[Objective characteristics of nystagmus in patients with posterior semicircular canal benign paroxysmal positional vertigo]

Objective: To analyze and discuss the parameters and clinical significance of nystagmus in patients with benign positional paroxysmal vertigo (BPPV) of posterior semicircular canal. Methods: The subjects of the study were 564 BPPV patients diagnosed with posterior semicircular canal canalithis (PSC-can) from January 2016 to July 2017 in Tianjin No.1 Central Hospital, including 186 males and 378 females, with a median age of 57 years. The induced nystagmus in Dix-Hallpike test was recorded by video nystagmuo graph(VNG), and the direction, latency, duration time and intensity characteristics of nystagmus were compared with the position of hanging and sitting.SPSS17.0 software was used for statistical analysis. Results: Vertical torsional nystagmus was both induced with the position of hanging and sitting during Dix-Hallpike test. The vertical direction of the induced nystagmus was upward and downward respectively. The latency, duration time and intensity of lesion side were L(2.65±1.92; 1.44±1.24), D(14.90±10.46; 15.28±8.06), and P(29.75±21.26; 14.08±9.48). The latency and intensity in hanging position were higher than those of sitting. The intensity rate was about 2∶1, with statistically significant difference (t=13.831, and 17.296, P all<0.01). The direction of the induced nystagmus was opposite to turning in HSC-Can BPPV. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2∶1, the difference was statistically significant (t=17.296, P<0.01). There was no statistical difference of nystagmus during time between the two positions(t=-0.735, P>0.05). Conclusions: The nystagmus intensity rate in Dix-Hallpike test between hanging and sitting position of lesion side in PSC-Can is 2∶1, which conforms to the Ewald's law. The direction, latency and intensity of nystagmus can be used as a reference index for the localization diagnosis of PSC-Canotolith.

[Nephrogenic clear cell carcinoma of nasal cavity：a case report]

SummaryRenal clear cell carcinoma（RCCC） is the most common type of renal cell carcinoma, but metastasis to the nasal cavity is extremely rare. A case of RCCC to the nasal cavity and paranasal sinuses was reported. The early clinical manifestations of this case were intermittent epistaxis and subsequent massive epistaxis. Imaging examination revealed that there were masses in the nasal cavity and paranasal sinus, accompanied by bleeding and destruction of the skull base. Renal CT examination showed a tumor in the right kidney, and considered the patient suffering from renal cell carcinoma. The patient underwent a nasal side incision to remove the tumor, the patient's pathological return; nasal nephrogenic clear-cell carcinoma.

[The value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis]

Objective: To investigate the value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis (UVCP). Methods: From May 2015 to April 2018, 51 patients with UVCP and 59 healthy controls in Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, were involved in this research retrospectively. The UVCP patients were diagnosed with stroboscopic laryngoscopy. The minimum glottal area (MGA) was calculated by KIPS software when the people were pronouncing/i:/. The fundamental frequency (F0), Jitter, Shimmer and NHR were detected by CSL4500 multiple acoustic voice analyzer. Results: MGA of UVCP patients was much higher than that of healthy control (male: 433.68±64.52 vs. 294.41±51.82, t=9.23, P=0.000; female: 498.80±73.42 vs. 302.03±76.54, t=13.21, P=0.000), which meaned vocal cord insufficiency.After voice therapy, MGA reduced significantly (male: 288.48±55.09, female: 258.22±57.17, t=24.41 and 31.22, P=0.000 vs. pre-therapy). MGA of untreated patients decreased in varying degrees. Compared with the voice therapy group, the MGA decreased in a significantly lower extent (24.25±22.91 vs. 188.31±54.37, t=8.97, P=0.000). The F0, Jitter, Shimmer and NHR raised significantly in UVCP patients group (P=0.000 vs. healthy control group), and they were reduced by voice therapy (all P<0.05). Each of the four acoustic parameters was relative with MGA, r=0.551, 0.867, 0.853 and 0.875 in turn, P=0.001, 0.000, 0.000, and 0.000. Conclusion: MGA and acoustic parameters can reflect the acoustic features of UVCP patients, which are useful tools in the UVCP assessment and voice therapy.

