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Objective: We conducted a Meta-analysis to investigate the necessity of postural restrictions after manual reduction in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We searched PubMed, EBSCO, Proquest, Web of Science databases, Ovid, and screened eligible studies that investigated the effect of post-maneuver postural restriction in treating patients with PC-BPPV. Outcomes included the efficacy of treatment and recurrence. Meta-analysis was performed using Stata 15.0 software. Results: Studies of the single visit efficiency included 11 references, with a sample size of 1 733 cases. The Meta-analysis results showed that the difference in the efficacy between the postural restricted group and the non-postural restricted group in PC-BPPV patients was statistically significant(RR=1.12, 95%CI=1.07-1.18, P<0.001). There were 12 references included in the study on the total efficiency, with a cumulative sample size of 1763 cases. There was no statistically significant difference between the effect of postural restriction after manipulative reduction and that of simple manipulative reduction (RR=1.03, 95%CI=0.99-1.08, P=0.118). There were 5 references included in the study of recurrence rate, and the cumulative sample size was 659 cases. There was no statistically significant difference in the recurrence rate between the postural restricted group and the non-postural restricted group(RR=0.98, 95%CI=0.62-1.54, P=0.937). Conclusions: In comparison with non-postural restriction group, post-maneuver postural restriction after a single visit can improve the treatment effective rate of PC-BPPV and contribute to the improvement in the symptoms of patients in a short term. However, postural restrictions has no significant effect on the final prognosis of PC-BPPV, and it also has no significant effect on the recurrence.
Subject(s)
Humans , Benign Paroxysmal Positional Vertigo/therapy , Environment , Patient Positioning , Recurrence , Semicircular Canals , Treatment OutcomeABSTRACT
Objective:To observe the clinical efficacy of addition and subtraction therapy of Shashen Maidongtang for syndrome of Yin deficiency and lung heat at convalescent period in patients with mycoplasma pneumoniae pneumonia， and to investigate its regulatory effect on immune inflammatory response. Method:One hundred and forty-eight patients were randomly divided into control group （74 cases） and observation group （74 cases） by random number table. During the treatment， 70 patients completed the study in control group （loss to follow-up in 2 cases， elimination in 3 cases）， and 71 patients completed the study in observation group （loss to follow-up in 4 cases）. Patients in both groups got Azithromycin tablets for 3 days， 10 mg·kg-1·d-1， pidotimod granules， 0.4-0.8 g/time， 2 times/day， and Ambroxol oral solution， 2.5-15 mL/time， 2 times/day. The patients in control group additionally received Yangyin Qingfei oral liquid， 5-10 mL/time， 2-3 times/day， while the patients in observation group additionally received addition and subtraction therapy of Shashen Maidongtang， 1 dose/day， with a treatment course of 7 days in both groups. Before and after treatment， scores of cough symptom and cough visual analogue score （VAS） were graded， and the time to disappearance of cough， lung rales and expectoration as well as the time to recovery of chest radiograph were recorded. Scores of syndrome of yin deficiency and lung heat and Leicester Cough Questionnaire （LCQ） were also graded. Levels of T lymphocyte subsets （CD3+， CD4+， CD8+ and CD4+/CD8+）， interleukin-6 （IL-6）， IL-10， tumor necrosis factor-α （TNF-α）， substance P （Substance P） and procalcitonin gene related peptide （CGRP） were detected， and the safety was also evaluated. Result:Total effective rate for the disease was 95.77% （68/71） in observation group， higher than 82.86% （58/70） in control group （χ2=6.186， P<0.05）. Scores of cough symptoms and VAS were higher than those in control group （P<0.01）， and scores of various items in LCQ scale and the total score of LCQ were all higher than those in control group （P<0.01）. The time to disappearance of cough， lung rales and expectoration as well as the time to recovery of chest radiograph in observation group were shorter than those in control group （P<0.01）. Levels of CD3+， CD4+ and CD4+/CD8+ were higher than those in control group （P<0.01）， and levels of CD8+， IL-6， IL-10， TNF-α， SP in serum and CGRP in sputum were all lower than those in control group （P<0.01）. Conclusion:On the basis of conventional western medicine treatment， addition and subtraction therapy of Shashen Maidongtang can reduce the degree of cough， shorten the course of disease， improve the quality of life， improve the cellular immune function， reduce the inflammatory injury， and reduce the sensitivity of cough， with better clinical efficacy and safety as compared with Western medicine alone.
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Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%. Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials, and remedial measures to improve the prognosis.
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<p><b>OBJECTIVE</b>To investigate the effect of fluvastatin on blood levels of c-reactive protein (CRP), tumor necrosis factor alpha (TNFalpha) and cardiac troponin I (cTnI) in patients with unstable angina undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Sixty patients who underwent PCI from July 2002 to April 2004 in our hospital were randomized into two groups: control group; fluvastatin group (40 mg/d). Serum levels of CRP, TNFalpha and cTnI were measured before and after two weeks treatment (in the early morning of the procedure) and at 24 hours after the procedure.</p><p><b>RESULTS</b>The serum levels of CRP, TNFalpha and cTnI in fluvastatin group were distinctly lower than those in control group before (P < 0.01) and after the procedure (P < 0.01), respectively.</p><p><b>CONCLUSION</b>The result suggested that PCI could lead to a detectable increase in serum levels of CRP, TNFalpha and cTnI in patients with coronary heart disease; Fluvastatin could significantly decrease the serum levels of CRP, TNFalpha and cTnI in patients with coronary heart disease; Fluvastatin could also decrease the serum levels of CRP, TNFalpha and cTnI in patients with PCI.</p>