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Objective:To analyze the risk factors of acute kidney injury (AKI) in patients with septic shock in intensive care unit (ICU), construct a predictive model, and explore the predictive value of the predictive model.Methods:The clinical data of patients with septic shock who were hospitalized in the ICU of the Affiliated Hospital of Jining Medical College from April 2015 to June 2019 were retrospectively analyzed. According to whether the patients had AKI within 7 days of admission to the ICU, they were divided into AKI group and non-AKI group. 70% of the cases were randomly selected as the training set for building the model, and the remaining 30% of the cases were used as the validation set. XGBoost model was used to integrate relevant parameters to predict the risk of AKI in patients with septic shock. The predictive ability was assessed through receiver operator characteristic curve (ROC curve), and was correlated with acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), procalcitonin (PCT) and other comparative verification models to verify the predictive value.Results:A total of 303 patients with septic shock were enrolled, including 153 patients with AKI and 150 patients without AKI. The incidence of AKI was 50.50%. Compared with the non-AKI group, the AKI group had higher APACHEⅡscore, SOFA score and blood lactate (Lac), higher dose of norepinephrine (NE), higher proportion of mechanical ventilation, and tachycardiac. In the XGBoost prediction model of AKI risk in septic shock patients, the top 10 features were serum creatinine (SCr) level at ICU admission, NE use, drinking history, albumin, serum sodium, C-reactive protein (CRP), Lac, body mass index (BMI), platelet count (PLT), and blood urea nitrogen (BUN) levels. Area under the ROC curve (AUC) of the XGBoost model for predicting the risk of AKI in patients with septic shock was 0.816, with a sensitivity of 73.3%, a specificity of 71.7%, and an accuracy of 72.5%. Compared with the APACHEⅡscore, SOFA score and PCT, the performance of the model improved significantly. The calibration curve of the model showed that the goodness of fit of the XGBoost model was higher than the other scores (the calibration curve had the lowest score, with a score of 0.205).Conclusion:Compared with the commonly used clinical scores, the XGBoost model can more accurately predict the risk of AKI in patients with septic shock, which helps to make appropriate diagnosis, treatment and follow-up strategies while predicting the prognosis of patients.
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Duodenal neuroendocrine neoplasms (D-NEN) is a kind of heterogeneous tumor originated from neuroendocrine cells. With the continuous progress of diagnostic technology, more and more examination methods and treatment methods are applied. This article reviews the characteristics, classification, imaging applications, biochemical markers' monitoring and treatment of D-NEN.
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OBJECTIVE:To explore the effects and safety of Hedan tablets on the levels of blood lipid,inflammatory factors and oxidative stress in coronary heart disease(CHD)patients with type 2 diabetes mellitus(DM2). METHODS:A total of 118 pa-tients diagnosed as CHD with DM2 were collected from our hospital during Jul. 2013-Nov. 2015,and then divided into observation group(63 cases)and control group(55 cases)according to random number table. Control group received conventional treatment such as controlling blood glucose,regulating blood lipid,vasodilator,anticoagulant. Observation group additionally received He-dan tablets 1.46 g before meal,tid,on the basis of control group. Both groups received treatment for 6 months. The levels of blood lipid (TC,TG,LDL-C,HDL-C),serum inflammatory factors (TNF-α ,IL-10,IL-6,hs-CRP) and oxidative stress indexes (MDA,SOD,NO)before and after treatment as well as the occurrence of ADR were compared in 2 groups. RESULTS:Before treatment,there was no statistical significance in levels of blood lipid,serum inflammatory factors or oxidative stress indexes be-tween 2 groups(P>0.05). After treatment,the serum levels of TC,TG,LDL-C,TNF-α,IL-6,hs-CRP and MDA in 2 groups were decreased significantly,while those of IL-10,SOD and NO were increased significantly;the observation group was signifi-cantly better than the control group,with statistical significance(P0.05). CONCLUSIONS:Hedan tablets can effectively improve the level of blood lipid,reduce the lev-el of inflammatory factors,relieve inflammatory injury,reduce the level of oxygen free radical,strengthen antioxidant capacity and lighten oxidative stress injury with good safety.
