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Objective@#The purpose of this study was to observe the clinical characteristics of two types of geotropic direction-changing positional nystagmus, the transient(nystagmus time <1 min) and the persistent(nystagmus time > 1 min), and to evaluate the efficacy of the barbecue roll maneuver.@*Methods@#A total of 105 cases diagnosed by supine roll test were studied, which including 35 males and 70 females and the average age was (56.9±14.6)years. There were 70 transient geotropic DCPN and 35 persistent geotropic DCPN. The clinical characteristics and the immediate and one-week efficacy of the barbecue roll maneuver were discussed.@*Results@#The nystagmus disappeared at the null-point position and the nystagmus in supine position were opposite to the bowing (90° nose-down) position in persistent geotropic DCPN cases. While to the transient geotropic DCPN cases, there were no NP and no nystagmus in prone position. The ratio of the first onset of the two groups was 28.6% (persistent) and 72.9% (transient) respectively, and the difference was statistically significant (P<0.05). The immediate and one-week efficacy after barbecue roll maneuver were 91.4% and 80.0% in transient geotropic DCPN cases, and 0% and 42.9% in persistent geotropic DCPN cases, which were statistically significant different(P<0.05).@*Conclusions@#The light cupula hypothesis can mainly explain the clinical features of persistent geotropic DCPN cases; the barbecue roll maneuver is invalid to persistent geotropic DCPN cases which can be self-healing.
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Objective To investigate the role of Rho-associated coiled-coil containing protein kinase 1 (ROCK1) and the relative signal molecules in sensing the mechanical stimulation from tensile strain and regulating the proliferation of vascular smooth muscle cells (VSMCs).Methods Physiological cyclic strain with magnitude of 10％ and at frequency of 1.25 Hz was applied to VSMCs in vitro by using the strain loading system.The proliferation level of VSMCs was analyzed by BrdU ELISA;the expression level of ROCK1,phosphorylations of protein kinase C (PKC) α/β Ⅱ,protein kinase D (PKD) and extracellular regulated protein kinase (ERK) in VSMCs modulated by cyclic strain were detected with Western blotting;the expression of ROCK1 was specifically repressed by using RNA interference (RNAi).Results Compared with the static control,10％ cyclic strain significantly decreased the expression of ROCK1 and phosphorylations of PKD and ERK.The phosphorylation of PKCα/βⅡ decreased significantly under 10％ cyclic strain for 12 h,but returned to normal level after loading for 24 h.Repressed expression of ROCK1 with RNAi significantly down-regulated VSMC proliferation,suppressed phosphorylations of PKCα/βⅡ and PKD,but no obvious changes were found in phosphorylation of ERK.Conclusions Physiological cyclic strain with magnitude of 10％ may repress the phosphorylation of PKCα/βⅡ and PKD via inhibiting the expression of ROCK1,and subsequently affects VSMC proliferation and maintains vascular hemostasis.The investigation on intracellular mechanotransduction network of VSMCs under mechanical stimulation of cyclic strain may contribute to studying the physiological and pathological mechanisms of cardiovascular diseases.
