Objective:To investigate the effects of the Epley and Semont procedures with varying lateral angles of the head on posterior semicircular canal benign paroxysmal positional vertigo （PC-BPPV）. Methods:A total of 115 patients with unilateral PC-BPPV were randomly divided into five groups: Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group, with 23 patients in each group. Corresponding reduction treatments were performed. Results:The total effective rates for the Epley group, Semont group, Semont+10° group, Semont+20° group, and Semont+30° group were 95.7% （22/23）, 4.3% （1/23）, 30.4% （7/23）, 52.2% （12/23）, and 87.0% （20/23） respectively. The inefficiencies were 4.3% （1/23）, 95.7% （22/23）, 69.6% （16/23）, 47.8% （11/23）, and 13.0% （3/23）. Statistically significant differences were observed in the total effective rates among the five groups （χ²=54.11, P<0.01）. The total effective rates in the Semont group, Semont+10° group, and Semont+20° group were significantly different from that of the Epley group （P<0.01）, while no statistically significant difference was found between the Semont+30° group and the Epley group （P= 0.608>0.012 5）. Conclusion:Among the four Semont methods with different lateral lying angles, the total effective rate of reduction treatment increased with the elevation of the lateral lying angle on the affected side. The efficacy of the Semont+30° group in treating PC-BPPV was not significantly different from the Epley group's reduction effect, which was markedly superior to that of the other four Semont methods at different angles. Therefore, the Semont+30° reduction technique is recommended for the treatment of PC-BPPV.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Benign Paroxysmal Positional Vertigo/therapy* ; Head ; Posture ; Semicircular Canals/physiopathology* ; Treatment Outcome

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Persistent Organic Pollutants (POPs) have the characteristics of resistance to environmental degradation, bioaccumulation and long-distance migration potential. Maternal exposure to POPs during pregnancy can enter the fetal blood circulation through the placental barrier, and have a potential impact on the functional development of the nervous system of the offspring. This in turn leads to the occurrence and development of neurological defects and diseases in adulthood. The purpose of this paper is to elucidate the effects of exposure to three major POPs (organochlorine compounds, perfluoroalkyl and polyfluoroalkyl substances, and polybrominated diphenyl ethers) during pregnancy on the functional development of the nervous system (social emotions, cognition, language, exercise, and adaptability) in children, and to provide reference for subsequent studies.

Objective To provide references,this study investigated the clinical characteristics of patients with non-syndromic oligodontia.Methods The information of 178 patients with oligodontia was collected,including histories,oral examinations,and panoramic radiographs.Tooth agenesis characteristics were calculated and evaluated.All the data were statistically analyzed with SPSS 24.0 software.Results No significant difference in the number of missing teeth was found between sexes nor between the right and left sides,and congenitally missing teeth affected the maxillary arch(P<0.05).The highest prevalence of tooth agenesis was observed in the mandibular second premolars.In the maxillary arch,the most common pattern of tooth agenesis was agenesis of the bilateral first and second premolars.The agenesis of the bilateral second premolars was observed in the mandibular arch.The prevalence of a symmetric pattern between the right and left quadrants was significantly higher than that of matched patterns between the maxillary and mandibular an-tagonistic quadrants.Approximately 16.85%of patients with nonsyndromic oligodontia were affected by other tooth-re-lated anomalies.Conclusion The common patterns of tooth agenesis were successfully identified in patients with non-syndromic oligodontia.Dentists need to provide multidisciplinary treatments for patients with nonsyndromic oligodontia because of variations in occluding and full-mouth tooth agenesis patterns.

