[Study on the relationship between adenoid and tonsil hypertrophy and obesity in children].

Objective: To study the relationship between adenoid hypertrophy, tonsillar hypertrophy and overweight or even obesity in children. Methods: A total of 799 children aged 2 to 12 years with tonsillar and adenoid hypertrophy from January 2015 to December 2019 in the Department of Otolaryngology Head Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital were selected. The body mass index (BMI) was calculated according to the height and weight measured routinely at the time of admission. The difference of BMI between children and normal children of the same age, and the correlation between adenoid, tonsil hypertrophy and obesity were compared. Chi-square test was used to compare the surgical children's BMI of different genders with normal children of the same age, and Spearman rank correlation was used to analyze the correlation between BMI and adenoid and tonsil hypertrophy. Results: The Spearman correlation coefficient between tonsil hypertrophy and BMI was 0.078, P=0.077, the Spearman correlation coefficient between adenoid hypertrophy and BMI was -0.058(P=0.100). χ(2) test showed that the proportion of overweight and obesity in school-age children (7~12 years old) was significantly higher than that in preschool children (2~6 years old), and the difference was statistically significant (χ(2)(male)=22.386, P(male)<0.001, χ(2)(female)=4.478, P(female)<0.001). Conclusion: There is no obvious correlation between adenoid hypertrophy, tonsil hypertrophy and overweight or obesity in children, but the probability of children overweight or obesity increases with age, and the proportion of obesity in children aged 7-12 years is higher.

[Long-term efficacy observation of BPPV repositioning maneuver].

Objective:The aim of this study is to observe and analyze the long-term follow-up of the recurrence of benign paroxysmal positional vertigo BPPV with repositioning maneuver, and to determine the long-term therapeutic effect of repositioning maneuver. Method:To collect 738 patients who were diagnosed with BBPV due to vertigo. Follow up by telephone, SMS and other contact methods to analyze and summarize the long-term follow up of the recurrence of patients who had been treated with the appropriate repositioning maneuver. Result:Of the 738 patients, 458 patients were followed up and 280 were lost to follow up. The total follow up rate was 62.06%. 458 patients were followed up with 314 patients without recurrence and 144 patients with recurrence. The total recurrence rate was 31.44%. Conclusion:Repositioning maneuver is the most commonly used way for the treatment of BPPV. It is safe, simple and effective. However, patients with BPPV who have been cured by manual reduction still have a risk of recurrence. Among patients with relapse, the proportion of patients who relapsed once after treatment was the highest, and the recurrence rate of women with BPPV was significantly higher than that of men.

[Preliminary study on age stability of VOR gain values of video head impulse test in healthy subjects].

Objective: To explore the age stability of the video head impulse test(vHIT) in healthy subjects. Method: This was a prospective study on healthy subjects referred to our department. One hundred and eighty healthy subjects(age range 21-80) without any current or previous history of brain disorder, vertigo, neck stiffness or eye diseases participated in this study and the vHIT was carried out in all 180 cases. The relationship between VOR gain and age was analysed using univariate regression model and one-way ANOVA for subjects. Result: The VOR gains of the left horizontal semicircular canal, posterior semicircular canal and anterior semicircular canal were 1.02±0.12, 1.04± 0.15 and 0.94±0.16 respectively. The VOR gains of the right horizontal semicircular canal, posterior semicircular canal and anterior semicircular canal were 1.05±0.14, 1.00±0.16, 0.97±0.15 respectively. The difference of VOR gain between left and right corresponding semicircular canals was not statistically significant(P>0.05). For male subjects, the VOR gains of horizontal, anterior and posterior semicircular canal were 1.05±0.13, 1.02±0.16, 0.99±0.16 respectively, and for female subjects, the VOR gains of horizontal, anterior and posterior semicircular canal were 1.05±0.13, 1.01±0.16, 0.97±0.16 respectively. There was no significant difference in VOR gain of three semicircular canals between male and female(P>0.05). The VOR gain in different age groups was analyzed by one-way ANOVA. There was no significant difference in the VOR gain among different age groups(P>0.05). Univariate linear regression analysis was performed between the age and the VOR gain of the three semicircular canals. The slopes of the regression equations were 0.001 8, 0.000 2 and 0.000 3, respectively. Conclusion:The VOR gain of the six semicircular canals in healthy subjects is not significantly influenced by gender, and it varies slightly with age without requirement for adjustment with age. .

[Clinical features and recurrence rate on benign paroxysmal positional vertigo].

