Effects and influencing factors of vestibular rehabilitation in 171 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the effect of vestibular rehabilitation and to identify factors that can affect rehabilitation outcomes. Methods: From December 2018 to October 2020, patients who underwent vestibular rehabilitation in the Eye, Ear, Nose and Throat Hospital of Fudan University were prospectively followed up. A battery of vestibular function examinations and psychological status evaluations were applied before and after rehabilitation initiation. The main outcomes were vertigo/dizziness and unsteadiness, measured by visual analogue scale (VAS); Secondary outcomes were daily activities and participation, assessed by vestibular activities and participation measure (VAP). Paired t-test was used to compare the effects before and after rehabilitation. Binary logistic regressions were applied to analyze the influencing factors of rehabilitation outcomes. Results: A total sample of 171 patients was followed up regularly with a median time of 11 months. Of the 171 patients evaluated, 72 were males and 99 were females; age ranged from 10 to 89 years old with a median age of 55 years old. At 6-month follow-up, the difference of VAS score of vertigo/dizziness and unsteadiness pre-post rehabilitation was 1.79±1.80 and 1.56±1.76, respectively; The difference of activity and participation domain of VAP score was 2.51±13 and 1.27±3.75, respectively. All differences pre-post rehabilitation exhibited statistically significant with P values<0.01. Regression analysis demonstrated that the length of symptom onset was a significant predictor of poor balance recovery (OR=6.52; 95%CI:2.10, 20.27). Visual dependence (OR=5.44; 95%CI: 1.38, 21.47) and suspectable anxiety (OR=6.45; 95%CI: 1.49, 28.30) were identified as risk factors for poor recovery of vertigo/dizziness. Conclusions: Vestibular rehabilitation effectively reduces dizziness, promotes balance, and improves the function of daily activities. Time from the onset, visual dependence and suspectable anxiety are the main factors hindering a desirable rehabilitation outcome.

Mechanism of Traditional Chinese Medicine in Treatment of Autism Spectrum Disorder Based on Heart and Spleen / 中国实验方剂学杂志

Autism spectrum disorder （ASD） is a common neurodevelopmental disorder in childhood， whereas there is no specific medicine at present. There are more and more researches on the treatment of ASD with traditional Chinese medicine（TCM） which the curative effect is reliable. The heart and spleen are the main viscera for the treatment of ASD， but there is still a lack of in-depth analysis of the mechanism of TCM. In order to explore the relationship between the core symptoms of ASD and the heart and spleen， this article specifically explores the theoretical origins of the heart and the spleen in the formation of the core symptoms of ASD， and to clarify the role of the heart and spleen in the occurrence and development of the two core symptoms of ASD from the perspective of TCM. In view of social communication and communication obstacles， the author puts forward and explains the language problems of children with ASD based on the functions of the heart and spleen， the theory of the viscera， the ascription of the meridians， and the classics. The mechanism of the heart and spleen in TCM about the failure of the spleen， the loss of the heart， and the endogenous phlegm. Aiming at the mechanism of the stereotyped symptoms of abnormal behaviors in children with ASD， this paper proposes and explains the TCM mechanism of constant deficiency of the spleen and dereliction of duty， leading to loss of mind， heart and spleen injury， and finally a series of stereotypes and strange syndromes due to lack of spirit. Through the analysis and excavation of TCM theory， it explores theoretical basis for ASD from the theory of heart and spleen， with a view to preliminarily constructing the theoretical framework of TCM syndrome differentiation and treatment of the deficiency of both the heart and spleen， and provide theoretical reference for TCM syndrome differentiation and treatment of ASD. The treatment of ASD from the differentiation of symptoms and signs of the heart and spleen is supported by a strong theoretical basis of TCM， and the rationale， law and prescriptions are complete， which may be the direction of screening effective TCM prescriptions for the treatment of ASD in the future.