Persistent Organic Pollutants (POPs) have the characteristics of resistance to environmental degradation, bioaccumulation and long-distance migration potential. Maternal exposure to POPs during pregnancy can enter the fetal blood circulation through the placental barrier, and have a potential impact on the functional development of the nervous system of the offspring. This in turn leads to the occurrence and development of neurological defects and diseases in adulthood. The purpose of this paper is to elucidate the effects of exposure to three major POPs (organochlorine compounds, perfluoroalkyl and polyfluoroalkyl substances, and polybrominated diphenyl ethers) during pregnancy on the functional development of the nervous system (social emotions, cognition, language, exercise, and adaptability) in children, and to provide reference for subsequent studies.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Objective To analyze and compare the clinical manifestations and imaging features of children with secondary massive cerebral infarction after acute subdural hematoma(ASDH),and to evaluate its potential risk factors in order to provide evidence for the prevention,early diagnosis and early treatment of secondary massive cerebral infarction after ASDH.Methods The clinical data of children with ASDH aged 4～12 years were retrospectively studied.All the children received routine operation.The diagnosis of post-traumatic secondary massive cerebral infarction(MCI)was based on low-density areas on CT images and clinical signs.Clinical and radiographic findings related to patient outcomes were reviewed and statistically compared.Univariate and multifactor Cox regression analysis was used to evaluate the MCI after operation to obtain the factors affecting MCI.Results A total of 67 cases were included in the study,with 32 cases included in the MCI group and 35 cases included in the non-MCI group.There were significant differences between MCI and non-MCI groups in age(t=2.016,P= 0.048),body mass(t=2.389,P=0.020),multiple injuries(χ2=11.121,P=0.001),GCS(Z=-4.730,P＜0.001),hematoma volume(χ2=12.890,P=0.002),MLS(χ2=12.261,P=0.002)and perioperative shock(χ2= 14.417,P＜0.001).GCS(OR=0.322,P=0.002),perioperative shock(OR=10.992,P=0.007),multiple injury(OR= 6.547,P=0.046)and MLS score(OR= 46.974,P=0.025)were major risk factors for MCI in children with ASDH.Conclusion Perioperative shock,multiple injuries,low GCS and MLS greater than 10mm are risk factors for MCI.The incidence of MCI is significantly increased in children with multiple risk factors.

Objective:To summarize the imaging presentations of the fallopian canal cerebrospinal fluid leaking (FCCFL).Methods:The high resolution CT (HRCT)and MRI materials of 4 patients (4 ears) with FCCFL confirmed by surgery between August 2016 to November 2023 were retrospectively analyzed. Among these, there were 2 males and 2 females, their ages ranged from 6 to 69 years.Results:All of the FCCFL were unilateral, including 2 on the left and 2 on the right.Clinically, the patients with FCCFL suffered from clear nasal fluid flow, ear tightness, and hearing loss. On CT, all of the affected ears were depicted markedly dilatation of the proximal portion of fallopian canal(FC), the labyrinthine segment and geniculate fossa were involved in 4 cases, and involvement of tympanic segment in 1 case at the same time. The geniculate fossa in the affected side were significantly enlarged, protruding upwards into the tympanic cavity, with one case simultaneously involving the cochlea. On MRI, the hyposignal on T 1WI and hypersignal on T 2WI or water sequence like cerebrospinal fluid (CSF) were shown in the enlargement FC, without diffusion restriction, and non-enhancing with administration Gadolinium contrast.CSF-like signal effusion was shown in all of the affected tympanum, of which, the CSF-like signal effusion was demonstrated in the area along the superficial petrosal nerve, the right pterygopalatine fossa and the parapharyngeal space. The adjacent intracranial meninges were presented thickening in 3 cases. Conclusion:The imaging appearances of FCCFL present some characteristics:on HRCT, the proximal portions of the affected FC depicts markedly enlargement,especially the geniculate fossa.While they present CSF-like signal, no diffusion restriction, and no enhancement administration, Gadolinium contrast on MRI, accompanying the CSF-like signal effusion in the affected tympanum.

