OBJECTIVE To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore the possible pathogenetic mechanism, diagnosis and treatment. METHODS 218 cases of the SD in our department were retrospectively analyzed, and 37 patients with primary BPPV during the same period were used as control group. All patients were confirmed by the examination of Dix-Hallpike and the roll check,the primary disease (sudden deafness) of secondary BPPV patients were in line with the Chinese Medical Association diagnostic criteria. RESULTS In all these patients with SD,there were 91 cases with BPPV secondary to the SD. There were 67 cases of BPPV of posterior semicircular canal and 21 cases of BPPV of lateral BPPV semicircular canal. Besides, 3 cases were of multi-semicircular canal affected. All patients with BPPV were diagnosed as the same ears as the SD. The symptoms were alleviated and initial success rate was 68.1%. During 6-22 month follow-ups, total success rate was 100%, and recurrence rate was7.7% (7/91). The hearing recovery of high frequency is worse than that of the low frequency. There were 2 cases of recurrence in lateral BPPV group, 5 cases in posterior BPPV group. All were cured by reposositioning maneuver. All patients with primary and secondary BPPV were cured with Epley maneuver or Barbecue roll maneuver, and the curative effect of them is similar. CONCLUSION The occurrence of BPPV may follow SD,and the majority of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy for secondary BPPV.

Objective To investigate the protective effect of desflurane preconditioning on human umbilical vein endothelial cells against anoxia-reoxygenation(A/R)injury.Methods The human umbilical vein endothelial cell line(ECV304)was provided by the Liver Cancer Institute,Zhongshan Hospital,Fudan University.ECV304 cells were randomly divided into 5 groups:group Ⅰ normal control;group Ⅱ A/R;group Ⅲ A/R+rhTNF-α;group Ⅳ Des + A/R and group Ⅴ Des + A/R + rhTNF-α.In group Ⅱ-Ⅴ the cells were exposed to 95% N2 + 5% CO2 in an incubator for 30 min followed by 60 min reoxygenation.In group Ⅲ and Ⅴ rhTNF-α(10 ng/ml)10 μl was added to the cells as soon as reoxygenation was started,while in group Ⅳ and Ⅴ the cells were pretreated with 7.2% desflurane for 30 min followed by 10 min washout before A/R.Apoptosis in endothelial cells was detected by fluorescence flow cytometry and TUNEL.Endothelial cells were examined with electron microscope for apoptosis and necrosis.Results The rates of apoptosis in the endothelial cells were significantly higher in A/R group and A/R + rhTNF-α group than in control group.Desflurane preconditioning significantly attenuated apoptosis in the endothelial cells induced by A/R and A/R + rhTNF-α respectively.Electron microscopy showed that there were significantly more necrotic cells in A/R group and A/R + rhTNF-α group.However in the two desflurane preconditioning groups(Ⅳ and Ⅴ)the cells were in a state of duplication and self-repairing.Conclusion Preconditioning with 30 min 7.2% desflurane can attenuate the A/R-induced injury to human umbilical vein endothelial cells.

Neonatal mortality has been significantly decreased because of the development of neo-natal respiratory support techniques. Nevertheless,constant and high frequency ventilators have some limita-tions to solve all problems in neonatal respiratory failure. Special mechanical ventilation,mainly including he-liox and partial liquid ventilation,provides new respiratory support for newborn infants. The clinical signifi-cance of heliox and partial liquid ventilation need further investigation.

Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.

Objective To evaluate the impact of human papillomavirus(HPV)infection on the risk of HIV acquisition in the female group.Methods Searched PubMed,EMbase,Coehrane Library,CNKI,wanfang database and Chinese Biomedical Lit-erature Database etc for articles about HIV-acquisition in HPV infected female patients.The quality of the literature were e-valuated according to standards of inclusion and exclusion.Data was extracted and methodologically quality evaluated by two independent investigators.Meta-analysis was accomplished using RevMan4.2 software.Results 6 articles were included,all of them were randomized controlled trials,a total of 9 606 cases studied.HIV infection risk was doubled in women with any HPV infection(OR= 2.02,95% CI:1.48 ~ 2.77),demonstrating High-risk HPV-positive (OR= 2.50,95% CI:1.73 ~3.61)and low-risk HPV-positive (OR=2.10,95% CI:1.48~2.96)respectively.Funnel plot analysis revealed no signifi-cant publication bias on HPV genotypes.Conclusion The analysis of selected research suggests the risk of HIV infection was increased in HPV-positive women.HPV vaccine may have some preventive effect on HIV infection.

