ABSTRACT
Objective: To investigate the frequency characteristics and the pathological characteristics of the horizontal crista ampullaris in patients with Meniere's disease,and to analyse its structural basis. Methods: Between March, 2019 and November, 2019, seventy-two patients diagnosed as Meniere's disease (27 males and 45 females, aged from 13 to 74 years, with a course of disease ranging from 4 months to 32 years)in Shandong Provincial ENT Hospital were included.Caloric test, sinusoidal harmonic acceleration test (SHA), video-head impulse test (v-HIT), Gadolinium-enhanced inner-ear 3D-FLAIR MRI and pure tone audiometry were conducted in the patients. The function of the horizontal semicircular canal in these patients were analysed as well as its relationship with the degree of endolymphatic hydrops,clinical stage and duration. Light microscopy and transmission electron microscopy were used to observe the ultrastructure of horizontal semicircular canal crista ampullaris from six patients with refractory Meniere's disease who underwent labyrinthectomy. The number of type Ⅰ and type Ⅱ vestibular hair cells, the common pathophysiological changes of horizontal semicircular canal crista ampullaris were investigated in these patients. Statistical analysis was performed using SPSS 19.0. Results: With the increase of detection frequency, the abnormal rate decreased gradually. The abnormal rate of caloric test was 69.4% (50/72), SHA 51.4% (37/72), V-HIT 36.1% (26/72), comparation of the positive rate among the three tests showed statistically significant differences(P<0.05).Neither caloric test nor SHA had correlation with the degree of hydrops(P>0.05), but v-HIT(r=0.434,P<0.01).There was correlation with clinical stage to SHA and v-HIT(r=0.338,0.462,P<0.01), except caloric test(P>0.05).No significant relation was found with caloric test, SHA, v-HIT and course of disease(P>0.05).Morphological observation found abnormal monolayer epithelialization of the horizontal semicircular canal crista ampullaris significantly decreased number of type Ⅱ hair cells compared with type Ⅰhair cells. Hair cells showed perinuclear vacuolization, cytoplasmic vacuoles, mitochondrial electron density increasement and loss of stereocilia. Conclusions: The horizontal semicircular canal damage in the patients with Meniere's disease has a frequency-dependent characteristic, mainly occurres in low frequency area. With progress of the disease, the high frequency area of ampulla will be impaired gradually, and it is related to the degree of endolymphatic hydrops and hearing level. Hair cell injury would be observed,the frequency characteristics may be more associated with the disorder of type Ⅱ hair cells.
Subject(s)
Female , Humans , Male , Caloric Tests , Endolymphatic Hydrops , Meniere Disease , Semicircular Canals , Semicircular DuctsABSTRACT
Objective@#To explore and compare the preventive effect of using letrozole and gonadotropin-releasing hormone (GnRH) antagonist during luteal phase of patients at high risk for ovarian hyperstimulation syndrome (OHSS).@*Methods@#A total of 99 infertile women undergoing in vitro fertilization and embryo transfer or intracytoplasmic sperm injection with high risk for OHSS were enrolled in this randomized controlled trial.The letrozole group (n=51) received letrozole of 7.5 mg daily for 3 days;the GnRH antagonist group (n=48) were given cetrorelix of 0.25 mg subcutaneously daily for 3 days. Both groups received support therapy combined with embryo cryopreservation. The incidence of OHSS was surveyed. And the serum concentration of estradiol, LH and progesterone on days 3, 5 and 8 after oocytes retrieval were measured.@*Results@#There were no statistical differences in terms of baseline characteristics of patients and outcomes of controlled ovarian hyperstimulation between the two groups.The incidence of moderate and severe OHSS was found no significantly difference between letrozole group [11.8%(6/51)] and GnRH antagonist group [10.4%(5/48);P>0.05]. The estradiol concentration of the indicated days on days 3,5 and 8 after oocytes retrieval in letrozole group and GnRH antagonist group were (1 417±3 543) versus (15 210±9 921) pmol/L, (1 692±4 330) versus (18 680±11 567) pmol/L, (239±336) versus (3 582±5 427) pmol/L, respectively;compared with GnRH antagonist group, the estradiol level was significantly lower in the letrozole group (all P<0.01). The luteinizing hormone level in the letrozole group were (0.46±0.40), (0.56±0.55)and (0.67±0.58) U/L on days 3,5 and 8 after oocytes retrieval, which were significantly higher than those of GnRH antagonist group [(0.28±0.28), (0.30±0.19) and (0.45±0.37) U/L, respectively; all P<0.05]. There was no obvious differences on progesterone levels between letrozole group and GnRH antagonist group (all P>0.05),and on days 8 after oocytes retrieval,the level of progesterone in each group were significantly lower than those on day 3 and 5 after oocytes retrieval (P<0.05).@*Conclusion@#Letrozole has the same efficiency as GnRH antagonist for the prevention of OHSS, faster and cheaper to use, but its efficacy seems not to be related to the suppression of steroidogenic during the luteal phase.
