OBJECTIVE Comparison of the maximum slow-phase velocity of cold and warm air with different stimulated sequence.METHODS Forty normal cases and 229 vertigo cases with bithermal caloric testing during 2004 to 2006 were randomly divided into two groups:20 normal cases and 101 vertigo cases were stimulated with cold air first,and the other cases with warm air first.According to the canal paresis(CP)≥20%,each patients group was subdivided into the normal semicircular canal(SC) function group and the paresis SC function group. The maximal slow-phase velocity(MSV)during the strongest 10 seconds was counted,and compared among the subgroups.RESULTS Except the normal cases with warm air first,the differences between the subgroups were statistically significant.The cold air first group presented stronger MSV with cold air and the warm air first group presented stronger MSV with warm air.CONCLUSION The MSV stimulated by warm air was as the same as that stimulated by the cold air.With different stimulated sequence,the first stimulation induced stronger response.In normal cases,the cold air firstly stimulated induced much more vestibular adaption.

Objective To summarize the experience and clinical characteristics in liver re- transplantation following adult-to-adult living donor liver transplantation.Methods Due to biliary complication (2 cases),vascular complication (2 cases),chronic rejection (1 case) and hepatitis recur- rence (1 case),liver re-transplantation was performed on 6 patients through modified piggyback liver transplantation.Vascular anastomosis was performed between the hepatic arteries of donor livers and receptor abdominal aorta in 1 case,and the rest were subjected to end-to-end homonymic vascular anastomosis.Results No operative death occurred.Due to primary non-function,1 died after the ope- ration.During the follow-up period,1 had anastomotic stricture of hepatic artery after the operation and was cured by percutaneous venoplasty.The survival of the rest patients was 12,9,6,4 and 3 months respectively.Conclusion Peritoneal adhesion is the operative difficulty for liver re-transplantation following adult-to-adult living donor liver transplantation.

Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.

Objective:To assess the effects of ohmefentanyl(OMF),a potent and selective agonist for ? opiate receptor,on respiratory function in chronic hypoxic rats.Methods:Totally 86 healthy male SD rats were randomly divided into the normal group ( n =20) and chronic hypoxic model group( n =66).The chronic hypoxic rat model was established by intravenous injections of papain once a week for 6 times.Rats in normal control group received OMF injection( n =10) and artificial cerebrospinal fluid(aCSF) injection( n =10).Rats in chronic hypoxic group were further divided into cerebroventricular administration group( n =48) and nucleus tractus solitari(NTS) administration group( n =18).Rats in cerebroventricular administration group received naloxone( n =12) and OMF( n =12),and the other 24 rats were taken as control.Rats in NTS group received OMF( n =9) and aCSF( n =9).The respiratory rate(RR) and tidal volume(V T) were determined 5,15,30,45 and 60 min after injection.Results:Intracerebroventricular administration of OMF in normal rats resulted in a significant decrease in RR and V T ( P

[Objective]The oxidative injury of retinal pigment epithelium(RPE)plays a key role in the pathogenesis of age-related macular degeneration(ARMD). This study is to investigate the effects of endoplasmic reticulum stress and the vital transcriptional factor X-box binding protein 1(XBP1)in acrolein-induced oxidative damage of RPE.[Methods]RPE cells were treated with acrolein (75μmol/L)for 2~24 h,expression of glucose regulated protein 78(GRP78)and XBP1 was determined by Western blot analysis. After being transfected with XBP1 siRNA with 24 h,the expression of XBP1 was knocked-down in RPE cells. Protein level of Nrf2 and SOD2 was then determined by Western blot analysis and intracellular Reactive Oxygen Species(ROS)generation was determined by DCF staining. Acrolein was added for 8 h after being transfected with XBP1 siRNA or control siRNA for 24 h. Apoptosis was detected by TUNEL assay before and after the treatment. Subretinal injection of Cre or GFP adenovirus was performed in XBP 1flox mice. After 1 week the mice were sacrificed. Total RNA was extracted from mice eyecups using TRIzol and real-time RT-PCR was performed to determine the two XBP1 down-stream genes,ERdj4 and p58IPK. Cryosectioning and immunofluorescent staining were performed to look at the expression of XBP1,Nrf2 and SOD2 in mice RPE.[Results]Protein level of GRP78 was significantly un-regulated after exposure to acrolein for 2 and 4 h. XBP1 was activated after acrolein treatment for 6 h. Knock-down of XBP1 by siRNA down-regu?lates anti-oxidant genes expression and increased ROS generation in RPE cells. Loss of XBP1 exacerbates acrolein-induced cell apoptosis. XBP1 was knocked-down in the RPE of XBP1flox mice after subretinal injection of Cre adenovirus. Decreased mRNA level of ERdj4 and p58IPK,and decreased Nrf2 and SOD2 expression were seen in the Cre-injected group.[Conclusions]Acrolein induces ER stress and activates XBP1 in RPE cells. Knock-down of XBP1 down-regulates anti-oxidant genes expression ,increases ROS generation,and exacerbates acrolein-induced cell apoptosis. XBP1 plays a role in the anti-oxidant defense in the RPE cells.