[The characteristics of semicircular canal injury frequency in vestibular neuritis patients]

Objective:To evaluate the frequency characteristics of semicircular canal injury in patients with vestibular neuritis. Method:Fifty-three patients with vestibular neuritis were respectively evaluated by caloric test(CT)，head shaking test(HST),video head impulse test (vHIT),which reflects semicircular canal function in the low, middle, high frequency region. The asymmetric value of CT unilateral semicircular canal reaction (UW), head shaking nystagmus induced by HST, gain value of VHIT (VHIT-G) and presence or absence of saccade (VHIT-S) were used as observation indicators. The data were analyzed by SPSS 17.0 statistical software.The characteristics of the results of the three tests in patients with vestibular neuritis was analyzed and the functional status of the high, middle and low frequency regions of the semicircular canal was evaluated. Result:The positive rates of CT, HST, VHIT-G and VHIT-S in 53 patients with vestibular neuritis were 94.3%（50/53）,75.5%（40/53）,81.1%（43/53）,96.2%（51/53）,respectively. The positive rates of CT, HST, VHIT-G and VHIT-S were 92.9%（26/28）,89.3%（25/28）,92.9%（26/28）,96.4%（27/28）in 28 cases with disease course ≤ 7 days, and the positive rates in 25 patients with disease course >7 days were 96.0%（24/25）,60.0%（15/25）,68.0%（17/25）,96.0%（24/25）,respectively. Compared with the positive rate of each index, CT and VHIT-G (P=0.076), HST and VHIT-G (P=0.480) had no statistical significance. The difference between CT and HST (P=0.015), VHIT-G and VHIT-S(P=0.032) was statistically significant. The positive rates of CT, HST, VHIT-G and VHIT-saccade in patients with course of disease ≤7 days were compared, and there was no significant difference. In patients with disease course >7 days, except HST and VHIT-G, there were statistical differences in other indexes. The correlation test between VHIT-G and VHIT-S：r=-0.437, P=0.006. Conclusion:The vestibular injury in patients with vestibular neuritis showed in a manner of full frequency injury. The multi-frequency detection technique is helpful for the clinical diagnosis of vestibular neuritis, and also can reflect the compensation and recovery of vestibular function.

[Economic burden of hepatitis C patients and related influencing factors in Guangdong province]

Objective: To investigate the economic burden of hepatitis C patients and related factors in Guangdong province. Methods: In this study, cluster sampling method was used to select cases, including acute hepatitis C, chronic hepatitis C and liver cirrhosis cases from eligible outpatients and inpatients in 1 or 2 large general hospitals in all the 21 cities in Guangdong province. Questionnaire survey was conducted for all the hepatitis C patients to analyze their economic burden, while multivariate linear regression model was used to identify the related influencing factors. Results: A total of 356 hepatitis C patients were enrolled in the study, with 176 outpatients (49.4%) and 180 inpatients (50.6%) respectively. The average age of the study subjects was (44.79±11.73) year-olds. The annual direct economic costs of patients with acute hepatitis C, chronic hepatitis C and liver cirrhosis were 10 703.22 (IQR: 7 396.75-16 891.91), 14 886.63 (IQR: 7 274.00-30 228.25) and 28 874.00 (IQR: 13 093.69-56 350.00) Yuan (RMB) respectively. The annual indirect costs appeared as 2 426.99 (IQR: 1 912.18-7 354.52), 3 235.99 (IQR: 1 323.81-6 619.07) and 5 442.35 (IQR: 3 235.99-10 296.33) Yuan (RMB) respectively. The annual intangible costs were 5 000.00 (IQR:2 000.00-10 000.00), 10 000.00 (IQR: 4 000.00-30 000.00) and 10 000.00 (IQR: 3 000.00-100 000.00) Yuan (RMB) respectively. The annual total costs were 22 306.17 (IQR: 14 581.24-50 569.17), 38 050.33 (IQR: 17 449.57-68 319.62) and 80 152.18 (IQR: 40 856.09-228 460.79) Yuan (RMB) respectively. Results from the multiple linear regression analysis showed that factors as: annual hospitalization days, annual number of outpatient visits, annual number of hospitalization, type of disease and the levels of the hospitals were related to the economic burden of patients with hepatitis C. Conclusion: Patients with HCV-related diseases presented serious economic problem which calls for close attention in Guangdong province.

