ABSTRACT
Abstract Objectives: To investigate the clinical value of using Head-Shaking Test (HST) + Head-Shaking Tilt Suppression Test (HSTST) to distinguish between peripheral and central vertigo as well as to analyze the consistency of findings between tests at the bedside vs. in the examination room. Methods: We retrospectively analyzed patients who presented for central or peripheral vertigo from July 2019 to July 2021. The results were compared between HST and HST+HSTST. The concordance between bedside and examination room outcomes was analyzed. Results: Forty-seven (58.8%) patients in the peripheral vertigo group and 33 (41.2%) patients in the central vertigo group were included. In the peripheral group, 44 (both examination room and bedside: 93.6%) patients had horizontal Head-Shaking Nystagmus (hHSN), most of which were suppressed in HSTST. However, in the central group, most cases had perverted HSN (pHSN; examination room: 72.7%; bedside: 66.7%), which was seldomly suppressed in HSTST. The HST+HSTST showed a >20% higher specificity in identifying peripheral vertigo than HST alone. The bedside results were consistent with the examination room results using the kappa test (p< 0.001). Conclusions: Suppressed hHSN was a strong indicator of peripheral vertigo. Conversely, pHSN was more often seen in central vertigo, which was not readily suppressed in HSTST. The bedside results of HST+ HSTST yielded qualitative agreement with the tests in the examination room. HST+ HSTST could be used as reliable methods in the clinic to distinguish between peripheral and central vestibular disorders. Level of evidence: Level 3.
ABSTRACT
Objective To investigate the relationship between the morphological features, pit pattern classification and pathological types of colorectal laterally spreading tumor (LST). To provide a basis for the selection of treatment modalities, and to explore the value of endoscopic treatment. Methods Retrospective analysis of 17 cases of LST from January 2015 to December 2016 detected by conventional endoscopy. 17 cases of LST first underwent dyeing magnifying endoscopy and pit pattern typing. Endoscopic submucosal dissection (ESD) or surgical treatment was performed in all patients with LST. Postoperative pathologic findings were analyzed retrospectively. Results Of the 17 cases, ESD was performed in 15 patients, and other 2 patients underwent surgical treatment. All of the 17 cases were treated successfully without complications such as bleeding or perforation. No recurrence was found under endoscopy in the 3-month to 2-year postoperative review. Conclusion The preoperative pit pattern classification can provide the basis for treatment. ESD has good curative effect, low recurrence rate and good safety in the treatment of colorectal LST.
ABSTRACT
Objective To investigate the relationship between the morphological features, pit pattern classification and pathological types of colorectal laterally spreading tumor (LST). To provide a basis for the selection of treatment modalities, and to explore the value of endoscopic treatment. Methods Retrospective analysis of 17 cases of LST from January 2015 to December 2016 detected by conventional endoscopy. 17 cases of LST first underwent dyeing magnifying endoscopy and pit pattern typing. Endoscopic submucosal dissection (ESD) or surgical treatment was performed in all patients with LST. Postoperative pathologic findings were analyzed retrospectively. Results Of the 17 cases, ESD was performed in 15 patients, and other 2 patients underwent surgical treatment. All of the 17 cases were treated successfully without complications such as bleeding or perforation. No recurrence was found under endoscopy in the 3-month to 2-year postoperative review. Conclusion The preoperative pit pattern classification can provide the basis for treatment. ESD has good curative effect, low recurrence rate and good safety in the treatment of colorectal LST.
ABSTRACT
The effects of berberine on the expression of hepatocyte nuclear factor-4α (HNF-4α) in liver of rats with fructose-induced insulin resistance and the molecular mechanism of berberine preventing insulin resistance were investigated. The experimental animals were divided into two groups of 16 animals each. The control group received a control routine diet containing 60% carbohydrate, and the study group a high-fructose diet containing 60% fructose as the sole source of carbohydrate. At the end of 6 weeks these were each subdivided into two groups. One was administered with berberine [187.5mg/(kg·d) in 5g/L carboxymethyl cellulosel] by intragastric intubation and the other group was treated with a vehicle (5g/L carboxymethyl cellulose). The rats were fed on the same dietary regimen for the next 4 weeks. After the experimental period of 10 weeks, plasma glucose, insulin and triglyceride levels were measured. HOMA insulin resistance index (HOMA-IR) was assayed. Immunohistochemistry, semiquantitative RT-PCR and western blot were used to detect the expression of HNF-4α in liver. Compared with control diet, fructose feeding induced hyperinsulinemia, HOMA-IR and increased triglyceride (all P<0.01). Berberine prevented the rise in plasma insulin (P<0.01), HOMA-IR (P<0.01) and triglyceride (P<0.05) in the fructose-fed rats. No change in plasma glucose was seen among these groups. The mRNA and protein expression of HNF-4α was decreased in the fructose-fed rats, but berberine could promote its expression. It was concluded that berberine could prevent fructose-induced insulin resistance in rats possibly by promoting the expression HNF-4α in liver.