Objective:To study the characteristics and the recurrence rate of manual reduction of BPPV. Method:The clinical characteristics of 735 patients with BPPV were analyzed retrospectively. The posterior semicircular canal BPPV（PC-BPPV） was treated with the Epley maneuver therapy; the horizontal semicircular canal BPPV（HC-BPPV） was treated with the Barbecue therapy; the anterior semicircular canal BPPV（AC-BPPV） was treated with the Yacovino therapy; the combined semicircular canal was treated with the Epley and the Barbecue therapy; and for the bilateral lesions, first treat the more severe side with manual reduction then the lighter side was treated with manual reduction after the more severe side nystagmus or vertigo completely disappears. Result:①Of the 735 patients with BPPV, 455（61.90%） were PC-BPPV, 272（37.01%） were HC-BPPV, 3（0.41%） were AC-BPPV, and 5（0.68%） were combined BPPV. ②A total of 455 patients with BPPV were followed up by telephone. 51 patients recurred within 3 years, the recurrence rate was 11.21%; the male recurrence rate was 25.68%（38/148）, and the female recurrence rate was 28.66%（88/307）. The recurrence rate was the highest in 51-60 years old, and the recurrence rate was 29.67%. ③300 patients with PC-BPPV were followed up by telephone, 81 cases（27.00%） recurred, and the recurrence rates of one month, six months, one year, two years, and three years were 0.67%（2/300）, 3.33%（10/300）, 6.67%（20/300）, 9.33%（28/300） and 11.67%（35/300） respectively; 155 patients with HC-BPPV were followed up by telephone, 45 cases（29.03%） recurred, the recurrence rates of one months, six months, one year, two years, and three years were 0（0/155）, 2.58%（4/155）, 3.23%（5/155）, 7.10%（11/155） and 9.68%（15/155） respectively. Conclusion:PC-BPPV is the most common disease in BPPV patients. Manual recurrence can effectively treat the recurrence rate of BPPV, female patients is slightly higher than that of male patients. The long-term recurrence rate of PC-BPPV is consistent with that of HC-BPPV. The BPPV were most common in posterior semicircular canal. Manual reduction is effective to treat BPPV cases. BPPV recurrence was not correlated with age and gender. The long-term recurrence rate of PC-BPPV and HC-BPPV is consistent.

[Short-term outcomes of Li's repositioning maneuver of different age groups patients of horizontal semicircular canal canalithiasis benign paroxysmal positional vertigo].

Objective:To analyse whether there is statistical difference between different age group short-term outcomes of horizontal semicircular canal canalithiasis benign paroxysmal positional vertigo (HC-BPPV) patients treated by Li's repositioning maneuver.Method:Since October 2009 to July 2017, we included 169 unilateral HC-BPPV patients treated by Li's repositioning maneuver. Then we recorded and analyse 3-day and 1-week outcomes.Result:Three-day efficacy rates of youth, middle aged, young elderly and elderly patients were 97.9%,93.9%,90.9% and 90.% (P=0.136), respectively. Rates of 1-week efficacy were 100.0%,98.5%,97.7%and 100.0% (P=0.799),respectively. There was no statistical difference.Conclusion:Treated by Li's repositioning maneuver,HC-BPPV patients of different age groups can both get good short-term outcomes without statistical difference.

[Treatment of patients with probable benign paroxysmal positional vertigot].

Objective:To study the treatment and outcome of the patients with probable BPPV who lacked typical nystagmus.Method： Nine hundred and twenty-two patients with posterior canal BPPV or lateral canal BPPV were selected from the database of our department. There were 801 patients with typical nystagmus during positional testing and 121 patients lacked of typical nystagmus. Manual reposition (Eply,modified Semount,Barbecue and Li manuve) were used and the follow-up was（3.7±2.5）days.Result：In the patients with probable BPPV,there were 44 patients affected by posterior canal and 77 patients had been affected by lateral canal.In the patients with definite BPPV,there were 489 patients affected by posterior canal and 312 by horizontal canal.There was no statistic difference in the result of the treatment (cure,relief and no response) between the probable BPPV and definite BPPV (P>0.05).However,the rate of 'cure' and 'relief' in the probable BPPV was higher than the definite BPPV in lateral canal (P=0.023).Conclusion:A few patients with probable BPPV may develop to definite BPPV or other disease with dizziness.Maneuver of reposition is meaningful for probable BPPV,especially for patients with lateral canal probable BPPV.

[A randomized controlled trial on short-term efficacy of the modified Semont maneuver for the treatment of posterior canal benign paroxysmal positional vertigo].

