Discussion on diagnosis and treatment of dizziness from cases / 临床耳鼻咽喉头颈外科杂志

Dizziness or vertigo is a common clinical symptom, and its underlying etiology is complex. Many clinicians are confused about its diagnosis and treatment. This article presents a case about chronic vestibular syndrome. And case appreciation and academic discussion are conducted by well-known domestic neurologists and otologists, so as to provide a good thinking model and basic ideas for the diagnosis and treatment of dizziness or vertigo, hoping to further improve the diagnosis and treatment level among clinicians.

Construction of evaluation indicator system for promoting common prosperity of health care in Zhejiang province / 中华医院管理杂志

Objective:To establish a set of scientific and reasonable indicator system of common prosperity in the field of health, so as to promote the construction and evaluation of the demonstration area of common prosperity with high quality of health.Methods:According to the requirements of promoting common prosperity demonstration area with high quality of health in Zhejiang province, the initial indicator pool was established through literature research and theoretical analysis in July 2021, and experts were convened to carry out expert brainstorming to determine indicator system in the form of meetings. Delphi method was used to conduct two rounds of expert consultation on the indicator system.Finally, the analytic hierarchy process and percentage weight method were used to calculate the indicator weight value.Results:The final indicator system included 4 first-level indicators and 30 second-level indicators. Among the first-level indicators, the weight values of the development, equilibrium, inclusiveness, and sustainability were 0.326 4, 0.242 8, 0.245 8, and 0.185 0. There were 8 second-level indicators in developmental indicator dimension, of which the indicator with the highest weight was the per capita health expectancy. The balance indicator dimension included 6 second-level indicators, of which the indicator with the highest weight was the per capita financing difference of basic medical insurance between the urban workers with the urban-rural residents. The inclusive indicator dimension included 6 second-level indicators, and the proportion of personal health expenditure to total health expenditure had the highest weight. The sustainability indicator dimension included 10 second-level indicators, and the proportion of government health expenditure in fiscal expenditure had the highest weight.Conclusions:The indicator system constructed in this research could provide certain guidance and reference for promoting the construction of common prosperity in health, and provide some reference for follow-up research in this field.

Abnormal metabolism of gut microbiota reveals the possible molecular mechanism of nephropathy induced by hyperuricemia

The progression of hyperuricemia disease is often accompanied by damage to renal function. However, there are few studies on hyperuricemia nephropathy, especially its association with intestinal flora. This study combines metabolomics and gut microbiota diversity analysis to explore metabolic changes using a rat model as well as the changes in intestinal flora composition. The results showed that amino acid metabolism was disturbed with serine, glutamate and glutamine being downregulated whilst glycine, hydroxyproline and alanine being upregulated. The combined glycine, serine and glutamate could predict hyperuricemia nephropathy with an area under the curve of 1.00. Imbalanced intestinal flora was also observed. , , , , and other conditional pathogens increased significantly in the model group, while and , the short-chain fatty acid producing bacteria, declined greatly. At phylum, family and genus levels, disordered nitrogen circulation in gut microbiota was detected. In the model group, the uric acid decomposition pathway was enhanced with reinforced urea liver-intestine circulation. The results implied that the intestinal flora play a vital role in the pathogenesis of hyperuricemia nephropathy. Hence, modulation of gut microbiota or targeting at metabolic enzymes, , urease, could assist the treatment and prevention of this disease.

Progress of the laryngeal framework surgery / 中华耳鼻咽喉头颈外科杂志

Isshiki systematically developed thyroplasty in the 1970 s. Based on Isshiki′s classification of thyroplasty, laryngeal framework surgery was classified by the Phonosurgery Committee of the European Laryngological Society in 2001. Then laryngeal framework surgery became more systematic and standardized, and made new progress in clinical applications and basic theoretical research. This article mainly expounds new progress in laryngeal framework surgery over the last five years.

Current status:low dose spiral CT lung screening and pulmonary nodules / 实用肿瘤学杂志

Lung cancer has become one of the most threatening malignant tumors in human life.Its morbidity and mortality rank is the first place in malignant tumors,so it is particularly important to screen for lung cancer.With the widespread use of low-dose CT,the detection rate of pulmonary nodules is increasing,and its research is also in-depth.This article described the status of lung cancer screening,factors of benign and malignant pulmonary nodules.It could provide the basis information for prevention and treatment of the lung cancer and pulmonary nodules.