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OBJECTIVE To explore the difference of vestibular damage between sudden deafness and vestibular neuritis.METHODS Patients in otolaryngology head and neck surgery eenterin PLA general hospital from February 25 in 2016 to July 20 in 2016 were included in this research.Among these patients,55 cases were diagnosed as sudden deafness group,including 39 cases With vertigo.And other 46 cases were diagnosed as vestibular neuritis.Vestibular bithermal caloric test,head impulse test(head impulse test,HIT),cervical vestibular evoked myogenic potentials(cervical vestibular evoked myogenic potential,cVEMP),ocular vestibular evoked myogenic potentials(ocular vestibular evoked myogenic potential,oVEMP) were performed to evaluate their vestibular function and were compared.RESULTS The abnormal rate of vestibular bithermal caloric test in sudden deafness group 25.45%,and 97.82% in vestibular neuritis group.There was significant difference between two groups(x2=54.01,P<0.001).HIT:the abnormal ratein sudden deafness groupwas 9.09% and 32.61% in vestibular neuritis group,there was significant difference between two groups(x2=8.72,P=0.003).VEMP:the abnormal rate of cVEMP in sudden deafness group was 69.10% and 43.47% in vestibular neuritis group,there was significant difference between two groups(x2=6.72,P=0.010).But the abnormal rate of oVEMP in sudden deafness group was 54.55% and 63.04% in vestibular neuritis group,and there was not statistically significant difference between two groups(x2=0.745,P=0.388).CONCLUSION The vestibular damage of sudden deafness with vertigo was more likely involved with saccule and inferior vestibular nerve,more close to the nerve terminal,and the injury was in a low frequency range;but the vestibular damage in vestibular neuritis was wider,and the injury involved a full band,the damaged part may be higher.
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<p><b>OBJECTIVE</b>To analyze the clinicopathologic features and prognosis of α-fetoprotein (AFP)-producing gastric cancers (AFPGC).</p><p><b>METHODS</b>Fifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions (study group) and sixty-five gastric cancer cases with normal AFP level (control group) treated in our department from January 2005 to December 2007 were included in this study. Their clinicopathologic features and follow-up data were statistically analyzed.</p><p><b>RESULTS</b>Compared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma (P=0.021) and liver metastasis (P=0.001) than that in the control group.The TNM stages in the study group were significantly higher than those in the control group (P=0.001). The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5% and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group (P<0.001 for all). The serum AFP levels in the study group ranged from 58.63 µg/L to 12 100.00 µg/L, and could be classified into two groups:27 cases <500 µg/L, and 24 cases ≥500 µg/L. There was no significant difference of the immunohistochemical staining results between the two subgroups (P=0.912).</p><p><b>CONCLUSIONS</b>AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis. Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.</p>
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Humans , Adenocarcinoma , Incidence , Liver Neoplasms , Prognosis , Stomach Neoplasms , Diagnosis , Metabolism , Pathology , Survival Rate , alpha-Fetoproteins , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical and genetic characteristics of three Chinese Meniere's disease (MD) families and decipher the mechanism of MD further.</p><p><b>METHODS</b>Personal and family medical evidence of hearing loss, vestibular symptoms, and other clinical abnormalities of the participants were identified, clinical and genetic features were analyzed. Targeted 307 genes capture and high-throughput sequencing were performed on the two ascertained members of family 1007184.</p><p><b>RESULTS</b>Eight patients from these three families showed post-lingual sensorineural hearing loss, six women and two men were involved. Age of onset in these affected members concentrated in the middle age, with the average age of 39.3 years old. Among them, patients from 1407278 were accompanied by migraine. All of the three probands presented as recurrent vertigo firstly, and then fluctuated hearing loss showed up, accompanying by tinnitus and ear fullness feeling. The hearing loss manifested as late-onset, low frequency-involved pattern, with subsequent gradual progression from moderate to severe level. Some of the patients progressed to severe level involving all frequencies at higher ages. In addition, most of the cases showed revitalization. Four cases received vestibular function tests, three of which had varying dysfunction of vestibular function, while the other one had normal vestibular function. Patients who had abnormal vestibular function showed much more severe hearing impairment. The three-generation family 1007193 had an autosomal recessive genetic characteristics, family 1007184 showed autosomal dominant inheritance of characteristics, family 1407278 were either autosomal dominant or X-linked dominant pattern. Through target genes capture high-throughput sequencing technology, we identified two candidate variants in the two members of family 1007184, named c. 2057G>A in EGFLAM and c. 1961C>T in ITGA8.</p><p><b>CONCLUSION</b>Meniere's disease has some genetic and familial aggregation in Chinese population, but its complex genetic pathogenic mechanisms need further study.</p>
