1.Diagnostic value of RART and LDT in determining the affected semicircular canal for the HSC-BPPV.
Yanning YUN ; Huimin CHANG ; Pan YANG ; Juanli XING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):319-323
Objective:To evaluate the utility of the Rapid Axial Roll Test (RART), Supine Roll Test (SRT), and Lying-Down Test (LDT) in determining the affected semicircular canal in cases of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods:A total of 330 patients diagnosed with HSCBPPV from September 2022 to September 2023 were collected and divided into three groups based on the different positional tests received: ①SRT Group, ②LDT+SRT Group, ③RART+SRT Group. The trial was divided into two stages: LDT/RART for patients in the first stage, and SRT for patients in the second stage. The elicitation rate of nystagmus among the three groups was compared to evaluate the accuracy in determining the affected semicircular canal in HSCBPPV. Results:Nystagmus was elicited in 84.55% (279/330) of the patients by positional tests. The elicitation rate of nystagmus in the RART+SRT/LDT group was 94.55% (104/110), in the LDT+SRT group it was 84.11% (90/107), and in the SRT group it was 69.91% (79/113). The differences among the three groups were statistically significant (χ²= 23.88, P<0.001). In the ② and ③ groups, there was a statistically significant difference in the elicitation rate of nystagmus between stage Ⅰ (patients with LDT or RART) (χ²=43.842, P<0.001). SRT was performed in the stage Ⅱ, and there was a statistically significant difference in nystagmus extraction rate between the two groups (χ² =4.690, P=0.030). The difference in the proportion of agreement between stage Ⅰ(LDT or RART) and stageⅡ (SRT) in determining the affected side of the semicircular canal was also statistically significant (χ² =40.502, P<0.001). For patients with a consistent diagnosis of the affected semicircular canal, the difference in cure rate was not significant (P=0.149). The Kappa statistic indicated substantial agreement between RART and SRT in terms of eliciting nystagmus (agreement 96.36%, Kappa = 0.730, P<0.001). Conclusion:RART and SRT show a high degree of agreement regarding the elicitation rate of nystagmus. RART is simple and safe, and it can effectively induce the characteristic nystagmus of HSC-BPPV, accurately identify the responsible semicircular canal and provide a more optimized examination protocol for clinical practice in HSCBPPV.
Humans
;
Semicircular Canals/physiopathology*
;
Benign Paroxysmal Positional Vertigo/diagnosis*
;
Female
;
Male
;
Middle Aged
;
Nystagmus, Pathologic/diagnosis*
;
Vestibular Function Tests/methods*
;
Aged
;
Vertigo/diagnosis*
;
Adult
2.Risk assessment of residual dizziness after repositioning in patients with benign paroxysmal positional vertigo according on multivariate analysis and nomogram.
Yanning YUN ; Xinyu XU ; Hansen ZHAO ; Ru HAN ; Jing LIU ; Suining XU ; Guirong LI ; Juanli XING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(10):923-929
Objective:To investigate the clinical characteristics of residual dizziness(RD) after repositioning in patients with benign paroxysmal positional vertigo(BPPV), identify its potential risk factors, and develop a predictive risk model. Methods:A total of 137 patients diagnosed with BPPV at the First Affiliated Hospital of Xi'an Jiaotong University between January 2023 and June 2023 were enrolled. Based on the presence or absence of subjective discomfort within 3 months after successful repositioning, patients were divided into the non-RD group(NRD, n=93) and the RD group(n=44). Differences in demographic characteristics, comorbidities, and disease-related features were compared between groups. Multivariate logistic regression analysis was used to identify independent risk factors for RD, and a nomogram was constructed based on these factors. The predictive performance of the model was assessed using the area under the curve(AUC). Results:The RD group showed significantly higher values in body mass index, prevalence of diabetes and motion sickness history, dizziness duration before repositioning, history of repositioning at external hospitals, number of treatments, and recurrence(all P<0.001). Multivariate logistic regression revealed that diabetes(adjusted OR=8.73, P=0.039), motion sickness history(adjusted OR=23.08, P<0.001), dizziness duration ≥30 days before repositioning(adjusted OR=15.16, P<0.001), and recurrence(adjusted OR=15.72, P=0.001) were independent risk factors for RD. The nomogram model based on these variables demonstrated good predictive ability, with an AUC of 0.804(95%CI 0.684-0.924). Conclusion:Diabetes, motion sickness history, dizziness duration ≥30 days, and recurrence are independent risk factors for RD after repositioning in patients with BPPV. The nomogram model based on these variables shows good predictive performance, with recurrence having the highest predictive value. This model can aid in early identification of high-risk patients and guide individualized intervention strategies.