Individualized Treatment of Allergic Rhinitis According to Nasal Cytology

PURPOSE: Nasal cytology is important in the diagnosis and treatment of nasal inflammatory diseases. Treatment of allergic rhinitis (AR) according to nasal cytology has not been fully studied. We plan to explore the individualized treatment of AR according to nasal cytology. METHODS: Nasal cytology from 468 AR patients was examined for inflammatory cell quantity (grade 0–5) and the percentage of neutrophils and eosinophils. Results were subdivided into the following categories: AR(Eos), eosinophil ≥50% of the whole inflammatory cells; AR(Neu), neutrophils ≥90%; AR(Eos/Neu), 10%≤ eosinophil <50%; AR(Low), grade 0/1 inflammatory cell quantity. Nasal cytology-guided treatment was implemented: all AR(Eos) patients (n=22) and half of the AR(Neu) patients (AR[Neu1], n=22) were treated with mometasone furoate spray and oral loratadine. Another half of the AR(Neu) patients (AR[Neu2], n=22) were treated with oral clarithromycin. Visual analog scale (VAS), symptom scores, and nasal cytology were evaluated 2 weeks before and after treatment. RESULTS: There were 224/468 (47.86%) AR(Eos), 67/468 (14.32%) AR(Neu), 112/468 (23.93%) AR(Eos/Neu), and 65/468 (13.89%) AR(Low) of the AR patients studied. There were no significant differences in clinical characteristics among these subgroups, except that the nasal blockage score was higher in AR(Eos) patients than in AR(Neu) patients (1.99 vs. 1.50, P=0.02). Comparing AR(Eos) patients with AR(Neu1) patients 2 weeks after treatment, nasal symptoms and VAS were significantly lower in AR(Eos) patients, except for nasal blockage symptoms (P<0.05 of nasal itching and sneezing; P<0.01 for nasal secretion, total scores, and VAS). Comparing AR(Neu1) with AR(Neu2) patients, nasal symptoms, and VAS were significantly lower in AR(Neu2), except for nasal blockage and nasal itching symptoms (P<0.05 for nasal secretions, sneezing, total score, and VAS). CONCLUSIONS: Nasal cytology may have important value in subtyping AR and optimizing AR treatment. Treating neutrophils is very important in AR patients with locally predominant neutrophils.

Study of anti-diabetic nephropathy efficacy of berberine analogue Y53 in STZ-induced diabetic C57 BL/6 J mice / 中国药理学通报

Aim To investigate the ameliorative effects pseudoberberine(Y53), a berberine(BBR) analogue, on diabetic nephropathy( DN) in streptozotocin( STZ)-induced diabetic mice. Methods Diabetes mellitus ( DM) of the C57BL/6J mice was induced by intraper-itoneal injection of STZ at 120 mg·kg-1 . The diabetic animals were divided into 4 groups, which were orally treated with saline, 50 mg · kg-1 of BBR, 50 mg · kg-1 of Y53 or 5 mg · kg-1 of rosiglitazone ( ROSI ) , respectively. During and after the experiment, the u-rine, blood, serum and kidney of the animals were harvested for determination of relevant parameters by kits. Kidney tissues of the mice were subjected to pathological examination by hematoxylin & eosin( HE) staining;mRNA and protein expression levels of target genes in the kidney were determined by quantitative re-al-time reverse transcriptase-polymerase chain reaction ( qRT-PCR) and Western blot, respectively. Results Y53 greatly reduced the fasting blood glucose ( FBG ) and glycosylated hemoglobin( GHb) , improved diabet-ic symptoms such as polyphagia and polyuria in the di-abetic mice( P<0. 01 vs DM control group) . Y53 po-tently reduced the blood urea nitrogen ( BUN ) , serum creatinine( Scr) , 24 h urinary protein, kidney index, serum and kidney advanced glycation end-products ( AGEs) and nitric oxide( NO) , as well as kidney cho-lesterol( CHO ) and triglyceride ( TG ) contents ( P <0. 05 or P<0. 01 vs DM control group) . In the patho-logical examination, Y53 greatly restored kidney mor-phology and suppressed glomerular sclerosis( P<0. 001 vs DM control group). In addition, Y53 significantly reduced the renal expression of fibrosis-related genes, such as the transforming growth factor-β1 ( TGF-β1 ) and smad2(P<0. 01 vs DM control group). The reno-protective efficacies of Y53 were superior to those of BBR and ROSI in our study ( P<0. 05 or P<0. 01 ) . Conclusions The BBR analogue Y53 has potent ac-tivities in ameliorating renal injury and restoring renal function in STZ-induced diabetic mice. Y53 may be developed as a novel kind of agent for the treatment of DN in the future.