Effects of Arsenic Disulfide Combined with Itraconazole on Proli- feration and Apoptosis and Hedgehog Pathway of Diffuse Large B-Cell Lymphoma Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of arsenic disulfide (AS@*METHODS@#The human DLBCL cell OCI-LY3 was treated with different concentrations of AS@*RESULTS@#The DLBCL cell viability was decreased significantly at 24, 48 or 72 h as cultured with itraconazole. Along with the increasing of itraconazole concentration, the DLBCL cell viability was significantly reduced as compared with that in control group, and the results showed statistically significant(r=-0.690，r=-0.639, r=-0.833, r=-0.808, r=-0.578). The inhibitory and apoptosis rates of the cells were significantly increased as compared with those of the single drug-treated group after treated by the combination of itraconazole and AS@*CONCLUSION@#Itraconazole can inhibit proliferation of DLBCL cells in a concentration-and time-dependent manner. In addition, the combination of AS

Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the characteristics of dynamic balance during the onset of benign paroxysmal positional vertigo (BPPV) and its prediction of residual symptoms after successful repositioning. Methods: From January 2018 to August 2019, patients diagnosed with unilateral posterior semicircular canal or horizontal semicircular canal BPPV were consecutively enrolled from five otolaryngology clinics in Shanghai. The dynamic balance function was measured by sensory organization test (SOT) before repositioning maneuver, and the residual symptoms and its duration were followed up from one week to up to three months. Results: A total of 260 patients were recruited. After excluding 17 cases, 243 cases were successfully followed up including 89 males and 154 females, with an average age of (52.9±13.0) years. There were 175 cases of posterior semicircular BPPV, 61 cases of horizontal semicircular BPPV and 7 cases of canal conversion (from horizontal to posterior semicircular). Among 243 patients, 118 cases reported residual symptoms, with an incidence of 48.6%. The results of SOT showed that 58.0%(141/243) of the patients had abnormal vestibular input and 41.6%(101/243) were categorized as "near falls". With respect to the detailed residual symptoms, 47 cases (39.8%) reported unsteadiness or floating, 35 cases (29.7%) had fogginess/heaviness feeling, 22 cases (18.6%) had transient dizzy while head moving, and 15 cases (12.7%) reported that the symptom was too subtle to describe. Compared with the group without residual symptoms, the group with residual symptoms had more abnormal vestibular input(χ²=67.25, P<0.001) and near falls(χ²=74.78, P<0.001) as identified by SOT test. Cox proportional hazards regression failed to reveal any SOT results having significantly impact on the duration of residual symptoms [abnormal vestibular input (HR= 0.93, 95%CI: 0.48, 1.80), and near falls (HR= 0.90, 95%CI: 0.56, 1.46)]. Kaplan-Meier survival analysis showed that there was no significant difference in the duration of residual symptoms among patients with different SOT manifestations [Log rank (Mantel-Cox) test, P>0.05]. Conclusions: The impaired dynamic balance during the onset of BPPV is characterized by "abnormal vestibular input". The residual symptoms are mainly characterized by unsteadiness or floating feeling. The defect of dynamic balance function is a predictor of the residual symptoms after successful repositioning, but not for the duration of such symptoms.

Intervention strategies for residual dizziness after successful repositioning maneuvers in benign paroxysmal positional vertigo: a single center randomized controlled trial / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the effects of different intervention strategies for the management of residual dizziness following successful canalith repositioning procedure (CRP) in patients with benign paroxysmal positional vertigo (BPPV). Methods: A total of 129 BPPV patients with residual dizziness following successful CRP were recruited during January 2019 and July 2019. They were randomly assigned into three groups with 43 cases in each group: the vestibular rehabilitation group received rehabilitation training for four weeks; betahistine group was given orally 12 mg betahistine three times a day for four weeks; and the control group had no specific treatment. The primary outcomes were daily activities and social participation assessed by the Vestibular Activities and Participation measure (VAP). Secondary outcomes includedbalance function assessed by sensory organization test (SOT) and the duration of residual symptoms. Stata15.0 software was used for statistical analysis. Results: The scores of VAP in the three groups decreased over time, but a more significant decrease was found in vestibular rehabilitation group. Further paired comparison showed that the difference between the vestibular rehabilitation group and the control group was of statistical significance (B=-3.88, χ2=18.29, P<0.01), while the difference between the betahistine group and the control group was not statistically significant (B=-0.96, χ2=1.16, P=0.28). The balance function of the three groups showed a trend of recovery over time, with no significant differences between groups (χ2=1.37, df=2, P>0.05). The median duration of residual dizziness for both vestibular rehabilitation and betahistine groups was 14 days, while that of control group was 19 days, with no significant difference between three groups[Log-rank (Mantel-Cox) test; χ2=1.82, df=2, P=0.40]. Conclusion: Vestibular rehabilitation can significantly improve the daily activities and social participation function in BPPV patients with residual symptoms following successful CRP, but its effects on shortening the duration of residual symptoms and promoting the recovery of balance function remain uncertain.

