[investigation on the triggers and the effect of healthy education on recurrence of vestibular migraine].

Objective:The aim of this study is to investigate the predisposing factors and the effect of healthy education on recurrence of vestibular migraine (VM), so as to provide a scientific basis for increasing the knowledge rate and reducing the recurrence rate of VM patients. Method: Questionnaires, memory diary, regular follow-up, etc. were used to understand the possible predisposing factors of VM patients. Self-assessment depression scale (SDS) and self-assessment anxiety scale (SAS) were used to evaluate patients' mental and psychological status, and visual analogue scale (VAS) was used to evaluate the severity of vertigo. Health education was conducted for VM patients through face-to-face consultation, material distribution, modern multimedia and other methods. The knowledge rate, anxiety and fear psychological state, recurrence frequency of vertigo, duration and severity of vertigo were compared before and after the healthy education. Result:Of 103 cases of the object of study, 100 patients (97.1%) with different degree of sleep disorders, 96 cases (93.2%) had a clear family history with vertigo or dizziness headache, 90 cases (87.4%) had history of motion sickness, 90 cases (87.4%) had confined space history of intolerance, 82 cases (79.6%), recurrent cause psychological anxiety, fear, 80 cases (77.7%), lack of exercise, 79 cases (76.7%) under pressure from life or work, 53 (51.5%) had food preference, 8 cases (7.8%) think much rain attacks more frequent when humid climate,seven (6.8%) reported more episodes during the spring or spring/summer exchanges.After health education, patients were followed up for 6 months to 2 years with a median of 15 months, and their knowledge rate of VM was increased from 12.6% (13 cases) to 98% (101 cases).The psychological ratio of anxiety and fear decreased from 79.6% (82 cases) to 7.8% (8 cases).The SAS score decreased from 47.9±4.4 to 45.5±4.2, and the SDS score decreased from 39.7±3.6 to 38.2±3.8.The unhealthy lifestyle and eating habits （lack of exercise, stress, and eating preferences at least 1 item）decreased from 89.4% (92 cases) to 32.1% (33 cases).The recurrence rate of 83.5% (86 cases) of the patients was reduced by 1 time or more, and the rate of no recurrence increased from 1% (1 case) to 15.5% (16 cases) within half a year.The duration of the attack was reduced by 20% or more in 48.5%(50 cases),The mean duration of the attack declined from (17.4±1.4) hours before healthy education to (10.5±0.9) hours after healthy education.The VAS score of 86.4%(89 cases) with recurrence severity decreased by 2 points or more. The average VAS score before and after education was (6.6±0.1) points and (4.5±0.1) points respectively.The above differences were statistically significant (P<0.01) compared with those before and after education.Conclusion: Sleep disorder, airtight space intolerance, excessive stress, lack of exercise, and dietary preference may be related factors to trigger VM attacks. Healthy education can significantly improve the awareness of VMs, and promote patients to change their lifestyle and eating habits. It can significantly improve patients' anxiety and fear psychological state, reduce the frequency of attack, shorten the duration of attack, and reduce the severity of selfassessment, which is worthy of clinical promotion.

[Analysis and evaluation of droplet digital PCR for H.pylori infections in chronic tonsillitis].