ABSTRACT
Objective:To explore and compare the preventive effect of using letrozole and gonadotropin-releasing hormone (GnRH) antagonist during luteal phase of patients at high risk for ovarian hyperstimulation syndrome (OHSS).Methods:A total of 99 infertile women undergoing in vitro fertilization and embryo transfer or intracytoplasmic sperm injection with high risk for OHSS were enrolled in this randomized controlled trial.The letrozole group ( n=51) received letrozole of 7.5 mg daily for 3 days;the GnRH antagonist group ( n=48) were given cetrorelix of 0.25 mg subcutaneously daily for 3 days. Both groups received support therapy combined with embryo cryopreservation. The incidence of OHSS was surveyed. And the serum concentration of estradiol, LH and progesterone on days 3, 5 and 8 after oocytes retrieval were measured. Results:There were no statistical differences in terms of baseline characteristics of patients and outcomes of controlled ovarian hyperstimulation between the two groups.The incidence of moderate and severe OHSS was found no significantly difference between letrozole group [11.8%(6/51)] and GnRH antagonist group [10.4%(5/48); P>0.05]. The estradiol concentration of the indicated days on days 3,5 and 8 after oocytes retrieval in letrozole group and GnRH antagonist group were (1 417±3 543) versus (15 210±9 921) pmol/L, (1 692±4 330) versus (18 680±11 567) pmol/L, (239±336) versus (3 582±5 427) pmol/L, respectively;compared with GnRH antagonist group, the estradiol level was significantly lower in the letrozole group (all P<0.01). The luteinizing hormone level in the letrozole group were (0.46±0.40), (0.56±0.55)and (0.67±0.58) U/L on days 3,5 and 8 after oocytes retrieval, which were significantly higher than those of GnRH antagonist group [(0.28±0.28), (0.30±0.19) and (0.45±0.37) U/L, respectively; all P<0.05]. There was no obvious differences on progesterone levels between letrozole group and GnRH antagonist group (all P>0.05),and on days 8 after oocytes retrieval,the level of progesterone in each group were significantly lower than those on day 3 and 5 after oocytes retrieval ( P<0.05). Conclusion:Letrozole has the same efficiency as GnRH antagonist for the prevention of OHSS, faster and cheaper to use, but its efficacy seems not to be related to the suppression of steroidogenic during the luteal phase.
ABSTRACT
Objective To investigate the effect of pelvic position angle on the angle of acetabular prosthesis by computer navigation system.Methods Computer navigation technique was used to simulate total hip arthroplasty (THA) on the whole pelvis.The anteversion and abduction angle of acetabular prosthesis were measured when the pelvis rotated around horizontal axis,long axis and sagittal axis.Results With the increase of the angle of the pelvis on the horizontal axis,the angle of the acetabular prosthesis was linearly decreased (Y=-1.32X+1,r=-0.982,P＜0.001) and the abduction angle showed a linear increase (Y=0.398X+ 3,r=0.975,P＜0.001).The obliquity and abduction angle of the acetabular component increased linearly angle (Y=0.764X+2,r=0.998,P＜0.001;Y=0.394X+4,r=0.975,P＜0.001) with the increase of the backward inclination.With the increase of the rotation angle of the pelvis to the left in the long axis,the anteversion angle of the acetabular component increased linearly (Y=l.42X+21,r=0.985,P＜0.001),and the abduction angle decreased linearly (Y=-0.67X+3,r=-0.976,P＜0.001).With the increase of the fight rotation angle of the pelvis,the anteversion and abduction angle of the acetabular component showed a linear increasing trend (Y=0.75X+2,r=0.997,P＜0.001;Y=3.94X+4,r=0.990,P＜0.001).With the increase of the sagittal axial oblique angle of the pelvis,the antegrade angle of acetabular prosthesis increased linearly (Y=0.39X+ 19,r=-0.993,P＜0.001),and the abduction angle decreased linearly (Y=-0.75X+7,r=-0.964,P＜0.001).The antegrade angle of acetabular prosthesis decreased linearly (Y=-0.11X+ 11,r=-0.990,P＜0.001) with the increase of the fight tilt angle of the pelvis,while the abduction angle increased linearly (Y=0.92X+4,r=0.994,P＜0.001).Conclusion The change of pelvic position angle has great influence on the angle of acetabular prosthesis placement,suggesting that the different pelvic position is very important during operation.Computer navigation can reduce the influence of pelvic position angle on the angle of acetabular prosthesis placement.