Analysis on allergen of clinical allergic rhinitis patients in north-west mountain area of Hubei Province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the main inhaled allergens and the difference of that between city and rural suburbs in patients with allergic rhinitis in the mountain region of the northwest Hubei province and to provide epidemiological basis for prevention and treatment in the region.@*METHOD@#Eight hundred and thirty-five cases who were diagnosed as allergic rhinitis with standardized allergens in Taihe Hospital of Hubei University of Medicine from Sep 2009 and Dec 2011 were studied. The data of allergens and the distribution of the patients were recorded and analyzed. χ2-test were used to analyze the data.@*RESULT@#The top 7 of inhaled allergens were house dust mites (89.6%), dust mites (86.0%), tropical mites (56.9%), croton bug (18.8%), felon herb (8.1%), the cat hair (8.1%) and fine chain alternata bacteria (9.5%), Two main kinds of allergen in three different area are with no obvious difference (P > 0.05).@*CONCLUSION@#In northwest Hubei Province, the highest rate of inhaled allergens was dust mites, which are approximate in different age groups and different regions, especially in the city.

Improving the surgical technology in treatment of OSAHS / 临床耳鼻咽喉头颈外科杂志

Noninvasive continuous positive airway pressure (CPAP) for the ventilation treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) is the first-line treatment method. This article aims to describe the effect of surgical operation especially for the UPPP in the individualized comprehensive treatment of OSAHS and the importance of surgical technique. Lower compliance is the bottleneck of CPAP therapy in clinical application, for the OSAHS patients with treatment failure in CPAP or those cannot accept CPAP therapy, when with no other ideal instrument therapeutics, accurate diagnosis of position in airway obstruction with an adequate surgical operation is the treatment,of choice. Surgical operation is particularly important either as a fore-lying means to improve the CPAP treatment compliance or as an independence treatment method of OSAHS. The pharyngeal cavity is the most common obstructive plane in patients with OSAHS. The operation of traditional UPPP aiming at the expansion of pharyngeal cavity is the classics surgery to solve obstruction in this plane, the lower operation effective rate is the main reason of restriction in its development. How to improve the effective rate of surgical treatment of OSAHS is our surgical goal. The effective rate of surgical operation treatment in OSAHS rely on the following sides: to follow the OSAHS individualized comprehensive treatment principle, reasonable choice of surgical operation indication, the precise localization diagnosis of upper airway obstruction, adequate surgical operation and skilled surgical techniques.

The balance function of the patients with benign paroxysmal positional vertigo during standing / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purpose of the study was to investigate the balance function of the patients with benign paroxysmal positional vertigo (BPPV) during standing.@*METHOD@#In this study 41 patients with posterior semicircular canal BPPV (PC BPPV) and 11 patients with horizontal semicircular canal BPPV (HC BPPV) were recruited. Dynamic balance during standing was measured in Sensory Organization Test (SOT). Static balance during standing was measured in modified Clinical Test of Sensory Interaction and Balance (mCTSIB). Data of BPPV patients were compared to that from 44 normal controls.@*RESULT@#Scores of the patients with PC BPPV were lower than that of the normal controls in the last three test conditions of SOT. Patients with PC BPPV demonstrated greater sway velocity in stance on foam with eyes open and eyes closed in mCTSIB. No postural deficit was observed in neither SOT nor mCTSIB when the patients with HC BPPV were compared to the normal controls.@*CONCLUSION@#Disorders of the horizontal semicircular canal do not influence postural control. Both dynamic and static posturography can detect the postural imbalance caused by posterior semicircular canal dysfunction.

