Isolated otolith dysfunction(iOD) involves a group of unexplained vestibular syndromes that manifest clinically as a sense of translation, tilting or floating, and blurred vision with head movement, with normal semicircular canal function but abnormal otolith function on laboratory vestibular testing. As vestibular medicine has gained widespread popularity in recent years, increasing attention has also been paid to iOD and case reports, clinical studies and diagnostic criteria have been published. However, there is no consensus document to guide the diagnosis of this disease in China. In this context, the Special Committee on Vertigo of China Medical Education Association organized a group of domestic experts in vestibular medicine and formulated this diagnostic consensus after thorough discussion based on the latest evidence in China and abroad, in order to promote the best clinical practice for iOD.
Humans ; Otolithic Membrane ; Vestibular Diseases/diagnosis* ; Vertigo/diagnosis* ; Vestibule, Labyrinth ; Semicircular Canals

Objective　 To explore the feasibility of recombinant adeno-associated virus (rAAV) as a vector for the gene therapy of liver cancer. Methods　 The rAAV/enhance green fluorescein protein (EGFP) recombinant was prepared by the routine method of two plasmids cotransfection. Results　 The experiment showed that one 10cm plate could produce 107-108 infection unit recombinant by the method of two plasmids cotransfection, and the transduction of HepG2 cell was increased with the increase of infection dosage of rAAV. About 100 multiplicity of infection (MOI) AAV vector could make all the tumor cell light. Conclusion　 Liver cancer cell can be efficiently transduced by rAAV, and AAV vector may be a valuable vector for the gene therapy of liver cancer.

Objective To provide morphological evidences for visual field defect caused by the compression of the saddle area tumors.Methods The shape and position of the optic chiasma and its surrounding saddle diaphragm,pituitary,internal carotid artery,and perforating arteries of optic chiasma were studied from 80 adult.Results Its maximum angle was 100° in anterior horn with prechiasmatic space, and minimum angle was 40° with postfixed optic chiasma.The area of optic chiasma averaged(1.32±0.04)cm2,the thickness of saddle diaphragm was 0.58 mm,and about 5% of saddie diaphragm did not exist.The foramen of saddle diaphragm pushed into the opposite side was 52.5%,and the maximum diameter was 7.8 mm×9.8 mm.The pituitary was found inferior to the saddle diaphragm foramen in 78%(62/80).In 76.3%(61/80) brains,the carotid artery touched chiasm opticum.Conclusions Visual field defect caused by compression from pituitary tumor and craniopharyngioma is directly related with the shape of the optic chiasma and its surrounding structures.

Objective To investigate the effects of ulinastatin on renal ischemia/reperfusion (I/R) in rats and assess the possible mechanism. Methods Seventy-five male SD rats weighing 210-250 g were randomly divided into three groups with 25 animals in each group : (Ⅰ) control group received sham operation; (Ⅱ)renal I/R group and (Ⅲ) ulinastatin + I/R group. The animals were anesthetized with intraperitoneal ketamine 50 mg?kg-1 . Bilateral kidneys were exposed through midline incision and bilateral renal pedicles were occluded with atraumatic mini-clamp. The kidneys turned pale. In control group the kidneys were exposed but their pedicles were not clamped, while in ulinastatin group (Ⅲ) ulinastatin 12 500 u was given i. v. 30 min before ischemia and at the beginning of reperfusion. Blood samples and kidneys were obtained at 0, 2, 6, 12, 24 h of reperfusion for determination of blood urea nitrogen (BUN) and serum creatinine (Cr) concentrations and the expression of heat shock protein 70 (HSP 70) and bcl-2 in kidney and for microscopic examination. Paller scoring system was used to evaluate the severity of histological changes ( the higher the score, the worse is the change) .Results BUN and serum Cr levels were significantly lower at 12 and 24 h of reperfusion in group Ⅲ than in group Ⅱ (P 0.05) . Conclusion Ulinastatin can reduce the risk of renal dysfunction and injury associated with renal I/ R. The protective effect of ulinastatin may be associated with the up-regulation of bcl-2 expression.

Objective To investigate the effects of autologous blood transfusion on serum neopterin and IL-2 concentrations after radical gastrectomy. Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes (33 male, 27 female) aged 40-65 yrs weighing 51-70 kg undergoing radical gastrectomy for stomach cancer were randomly divided into 2 groups (n = 30 each):homologous blood transfusion group (H) and autologous blood transfusion group (A). The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 5 ?g?kg-1, propofol 1 mg?kg-1 and vecuronium 0.12 mg? kg-1 and maintained with isoflurane inhalation (1 % -2 %) and intermittent i. v. boluses of fentanyl and vecuronium. In group H homologous blood 400 ml was infused during gastro-intestinal anastomosis. In group A 400 ml of blood was removed from radial artery after induction of anesthesia, before surgery. Blood volume was maintained by simultaneous infusion of succinylated gelatin 500 ml. The 400 ml autologous blood was infused also during gastrointestinal anastomosis. Venous blood samples were taken before operation (baseline) , at the end of operation and on the 5th postoperative day for determination of serum concentrations of neopterin and IL-2 (ELISA) Results The two groups were comparable with regard to sex (M/F ratio), age, body weight, duration of operation and total blood loss. The serum concentrations of neopterin and IL-2 were significantly decreased after operation compared to the baseline values before operation in group H (P

Objective To investigate the feasibility of laparoscopic cholecystectomy through the transumbilical approach.Methods The clinical data of 18 patients underwent endoscopic cholecystectomy through only one transumbilical incision at West China Hospital were retrospectively analyzed.Results All of the operations were successfully completed without conversion to routine laparoscopic surgery or open surgery.The operation time was 40-130(58?10)min.There was no intraoperative complication.The patients did well postoperatively and were discharged 1 day after operation.There was no postoperative complications and without visible abdominal scar on 1 month follow-up.Conclusions Laparoscopic cholecystectomy through the transumbilical approach is technically feasible and safe.But this technique is difficult,the patients should be selected carefully.