ABSTRACT
Objective: To investigate the clinical features of epistaxis in the posterior fornix of the inferior nasal meatus and compare the treatment outcomes of endoscopic surgery and conventional nasal packing for this intractable form of epistaxis
Methods: Between August 2011 and August 2014, the medical records of 53 adult patients with idiopathic epistaxis in the posterior fornix of the inferior nasal meatus diagnosed by nasal endoscopy were obtained from our department. Of these, 38 patients underwent endoscopic surgery [surgery group] and 15 received a nasal pack [packing group]. The patients' background characteristics, incidence of re-bleeding, extent of discomfort after treatment as assessed using a 10-point visual analogue scale [VAS] and incidence of nasal cavity adhesion after treatment were analysed
Results: There were no significant differences in background characteristics between the two groups. The incidence of re-bleeding [0/38 vs. 4/15, surgery vs. control, P = 0.001], VAS score for discomfort [2.4 +/- 1.4 vs. 7.6 +/- 1.0, surgery vs. control, P = 0.001] and incidence of nasal cavity adhesion after treatment [2/38 vs. 7/15, surgery vs. control, P = 0.007] were significantly lower in the surgery group than in the packing group
Conclusion: Endoscopic surgery is superior to conventional nasal packing for the management of epistaxis in the posterior fornix of the inferior nasal meatus. During surgery, it is crucial to expose the bleeding sites by shifting the inferior turbinate inward by fracture
Subject(s)
Humans , Female , Male , Adult , Middle Aged , Endoscopy , Administration, IntranasalABSTRACT
<p><b>BACKGROUND</b>Awake fiberoptic intubation (AFOI) is usually performed in the management of the predicted difficult airway. The aim of this study was to evaluate the feasibility of dexmedetomidine with midazolam (DM) and sufentanil with midazolam (SM) for sedation for awake fiberoptic nasotracheal intubation.</p><p><b>METHODS</b>Fifty patients with limited mouth opening scheduled for AFOI were randomly assigned to two groups (n = 25 per group) by a computer-generated randomization schedule. All subjects received midazolam 0.02 mg/kg as premedication and airway topical anesthesia with a modified "spray-as-you-go" technique. Group DM received dexmedetomidine at a loading dose of 0.5 μg/kg over 10 min followed by a continuous infusion of 0.25 μg·kg-1·h-1, whereas Group SM received sufentanil at a loading dose of 0.2 μg/kg over 10 min followed by a continuous infusion of 0.1 μg·kg-1·h-1. As necessary, since the end of the administration of the loading dose of the study drug, an additional dose of midazolam 0.5 mg at 2-min intervals was given to achieve a modified Observers' Assessment of Alertness/Sedation of 2-3. The quality of intubation conditions and adverse events were observed.</p><p><b>RESULTS</b>The scores of ease of the AFOI procedure, patient's reaction during AFOI, coughing severity, tolerance after intubation, recall of the procedure and discomfort during the procedure were comparable in both groups (z = 0.572, 0.664, 1.297, 0.467, 0.895, and 0.188, respectively, P > 0.05). Hypoxic episodes similarly occurred in the two groups, but the first partial pressure of end-tidal CO2after intubation was higher in Group SM than that in Group DM (45.2 ± 4.2 mmHg vs. 42.2 ± 4.3 mmHg, t = 2.495, P < 0.05).</p><p><b>CONCLUSIONS</b>Both dexmedetomidine and sufentanil are effective as an adjuvant for AFOI under airway topical anesthesia combined with midazolam sedation, but respiratory depression is still a potential risk in the sufentanil regimen.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Conscious Sedation , Methods , Dexmedetomidine , Therapeutic Uses , Double-Blind Method , Fiber Optic Technology , Methods , Hypnotics and Sedatives , Therapeutic Uses , Intubation, Intratracheal , Methods , Midazolam , Therapeutic Uses , Sufentanil , Therapeutic Uses , WakefulnessABSTRACT
<p><b>OBJECTIVE</b>To evaluate the relationship between bacterial biofilm (BBF) and chronic rhinosinusitis (CRS).</p><p><b>METHODS</b>The database on line was searched to collect the studies on BBF and CRS. The method of meta analysis was used to analyze the data of suitable studies.</p><p><b>RESULTS</b>Fourteen studies were included. System evaluation indicated that the BBF detection rate in CRS group was significantly higher than that in the control group (OR = 17.01, P < 0.01), and the nasal surgery's rate of BBF positive group was significantly higher than the negative group (OR = 3.99, P < 0.01). Preoperative Lund-Kennedy endoscopic score, Lund-MacKay CT score, symptom severity score, postoperative Lund-Kennedy score after six months showed no difference between BBF positive group and negative group.</p><p><b>CONCLUSION</b>The presence of BBF is related to the pathogenesis of CRS and the history of nasal surgery.</p>