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Adult , Female , Humans , Male , Middle Aged , Deafness , Family Health , Hearing Loss, Sensorineural , Inheritance Patterns , Meniere Disease , Genetics , Migraine Disorders , Tinnitus , Vestibular Function Tests , Vestibule, LabyrinthABSTRACT
Objective To explore the effect of quality control circle (QCC) on nipple maternal breastfeeding by parturients with nipple defects. Method A QCC with a theme ofimprove the maternal breastfeeding rate among the partureints with nipple defectswas established to investigate the current status, analyze the main causes, propose countermeasures and finally carry out countermeasures and check the effects according to the PDCA principles. Result The post-QCC adverse events of maternal breastfeeding in not enough lactation, breast swelling, cracked nipples, failure in the first suck and unqualified breastfeeding at discharge were significantly lower than those of pre-QCC ones (P<0.01). Conclusion Quality control circle can effectively solve the problems in nipple maternal breastfeeding and meanwhile improve the nurse work enthusiasm as well as their ability to solve problems.
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OBJECTIVE@#To investigate the result of vestibular evoked myogenic potentials (VEMP) of primary benign paroxysmal positional vertigo(BPPV)and to identify the characteristics in VEMP examination of the primary BPPV and to observe the relevance of patients with primary BPPV and abnormal VEMP with hearing loss.@*METHOD@#Patients with primary BPPV were tested with pure tone audiometry, videonystagmograph and VEMPs test. We analyzed the difference in the two groups with normal hearing and hearing loss, discussed the etiology and pathogenesis.@*RESULT@#Primary BPPV comprised 23.0% with hearing lost, 77.0% hearing normal. The results of oVEMP were abnormal in 79. 7% (59/74) of the cases; and the results of cVEMP were abnormal in 66. 2% (49/74) of the cases; oVEMP and cVEMP differences to the diagnosis of primary BPPV (P<0. 05); oVEMP and cVEMP differences to the diagnosis primary BPPV with hearing lost (P<0. 05).@*CONCLUSION@#oVEMP detection positive rate of primary BPPV is higher than cVEMP,which may be due to otolithic particles falling from the utricle; positive rate of cVEMP in primary BPPV with hearing loss is higher than that of oVEMP, which may related to the cochlear and sacculus occured in the same embryonic tissue structure.
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Humans , Audiometry, Pure-Tone , Benign Paroxysmal Positional Vertigo , Cochlea , Hearing Loss , Hearing Tests , Otolithic Membrane , Saccule and Utricle , Vestibular Evoked Myogenic PotentialsABSTRACT
Objective To establish the reference value about index of serum thyroid specific during pregnancy ,Improve the birth population quality in this district .Methods Collect the blood serum sample of normal pregnant women according to Diagnosis and treatment of thyroid disease during pregnancy and postpartum Guide,to establish the reference value about index of serum thyroid specific during pregnancy .Total 167 cases were collect ,the first trimester were 47 cases ,the second trimester were 86 cases ,and the third trimester were 34 cases .The TSH and FT4 were detected in the cobas e 601 .The mean and standard deviation of TSH and FT4 in the three period of pregnancy were performed with SPSS14 .0 then established the the 95% confidence interval of TSH and FT4 of the three period of pregnancy .That was the the reference value about index of serum thyroid specific during pregnancy .Re‐sults The reference value of the TSH was 0 .05-2 .90 mIU/L in the first trimester ,FT4 was 12 .5-18 .3 pmol/L in the first tri‐mester ;The reference value of TSH was 0 .2-3 .63 mIU/L in the second trimester ,FT4 was 9 .99-16 .2 pmol/L in the second tri‐mester ;The reference value of TSH was 0 .17-4 .90 mIU/L in the third trimester ,FT4 was 9 .34-13 .9 pmol/L in the third tri‐mester .Conclusion Electrochemiluminescence detect the reference value about index of serum thyroid specific during pregnancy on Cobas e 601 ,could improve the detection rate of local gestational thyroid dysfunction ,and lay a solid foundation for the prenatal and postnatal care and improve the quality of the population .