[Epidemiologic characteristics and strategies on prevention and control of sexually transmitted human immunodeficiency virus/acquired immunodeficiency syndrome in China]

At present, sexual route is the main transmission route of AIDS in China, and its role in the process of AIDS epidemic has been evolving. Various modes of transmission in sexual transmission and the prevention and control strategies adopted by China have also been changing. This paper mainly summarizes the epidemic characteristics of different periods and different modes of transmission of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in China in recent years. The strategies of prevention and control were described from seven aspects, including health education, promotion of condom use, expanded testing, HIV/AIDS antiviral treatment, pre-exposure prophylactic medication, post-exposure prophylactic medication, social organization participation and sexually transmitted diseases prevention and control. Only when innovative and targeted measures according to the evolution of the HIV/AIDS epidemic and various specific methods are complemented by each other, can the transmission of HIV/AIDS through sexual route be effectively prevented and controlled.

[Epidemiological characteristics and latent class analysis of non-marital heterosexual behaviors among human immunodeficiency virus/acquired immunodeficiency syndrome individuals in Jiangmen, Guangdong province between 2015 and 2017]

Objective: To study the epidemiological characteristics and latent classes of non-marital heterosexual transmission among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) individuals in Jiangmen, Guangdong province between 2015 and 2017. Methods: HIV/AIDS cases from Chinese HIV/AIDS Comprehensive Response Information Management System were collected from January 1, 2015 to December 31, 2017. Inclusion criteria of HIV/AIDS were heterosexual transmission, non-marital heterosexual contact and older than 15 years. Exclusion criteria were homosexual contact, repeated reports, injecting drugs, current address in the non-Jiangmen area and not classified non-marital heterosexual contact. A total of 665 HIV/AIDS cases were included in this study. The general demographic characteristics (gender, age, ethnicity, education, occupation, etc.), floating population characteristics, HIV high-risk behaviors, HIV testing and other information were collected from database. Chi square test was used to compare the infection status of HIV/AIDS with different characteristics through commercial channels, and the latent class model was used to analyze the latent classes of HIV/AIDS. Results: Among 665 cases, the age was (48.73±15.61) years old. And 46.5% (309/665) cases were married and 73.8% (491/665) were male. Four classes were identified as heterogeneous sub-population by the latent class analysis: the first class occupied 40.13% (267 cases) with feature of nearly equal proportion of males and females and higher proportion of non-service industry workers; the second class occupied 37.40% (248 cases) with features of more than 46 years old, nearly all males, high proportion of farmers, high proportion of marital status, low education and the low propensity of floating; the third class occupied 11.90% (79 cases) with feature of cases from voluntary HIV testing and counseling in center for disease control and prevention; the forth class occupied 10.57% (70 cases) with the feature of less 45 years old, high proportion of service industry workers, no marital history and higher education. Conclusions: HIV/AIDS transmitted by non-marital heterosexual sex in Jiangmen city during 2015-2017 could be divided into four latent classes according to epidemic characteristics, which could provide appropriate classified guidance for AIDS prevention and treatment.

Efficacy and safety of rituximab therapy for membranous nephropathy: a meta-analysis

OBJECTIVE

Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults, but the treatment of MN remains controversial. Rituximab, a possible alternative treatment option, represented a new therapeutic hope for the treatment of membranous nephropathy (MN). We performed a meta-analysis to perform the efficacy and safety of rituximab therapy.

MATERIALS AND METHODS

Either randomized controlled trials (RCTs), cohort studies or case studies were eligible for review and were performed in Medline, Embase, Web of Science, Cochrane database with the computerized searches. The primary outcome measure was remissions and the endpoint outcomes. We assessed the following studies methodological quality independently by using the Cochrane Collaboration tool for assessing risk of bias scale. The primary meta-analyses were performed using fixed or random effects models due to a1n expected clinical diversity.

RESULTS

Five trials with a total of 351 patients were included. We found significant difference between rituximab and the placebo group on complete remissions rate (OR=1.6, 95%; CI=0.96, 2.66; I2 of 0% indicating no heterogeneity) and eGFR (MD=-0.69, 95% CI=-14.53, 0.73). The factors of remission and no remission MN patients who received treatment with rituximab on remission were proteinuria and albumin, which reported different (MD=7.20, 95% CI=-9.07, -5.33) (MD=10.70, 95% CI=7.23, 14.17). But remains high risk of infusion reactions (OR= 81.37, 95% CI=4.89, 1354.41). No evidence of significant risk of bias was reported.

CONCLUSIONS

Rituximab had a beneficial effect and remissions of proteinuria on MN during follow-up times, but some adverse events were still unknown. Taking consideration of long-term therapeutic side effects and dose of the drug, we suggest that rituximab might replace cyclophosphamide and steroids as first-line immunosuppressive therapy in MN patients.