Subject(s)
Humans , Bacterial Physiological Phenomena , Biofilms , Chronic Disease , Nasal Surgical Procedures , Rhinitis , Microbiology , Sinusitis , MicrobiologyABSTRACT
Objective To study the clinical pathological features, treatment and prognosis of umbilical metastases of colorectal carcinoma. Methods From January 2000 to September 2010, 10 umbilical metastases of colorectal carcinoma cases were admitted. The clinical features were reviewed. Results Four radical resection of colon cancer and resection of the umbilical plexus metastases cases with chemotherapeutic intraperitoneal perfusion lived 9,11,14 and 18 months respectively, 1 ileum-transverse colon anastomosis case with chemotherapeutic intraperitoneal perfusion lived six months, 2 patients with systemic widely transfer and umbilical transfer with pure venous chemotherapy lived 3, 3.5 months respectively, 3 colon intra-operative cases with venous chemotherapy lived 5 ,5. 5 and 7 months respectively. Conclusion Surgical resection of the primary focal and periumbilical metastases can prolong survival time with adjunctive therapy.
ABSTRACT
The entire S1 protein gene of five infectious bronchitis (IB) vaccine strains (JAAS, IBN, Jilin, J9, H120) used in China were compared with that of the IB field isolate CK/CH/LDL/97 I present in China. The nucleotide and deduced amino acid similarities between the five IB vaccine strains and the field strain, CK/CH/LDL/97 I, were not more than 76.4% and 78.7%, respectively. Phylogenetic analysis based on the S1 gene showed that the vaccine strains and the field strain belonged to different clusters and had larger evolutionary distances, indicating that they were of different genotypes. The five vaccine strains were used for protection test against challenge of the field isolate CK/CH/LDL/97 I. The chickens inoculated with five vaccine strains showed morbidity as high as 30%-100% after challenged with the CK/CH/ LDL/97 I strain. The organ samples at 5 days post challenge showed that the viral detection rates were 50%-90% and 10%-30% for trachea and kidney, respectively. The live attenuated vaccines only provided partial protection to the vaccinated chickens against heterologous IBV infection, CK/CH/LDL/97 I.
Subject(s)
Animals , Antibodies, Viral , Blood , Chickens , Virology , Coronavirus Infections , Infectious bronchitis virus , Classification , Genetics , Allergy and Immunology , Membrane Glycoproteins , Genetics , Phylogeny , Poultry Diseases , Spike Glycoprotein, Coronavirus , Vaccines, Attenuated , Allergy and Immunology , Viral Envelope Proteins , Genetics , Viral Vaccines , Allergy and ImmunologyABSTRACT
192 samples of Masked Palm Civet (Paguma Larvata) from Guangdong Province were inoculated in Vero-E6 cells. One sample which came from masked palm Civet didn't cause cytopathic effects (CPE) until fourth-passage on Vero-E6 cells. Infected cells emerged granulating, shrinking, rounding and falling off. After three times freeze-thaw, cells and culture medium were harvested for electron microscopy. Virus particles were nonenveloped, double capsid and icosahedral symmetry. This virus was designated Masked Palm Civet/China/2004 (MPC/04). Hemagglutination test indicated that the virus could agglutinate healthy human type O red cells, but not the red cells of SPF chicken, experimental common bovine, rat and guinea pig. This virus was tolerant to chloroform treatment, pH 3.0 and water bath 50 degrees C 1 h. 1 M MgCl2 treatment could enhance resistance of virus to heat and increase infectivity. In order to classify the strain on the molecular level, specific primers according to mammalian reovirus were used for Reverse Transcription Polymerase Chain Reaction (RT-PCR). Appropriate specific products were amplified by RT-PCR. NCBI BLAST analysis indicated that this segment shared the highest identity to mammalian reovirus serotype 1 (T1L) virus. So we can deduce this virus is a member of the Reoviridae.