Objective To evaluate the suitability of the biodegradable microsphere encapsulation of adenovirus as a targeting vector for gene therapy of hepatocellular carcinoma. Methods Encapsulate the recombinant adenovirus in PLG poly (lactic/glycolic) copolymer by the solution evaporation method, the release test and the bioactivity of viruses incorporated in vitro were studied. Results More than 19.3% of adenovirus was encapsulated in PLG microspheres. The release test shows that the adenovirus was released for more than 200 h, 50% were shed within the first 100 h, and their activity was retained. Conclusion Recombinant adenovirus can be formulated in a polymer preparation of PLG with retention of bioactivity. It may be a valuable vector for the gene therapy of liver cancer.

Objectives To observe the expressions ofα-smooth muscle actin (a-SMA) and type III collagen (Col-III) of tubuloin-terstitial ifbrosis(TIF) induced by unilateral ureteral obstruction (UUO) in rat and the intervention effect of supplemental hydrogen sul-ifde (H2S). Methods Ninety-six male Sprague-Dawley rats were randomly divided into 4 groups, sham-operated group, UUO model group, NaHS low-dose group and high-dose group. TIF rat model was established via UUO. After UUO operation, low-dose and high-dose group were intraperitoneally injected twice a day with 1.4μmol/kg and 7.0μmol/kg NaHS, respectively. Sham-operated group and UUO model group were given an equivalent volume of normal saline. Eight rats in each group were killed randomly at 7, 14 and 21 days after UUO operation. The concentration of plasma H2S was detected using deproteinization. Renal tubulointerstitial damage was evaluated with routine Hematoxylin and Eosin staining and Masson staining under microscope. The expressions ofα-SMA, Col-III were measured with immunohistochemistry. Results Compared with sham-operated group, renal tubulointerstitial injury was severer in UUO model group and was alleviated after intervention of NaHS. There was signiifcant difference in tubulointerstitial injury among all groups (P<0.01), but no difference was found between high-dose and low-dose group. Exogenous H2S supplement could down-regu-late the expressions ofα-SMA and Col-III in renal tissues (P<0.05). There was no difference between high-dose and low-dose group in the expressions ofα-SMA and Col-III (P>0.05). Conclusions TIF induced by UUO is associated with decreased level of endogenous H2S. H2S supplementation can ameliorate the development of UUO-associated TIF in part through down-regulating the expressions ofα-SMA and Col-III in renal tissues. However, a dose dependent manner between the two doses of exogenous H2S supplementation was not observed.

Objective Tubulointerstitial fibrosis(TIF) is the most important marker reflecting the degree of renal function decline and prognosis and hydrogen sulfide ( H2 S) is crucial in maintaining normal renal function and many diseases of renal injury. The aim of the article was to investigate the effects of exogenous H2 S on the expressions of angiotensinⅡ ( AngⅡ) , proliferating cell nuclear antigen (PCNA) and transforming growth factor beta-1 (TGF-β1) in rats with unilateral ureteral obstruction (UUO). Methods TIF rat model was built with UUO. Ninety-six SD rats were randomly divided into four groups:sham operation group, modelgroup, UUO+low-dose NaHS treatment group ( low dose group) and UUO+high-dose NaHS treatment group ( high dose group) ( n=24, respectively) . Rats in model group were treated with left-side ureteral obstruction and ureteral separation without obstruction was done in sham operation group. UUO rats in two treatment groups were injected intraperitoneally with two different doses of sodium hydrosulfide (NaHS, donor of endogenous H2 S), respectively. HE and Massonstaining and immunohistochemical staining were performed at the 7 d, 14 d and 21 d, respectively. Results In sham operation group, the expressions of AngⅡ, PCNA, and TGF-β1 were found in microamount in tubulointerstitium at each time points. Compared with sham operation group, the expressions of AngⅡ, PCNA and TGF-β1 in model group increased( P<0.01) . While in comparison to model group, the expressions of AngⅡ, PCNA and TGF-β1 decreased in low dose group and high dose group, but no significant differ-ence was found between low dose group and high dose group. Conclusion Exogenous H2 S supplementation can attenuate TIF partly via downregulating the expressions of AngⅡ, PCNA and TGF-β1 .

Objective To investigate the prevalence of BPPV in patients with Meniere’s Disease(MD),and to investigate the diagnostic and predictive values of VEMP in patients with MD and BPPV.Methods A total of 1 1 6 patients previously diagnosed MD were followed up through telephone about their BPPV-like attacks.We recorded the detailed history of BPPV-like attacks,and provided them with complete Dix-Hallpike and roll tests if patients were on their BPPV-like attacks.Results In all,4 patients'histories supported BPPV,and 4 patients were found with BPPV.The prevalence of BPPV in patients with MD was 3 .4%(4/1 1 6 ).Meniere's symptoms preceded the on-set of BPPV in 8 patients.In 4 confirmed BPPV patients with Meniere's disease,BPPV was limited to the same ear as the MD in 2 cases,and 1 had contralateral BPPV,and 1 was uncertain.Six histories supported or confirmed BP-PVpatients with high abnormal oVEMP rates (5/6).Four in this 5 (80%)had abnormal oVEMP of the same MD ear.The single repositioning procedures can improve vertigo and eliminated positional nystagmus in cases of BPPV associated with MD.Conclusion In the present study,the prevalence of BPPV in patients with MD was 3 .45%.De-tailed medical histories combined with Dix-Hallpike and roll tests and VEMP tests can identify BPPV in patients with MD.