Effect of Dredging Correcting Manipulation on Stunting in Children with cblC Methylmalonic Aciduria / 中国康复理论与实践

Objective:To observe the effect of Dredging Correcting Manipulation on cblC methylmalonic aciduria (MMA). Methods:From October, 2017 to October, 2018, 72 children with cblC MMA combined with growth retardation were divided into control group (n = 36) and experimental group (n = 36) according to the consent of their parents. The control group accepted routine medicine, and the experimental group received Dredging Correcting Manipulation in addition. The Griffiths Development Scale-Chinese version (GDS-C) was used to evaluate the two groups before and after treatment. At the same time, body length, body mass and head circumference were measured. Results:Six cases in the control group and five cases in the experimental group were dropped out. There was no significant difference in the development quotients of GDS-C in gross movement, personal and social, hearing and speech, hand-eye coordination, operation and total quotient between two groups before treatment (P > 0.05). After treatment, all the development quotients increased in both groups (t > 6.110, P < 0.001), and the development quotients of GDS-C in gross movement, personal and social, hand-eye coordination and total quotient were higher in the experimental group than in the control group (t > 2.154, P < 0.05), as well as the body length (t = 2.027, P < 0.05). Conclusion:Dredging Correcting Manipulation can promote the neuropsychological and physical development of children with cblC MMA combined with retardation.

Effect of baicalin on growth state of attention deficit hyperactivity disorder animal model and its regulation on Ca MKⅡ and ERK1/2 / 中国中药杂志

The aim of this study was to observe the effect of baicalin on the growth state of attention deficit hyperactivity disorder animal model and its regulation on Ca MKⅡand ERK1/2.In the present study,a total of 40 SHR rats were randomly divided into model group,methylphenidate hydrochloride group,and low,medium,and high dose baicalin groups,with 8 rats in each group.Eight WKYrats were selected as a normal control group.The methylphenidate hydrochloride group(0.07 g·L~(-1))and the low(3.33 g·L~(-1)),medium(6.67 g·L~(-1)),and high dose(10 g·L~(-1))baicalin groups received corresponding drugs by gavage administration according to the body weight(0.015 m L·g~(-1)),while the normal group and the model group received the same volume of normal saline by gavage.Thegavage administration lasted for 4 weeks,twice a day.The body weight of the rats and the amount of remaining feed were weighed daily,and the growth state of the rats was statistically evaluated weekly.Percoll density gradient centrifugation was used to prepare brain synaptosomes and an electron microscope was used to observe their structures.The Ca MKⅡand ERK1/2 protein and mRNA expression levels were detected with Western blot and Real-time PCR methods,respectively.RESULTS: showed that baicalin did not affect the normal eating and weight gain of rats,and the weight gain of rats was even more significant than that in the normal group(P<0.05).In the study of its effects on Ca MKⅡand ERK1/2 protein expression in rat synaptosomes,the expression of both proteins in each drug-administered group was higher than that in the model group(P<0.05);besides,the expression levels of Ca MKⅡand ERK1/2 protein were significantly increased in both baicalin high dose group and the methylphenidate hydrochloride group(P<0.05).The relative expression of Ca MKⅡand ERK1/2 mRNA in synaptosome was detected by PCR.The results showed that medium and high doses of baicalin and methylphenidate hydrochloride significantly increased the relative expression of Ca MKⅡand ERK1/2 mRNA in synaptosomes of SHR rats(P<0.05).In conclusion,baicalin does not affect the normal growth and development of SHR rats,so it is safe for administration.Both baicalin and methylphenidate hydrochloride could up-regulate the relative expression of Ca MKⅡand ERK1/2 in mRNA and protein,and the pharmacodynamic stability of baicalin is in a dose-dependent manner to certain extent.