Subject(s)
Animals , Cats , Cattle , Humans , Base Sequence , Virology , Molecular Sequence Data , Phylogeny , Reoviridae , ClassificationABSTRACT
The donkey leukocyte-attenuated vaccine of equine infectious anemia virus (EIAV) was the first lentiviral vaccine that induced solid protection from the infection of virulent strains. To elucidate the mechanism of increased immunogenicity and attenuated virulence of the vaccine, the proviral genomic DNA of an EIAV vaccine strain, EIAV(DLV121) was analyzed and compared with the genome of a parental virulent strain EIAV(DV117). Full length viral genomic DNAs were amplified as two segments by LA-PCR and were cloned. Because of the genomic diversity of retroviral quasispecies, 10 full-length sequences of EIAV(DLV121) and 4 full-length sequences of EIAV(DV117) from randomly picked clones were analyzed. Results showed that the average length of the complete nucleotide sequence of EIAV(DLV121) was 8,236bp and EIAV(DV117) was 8,249bp, with the inter-strain diversity of 2.8%. As for individual genes between the vaccine and virulent strains, the differences in nucleotide sequence of S2, LTR and env were significantly higher than the other genes with the diversity of 4.1%, 3.7% and 3.1%, respectively. Considerable variations in deduced amino acid sequences were found in S2, S3 and env. The diversities were 10.4%, 5.6% and 4.8%, respectively. Furthermore, the LTR of EIAV(DLV121) consisted of at least 5 subtypes grouped by their nucleotide sequences. There were two additional N-linked glycosylation sites in the deduced amino acid sequence of EIAV(DV117) gp90 than that of EIAV(DLV121). Among glycosylation sites in the gp90 of virulent strain, 3 were found unique only in EIAV(DV117), of which 2 were located in the principle neutralizing domain (PND). In addition, there was one EIAV(DLV121) -specific glycosylation site, which was positioned in the PND, too. Taken together, it is clear that greatly increased genomic diversity exists in the EIAV vaccine strain, which provides important information for the further study on biological characters of the Chinese EIAV attenuated vaccine.
Subject(s)
Animals , Amino Acid Sequence , Base Sequence , Equidae , Genome, Viral , Infectious Anemia Virus, Equine , Chemistry , Genetics , Allergy and Immunology , Leukocytes , Allergy and Immunology , Virology , Molecular Sequence Data , Sequence Alignment , Vaccines, Attenuated , Chemistry , Genetics , Allergy and Immunology , Viral Proteins , Chemistry , Genetics , Allergy and Immunology , VirulenceABSTRACT
In order to remove the artifacts of peripheral digital subtraction angiography (DSA), an affine transformation-based automatic image registration algorithm is introduced here. The whole process is described as follows: First, rectangle feature templates are constructed with their centers of the extracted Harris corners in the mask, and motion vectors of the central feature points are estimated using template matching technology with the similarity measure of maximum histogram energy. And then the optimal parameters of the affine transformation are calculated with the matrix singular value decomposition (SVD) method. Finally, bilinear intensity interpolation is taken to the mask according to the specific affine transformation. More than 30 peripheral DSA registrations are performed with the presented algorithm, and as the result, moving artifacts of the images are removed with sub-pixel precision, and the time consumption is less enough to satisfy the clinical requirements. Experimental results show the efficiency and robustness of the algorithm.
Subject(s)
Algorithms , Angiography, Digital Subtraction , Methods , Artifacts , Automation , Methods , Image Processing, Computer-Assisted , MethodsABSTRACT
Membrane (M) protein genes of 20 infectious bronchitis virus (IBV) strains isolated in China between 1995 and 2004 were sequenced and analyzed. The M genes of twenty isolates were composed of 672 to 681 nucleotides, encoding polypeptides of 223 to 226 amino acid residues. Variations of the deduced amino acids of M gene mainly occurred at positions 2 to 17 and 221 to 233, comparing with that of the IBV strain LX4. There were deletions or insertions in the M gene of Chinese isolates at amino acid position 2 to 6, leading to the loss or gain of a glycosylation site. Phylogenetic tree based on amino acid sequences of M genes from 20 Chinese isolates and 34 reference strains showed that they were classified into five distinct clusters. Most of the Chinese IBV strains were included in clusters II and IV, forming distinct groups. The isolates in cluster II showed a close evolutionary relationship with Taiwan isolates. Furthermore, recombination especially the recombination between field isolates and vaccine strains had been observed while comparing the phylogeny of M genes with those of S1 and N genes.