Objective To discuss the application of run?through wire stretch technique in the procedure of endovascular therapy for complex subclavian artery occlusive diseases. Methods The clinical data of 22 patients who were diagnosed complex subclavian artery occlusive diseases were retrospectively analyzed from June 2013 to January 2016 in vascular surgery department of Wangjing Hospital .The patients were treated endovascular therapy using run?through wire stretch technique in all procedures successfully. Results The complex subclavian artery occlusive diseases were including long segment occlusion of the left subclavian artery and ostial stenosis or occlusion of the right subclavian artery. The left subclavian artery occlusion patients was 16 and right subclavian artery ostial stenosis or occlusion was 6. The technical success rate was 100%. All patients were using combination of femoral artery and brachial artery approach. Run?through wire stretch technique was used in the procedure of endovascular therapy, which had improved the technical success rate. After the treatment the symptom improvement rate was 88%. The symptoms of upper limb and posterior circulation ischemia were improved. Conlusion Upper limb artery combined femoral artery approachand run?through wire stretch technique can improve the recanalization in the procedure of endovascular therapy for complex subclavian artery occlusive diseases.

Objective To observe the benefits and safety of low-dose azithromycin maintenance treatment on pulmonary function and quality of life in patients with bronchiectasis. Methods Thirty-seven adult bronchiectasis patients accompanied with chronic purulent respiratory tract symptoms were selected, and all the patients were given azithromycin 250 mg oral, once/d for 12 months. The respiratory symptoms, pulmonary function and quality of life before treatment and 16, 52 weeks after treatment were observed. Results Among 37 patients with bronchiectasis, 3 cases were lost, 1 case was in the follow-up of the 16th week, and 2 cases exited because of acute exacerbation. There were no statistical differences in body mass index (BMI) and inspiratory capacity percentage of estimated value (IC%Pred) before treatment, 16 and 52 weeks after treatment (P>0.05). The C-reactive protein (CRP), forced expiratory volume in 1 second (FEV1)/ forced ventilatory capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity percentage of estimated value (FEF25-75%Pred), modified British medical research council dyspnea scale (mMRC) score 16 and 52 weeks after treatment were significantly better than those before treatment:(15.33 ± 4.00) and (9.21 ± 3.04) mg/L vs. (25.59 ± 9.82) mg/L, (75.94 ± 5.59)%and (75.52 ± 7.06)% vs. (72.14 ± 5.62)%, (60.22 ± 10.90)% and (63.73 ± 6.54)% vs. (55.44 ± 9.16)%, (1.75 ± 0.69) and (1.41 ± 0.56) scores vs. (2.19 ± 0.74) scores;the low respiratory tract infection visual analog scale (LRTI- VAS) score, FEV1 percentage of estimated value (FEV1% Pred) and chronic obstructive pulmonary disease assessment test (CAT) score 52 weeks after treatment were significantly better than those before treatment: (17.74 ± 3.76) scores vs. (21.57 ± 4.47) scores, (70.31 ± 4.07)% vs. (66.95 ± 5.48)%and (18.06 ± 3.32) scores vs. (21.54 ± 4.89) scores, and there were statistical differences (P<0.05). In the course of treatment, 5 cases might be associated with the drug adverse reactions, but the symptoms were mild. No patients exited because of adverse reaction. Five patients had 7 episodes of acute exacerbation, among whom 2 cases exited and the other 3 cases did not interrupt azithromycin treatment during acute exacerbation. Conclusions For adult patients with bronchiectasis, the long-term treatment of low-dose azithromycin (250 mg/d) can improve the respiratory symptoms and quality of life, and reduce the airflow limitation of peripheral airway.