Objective:To investigate the measurement effect of droplet digital PCR(dd-PCR) for H.pylori infections in chronic tonsillitis and explore the correlations between H.pylori infections and chronic tonsillitis.Method:The subjects consisted of 48 chronic tonsillitis patients aged between 7 and 52 years scheduled for tonsillectomy.Core biopsy samples from resected tonsillary tissue was tested for H.pylori detection using both RT-PCR and dd-PCR for the CagA and VacA genes.Preoperative patient venous blood samples were also tested for H.pylori antibodies by Enzyme-linked immunosorbent assay(ELISA).ELISA,RT-PCR and dd-PCR were also used to detect expression of CagA and VacA genes in plasma and tissue of 30 cases of obstructive sleep apnea syndrome(OSAHS) and 35 cases of plasma from healthy subjects.Result:The expression of H.pylori antibodies is tested in plasma:48 chronic tonsillitis patients(10.12±3.23)ng/ml, OSAS(9.87±2.43)ng/ml, healthy subjects(9.34±3.38) ng/ml.There was no significant difference between groups in the plasma.The VacA and CagA gene sequences were detected by RT-PCR:48 chronic tonsillitis patients VacA(27.1%),CagA(16.7%),VacA+CagA(16.7%);30 OSAHS,VacA(23.3%),CagA(20.0%),VacA+CagA(16.7%);all of which were also positive by dd-PCR,thus were considered H.pylori infected.Moreover,The expression of VacA and CagA increased in tissues testing by dd-PCR:48 chronic tonsillitis patients VacA(72.9%),CagA(52.1%),VacA+CagA(39.6%);30 OSAHS,VacA(33.3%),CagA(23.3%),VacA+CagA(16.7%).Conclusion:Our study supports the possible role of H.pylori in chronic tonsillitis.H.pylori maybe one of the risk factors of chronic tonsillitis.dd PCR had bettersensitivity and specificity compare to H.pylori serological and RT PCR.Feasible anti H.pylori treatment maybe used for H.pylori associated chronic tonsillitis.

Silencing ECHS1 attenuates the proliferation and induces the autophagy of hepatocellular carcinoma via impairing cell metabolism and activating AMPK.

Hepatocellular carcinoma (HCC) is among the most common cancers in the world with a low survival rate. Our previous study showed Short chain enoyl-CoA hydratase (ECHS1) could bind to HBsAg (HBs) and that ECHS1's localization in mitochondria induced HepG2 cell apoptosis. However, the role of the ECHS1 in energy metabolism and autophagy during hepatocellular carcinoma development remains undefined. We aimed to determine what ECHS1 does to energy metabolism and its effects on HCC progression. We performed CCK-8, EdU assays in hepatocellular carcinoma cell lines (HepG2 and HuH7) with stable ECHS1 knock-down. ATP and NADP+/NADPH levels were measured using an colorimetric assay. Our data demonstrated that ECHS1 silencing inhibited cell proliferation and induced autophagy. ECHS1 knockdown did not increase fatty acid synthesis, but decreased cellular ATP. This resulted in AMP-activated protein kinase (AMPK) activation and induced HCC cell autophagy. Our results showed that silencing ECHS1 to attenuate proliferation and induce autophagy may make it a novel cancer therapy target.

Age over 80 years is not associated with increased hemorrhagic transformation after stroke thrombolysis.

Thrombolysis trials have recruited few patients aged ≥80 years, which has led to uncertainty about the likely risk-to-benefit profile in the elderly. Leukoaraiosis (LA) has been associated with hemorrhagic transformation (HT) and increases with advanced age. We tested whether there were any independent associations between age, LA and HT. Consecutive patients treated with intravenous (IV) tissue plasminogen activator (tPA) were identified from a prospective database. LA on baseline CT scans was assessed by two independent raters using the modified Van Swieten Score (mVSS) (maximum score 8, severe >4). HT was assessed on routine 24 hour to 48 hour CT /MRI scans using the European Cooperative Acute Stroke Study criteria for hemorrhagic infarct (HI) or parenchymal hematoma (PH) and judged symptomatic by the treating neurologist as per Safe Implementation of Thrombolysis in Stroke criteria. There were 206 patients treated with IV tPA (mean age: 71.0 years; range: 24-92 years), of whom 65/206 (32%) were aged ≥80 years. Overall, HT occurred in 41/206 patients (20%), HI in 31, PH1 in four (one symptomatic) and PH2 in six (three symptomatic). Age was not associated with HT (any HT: odds ratio [OR]=1.01; 95% confidence interval [CI]=0.5-2.08; p=0.99; PH: OR=0.53; 95% CI=0.12-2.3; p=0.51). There was one patient with PH1 and one patient with PH2 in 65 patients ≥80 years, both asymptomatic. LA was present in 112/208 (54%), and severe in 16.5%. LA increased with age (p<0.001) but was not associated with PH (any LA: OR=0.83; 95% CI=0.25-2.8; p=0.99; severe LA: OR=0.54, 95% CI=0.09-3.5; p=0.99). Age ≥80 years or LA did not increase the risk of HT (including PH) after thrombolysis, although LA increased with age. Neither factor should exclude otherwise eligible patients from tPA treatment.