Gastrodin ameliorates oleic acid-induced fat accumulation through activation of AMPK pathway in HL-7702 cells / 中国药理学通报

Aim To study the inhibitory effect of gast-rodin (GSTD) on oleic acid (OA)-induced fat accu-mulation in HL-7702 cells and explore possible cellular signaling pathways. Methods The MTT method was used to study the impact of GSTD on cell viability in HL-7702 cells. Cellular steatosis was induced by 1 mmol·L-1 of OA administration for 24 h, and differ-ent concentrations of GSTD were added at the same time. Oil red O ( ORO) staining was used to determine fat accumulation in cells, and intracellular triglyceride ( TG) contents were assayed. Western blot was used to determine the phosphorylation levels of AMPKα and ACC in cells after GSTD administration. Compound C was used to treat the cells in order to study its influ-ence on the efficacies of GSTD. Results GSTD had no obvious toxicity in HL-7702 cells when its concen-tration was≤3 386. 5 μmol · L-1 . After 24 h of OA administration, there were large amounts of lipid drop-lets accumulated in HL-7702 cells, and intracellular TG contents greatly increased as well. However, when 169. 3 or 338. 7 μmol · L-1 of GSTD was added to-gether with OA, fat accumulation in cells was greatly inhibited, and intracellular TG contents were reduced averagely by 35% and 43 . 6%, respectively ( P<0. 01 vs OA alone ) . After administration, GSTD could in-crease the levels of p-AMPKα and p-ACC in HL-7702 cells time and dose dependently. Compound C could completely abolish the stimulating activity of GSTD on AMPK pathway and block its reducing effect on hepatic TG accumulation. Conclusions GSTD greatly inhibits OA-induced fat accumulation and reduces intracellular TG contents in HL-7702 cells;the efficacy of GSTD is dependent on the activation of cellular AMPK pathway.

Evaluation of the status quo of the eight-year program medical doctors' career development potential / 中华医学教育探索杂志

Objective By investigating the actualities of career development potential of eight-year program medical students, to explore a direction of training mode innovation aiming to improve career development potential. Methods Eight-year program medical graduates, their tutors, and di-rectors of their clinical department in a university hospital were the subjects of the current study. Questionnaire method was applied to evaluate professional competence including clinical skills, re-search capabilities and integrative ability . Anonymous questionnaires were dispensed to eight-year program medical graduates for self-evaluation. Distinct anonymous questionnaires were dispensed to tutors directors for evaluation. Traditional doctoral graduates (professional degree or academic degree) were set as standard for comparison of specific ability of eight-year program medical students. Results 74 out of 85 (87%) questionnaires for Eight-year program medical graduates were available. 53 out of 63 (84%) questionnaires for tutors were available. 21 out of 26 (81%) questionnaires for directors of clinical departments were available. In clinical capabilities, according to 43 percent (32 persons) of the eight-year MD graduates' self-assessment and the evaluation of 94%(50 persons) mentors and 81%(17 people) department directors, eight-year program medical graduates were regarded as lower-skilled clinicians compared with doctoral graduates with professional degree . Eight-year program medical graduates were also considered with worse research capabilities than doctoral graduates with profes-sional degree by themselves (76%, n=56), their tutors (91%, n=48), and their department directors (86%, n=18). Conclusions The survey shows that to some extent, the current eight-year clinical doctoral graduates lack of career development potential, reflecting the current training mode cannot lead to the given training goals. We suggest that both clinical skills and research capabilities should be enhanced to make sure that eight-year program medical graduates deserve the title of academic physicianorphysician scientists.

The clinical characteristics and treatment progress of otitis media in children / 临床耳鼻咽喉头颈外科杂志

Otitis media is a common problem in children, which may cause hearing loss and complications sometimes. This topic will review the definition, causes, types, clinical characteristics and treatments of each type of ear infections in children, by reading recently literatures. It is important to make an accurate diagnosis and choose a appropriate treatment of otitis media in children to avoid antibiotics abusing. Sometime some cases need operations, which are effective, especially in chronic suppurative otitis media and cholesteatoma, and we need further studying focuse on when do the operations and how to shoose them.