Objective:To observe the short-term efficacy of modified Semont maneuver for posterior canal benign paroxysmal positional vertigo (PC-BPPV)Method:This was a prospective randomized controlled trial on 130 PC-BPPV patients. Subjects were randomized divided into two groups: modified Semont (65 patients),and Epley(65 patients).Each maneuver was repeated twice,and the presence of sequelae,nystagmus and vertigo on positional testing were evaluated 3rd day and 1 week after treatment.Result:Five patients were lost to follow up (all five in the modified Semont group),and three patients failed to complete treatment (all three in the Epley group). The sequelae at the 3rd day and one week after modified Semont maneuver were 27 and 9,while 41 and 15 in Epley group. The efficacy rates at the 3rd day and one week after modified Semont maneuver were 91.7% and 98.3%,and 91.9% and 96.8% in Epley group retrospectively. The sequelae and short-term effective rate of patients in modified Semont group was no difference when compared with that in Epley group (P>0.05).Conclusion:Modified Semont maneuver represents a simple rapid and effective approach to the treatment of posterior canal benign paroxysmal positional vertigo.

[Clinical characteristics and short term outcome of very old benign paroxysmal positional vertigo patients].

Objective:To provide evidence and strategy for treatment of very old patients with benign paroxysmal positional vertigo (v-BPPV) by retrospective analysis of v-BPPV patients. Method:According to the criteria, 19 v-BPPV patients were collected, aging from 80 to 91 years old, including 10 horizontal semicircular canal BPPV (HC-BPPV), 4 posterior semicircular canal (PC-BPPV) and 5 mutiple semicircular canal BPPV patients. PC-BPPV patients were treated by Epley or Li maneuver, and HC-BPPV patients were treated by Barbecue or Li maneuver. Each patient was treated twice, with an interval of 5 to 10 minutes. Result:Rates of 3-day cure and efficacy were 63.16% and 94.74%, respectively. Rates of 1-week cure and efficacy were 89.47% and 100.00%, respectively. Conclusion:v-BPPV can have good outcomes via proper treatment. Age should not influence BPPV outcomes, while we should pay more attention to v-BPPV patients' physiclal status and systematic diseases which may increase risk to diagnosis and treatment.

[Lateral semicircular canal cupulolithiasis in children: a case report].

We report a case of lateral semicircular canal cupulolithiasis in a 12 years old child. He presented to ENT clinic due to vertigo and nausea for 4 hours. Roll test showed strong apogeotropic nystagmus for about 70 seconds when roll to the left recumbent position. The right lateral semicircular canal cupulolithiasis was diagnosed. The child was treated with the Li's quick repositioning maneuver and the vertigo was disappeared. His symptoms did not occurred after 6 months follow-up.

[Diagnosis and management of pharyngeal dysphagia].

Objective:To evaluate the effects of different managements on the patients with pharyngeal dysphagia.Method:One hundred patients with pharyngeal dysphagia were recruited for this study.They were divided into three groups after evaluation of swallow function. Then the patients in each groups received treatments include oropharyngeal strengthening exercises, esophageal entrance balloon dilation and cricopharyngeal myotomy, respectively.After 3 months of treatment,the swallow function of the patients was evaluated again to determine the efficacy of the treatments.Result:Seventyfive patients received oropharyngeal strengthening exercises,21 patients received esophageal entrance balloon dilation and 4 patients received cricopharyngeal myotomy. After 3 months of treatment, the effective rates of three groups were 65.33%,76.19% and 75.00%, respectively, with a total efficacy of 68.00%. There was no significant difference of the treatment efficacy among three groups（χ²=0.983，P＞0.05）.Conclusion:Pharyngeal dysphagia can be improved after selected treatments according to the causes and severity of the disease.

Contraction and relaxation of isolated cardiac myocytes of the frog under varying mechanical loads.