[The nystagmus characteristics of two positions of the horizontal semicircular canal cupulolithiasis]

Objective: To analyze the characteristics of nystagmus of horizontal semicircular canal cupulolithiasis(HSC-Cup) in Roll test and Dix-Hallpike test. Methods: Between December 2016 and December 2017, a total of 164 patients with BPPV from Tianjin First Center Hospital, 124 HSC-Can BPPV and 40 HSC-Cup BPPV, were involved.The induced nystagmus in Roll test and Dix-Hallpike test were recorded by video-nystagmograph(VNG), whose direction and intensity characteristics were compared in various BPPV. Results: HSC-Can patients were induced a horizontal nystagmus with Roll test, the nystagmus intensity of the disease and healthy side were (41.3±20.1)°/s (mean standard deviation)and(21.9±9.4)°/s respectively, the difference was statistically significant (t=6.709, P<0.05). HSC-Cup patients were induced a horizontal nystagmus that was opposite to the direction of the Roll test, the nystagmus intensity of the disease and the healthy side were (12.9±6.4)°/s and(29.1±9.3)°/s respectively, with significant difference (t=9.066, P<0.05). Among 124 cases of HSC-Can patients, 120 cases of horizontal nystagmus were recorded in the left and right sides of the Dix-Hallpike test in the same direction as the turning direction, the horizontal nystagmus intensity of the disease and the healthy sides were (15.1±10.0)°/s and(9.4±7.4)°/s respectively, the difference was statistically significant (t=2.365, P<0.05). And 40 cases of HSC-Cup patients were recorded at the head of the Dix-Hallpike test in the opposite direction to the horizontal eye earthquake.The horizontal nystagmus intensity of the disease and the healthy side were (5.3±2.8)°/s and(13.9±4.4)°/s respectively, the difference was statistically significant (t=10.579, P<0.05). Conclusions: Characteristic horizontal nystagmus can be induced by HSC-Cup in both roll test and Dix-Hallpike test. Preliminary localization of Dix-Hallpike Test can also be used for HSC-Cup.

[The characteristics and clinical significance of vestibular autorotation test in patients with vestibular migraine]

Objective: To investigate the characteristics and clinical utility of vestibular autorotation test (VAT) in patients with vestibular migraine(VM). Methods: This study included two groups, a VM group (441 patients from Tianjin First Center Hospital between January 2015 and May 2016) and a control group (65 healthy subjects). Both groups undertook VAT; the parameters evaluated were horizontal gain/phase, vertical gain/phase and asymmetry. The differences in VAT results between the two groups were investigated. Results: There were statistically significant differences in VAT results between the VM and the control group, namely elevated horizontal gain at frequency 2, 3, 4 and 5 Hz, delay horizontal phase at frequency 2, 4, 5 and 6 Hz, elevated vertical gain at frequency 2-6 Hz and delay vertical phase at frequency 4-6 Hz. There was no significant difference in asymmetric values between the VM group and the control group. Conclusions: The results of this study indicate that VM patients have elevated horizontal gain and vertical gain, and delay horizontal phase and vertical phase. It is suggested that VAT represents a useful diagnostic tool which may provide objective evidence for the diagnosis and differential diagnosis of VM.

[The diagnosis and treatment of thyroid microcarcinoma]

Thyroid microcarcinoma(TMC)refers to the diameter less than 1 cm in thyroid carcinoma.With the development of high frequency ultrasound and pathological diagnosis technology,the incidence of TMC increased.Preoperation examination methods include routine ultrasound､ultrasound elastography､CT and fine needle aspiration biopsy.But its treatment methods are controversal.In this paprer,we review the present status in the diagnosis and treatment of thyroid microcarcinoma.