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Objective To observe the effects of puhnonary rehabilitation on the symptoms and quality of life of persons with chronic obstructive pulmonary disease (COPD).Methods COPD patients were recruited from a hospital and community health centers and given pulmonary rehabilitation in the community.The rehabilitation program included health education and nutrition guidance,medication,breathing exercises,and physical exercise.Each patient was followed up every 4 weeks by telephone.The outcome measures included pulmonary function (FEV1%,FEV1/FVC%),St George's questionnaire (SGRQ),the Medical Research Council scale (MRC),Borg scoring,evaluation of anxiety and depression,the six-minute walk test (6MWT),and an evaluation of nutritional status.All of the patients were observed for one year.Results A total of 85 patients completed the program and were included in the final statistical analysis.There was no difference in FEV1 % before and after rehabilitation.Six-minute walking distance improved significantly in statistical terms but the average increase was only from (416.1 ±99.84)m to (437.51 ±116.17)m.The SGRQ scores decreased by an average of 4.8 points after a year of rehabilitation,with significant improvements among the moderately and severely impaired.Incidents of COPD exacerbation also decreased significantly.Patients with a low body mass index had the greatest SGRQ score improvments.Few patients showed depression or anxiety in this research population.Conclusions Pulmonary rehabilitation in the community can improve exercise tolerance and the quality of life for persons with COPD,reducing incidents of acute exacerbation.Patients may benefit from such pulmonary rehabilitation regardless of disease severity.The compliance was good despite the infrequent monitoring.Pulmonary rehabilitation in the community is worthy of more widespread use.
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Objective To evaluate the accuracy and reliability of Diana automated blood grouping analyzer in blood grouping and cross matching.Methods 2 300 patients′ABO and RhD blood groups were examined by conventional tube test and the fully auto-mated blood grouping analyzer and 900 patients′samples were tested using Diana automated blood grouping for blood cross matc-hing,and it was compared with polymatching method.Results The analyzer′s accuracy rate of blood grouping by two methods were 99.87% and 100.00%.The incompatibility occurred in 30 specimens in automatic blood type instrument,in 3 specimens in manual polymatching method.Conclusion The results of Diana automated blood grouping analyzer used for blood grouping and cross matc-hing blood testing are reliable.Its experimental operation is normalized and standardized with an advantage of low incidence of human er-ror.Moreover,the experimental results can be permanently preserved,which provides a convenience to search for medical proof.
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Objective To observe the short-term efficacy and adverse reactions of S-1 combined intrathoracic and intraperitoneal injection for the treatment of aged patients with gastric cancer and with malignant hydrothorax and ascites.Methods The patients were divided into treatment group (A group,22 cases) randomly and control group (B group,24 cases).The two groups underwent intrathoracic and intraperitoneal injection chemotherapy and biological therapy.Drainage tubes were placed in thoracic or abdominal cavity to discharge the effusion,cisplatin 40-60 mg,lentinan 4-6 mg,dexamethasone 10 mg were injected into the chest or abdomen,once per week,administered for 2-4 weeks.S-1 was added to the treatment group,S-1 capsules were administered orally on the first day of serous cavity drug injection,40-60 mg/m2,2 times per day,oral administration after morning and evening meal for 14 days,stop for 7 days,21 days were 1 cycle.The short-term curative effects,clinical quality of life and adverse reactions were compared between the two groups.Results Total effective rate of group A was 77.3 %,50.0 % in B group,the difference of short-term effects of two groups was with statistical significance (P < 0.05).The improvement rates of quality of life (QOL) of group A and group B were 86.4 % and 70.1% respectively,with significant difference in the two groups (P < 0.05).The major adverse reactions were gastrointestinal reaction and bone marrow suppression,nausea and vomiting rate in A group was 54.5 % (12/22),grade Ⅲ-Ⅳ neutropenia was 54.5 % (4/22),significantly higher than that in B group,there was significant difference in two groups (P < 0.05).No treatment related death.Conclusion There is curative effect of S-1 combined with cisplatin and lentinan in treatment of the aged patients of gastric carcinoma and malignant hydrothorax and ascites.Gastrointestinal side efforts and bone marrow suppression in treatment group have been observed,but it is tolerable.This scheme can improve the QOL of patients and prolong the survival period.