DNA microarray screening analysis in children with profound hearing impairment in Hubei province / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate characteristics of molecular etiology of children with profound sensorineural hearing loss in Hubei province, and to provide reference for deafness treatment and genetic counseling.@*METHOD@#Three hundred and six children with profound sensorineural hearing loss in Hubei province were enrolled, their genomic DNA were extracted from peripheral blood and a deafness gene test chip was used to screen nine hot spot mutation in the GJB2, GJB3, SLC26A4, and mitochondria 12SrRNA gene. All patients with SLC26A4 gene mutation were given temporal bone CT scan.@*RESULT@#One hundred and thirty-two (43.14%) out of 306 children were found carrying at least one pathogenic gene mutation. The mutation rates of GJB2, SLC26A4 and mitochondria DNA 12SrRNA gene were 29.41% (90/306), 13.72% (42/306) and 0.65% (2/306), respectively. None out of 306 children was detected GJB3 gene mutation. Thirty-six patients carrying SLC26A4 gene mutation were detected enlarged vestibular aqueduct by CT scan.@*CONCLUSION@#Mutations of GJB2 and SLC26A4 gene are two major pathogenic gene for genetic hearing loss in children. 235delC mutation is the main mutation type, followed by IVS7-2A> G mutation type. The screening of SLC26A4 gene common mutations contribute to the diagnosis of enlarged vestibular aqueduct syndrome.

Expression of PPAR-γ in patients with chronic rhinosinusitis without or with nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of peroxisome proliferator-activated receptor γ (PPAR-γ) in the sinus mucosa of chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP).@*METHOD@#Using immunohistochemistry and RT-PCR, testing the content of PPAR-γ in sinus mucosa and nasal polyps of patients with chronic sinusitis without nasal polyps and normal inferior turbinate, and analyzing the differences.@*RESULT@#The PPAR-γ was found both in sinus mucosa of CRSsNP, nasal polyps of CRSwNP and in normal inferior turbinate; (2) The expression of PPAR-γ in sinus mucosa of CRSsNP and nasal polyps of CRSwNP was lower than that in normal inferior turbinate tissue, and the differences was prominent in statistics; (3) No differences in the expression of PPAR-γ were obtained in sinus mucosa of CRSsNP and nasal polyps of CRSwNP.@*CONCLUSION@#The PPAR-γ expressed in human nasal mucosa, meanwhile it was descending in sinus mucosa of CRSsNP and nasal polyps of CRSwNP. The long-term inflammations resulted from CRSsNP and nasal polyps of CRSwNP might relate to PPAR-γ, it suggested that PPAR-γ agonists may offer a new therapy for the treatment of Chronic Rhinosinusitis.

The key points to the successful repair of cerebrospinal fluid rhinorrhea / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the clinical experience of endoscopic repair for cerebrospinal fluid (CSF) rhinorrhea in our department in the last 4 years.@*METHOD@#Clinical data of 16 patients with CSF rhinorrhea who underwent nasal endoscopic repair was analyzed retrospectively. The effect of etiology, image data, location of CSF leaks and surgical techniques on treatment were discussed.@*RESULT@#Among the 16 patients, 10 were diagnosed with spontaneous CSF rhinorrhea, 2 were diagnosed with traumatic CSF rhinorrhea, 3 were diagnosed with CSF rhinorrhea after catching cold and 1 was diagnosed with meningo-encephalocele in with CSF rhinorrhea. The leak was located by CT scan in 11 cases, by MRI in 7 cases. The common locations of the defect were the frontal sinus (3 cases), cribriform roof (3 cases), sphenoid sinus (6 cases) and the nasal cavity top (4 cases). All the cases were successfully cured after the first nasal endoscopic repair with autologous materials. None of patients had a reoccurrence during 10 to 42 months follow-up time.@*CONCLUSION@#The application of CT and MRC before surgery which could make an accurate diagnosis of the location and the size of the defect. The correct selection of repair materials, processing planting bed around the leakage and complete contacting leakage with graft bed are the key points to the successful surgery of CSF rhinorrhea.