The development of a rapid loop-mediated indirect PCR method for detection and differentiation of highly and lowly pathogenic porcine reproductive and respiratory syndrome virus / 病毒学报

The aim of this study is to establish the method of loop-mediated indirect PCR assay for detection of Reproductive and Respiratory Syndrome Virus (PRRSV) infection and differentiation of highly pathogenic PRRSV (HP-PRRSV) and lowly pathogenic PRRSV (LP-PRRSV). Based on the alignments of ORF2 gene sequences and ORFla gene sequences of PRRSV Chinese isolates deposited in GenBank, two pairs of specific probes were designed and labeled to both ends of the soybean Lectin gene fragment by PCR, respectively. The probe-labeled soybean Lectin genes were used to be reporter genes for detection and differentiation of PRRSV. After one round strand displacement reaction, the reporter genes were amplified by reverse PCR. The specific PCR products were 193bp, 355bp for HP-PRRSV and 193bp, 442bp for LP-PRRSV, respectively. The method could detect 5. 6 TCID50/mL LP-PRRSV RNA and 18 TCIDs0/ mL HP-PRRSV RNA, and co-infection did not affect detection sensitivity. No amplification was observed with other porcine originated pathogens including CSFV, PPV, PRV, PCV2, ETEC and Haemophilus parasui. Twenty clinical samples were used for comparative testing with conventional PCR. Fourteen samples were found positive for PRRSV by the loop-mediated indirect PCR, of which 4 were LP-PRRSV, 9 HP-PRRSV and 1 LP/HP-PRRSV co-infection, consistent with the conventional PCR test results. In conclusion, the loop-mediated indirect PCR is a simple, rapid, sensitive and specific etiologic diagnosis tool, and suitable for the differential diagnosis of HP/LP-PRRSV, especially for identification of mixed infection of HP/LP-PRRSV.

Effect of rosiglitazone on rabbit model of myocardial ischemia-reperfusion injury

OBJECTIVE@#To explore mechanism and protective effect of rosiglitazone on myocardial ischemia reperfusion (I/R) injury.@*METHODS@#A total of 48 male Japanese white big-ear rabbits were randomly divided into control group (A), I/R group (B), low dose of rosiglitazone group (C), high dose of rosiglitazone group (D). Plasma concentration of and also reduced the concentration of plasma serum creatine kinase (CK), CK-MB, high-sensitivity C-reactive protein (hsCRP), ultra-superoxide dismutase (SOD), malondialdehyde (MDA), lactic acid glutathione skin peroxidase (GSH-PX), nitric oxide (NO) and endothelin (ET) were measured 1 h later after I/R. Twenty-four hours after I/R the hearts were harvested for pathological and ultrastructural analysis. Area of myocardial infarction were tested.@*RESULTS@#Plasma concentration of CK, CK-MB, hsCRP, NO, MDA and ET were decreased in C, D group compared with group B. Plasma concentration of T-SOD and GSH-Px were increased significantly in C, D group compared with group B. Compared with group B, pathological and ultrastructural changes in C and D group were slightly. There was significant difference in myocardial infarction area between group C, D and group B (P<0.05). Myocardial infarction area and arrhythmia rate were lower in group C, D compare with group B.@*CONCLUSIONS@#Rosiglitazone may protect myocardium from I/R injury by enhancing T-SOD and GSH-Px concentration, inhibit inflammatory reaction, and improve endothelial function.

Olfactory ensheathing cells promote the survival of newborn rat spiral ganglion cells in vitro / 生理学报

The objective of this study is to explore whether olfactory ensheathing cells (OECs) can promote the survival of newborn rat spiral ganglion cells (SGCs) and the underlying possible mechanisms. Co-culture of OECs from adult rats with SGCs from newborn rat cochlea was established and single culture of SGCs acted as control. OECs were obtained and purified based on their special rate of attachment which was different from the other harvested cell types during culture. OECs and SGCs were immunocytochemically characterized and confirmed by expression of low-affinity nerve growth factor receptor p75 or positive label of neuron-specific betaIII-tubulin. To investigate the mechanisms of the role of OECs in survival of SGCs, brain derived neurotrophic factor (BDNF) and anti-BDNF antibody (IgY) were added into the media of the co-cultures respectively, and the surviving SGCs were examined after treatment. Single layer of OECs (92% pure) was seen seven days after plating. Surviving SGCs, which extended their primary neurites, were found on the surface of the layer in the co-cultures. When OECs and SGCs were co-cultured, the number of surviving SGCs was significantly greater than that in the single culture (P<0.01). Nine days after culture, there was even no change in the number of surviving SGCs in the co-culture while the number reduced to almost zero in the single culture. In comparison with co-culture without treatment, addition of BDNF (500 pg/mL) into the media had no obvious promoting effect on the survival of SGCs. The number of surviving SGCs reduced significantly when anti-BDNF antibody was applied into the media of co-cultures (P<0.01). These results suggest that OECs can promote the survival of SGCs when they are co-cultured in vitro. BDNF released from OECs, as one of the survival factors, plays an important role in the survival of SGCs.