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Objective To explore a compatible approach to detect and classify the lesions of inferior vena cavas (IVCs) on sonogram in patients with Budd-Chiari syndrome(BCS).Methods Ultrasonogram of the IVCs were observed detailedly in 300 patients with BCS by using trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections.Transducers usually used for heart examination were applied in the latter.Lesions of the IVCs found in 277 out of 300 patients were classified.All lesions were confirmed by digital subtraction angiography (DSA) and among them,52 cases underwent computed tomography angiography (CTA).Results Lesions of IVCs were classified into 3 categories as follows:membranous type,segmental type,and ex-pressed type.① Membranous type (thickness ≤ 15 mm) included membranous stenosis type and membranous occlusion type.On the basis of the thickness,the membranous stenosis type was further classified into thinner membranous stenosis type (thickness ≤5mm) and thicker membranous stenosis type (5 mm<thickness≤ 15 mm).The membranous occlusion type was further classified into thinner membranous occlusion type (thickness ≤5 mm) and thicker membranous occlusion type (5 mm<thickness ≤15 mm).② Segmental type (lengtb > 15 mm) was consist of segmental stenosis type and segmental occlusion type.Based on the length of the lesion,the segmental stenosis type was further divided into longer segmental stenosis type (length > 30 mm) and shorter segmental stenosis type (15 mm<length ≤30 mm).The segmental occlusion type was further divided into longer segmental occlusion type (length > 20mm) and shorter segmental occlusion type (15 mm< length ≤20 mm).③ Ex-pressed type of IVCs was mainly caused by compression of intumescent caudate lobes.Corresponding sonographic features were demonstrated in each type.Conclusions Ultrasonogram of trans-abdomen and trans-thorax-right atrium-inferior vena cava ingress sections could accurately classify the lesions of IVCs.It is of important significance for the clinical treatment.
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Objective To investigate the influence of nursing intervention on hormone treatment compliance of patients with nephrotic syndrome. Methods 130 patients with nephrotic syndrome who received hormone treatment were randomly divided into the experimental group and the control group ac-cording to the time of admission. The control group were treated with conventional nursing, and the ex-perimental group was given whole-process health education besides conventional nursing.Using question-naires, the level of relevant knowledge and medication compliance were compared between the two groups .The results underwent χ2 and t test. Results The treatment compliance was not significant be-fore nursing intervention, while after nursing intervention, the treatment compliance of the experimental group was better than that of the control group. The score of relevant knowledge about nephrotic syn-drome of the experimental group was higher than that of the control group Conclusions Active nurs-ing intervention can improve the health knowledge level of patients and improve the treatment compli-ance of hormone therapy.
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OBJECTIVE@#To focus on the prevalence of rare Meniere's disease in the elderly(> or = 60 yrs) and to investigate its clinical characteristics.@*METHOD@#To observe the elderly with Meniere's disease from 2004-01-2007-7 and to investigate its clinical manifestation, electrocochleography (ECoG), vestibular evoked myogenic potential (VEMP), caloric test and pure tone audiogram.@*RESULT@#There were 13 cases of Meniere's disease in the elderly. And the prevalence of Meniere's disease was 2.22% (13/586). The initial symptoms were as following: 2 cases with cochlear and vestibular symptoms, 9 cases with mere cochlear symptoms, 1 cases with mere spinning vertigo and 1 case with mere drop attack. The audiogram in the elderly were varied: low and high frequency hearing loss, flat, and high-frequency hearing loss. And the high frequency hearing loss had no relation with the duration of Meniere's disease. The results of vestibular function were varied. The percentage of positive result of ECoG was 63.6% (7/11, 2 cases not determined).@*CONCLUSION@#The prevalence of Meniere's disease in children was 2.22%. The initial symptoms was cochlear and vestibular symptoms, mere cochlear symptoms, mere spinning vertigo and mere drop attack, respectively. The audiogram showed prominent high frequency hearing loss. The percentage of positive result of ECoG was high. And the results of vestibular function tests were varied.