The study on 235delC mutation of GJB2 gene in patients with idiopathic sudden hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the rate of 235delC mutation in GJB2 gene in patients with idiopathic sudden hearing loss, and to explore its possible correlation with pathogenesis of idiopathic sudden hearing loss.@*METHOD@#Two hundred and thirty-four patients with diagnosis of idiopathic sudden hearing loss in otolaryngology department were recruited as experimental group. Eighty people with normal hearing level were enrolled as control group. Their peripheral blood samples were obtained and genomic DNA was extracted. Using polymerase chain reaction, the coding region of GJB2 gene was amplified, and 235delC mutation is screened for in GJB2 gene by restriction endonuclease. At same time the clinical data of 234 patients was collected to analyze.@*RESULT@#In 234 cases of idiopathic sudden hearing loss, 5 cases were found to have heterozygous 235delC mutation, none of them harbored homozygous 235delC mutation, the 235delC mutation rate was 2.1% (5/234). No 235delC mutation was found in control group. The rate of 235delC mutation in two group showed no statistically significant difference (P > 0.05).@*CONCLUSION@#This research shows that the rate of 235delC mutation in GJB2 is low in patients with idiopathic sudden hearing loss, and suggest that 235delC mutation possible has no correlation with idiopathic sudden hearing loss.

Safety of rush allergen-specific immunotherapy in allergic rhinitis patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The safety of rush immunotherapy (RIT) in Chinese allergic rhinitis (AR)patients is unknown. The purpose of this prospective was to assess the safety differences between RIT and conventional immunotherapy in Chinese AR patients, and then discuss the clinical application feasibility of RIT.@*METHOD@#A one-year study period was set for this study. The enrolled patients were divided into 2 groups according to their preference of therapy: RIT or conventional immunotherapy using standardized house dust mite allergen vaccine. For safety evaluation, the local and systemic adverse reactions were recorded throughout the both groups initial phase. Week 0 (W0), Week 2 (W2), Week 5 (W5), Week 17 (W17) were set as observation time points for leukotriene (LT-B4) and so on. The Generalized Mixed Linear Model with SPSS13. O and the chi-square test with SAS 9. 1.3 were used for Statistics.@*RESULT@#Fifty-two cases were enrolled into the RIT group, of which 49 patients have completed the established treatment study, and 3 cases were lost to follow-up. In the conventional immunotherapy group, 35 cases were enrolled, of which 32 have completed established treatment study, and 3 cases were lost to follow-up. The local and systemic adverse events of AR RIT appeared to be similar to those of conventional therapy and LT-B4 was descended steadily in the two groups.@*CONCLUSION@#Processed in advance Chinesear with drugs, RIT is similar to the safety of conventional immunotherapy.

Primary nasopharyngeal tuberculosis presenting as durative aural fullness: one case report and literature review / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical features, diagnosis and treatments of primary nasopharyngeal tuberculosis.@*METHOD@#A case report was presented, and meanwhile etiopathogenesis and differential diagnosis were also reviewed.@*RESULT@#A biopsy was taken and the histopathological examination showed tuberculosis granuloma with caseous necrosis. After anti-tuberculosis therapy, the symptoms disappeared.@*CONCLUSION@#Not only otologic disorders but also nasopharyngeal diseases need to be considered when aural fullness exists. More importantly, primary nasopharyngeal tuberculosis should be taken as one of the differential diagnosis.

Study of allergen skin prick tests on different region of forearm / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the variation on different regions of the forearm when taking the allergen skin prick tests(SPTs).@*METHOD@#Forty-one patients with hyper-reactive nasal symptoms were included. SPTs were done on the proximal, telecentric, middle region of right forearm and telecentric region of left forearm with house dust mite and histamine. The average diameter of wheal and the reactive grade were calculated and analyzed.@*RESULT@#The diameters of the wheal on equal position of two forearms were similar (P > 0.05). The intension of SPTs reaction decreased from proximal to telecentric region of the same forearm (P < 0.05).@*CONCLUSION@#The intension of SPTs reaction on different region of forearm are quite different, which should be noticed in clinical practice.