Effect of REZ-I cochlear implantation on residual hearing in adult patients / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of cochlear implantation with REZ-I straight electrodes on residual hearing of postlingually deafened adults, and to explore the audiologically safety and injury characteristics of cochlear implantation.</p><p><b>METHODS</b>Sixteen unilateral REZ-I (22 channels) cochlear implantation recipients from September 2009 to December 2009 were picked out. Their pre-and post-implantation audiometry data including pure-tone audiometry (PTA), auditory steady-state responses (ASSR), auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE) were retrospectively analyzed, in order to compare the change between pre- and post-implantation residual hearing.</p><p><b>RESULTS</b>Among the 12 recipients who had some measurable residual hearing before implantation, 5 (41.6%) patients had conserved some measurable hearing but the other 7 (58.4%) recipients had lost all measurable hearing after implantation on the implanted side. The implanted ears had an average PTA threshold drop of 9.5 dB HL and a statistically significant difference between pre- and post-implantation (P < 0.05) PTA thresholds in the frequencies of 250 Hz, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Compared to non-implanted ears, the drop in 500 Hz and 1kHz had a statistically significant difference between pre- and post-implantation PTA thresholds (P < 0.05). The ASSR residual hearing threshold elevation were statistically significant (P < 0.05) between pre- and post-implantation ASSR at 250 Hz and 500 Hz on the implanted side, while the The ASSR residual hearing threshold elevation were statistically significant (P < 0.05) at 500 Hz when compared to non-implanted side. The difference of residual hearing between pre- and post-implantation was not statistically significant for both DPOAE and ABR.</p><p><b>CONCLUSION</b>There will be a certain degree of damage to residual hearing of the implanted side following REZ-I cochlear implantation.</p>

Apoptosis of olfactory receptor neurons induced by bulbectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study whether apoptosis plays a role in controlling the number of olfactory receptor neurons, so as to reveal the specialty and mystery of neurogenesis.</p><p><b>METHODS</b>Using terminal deoxynucleotidyl transferase-mediated dUTP-fluorescein nick end labeling (TUNEL) and transmission electron microscopy to detect apoptosis in olfactory mucosa of normal adult rats and damaged olfactory mucosa of 16, 32, 48 hours and 3, 7, 30 days after bulbectomy.</p><p><b>RESULTS</b>In normal olfactory epithelium, a subpopulation of immature neurons, as well as mature neurons, showed internucleosomal DNA-fragmentation. The number of TUNEL-labeled neurons increased dramatically 32 hours after removal of olfactory bulb. Then it declined quickly and remained at low level. Ultrastructural data of olfactory mucosa showed that the feature of apoptotic neurons was chromatin condensation and cell shrinkage. Besides, some dying cells were characterized by the formation of numerous autophagic vacuoles, and few had some of the features of necrosis but without obvious mitochondrial swelling.</p><p><b>CONCLUSIONS</b>Apoptosis might play a role in turnover of the olfactory epithelium and regeneration in adult rats. There might be other two types of neural death through different mechanism.</p>

Clinical research about the distribution of perineural vascular plexus of the facial nerve / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To objectively evaluate the usefulness and the reliability of the perineural vascular plexus as a landmark for facial nerve as well as whether it will be a landmark for identification of the facial nerve in surgery for otology and neurotology by means of investigating the location of the facial nerve for prevention of iatrogenic facial palsy.</p><p><b>METHODS</b>Prospective case series were designed. Three hundred and eleven consecutive patients were studied which required tympanoplasty for chronic otitis media or microsurgery for facial nerve decompression and congenitally malformation of the ear from July 2002 to July 2005. All the patients were operated by the first author. Perineural vascular plexus as a landmark for identification of the facial nerve in surgery were observed to assess the utility.</p><p><b>RESULTS</b>The well recognized perineural vascular plexus were seen on the horizontal mesotympanic segment of the nerve in 95.8% of patients (298 cases), and only in 4.2% of the patients (13 cases), the vessel plexus was difficult to identify. The 95% confidence interval was from 93.6% to 98.0%.</p><p><b>CONCLUSIONS</b>The vascular plexuses around or over the horizontal portion of the facial nerve provide an early and direct indicator of the location of the facial nerve. The perineural vascular plexus could be a dependable and reliable landmark for the identification the horizontal part of the facial nerve in surgery for otology and neurotology.</p>