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Aged , Female , Humans , Male , Middle Aged , Audiometry, Evoked Response , Audiometry, Pure-Tone , Cochlea , Meniere DiseaseABSTRACT
OBJECTIVE@#To analyze two groups of patients with migrainous vertigo (MV )and vertigo resulting from posterior circulation ischemia (PCIV) and investigate the differential diagnosis between them.@*METHOD@#There were 60 patients with MV and 64 patients with PCIV. Clinical tests include high risk factors of posterior circulation ischemia (PCI), cerebral MRI, ocular motion and high stimulating rate ABR.@*RESULT@#Among 64 patients with PCIV, 29 had abnormal blood pressure and 14 had abnormal blood fat and/or pathoglycemia; 37 had abnormality in cervical vascular ultrasound; 14 suffered from amaurosis or dizziness upon fast getting up. Twenty two had abnormal high stimulating rate ABR and 4 had cerebral lacunar infarction in MRI. As for 60 patients with MV, 45 suffered from motion sickness; 20 were sensitive to motion; 32 had photophobia and (or) phonophobia; 45 had migraine; 16 had abnormal ocular motion function; 3 had abnormal cerebral MRI and 40 had abnormal results in high stimulating rate ABR. The percentage of abnormal high stimulating rate ABR in MV and PCIV were 53% (22/42) and 67% (40/60) respectively.@*CONCLUSION@#The mean age of MV is younger than that of PCIV. Female is more prone to MV than male (2.75 : 1. 00); the sex difference in PCIV is lesser (1.46 : 1.00). Motion sickness, motion sensitivity, photophobia and (or) phonophobia are principal differential highlights to MV. The major characteristics of PCIV include abnormal blood pressure, abnormal blood fat, pathoglycemia and arteriosclerosis. Vestibular function tests could not serve as a differential point; Cerebral MRI might be helpful to differential diagnosis. The results of high stimulating rate ABR is not a differential point between PCIV and MV, but it might play a role in differentiating other kinds of vertigo.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Diagnosis, Differential , Ischemia , Migraine Disorders , Sex Factors , Vertigo , DiagnosisABSTRACT
Objective To review and summarize the latest development of the therapy for the Duchenne muscular dystrophy (DMD). Methods The recently-published articles related to the therapies for DMD were extensively reviewed and briefly summarized. Results The therapeutic approaches for DMD included the gene therapy, the cell therapy, and the pharmacological therapy.The gene therapy and the cell therapy were focused on the treatment for the cause of DMD by the delivery of the missing gene, the modification of the mutated gene, and the transfer of the normal cells including the stem cells, while the pharmacological therapy dealt with the downstream events caused by the dystrophin gene defect, slowed down the pathologic progress of DMD, and improved the DMD patient's life quality and life span, by medication and other factor treatments. Conclusion There is still no cure for DMD because of various difficulties in replacing or repairing the defected gene and of the multifaceted nature of the severe symptoms. Therefore, it is imperative for us to find out a more effective treatment that can solve these problems.
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@#ObjectiveTo inspect the real-time heart rate changes of middle aged and older women when practicing Wuqinxi exercise.Methods35 healthy women, Wuqinxi exerciser, were selected randomly, whose heart rates were inspected during exercise.ResultsDuring once Wuqinxi exercise, the average heart rate of middle aged women reached the target heart rate after 9 minutes, and the average maximal heart rate was 122 beats/min, increased by 44 beats/min compared with sedentary heart rate. The same data of older women were 11 minutes, 131 beats/min and 55 beats/min respectively.ConclusionWuqinxi exercise is a healthy sport fitting for middle aged and older women.