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Objective To study the effectiveness of intravenous Lidocaine on subjective tinnitus in the elderly, and analyze its correlation with the effectiveness of subsequently oral Carbamazepine.Methods A prospective case-control study was conducted in 120 elderly patients with subjective tinnitus, who were divided into two groups.The control group (n=60) was treated with oral Carbamazepine 0.1 g Bid for one month, and the treatment group (n=60) was treated with 2％ lidocaine by intravenous injection.Patients in the treatment group were observed on responses in tinnitus during the period with Lidocaine injections.The treatment group was further divided into the improvement subgroup and the no-improvement subgroup, according to responses to intravenous lidocaine.All the patients in the treatment group received oral carbamazepine 0.1 g Bid for one month following the intravenous lidocaine injection phase.Results In the control group, 5 patients showed marked improvement, 20 patients showed partial improvement, 33 patients showed no improvement, and 2 patients showed symptom deterioration, with an effectiveness rate of 41.7％ (25/60).In the treatment group, 6 patients showed marked improvement, 26 patients showed partial improvement, 24 patients showed no improvement, and 4 patients showed symptom deterioration, with an effectiveness rate of 53.3％ (32/60).Of the 32 patients in the improvement subgroup, 6 cases showed marked improvement, 16 cases showed partial improvement, 8 cases showed no improvement, and 2 cases showed symptom deterioration after subsequent oral Carbamazepine treatment, and the effectiveness rate was 68.8％ (22/32).Of the 28 patients in the no-improvement subgroup, 1 case showed marked improvement, 9 cases showed partial improvement, 16 cases showed no improvement, and 2 cases showed symptom deterioration, and the effectiveness rate was 35.7％ (10/28).The effectiveness rate in the improvement subgroup was higher than in the no-improvement subgroup (68.8％ vs.35.7％, x2 =6.55, P＜0.05).The effectiveness of lidocaine followed by carbamazepine was better than that of carbamazepine alone (68.8％ vs.53.3％, x2 =6.13, P＜0.05).Conclusions Oral Carbamazepine treatment following intravenous Lidocaine injection in elderly patients with subjective tinnitus has better therapeutic outcomes than treatment with oral Carbamazepine alone, but is not as effective in patients with negative responses to Lidocaine as in patients with positive responses.
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Objective To evaluate the knowledge,attitude and practice(KAP)related with AIDS of local floating population.Methods A total of 1 942 floating persons were sampled by multistage cluster sampling and interviewed with questionnaire in the agricultural markets,construction sites,and their habitats within 3 communities in Hongkou District.Results 82.9% of the interviewees were 20 ～49 years old.The average score was 34.77 ±3.52 (maximum score is 44)for knowledge,12.11 ±2.32(maximum score is 19)for attitude,5.50 ±0.95(maximum score is 7)for practice,respectively.The scores increased with educational level significantly.The scores of knowledge were 33.26 ±3.54,34.63 ±3.23,36.56 ±3.39 among the subjects with educational levels of primary school and below,junior high school,senior high school and above.The scores of attitude were 13.77 ±2.27,14.79 ±2.39,15.62 ±2.38,respectively.And the score of practice was 5.40 ±0.90,5.51 ±0.93,5.58 ±1.03,respectively.Conclusion In the present,the KAP relating AIDS of local floating population is poor in Hongkou District.A variety of intervention methods and operational patterns should be developed for the floating population with different educational levels and jobs.
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Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai, so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling, among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20. 04% and 18. 73%, respectively. The smoking rate and standardized smoking rate of males were 41.05% and 30.07%, and those of females were 0. 80% and 1. 70% , respectively. The smoking rate of males was higher than that of females (RR = 0.02, 95% CI: 0.01 -0.03). The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old, and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education (RR=0.45, 95% CI: 0.25 -0.79). Subjects who drank alcohol smoked more than those did not (RR = 2. 68, 95% CI: 1. 76 - 4.09). Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower. Age, gender, education status and alcohol drinking were influencing factors of smoking. Education on tobacco control among subjects aged more than 35 years should be strengthened, and more attention should be paid to those with lower education. Besides, education on alcohol control should be managed together with tobacco control.
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OBJECTIVE To analyze the caloric test findings of the unilateral primary horizontal and posterior semicircular canal benign paroxysmal positional vertigo(HSC-BPPV and PSC-BPPV).METHODS Caloric test were tested in 152 PSC-BPPV patients and 25 HSC-BPPV patients after Dix-Hallpike test and Roll test.RESULTS Of 152 PSC-BPPV patients 64 canal paresis(CP)were found in the abnormal side and 44 in the normal side;Of 25 HSC-BPPV patients 16 canal paresis were found in the abnormal side and 9 in the normal side.The incidence of CP in PSC-BPPV is 30.3% and the incidence of CP in HSC-BPPV is 52%.13 Patients with PSC-BPPV were found abnormal Directional Preponderance(DP)and 10 Patients with PSC-BPPV were found abnormal Directional Preponderance.CONCLUSION The incidence of CP in the abnormal side of HSC-BPPV and PSC-BPPV is more than that of the normal side.The incidence of CP in abnormal side of the HSC-BPPV is more than that of PSC-BPPV.The incidence of abnormal DP in HSC-BPPV is more than that of PSC-BPPV.