Humans
;
Nomograms
;
Benign Paroxysmal Positional Vertigo/therapy*
;
Dizziness/etiology*
;
Risk Factors
;
Risk Assessment
;
Multivariate Analysis
;
Male
;
Female
;
Logistic Models
;
Middle Aged
;
Patient Positioning
;
Adult
3.Research on the diagnosis and treatment path of acute vestibular syndrome patients under the concept of humanistic care
Yingying LIU ; Yanning YUN ; Qun WU ; Pan YANG ; Zixuan YUN ; Li LU ; Juanli XING
Chinese Medical Ethics 2024;37(4):466-469
At present,there are many difficulties in the diagnosis and treatment of acute vestibular syndrome(AVS).For example,complex and difficult identification of the cause of disease,uneven diagnosis and treatment levels of clinical doctors,weak humanistic care awareness,lack of communication skills,intrinsic affinity and other reasons,which make it difficult for AVS patients in the process of diagnosis and treatment,and cannot receive timely and effective treatment,resulting in an exacerbation of doctor-patient conflicts.Therefore,it is recommended to explore new paths of AVS diagnosis and treatment work using the humanistic care concept,respect each other between doctors and patients,build a team of medical staff with the value orientation of"humanistic care",and promote the organic unity of theory and practice of"humanistic care",with a view to better promoting the implementation of AVS diagnosis and treatment work,helping more patients rebuild confidence,enhancing quality of life,and improving the doctor-patient relationship.
4.Humanistic Care in Clinical Diagnosis and Treatment of Elderly Benign Paroxysmal Positional Vertigo Patients
Juanli XING ; Xindi WANG ; Leyi ZHANG ; Li LU ; Guifang ZHANG ; Yanning YUN ; Juanli LI
Chinese Medical Ethics 2023;36(6):698-702
Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disease with the highest incidence rate, and the elderly are the high incidence population. Particle repositioning maneuver, simple and practicable, and has good clinical effects, is recognized as the preferred treatment method for BPPV. However, the elderly patients have a higher prevalence rate, often suffer from multiple chronic diseases, and their various bodily functions have entered a declining stage, with poor response to treatment and a tendency to recur. Based on these, medical staff should continuously improve their professional abilities, and pay attention to and implement some comprehensive and multi-dimensional humanistic care measures from physiological to psychological aspects such as verbal encouragement, behavioral support, and spiritual integration during the diagnosis and treatment process, to improve the quality of life of elderly BPPV patients, reduce medical disputes, and save medical resources.
5.Investigation of Patient Satisfaction Degree with ECG Examination in a Tertiary A Hospital and Its Improvement Strategy
Wei YUAN ; Xindi WANG ; Yingying LIU ; Yanning YUN ; Hansen ZHAO ; Juanli XING
Chinese Medical Ethics 2023;36(4):462-469
To improve overall satisfaction of patients with the hospital and build a harmonious doctor-patient relationship, a survey on satisfaction of patients with ECG examination was conducted in a tertiary A hospital. The analysis was carried out from the aspects of inspection environment, inspection process, inspection experience and overall satisfaction. Logistic regression model was used to analyze the effect of various variables on satisfaction. This paper found that the overall satisfaction rate of patients with ECG examination was 85.18%, lower than that of outpatients. Patients with different characteristics had different satisfaction degree with ECG examination. Patient satisfaction was lower on Mondays and Wednesdays than that on other inspection days, and was lower between 10 a.m. and 14 p.m. The longer the waiting time, the lower satisfaction degree of patients with examination. Based on the results, hospitals should improve the construction of humanistic soft environment to improve the medical environment, scientifically plan the medical treatment process of ECG examination, and further strengthen doctor-patient communication. The ECG room should further promote its management level and strengthen its cultural construction.
6.Study on the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo by SRM-vertigo diagnosis system.
Yanning YUN ; Pan YANG ; Hansen ZHAO ; Zijun CHENG ; Ting ZHANG ; Peng HAN ; Huimin CHANG ; Juanli XING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):786-795
Objective:To investigate the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo(HC-BPPV) by SRM-vertigo diagnosis system. Methods:A total of 406 patients diagnosed with HC-BPPV from Nov 2021 to Nov 2022 were enrolled by rapid axial roll test and Dix-Hallpike in the department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups by hospital card numbers, in which the numbers that were odd were considered as group A, and the numbers that were even were considered as group B. The group A underwent two circles of Barbecure repositioning procedure by SRM-vertigo diagnosis system, while the group B underwent two circles Barbecure combined with Epley repositioning procedure by SRM-vertigo diagnosis system. The treatment was stopped on the next day when two groups of patients were cured, and those who were not cured will continue treatment with the same method. Results:The cure rate of group A was 83.41%, and the cure rate of group B was 80.51%, the difference between the two groups was not-statistically significant difference(P>0.05). The rate of residual dizziness of group A was 23.30%, the rate of residual dizziness of group B was 11.46%, the difference between the two groups was statistically significant(P<0.05). Conclusion:The Barbecure combined with Epley otoliths repositioning maneuver by SRM-vertigo diagnosis system can significantly reduce the rate of residual dizziness after the treatment of HC-BPPV, and improve the quality of life of patients.