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BACKGROUND: Old people above 80 years old have a high incidence of dizziness and tumble, which are associated with weakening vestibular function, balance function and optokinetic function.OBJECTIVE:This study was designed to make a quantitative evaluation of vestibular function,balance function and optokinetic function in people over 80 years old.DESIGN:It was a quantitative study on posture function(vestibular and balance function),auditory function(frequency audiometry)and visual function (optokinetic function) in elderly persons.SETTING:Department of Otolaryngology ,General Hospital of Chinese PLA.PARTICIPANTS:Totally 41 old male inpatients with systemic diseases in Rehabilitation Department of the General Hospital of Chinese PLA, with an age from 80 to 94 were selected from March 1993 to January 1994.Of them,12 had tinnitus,20 had dizziness.During the same period,old cadres including 11 males and 7 females aged from 60 to 79 years with normal findings of physical examinations were selected as controls. No participant in this group suffered from tinnitus, deafness and dizziness. All the participants were voluntary.METHODS: Patients underwent full-scale otolaryngological examinations.Audiometry consisted of battery of tests including frequency audiometry and evoked auditory brainstem responses(ABR). Vestibular function (posture) was assessed by vestibular-ocular reflexes. Participants accelerated from 1 /s to 90 /s. Then, the angular speed was kept until the nystagmus disappeared,at the time a sudden stop was made.Changes in nystagmus during the tests were recorded.The eyes firstly turned to left and 10 minutes later turned to right.Slow-phase angular velocity was recorded and the imbalanced left/right rate was calculated.Vestibularspinal reflex (VSR) was measured using balance beam and the length of the sway of the center of gravity (CG) and the sway velocity of CG were all calculated. Balance tests using a cursor were employed to examine the central optokinetic system, including sweeping, tracking, and optokinetic responses.MAIN OUTCOME MEASURES: Frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were examined to assess the posture function, auditory function and visual function in elderly persons over 80 years old.And the results were compared with those of balance function tests and visual function tests in old population aged from 60 to 79 years old.RESULTS:Practically,the number of old participants over 80 years old receiving the tests of frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were 41,24,39,40 and 34 respectively;The number of 60-79 participants receiving balance tests and visual tests were 18 and 10.Individuals refusing to participate were omitted. ① Auditory function:In 41 elderly persons >80 years,13 ears (16%) had a normal middle frequency audiometry, 69 ears (84%) had a loss of hearing. ② Posture function: 15 (62%) had normal vestibular-ocular reflexes, and 9 (38%) had abnormalities in vestibular-ocular reflexes.Ten (26%) had a normal vestibular-spinal reflex and 29 (74%) had an abnormal vestibular-spinal reflex.③ Balance function:Of all the variables of balance function,the length of the sway of CG and the sway velocity of CG were most valuable. In populations in both brackets, the length of the sway of CG and the sway velocity of CG in eyes-closed condition were longer and faster than those in eyes-opened .condition (P < 0.01). In over 80 years group,the length of the sway of CG and the sway velocity of CG were longer and faster than in 60-79 group (P < 0.01). ④ Optokinetic responses:Optokinetic plus were not obviously different between over-80 group and 60-79 group (P > 0.05) and the latent period of sweeping and the distortion of tracking were significantly longer and greater in former group than in later(P < 0.05-0.01 ).CONCLUSION:Most of the elderly persons over 80 years have a decrease in auditory and posture functions.Their optokinetic and balance functions are degenerated more severely than 60-79 years old population.
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Objective To observe the protective effect of ? receptor antagonist(Vasobral) against the aging process in rats otoconia morphology.Methods 15 healthy Wistar rats were subdivided into 3 groups:Normal control( n=5 ),aging group( n=5 ) and aging plus Vasobral group( n=5 ).Results The aged otlith took the form of clew-like fusion,flattening and some giant otoconia.And there was also some sphericand strange otoconia.In the region of transitional cells,there was many otoconia phagocytosis.Some scraps of saccule lost cilia,And the otoconia in the Vasobral group appeared to be spheric and some of them adhered together,but this phenomenon was not wide-spread.No giant otoconia was found in this group.The otoconia in the transitional region was less compared with the aged group.Conclusion ? receptor antagonist(Vasobral) has the effect of protection on the aging process of the otoconia.