Objective:To summarize the HRCT and MRI appearances of stapical footplate fistula related to inner ear malformation (SFF-Re-IEM).Methods:The HRCT and MRI materials of 48 cases (53 ears) SFF-Re-IEM were retrospectively analyzed. Among them, 25 SFF-Re-IEM ears were confirmed by surgery. Their CT and MRI findings including associated IEM type, internal auditory canal (IAC) malformation, tympanic fluid, its density and signal features, and accompanied labyrinthitis were recorded.Results:Among 48 cases (53 ears) with SFF-Re-IEM, 17 ears with incomplete partition type Ⅰ, accounting for 32.1%, 13 ears with common cavity for 24.5%, 13 ears with cochlear aplasia for 24.5%, 7 ears with cochlear dysplasia Ⅱ for 13.2%, and 3 ears with Mondini for 5.7%,were found respectively. 94.3% of them were associated with a defect or dysplasia in the found of the IAC. They were divided into 4 types according to the intact of the stapical footplate and accompanied CSF otorrhea: 22 ears were diagnosed as the stapical footplate leaking, of them, 2 ears might come from the stapical footplate bony defect, 6 ears were from the stapical footplate hernia. 1 ear belonged to the peristapical footplate leaking. 30 ears with the isolated the stapical footplate hernia were another found. The bony defect in 2 ears with the stapical footplate bony defect were not presented on CT and MRI.The focal bony defect of the affected stapical footplate of 36 ears with the stapical footplate hernia were demonstrated, which presented the hemispherical protruding into the tympana, the soft-tissue density on CT, and CSF-like signal on the MR heaved-T2WI images. Among 22 ears with the stapical footplate leaking, their imaging appearances varied from the different amount of the leaking CSF. Besides the focal bony defects of the affected stapical footplates, there were much more CSF-like density or signal in the ipsilateral tympanic cavity in 17 affected ears connecting with the vestibule through the defect area. In the CSF leaking ears with less CSF leaking in 5 ears, the CSF-like cysts like SFH were shown on the stapical footplate defect area, but their outer edges were irregular, and the CSF-like signal scattering in the tympanic cavity did not connect with the protruding cysts at the stapical area.Conclusion:The variable appearances of the SFF-Re-IEM ears based on the different subtypes are its characteristic HRCT and MRI appearances. This is helpful for the SFF-Re-IEM diagnosing to grasp its imaging features.

Objective To investigate the effect of intravenous lidocaine on enhanced recovery of elderly men after laparoscopic radical prostatectomy.Methods A total of 78 patients who planned to undergo laparoscopic radical prostatectomy in Affiliated Lihuili Hospital of Ningbo University from September to December 2023 were selected as study objects,and they were divided into control group and experimental group according to random number table method,with 39 patients in each group.Experimental group received intravenous lidocaine of 1.5mg/kg during induction of anesthesia,followed by micropump injection at a rate of 2mg/(kg·h),and control group was injected with an equal amount of normal saline.The intraoperative dosage of propofol and remifentanil was recorded.Visual analogue scale(VAS)score,postoperative postanesthesia care unit(PACU)residence time,first anal exhaust time,first defecation time,first getting out of bed activity time,length of hospital stay,number of effective patient-controlled intravenous analgesia(PCIA)compressions within 48h after surgery,number and dosage of sufentanil addition,quality of recovery-40(QoR-40)scale score,and occurrence of adverse reactions within 48h after surgery were compared between two groups.Results The intraoperative dosage of propofol and remifentanil,the number of effective PCIA compression,the number of sufentanil addition and the amount of sufentanil in postoperative 48h in experimental group were significantly lower than those in control group(P＜0.05).The VAS scores of experimental group at 2h,6h,12h,24h and 48h were significantly lower than those of control group(P＜0.05).The PACU residence time,first anal exhaust time,first defecation time,first getting out of bed activity time and hospital stay time of experimental group were significantly shorter than those of control group(P＜0.05).The incidence of nausea and vomiting in experimental group was significantly lower than that in control group within postoperative 48h(P＜0.05),and no adverse reactions such as drowsiness,respiratory depression,and severe bradycardia occurred in both groups.48h after surgery,the comfort,emotion,pain scores and total scores of QoR-40 in experimental group were significantly higher than those in control group(P＜0.05).Conclusion In elderly men undergoing laparoscopic radical prostatectomy,intravenous infusion of lidocaine can reduce the amount of perioperative anesthetic drugs,reduce postoperative pain and adverse reactions,and promote postoperative recovery.