Humans
;
Benign Paroxysmal Positional Vertigo/therapy*
;
Dizziness
;
Quality of Life
;
Patient Positioning/methods*
;
Semicircular Canals
7.The influence of additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo.
Juanli XING ; Shu ZHANG ; Hansen ZHAO ; Yanning YUN ; Baiya LI ; Shaoqiang ZHANG ; Pan YANG ; Peng HAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(4):268-271
Objective:To evaluate the influence of an additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo(HC-BPPV). Methods:A total of 713 patients diagnosed with HC-BPPV in Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi'an Jiaotong University from Jan 2020 to Feb 2022 were enrolled. The patients were divided into two groups by hospital card numbers, in which the number is odd were considered as group A, and the number is even were considered as group B. The group A underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, while the group B first performed an additional roll test and then underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, to observe the cure rate and compare influence of HC-BPPV by an additional roll test. The quality of life and sleep of patients before and one-month after the treatment were assessed by the dizziness handicap inventory(DHI) and the pittsburgh sleep quality(PSQI). Results:The cure rate of group A was 63.21%, and the cure rate of group B was 87.68%,the difference between the two groups was statistically significant(P<0.05); The DHI score of patients after the repositioning was significantly lower than that before the repositioning(P<0.05). The PSQI score after the repositioning was significantly lower than that before the repositioning(P<0.05). The DHI and the PSQI scores after the repositioning were significantly lower than that before the repositioning, with a statistically significant difference (P< 0.05). The total score of DHI in group B after treatment was lower than that in group A, with a statistically significant difference(P<0.05). The total score of PSQI in group B after treatment was lower than that in group A, with non-statistically significant difference (P< 0.05). Conclusion:An additional roll test before the repositioning procedure by SRM-vertigo diagnosis system can significantly improve the cure rate of HC-BPPV, relieve anxiety, and improve the quality of life.
Humans
;
Benign Paroxysmal Positional Vertigo/diagnosis*
;
Quality of Life
;
Patient Positioning/methods*
;
Dizziness
;
Semicircular Canals
8.Analysis of the application mechanism of clinical biobank
Haiyan LI ; Mingyu NI ; Jinxi LI ; Yun ZHANG ; Yonghong ZHANG ; Yanning CAI ; Hong YOU ; Xiaomin WANG
Chinese Journal of Medical Science Research Management 2019;32(5):397-400
Objective Analyze the application status and existed problems of clinical biobank in China,propose possible application mechanisms for clinical biobank.Methods Through questionnaire survey and case analysis combined with relevant literature reports from home and abroad,conduct qualitative analysis to understand the application status and problems of clinical biobank.Results With the rapid development of biobank,its application rate was far from expected.The construction of clinical database lags behind in China will affect the application of samples.The lag of application mechanism will affect the opening and application of the biobank.Conclusions At the beginning of construction,the clinical biobank should take full account of what and how resources can be used,and establish tailored application mechanism.More attention should be paid to the possible benefit of biobank construction.
9.Analysis on clinical Bio-Bank quality construction mechanism
Mingyu NI ; Xin LI ; Yongli GUO ; Yun ZHANG ; Shunai LIU ; Yanning CAI ; Haiyan LI ; Xiaomin WANG
Chinese Journal of Medical Science Research Management 2018;31(3):170-174
Objective Based on Total Quality Management (TQM) theory,our study aims to analyze the clinical Bio-Bank overall quality management implications,basic characteristics,principles,and management mechanisms,and provide theoretical basis for the clinical Bio-Bank quality construction.Methods Using theoretical and literature research methods,Bio-Bank overall quality management qualitative analysis was conducted,putting forward a framework of Bio-Bank comprehensive quality management.Results Biological sample overall quality management was defined theoretically including its connotation,concepts and basic characteristics.We also put forward an application principle and basic operation method at the application level.Conclusions Total Quality Management (TQM) is applied to the clinical Bio-Bank construction,from where,the scientific and unique management content can effectively optimize the Bio-Bank management regulation and standardization of the sample operation process in the PDCA cycle,which is critical to improve the quality of clinical Bio-Bank.

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