[A pilot study of the unilateral centrifugation subjective visual vertical in healthy young people]

Objective: To evaluate the data of unilateral centrifugation subjective visual vertical (UC-SVV) in healthy young people.To study the function of utricle. Methods: Between Decem ber 2017 and May 2018, thirty-two healthy young volunteers were tested by static subjective visual vertical(SVV) and low velocity UC-SVV with Neuro Kinetics Inc I-portal 6.0 Video nystagmus recording system and NOTC rotating chair system.The static SVV preset angle were -15.00°, 15.00°, -20.00°, 20.00°, -12.00° and 12.00° respectively.UC-SVV test parameters: rotating chair's peak speed was 60°/s.The shift time from the middle to the lateral position was 30 s and the displacement was 3.85 cm.The chair rotated at 60 s at left, right and middle positions.Subjects underwent SVV during this period.SPSS 17.0 software was used to analyze the data. Results: The mean and standard deviation of static SVV deviation in 32 volunteers was 0.21°±0.17°, 95%CI (-0.14°, 0.55°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the clockwise was 0.24°±0.25°, -0.10°±0.27°, -0.63°±0.26°, 95%CI(-0.26°, 0.74°), (-0.65°, 0.44°), (-1.16°, -0.10°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the counter clockwise was 0.03°±0.27°, -0.11°±0.26°, -0.23°±0.26°, 95%CI(-0.52°, 0.59°), (-0.65°, 0.42°), (-0.76°, 0.30°). There was significant difference in the deviation between the left and the right side of counter clockwise rotation of UC-SVV(t=2.432, P<0.05), however, there was no significant difference in the angle of deviation between the left and right sides and the median position(t value was 0.951, -1.400, both P>0.05). There was no significant difference among each position in clockwise rotation of UC-SVV(F=0.253, P>0.05). Conclusion: UC-SVV test with peak speed of 60°/s can cause vertical line deviation in the left and right lateral position, but the angle is small and the value of clinical application is limited.

[Comparison of the short-term and long-term curative effect and prognosis of 102 patients with sudden deafness]

Objective:To compare the short-term and long-term curative effect and prognostic factors of 102 patients with sudden deafness.Method:The clinical data of 102 patients with sudden deafness from 2012 to 2014 were analyzed retrospectively. Pure tone hearing thresholds were measured in patients with sudden deafness for 2 weeks after treatment and 3 to 5 years after discharge, in order to evaluate the short-term and long-term effects, and related prognostic factors were also compared.Result:The short-term total effective rate of 102 patients with sudden deafness was 56.86%, and the long-term total effective rate was 69.61%.Under the same influence factors(female group, TG abnormal group,LDL abnormal group,HDL abnormality,blood rheology abnormality),the long-term total effective rate was greater than the short-term total effective rate(P<0.05),the difference was statistically significant.Further analysis of the influencing factors of the prognosis of sudden deafness found that audiogram shapes, blood rheology and blood lipid(TC,LDL,HDL),age,were the same prognostic factors of sudden deafness. Different audiogram shapes,normal and abnormal hemorheology group,normal blood lipid group and abnormal group,the curative effect of different age groups,the difference which the results of each group were compared was significant(P<0.05). However, there were differences between short-term and long-term prognostic factors.The short-term prognostic factors were also related to blood glucose and TG,the difference between normal blood glucose group and abnormal was significant(P<0.05). The difference between the normal TG group and the abnormal group was compared,the difference was significant(P<0.05).Conclusion:The long-term curative effect of sudden deafness was better than that of the short-term.

Bombyx mori epidermal growth factor receptor is required for nucleopolyhedrovirus replication

Baculovirus-host interactions are important models for studying the biological control of lepidopteran pests. Research on baculovirus-host interactions has focussed on baculovirus manipulation of cellular signalling pathways, including the extracellular signal-regulated kinase (ERK) and phosphatidylinositol-3-kinases/protein kinase B (PI3K/Akt) signalling pathways. However, the mechanism underlying ERK and PI3K/Akt activation and function in response to baculovirus infection remains poorly understood. Here, we demonstrated that baculovirus activated the Bombyx mori ERK and PI3K/Akt signalling pathways via the B. mori epidermal growth factor receptor (BmEGFR). To further characterize the function of the BmEGFR/ERK signalling pathway in baculovirus replication, we calculated genome-wide changes in kinase-chromatin interactions for ERK after baculovirus infection using chromatin immunoprecipitation followed by high-throughput sequencing. A Gene Ontology analysis showed that virus infection had effects on the biological regulation, cellular process and metabolic process pathways. Moreover, ERK was shown to regulate the transcription of late viral genes. Taken together, our results suggest that baculoviruses manipulate components of the host cell machinery for replication via modulation of the BmEGFR signalling pathway.