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OBJECTIVE To discuss the operative plan for nasal cavity abnormality and evaluate the effect of revision FESS. METHODS A retrospective study of 36 revision FESS performed during 2002.3-2005.5 (age from 17 to 55 years old) is presented. Patients were evaluated with endoscopic examination of the nasal cavities and computed tomography of the sinuses and nasal cavities. Information was also collected during the revision surgery. The plan was designed according to nasal cavity abnormality. RESULTS The reasons of revision FESS: Among 36 cases there are 24 ethmoid sinusitis, 16 cases with recurrence of polyps,13 middle meatal stenosis, 11 middle turbinate adhesion, 10 septal deviation, 5 frontal recess stenosis, 5 sphenoid sisusitis, 3 maxillary ostium obstruction,3 inferior turbinate hypertrophy. Follow up for 6 month～43 month after revision FESS, 22 cases were successful, 10 satisfied and 4 inefficacy. CONCLUSION The primary FESS failure was associated with nasal cavity structure diseases. Meticulous attention in these areas and correcting it during surgery may reduce recurrence and ensure operative effect after revision FESS.
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Objective To study the changes of the rat's hearing threshold by long-term treatment with Vitamin-C and the reason of the changes. Methods Forty-two Wistar rats were randomly divided into two groups: the treatment group was treated with water added Vit-C and the placebo group was treated with drinking water.(1)Concentrations of malondialolehyde(MDA)of the cochlea with fluorescence chromatometry.(2) Auditory sensibilities with auditory brainstem response testing.(3) The frequency of the mtDNA~(4834)bp deletion in the cochlea with polymerase chain reaction technique. Results Hearing threshold of both groups become worse with aging,and the treatment group showed the better auditory sensitivities,the less concentrations of MDA and the less frequency of mtDNA~(4834)bp deletion compare with the placebo group. Conclusions Long-term treatment with Vitamin-C could reduce the degree of hearing loss of the rats and the concentrations of MDA of the cochlea and the frequency of mtDNA~(4834)bp deletion in the cochlea.The oxygen radicals theory should be the etiology of presbyacusis.
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Objective To explore the principles and methods of surgcal treatment for acute neoplastic colorectal obstruction.Methods The clinical data of 103 patients diagnosed as acute neoplastic colorectal obstruction were analyzed retrospectively.Results In this group,80 cases underwent emergency surgical treatment,(among) which,25 cases of carcinoma of right colon underwent primary resection and anastomosis;in 45 cases of carcinoma of left colon,primary resection and anastomosis was performed in 37 cases;and emergent(operations) were performed in 10 cases of rectal cancer.23 cases received non-emergency surgery.(Anastomotic) fistula occurred in 3 patients,pulmonary infection in 2 patients,pelvic cavity infection in 1(patient),1 patient died and the rest recovered well and were discharged.Conclusions The initial treatment for acute neoplastic colorectal obstruction should be non-surgcal treatment for 1~3d to make non-emergency surgical treatment more possible.If indications are properly selected,primary tumor resection and anastomosis is safe.For patients with severe contamination of abdominal cavity and bowel perforation, primary tumor(resection) should be performed if possible.
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Objective To study the epidemiological features of patients for emergency transport so as to enhance the control level of pre hospital emergency treatment. Methods Investigations were made of 956 cases of patients for emergency transport in the authors hospital in 2000～2001 and their epidemiological features analyzed. Results Among the 956 cases, males outnumbered females, patients within the age group of 20 to 39 numbered 391, accounting for 40.9%, and patients within the age group of 50 to 69 numbered 400, accounting for 41.8%. Of all the cases, ordinary ones numbered 671(70.2%),critical ones numbered 241(25.2%), and cases that died numbered 44(4.6%). The first three diseases demanding emergency transport were successively craniocerebral wound(17.4%), cerebrovascular disease(16.0%), and cardiovascular disease(13.5%). The periods for emergency transport ranged mainly from 9:00 to 12:00 and from 15:00 to 18:00. The sources of emergency cases were successively township hospitals(53.8%), hospitals at the county level(26.0%), and hospitals at the city level(20.2%). Conclusion Control of pre hospital emergency treatment needs to be strengthened according to the epidemiological features of patients for emergency transport.