Objective:To study the clinical effect of letrozole combined with triptorelin acetate (GnRH-a) on the serum estrogen level and ovulation quality of patients with polycystic ovary syndrome(PCOS).Methods:112 cases of PCOS patients in our hospital from August 2014 to January 2016 were selected and randomly divided into the control group (50 cases) and the observation group (62 cases) according to the wishes of patients.During the first 3～7 days of the menstrual cycle,the patients in the observation group were treated by LE,2.5 mg/d;the patients in the control group were given intramuscular injection of human menopausal gonadotropin (HMG),75 IU/d.when the diameter of the largest follicle (MFD)≥ 18 mm,the patients in the observation group were were given subcutaneous injection of 0.1 mg triptorelin acetate induced ovulation,patients in the control group were given intramuscular injection of Human chorionic gonadotropin HCG6000～10000IU induced ovulation.The ovulation induced ovulation effect and the serum hormone levels and pregnancy outcome were compared between two groups.Results:On the induced ovulation day,no significant difference was found in the endometrial thickness,the number of mature follicles,serum LH and P levels,rate of pregnancy and the luteal function between two groups of patients (P＞0.05),the number of dominant follicles,serum E2 and T levels,multiple pregnancy rate,the incidence of OHSS and ovarian cyst in observed group were significantly lower than those of the control group (P＜0.05).Conclusion:LE combined with GnRH-a could effectively improve the quality of ovulation in patients with PCOS,reduce the serum level of estrogen,and prevent the occurrence of OHSS,improve the outcome of pregnancy.

Objective To investigate the survival status of liver cirrhosis patients without upper gastrointestinal hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS).Methods From 2004 to 2013,15 liver cirrhosis patients without upper gastrointestinal hemorrhage volunteered received TIPS treatment were followed up to find out the difficulty and the success rate of TIPS procedure,the incidence of hepatic encephalopathy,upper gastrointestinal hemorrhage and improving of hypersplenism.Results The success rate of operation was 100％.The average of operation time was 60 minutes.During follow-up,no stent angulation occurred,no gastrointestinal hemorrhage happened and no one died in all 15 patients after TIPS operation.There were four patients with hepatic encephalopathy in eight weeks after operation.The anemia of four patients improved compared with that before operation.Conclusions TIPS is a safe and effective threapy in the prevention of gastrointestinal hemorrhage in the patients with liver cirrhosis accompanied with severe gastroesophageal varices.It may become the primary prophylaxis for liver cirrhosis patients without upper gastrointestinal hemorrhage.

Objective To evaluate neurodevelopmental outcome of very preterm(gestational age ＜ 32 weeks) and very low birth weight infant (VLBWI) (weight ＜ 1 500 g) and to examine the effectiveness of an early intervention program till 12 months corrected age.Methods Seventy followed-up very preterms and VLB-WI in Jinan Maternity and Childcare Hospital were enrolled in this study from January 2012 to and were divided into two groups by birth weight.All infants received 20 items of behavioral neurological assessment at 1 to 12 months corrected age and tested mental and psychomotor development with the use of CDCC at 6,12 months corrected age.The preterms who were abnomal in the 20 items of behavioral neurological assessment would receive early intervention (including kinesitherapy, physiotherapy, cereal circulation therapeutic equipment) by physiotherapists and their parents who received an intervention program training and were strongly encouraged to participate in the intervention sessions.The intervention method was adjusted according to the neurological assessment.The SPSS statistical software package for Windows, version 15.0, was used to run Fisher's exact test and t-test on the data presented,and P value of less than 0.05 was regarded as statistically significant.Results The average gestational age of infants was (30.4 ± 1.8) weeks,and average birth weight (1 463.7 ± 307.5) g.The incidence of extrauterine growth restriction was 57.1％ at first follow-up.The incidence of neurodevelpmental impairment NDI) and cerebral palsy tendency at 6 corrected months were 14.3％ ,8.6％ respectively.At 12 months corrected age,the incidence of NDI decreased to 2.9％ and cerebral palsy to 2.9％.There was significant difference in the incidence of NDI between 6 and 12 corrected months.There was no significant difference in the incidence of psychomotor developmental index ＜ 70, mental developmental index ＜ 70, NDI and cerebral palsy between the two groups.Conclusion The early intervention program can improve VLBWI neurodevelopmental outcomes at 12 months' corrected age and reduce the incidence of cerebral palsy.

Acquired Immunodeficiency Syndrome ; prevention & control ; China ; epidemiology ; Condoms ; utilization ; Humans ; Surveys and Questionnaires ; Transients and Migrants

Objective: To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. Methods : The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model. Results: Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. Conclusions The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.