glutamic acid (GIx)/Cr at genu and splenium of corpus cellosum, and basal ganglia were quantified using 1HMRS.RESULTS: Compared with control and non-DAI groups, DAI group had decreased NAA/Cr and increased Cho/Cr at genu and splenium of corpus callosum, and basal ganglia (P < 0.05- 0.01), as well as increased mlNs/Cr and Glx/Cr at genu and splenium of corpus cellosum (P < 0.05). Non-DAI group also showed decreased NAA/Cr at splenium and increased Cho/Cr at genu of corpus callosum compared with control group (P < 0.01), but the change degree was less than DAI group. A positive correlation between Cho/Cr at genu of corpus callosum and the peded of primary unconsciousness was identified in DAI group (r=0.824, P < 0.01). CONCLUSION: The 1HMRS indexes at genu and splenium of corpus callosum, and basal ganglia could serve as effective indexes for the diagnosis of DAI. The Cho/Cr could well reflect histological changes following injury and act as sensitive index to predict clinical injury.

Objective To evaluate therapeutic effects and complications of concurrent three-dimensional conformal radiotherapy (3DCRT) and chemotherapy in patients with limited-stage small cell lung cancer (LSCLC).Methods From June 2000 to August 2005, 93 histologically proved LSCLC patients were randomized into two groups:3DCRT group (n =46) and conventional group (n =47).In both groups, patients received one cycle chemotherapy, followed by concurrent chemoradiotherapy and then received consolidate chemotherapy.Chemotherapy was four to six cycles of PE regimen.Conventional irradiation field was setup in conventional group, while in 3 DCRT group clinical target volume (CTV) only involved visible tumor and adjacent lymphatic region.Radiotherapy was delivered at 2 Gy per fraction, 5 fractions per week to a median total dose of 60 -64 Gy.Those who achieved a complete response were treated with prophylactic cranial irradiation (PCI) with 30 Gy in 10 fractions.Results The follow-up rate was 100% in both groups.The number of patients completed 1-, 2-and 3-year follow-up were 36, 34 and 16 in 3DCRT group, 14, 7 and 8 in conventional group, respectively.The complete and overall response rate were 52% and 89% in 3DCRT group, while 47% and 85% in conventional group, respectively.The 1-, 2-and 3-year survival rates were 78%, 35% and 15% in 3DCRT group, 72%, 30% and 17% in conventional group, respectively.The median survival time was 23.2 and 22.8 months, respectively.There was no statistical difference in short-term (Χ~2 = 0.34 ,P = O.759) and long-term outcomes (Χ~2 = 0.18 ,P = 0.92).In 3DCRT group, the incidence of grade 1 +2 acute radiation pneumonitis and esophagitis, grade 1 +2 and grade 3 chronic radiation pneumonitis were lower than those in conventional group.There was no grade 3 or 4 acute radiation pneumonitis or esophagitis, or grade 4 chronic radiation pneumonitis in both groups.There was no difference in grade 1 + 2, grade 3 or grade 4 acute myelo-suppression between the two groups.Conclusions In the treatment of LSCLC, concurrent 3DCRT and chemotherapy can achieve satisfactory short-term and long-term outcomes with acceptable complications.

Objective To observe the clinical efficacy of modified Sanzi Yangqin Decoction for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Totally 80 cases of OSAHS patients were randomly divided into treatment group and control group, with 40 cases in each group. Both groups received intervention of diet and life. The control group was given vitamin C, 100 mg each time, 3 times a day orally. Treatment group was given modified Sanzi Yangqin Decoction, 1 dosage per day, twice a day, orally, for 14 d. The scores of TCM symptoms, sleep apnea (AHI), lowest oxygen saturation (LSaO2) and longest apnea were observed before and after treatment. Results The overall effective rate of TCM syndrome was 90% (36/40) in the treatment group and 65% (26/40) in the control group, with statistical significance (P<0.05). Compared with before treatment, there was statistical significance in the scores of TCM symptoms, AHI, LSaO2, and longest apnea (P<0.05,P<0.01). After the treatment, compared with the control group, there was statistical significance in the scores of TCM symptoms, AHI, and LSaO2 in the treatment group (P<0.05,P<0.01). Conclusion Modified Sanzi Yangqin Decoction can effectively treat OSAHS and improve the life quality of patients.

Objective To evaluate the changes to mitochondrial ultrastructure in melanocytes of perilesional skin from patients with vitiligo.Methods Skin specimens were obtained from the perilesional area (0.5-1 cm distal to vitiligo lesions) of 10 patients with progressive vitiligo and 10 patients with stable vitiligo,as well as from the normal skin of 10 healthy volunteers.The morphology of melanocytes was observed by using transmission electron microscopy (TEM).Besides,stereological parameters of mitochondria,such as volume density (Vv),surface density (Sv) and numerical density (Nv),were measured.Results In melanocytes from the healthy controls,there were a large number of melanosomes with the number of melanosomes per melanocyte being 28.57± 3.21,which were mainly at stage Ⅲ and Ⅳ; mitochondria with normal structure and densely packed cristae were regularly arranged; autophagosomes were seen occasionally.Compared with the melanocytes from healthy controls,there was an obvious decrease in the number of melanosomes (especially stage Ⅲ melanosomes) in melanocytes from the perilesional skin of patients,with the number of melanosomes per melanocyte being 22.00 ± 6.16 (P ＜ 0.05) and 17.43 ± 6.24 (P ＜ 0.05) in patients with progressive vitiligo and stable vitiligo,respectively.TEM also showed disorganized or disrupted mitochondria in various shapes and sizes,most of which were swelling with obscure cristae and vacuolization,in melanocytes from the perilesional skin,and no autophagy was observed.The three stereological parameters were significantly different between the three groups of tissue specimens (all P ＜ 0.05),with the Nv,Vv and Sv of mitochondria being (7.194 ± 1.434) μm-3,(4.8 ± 1.2) ％,(2.42 ± 0.86) μ m-1 respectively in melanocytes from the healthy controls,(4.055 ± 0.906) μm-3,(7.4 ± 2.1)％,(3.58 ± 1.15)μm-1 respectively from patients with progressive vitiligo,(5.311 ± 0.873) μm-3,(6.5 ± 1.4)％,(2.82 ± 0.94) μm-1 respectively from patients with stable vitiligo.Conclusions Mitochondria are injured in melanocytes from perilesional skin of patients with vitiligo,and the degree of injury is more intense in progressive vitiligo than in stable vitiligo.