Objective To discuss the feature of transient intrahepatic cholestasis in early stage of orthotopic liver transplantation. Methods Based on the review of early (within 1 month) postoperative hyperbilirubinemia in consecutive 200 patients undergoing liver transplantation, we summarized the occurrence, development and outcome of early postoperative intrahepatic cholestasis. Results Early transient intrahepatic cholestasis was identified in 112 patients. The characteristic of early intrahepatic cholestasis is that DBIL and?-GT increasingly elevated from the second or third day postoperatively, with a peak on the 7 - 14th d, then descended to normal level on approximately 21 -28th day. The average peak level of DBIL and?-GT were( 157. 32?82. 08)?mol/L and (172?80) IU/L respectively. During the period of DBIL and?-GT ascending, AST and ALT kept descending, and within 1 week it could fall to normal level. Acute rejection, drug toxicosis and bile duct obstruction were excluded. Conclusions Postoperative early transient intrahepatic cholestasis associated with ischemia-reperfusion injury has its special clinical process and most patients recover themselves without the need for special therapy.

30% was considered sensitive and the rate ≤30% was considered resistant;and the 6 specimens were divided into 2 group according to the above standard.cDNA microassay combined with clustering analysis was used to screen for resistance-related genes.Semi-quantitative RT-PCR was used for verification of HDAC1 gene expression.Results:Three of the 6 glioma specimens belonged to the drug resistance group and the other 3 to the drug sensitive group.cDNA microarray analysis combined with cluster analysis screened out 21 genes,with 6 up-regulated and 15 down-regulated.High expression of gene HDAC1 was noticed in all the 6 specimens by semi-quantitative RT-PCR,and the trend was similar to that by microassay.Conclusion:The primary drug resistance of glioma may be associated with the 21 genes screened by cDNA microarray;the detailed mechanisms for drug controlling still need to discussed in the future.

Background To establish the ideal animal model of retinitis pigmentosa (RP) is very important for onward relevant study.Previous research determined that N-methyl-N-nitrosourea (MNU) can selectively damage photoreceptors via intravenous injection in mammal.However,whether MNU can be used to create an RP model needs to be investigated.Objective This experiment was designed to evaluate the toxic effect of MNU on photoreceptor cells of cats.Methods MNU was injected into 20 2-year-old cats via femoral vein and randomized into 20mg/kg, 25mg/kg, 30mg/kg, 35mg/kg and 40mg/kg MNU groups,and equal amount of normal saline solution was used in the same way in 4 normal cats as the control group.The activity,pupil size and light reflex were observed after injection of MNU.The cats were sacrificed and eyeballs were enucleated for histological examination to evaluate the structural and morphological changes of photoreceptors at 24 hours,72 hours,7 days and 14 days after the administration of MNU.This experimental study complied with the Statement for the Use of Animals in Ophthalmic and Vision Research.Results Dilated pupil and inertia of light reaction were found in experimental cats on the 7th days in the various groups.In 24 hours after MNU injection,the damage of photoreceptors was primarily characterized by pyknosis and disorder.In 72 hours after MNU injection,attenuation of the outer nuclear layer and disruption of cells were seen.Loss of photoreceptors and disappearance of the outer nuclear layer were observed on the 7th and 14th day.The extent of retinal photoreceptor cell damage was dependent on the dose of MNU.Conclusion MNU can selectively induce serious damage of the photoreceptor cells in cats retina in a time- and dose-dependent manner.