The mechanics of cardiac systole and relaxation have been studied primarily at the level of the whole heart or intact muscle. End-systolic pressure-volume relations of frog hearts have been found to be load dependent, whereas those of the mammal are relatively load independent. On the other hand, myocardial relaxation as studied at the muscle level is load independent in the frog but markedly load dependent in the mammal. Interpretation of these studies is complicated because of the unknown contribution of extracellular connective tissue, neurohumoral factors, and, in the case of the heart, the complex chamber geometry. Therefore, it is valuable to study cardiac mechanics at the level of the basic unit of contractile activity--the isolated myocyte. The goal of this study was to subject isolated frog cardiomyocytes to mechanical loading paradigms that mimic those presented to the cells within the heart. In the first part of this study, the afterload and preload of contracting cells were varied to study their effects on the end-systolic force-length relation, which was consistently found to be load independent over the range of isotonic shortening tested (typically 5%). We also investigated the force-length-time response of the cells to test the concept of the heart behaving as a time-varying elastance. Our results suggest that in this regard the frog myocyte behaves like mammalian muscle, and they are consistent with the presence of a small viscosity within the cell. We conclude that the tissue structure of the frog heart may contribute to disparity in mechanical behavior at the different structural levels. In the second part of this study, we subjected isolated frog cardiomyocytes to four different loading paradigms to test the hypothesis that myocardial relaxation in the frog is independent of load. These sequences consisted of afterloaded contractions followed by conventional isotonic-isometric relaxation (ACCR) or afterloaded contractions followed by physiologically reversed isometric-isotonic relaxation (ACPR). Relaxation was measured under isometric conditions using a variable afterload with either the ACCR or ACPR paradigms. The decay of force was independent of the cell length at which it occurred or the amount of shortening prior to it within the contractile cycle. Relaxation also was measured as relengthening of the cell under isotonic late-load conditions, using the ACPR paradigm either with a variable afterload or variable late load. Relengthening had a time course that was unaffected by changes in afterload (i.e., extents of shortening) or late load (equivalent to the filling pressure for the heart).(ABSTRACT TRUNCATED AT 400 WORDS)

[Use of a computer-controlled servo system to produce "ephysiological" contraction of isolated rat papillary muscle].

A computer-controlled servo system consisting of an ergometer with a force-displacement dual mode transducer, a Z-80 single-board microcomputer and a designed software was constructed. This servo system can be used to generate physiological contraction in isolated rat papillary muscle, in which the muscle went through a complete 4-phase cycle of force and length changes, similar to those undergone by muscle fibers in the beating heart during the cardiac cycle. This system is being used to investigate the tension-length relation and the network of isolated myocardium as well as the end-systolic tension-length relation and the force-velocity relation simultaneously.

Design and use of an "optrode" for optical recordings of cardiac action potentials.

An optical method was used to measure action potentials from frog ventricle, in vitro, under normal physiological conditions with 0.5-1 mM Ca2+ Ringer's solution. The approach presented in this paper involves a portable fluorimeter coupled to a multimode optical fiber running into a glass pipette ("optrode") to carry both excitation light to and fluorescence from the ventricle stained with the voltage sensitive dye di-4-ANEPPS. A suction technique was used to stabilize the optrode-tissue interface, significantly reducing motion artifacts from the beating ventricle. The typical fractional change in fluorescence intensity for an action potential was -9%. The optical recordings faithfully reproduced membrane action potentials as measured with microelectrode recordings. To confirm further the validity of our method we studied the effect of an increasing stimulation rate on the optical action potential. The amplitude of the action potential did not increase, and the change in action potential duration was similar to published results obtained with microelectrode recordings, suggesting that our optical action potentials are relatively free of motion artifacts. Finally, our optical recordings suggest that during anodal and cathodal point stimulation, the time course of membrane potential differs from that predicted simply by a passive cable model.

[Left ventricular end-systolic pressure-dimension relation and its sensitility to the positive inotropic factor in the anesthetized open-chest dogs].

Left ventricular end-systolic pressure-dimension relation (ESPDR) was generated by the transient occlusion of the inferior vena cava (IVC) or thoracic aorta (AO) in 13 anesthetized open-chest dogs, while the left ventricular pressure was measured by a TP-200T pressure transducer and the anterior-posterior dimension was measured by a pair of ultrasonic crystal implanted in the endocardium and recorded by a Sonomicrometer. The results showed that: (1) the ESPDR was shown to be linear, unaltered by preload or afterload changes; (2) dobutamine produced a significant increase in the slope (Emax) of the ESPDR-IVC and ESPDR-AO relations, without remarkable effect on the dimension-axis intercept (Do). However, the change in Emax was more significant for ESPDR-IVC (174.43 +/- 23.48%, n = 18), as compared with that for the ESPDR-AO (71.02 +/- 12.46%, n = 12); (3) Do of the ESPDR-AO relation was smaller than that of the ESPDR-IVC both under control and during dobulamine infusion. We conclude that the linear ESPDR can be derived in the anesthetized open-chest dogs either by caval occlusion or by aortic occlusion, and the slope appears to reflect left ventricular contractility. However, techniques used to generate the ESPDR may influence results, including the Do and the sensitivity of Emax to the inotropic state.