Nanoscale diffusive memristor crossbars as physical unclonable functions

Physical unclonable functions have emerged as promising hardware security primitives for device authentication and key generation in the era of the Internet of Things. Herein, we report novel physical unclonable functions built upon the crossbars of nanoscale diffusive memristors that translate the stochastic distribution of Ag clusters in a SiO₂ matrix into a random binary bitmap that serves as a device fingerprint. The random dispersion of Ag led to an uneven number of clusters at each cross-point, which in turn resulted in a stochastic ability to switch in the Ag:SiO₂ diffusive memristors in an array. The randomness of the dispersion was a barrier to fingerprint cloning and the unique fingerprints of each device were persistent after fabrication. Using an optimized fabrication procedure, we maximized the randomness and achieved an inter-class Hamming distance of 50.68%. We also discovered that the bits were not flipping after over 10⁴ s at 400 K, suggesting superior reliability of our physical unclonable functions. In addition, our diffusive memristor-based physical unclonable functions were easy to fabricate and did not require complicated post-processing for digitization and thus, provide new opportunities in hardware security applications.

[The characteristic of vestibular ocular reflex in patients with vestibular migraine]

Objective:Analysis of vestibular ocular reflex (VOR) in patients with vestibular migraine (VM) by vestibular autorotation test (VAT). To explore the clinical value of VAT technology in the diagnosis of vestibular migraine.Method:Sixty-nine patients with VM, 73 patients with posterior circulation (PCI) vertigo and 65 normal people were examined by VAT test. The characteristics of vestibular ocular reflex were analyzed by using VAT gain, phase and asymmetry among them.Result:①Among the 69 cases of VM patients,54 cases (78.3%) were horizontal or vertical gain abnormalities, 66 cases (95.7%) were horizontal or/and vertical phase delay, and 13 cases (18.8%) were asymmetric abnormalities. ②Among the 54 (78.3%) cases of abnormal gain, 46 (66.7%) cases demonstrated high gain, 42 had high gain combined with high phase, and 36 cases were simple horizontal high gain (and mainly concentrated at 2-4 Hz, 26 cases), 8 cases (11.6%) showed low gain. ③VAT characteristics in PCI group:47 cases (64.4%) were high gain, and 11 cases (15.1%) were low gain. There was no significant difference in high gain and low gain between PCI group and VM group (χ² was 0.07 and 0.37, P>0.05). Both VM group and PCI group are high-gain, but there was significant difference in the phase delay and asymmetric indicators. ④VAT characteristics in normal people group: The four indices have low abnormally positive rates. There were statistically significant differences of the high gain and the low gain between the normal people group and VM group(χ² were 56.17 and 97.57, P<0.01).Conclusion:The vestibular ocular reflex of VM is high-gain based and was mostly in the 2-4 Hz frequency,and accompanied by phase delay. Vestibular central system was mainly involved in VM. VAT detection can provide a clue for VM diagnostics.

[Experimental model study on Li's repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo]

Objective:Based on the standard spatial semicircular canal model, the scientificity and feasibility of Li's repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo were analyzed.Method:The standard space semicircular canal model was established. The significance and shortcomings of each step were analyzed by simulating and observing the Li's repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo.Result:According to the model of semicircular canal, the otoliths of horizontal semicircular canal are more likely to return to the ampulla instead of moving into the utriculus through the semicircular canal after using Li's repositioning maneuver.Conclusion:The experimental model suggests that Li's repositioning maneuver omits the necessary steps of repositioning method, and can not simulate the result of the reposition of otoliths.

[The exploration on optimization of two alternatives between roll test and Dix-Hallpike test in benign paroxysmal positional vertigo]

Objective: To analyze the objective characteristics of roll test and Dix-Hallpike test in benign paroxysmal positional vertigo(BPPV)patients, discussing the premier solution of positional test. Methods: A total of 230 patients with BPPV, whereas 170 posterior semicircular canal canalithiasis (PSC-Can) BPPV and 60 horizontal semicircular canal canalithiasis (HSC-Can) BPPV were involved respectively. The induced nystagmus in roll test and Dix-Hallpike test was recorded by video nystagmuo graph (VNG), and the direction, intensity and time characteristics of nystagmus were compared in various BPPV.SPSS19.0 software was used for statistical analysis. Results: Vertically upward nystagmus was induced by hanging in 170 PSC-Can Dix-Hallpike test, and the nystagmus reversed and turned weaker when the subjects came to sit. The intensity of nystagmus at turning to lesion side by hanging and sitting were (30.3±14.1)°/s and (12.6±7.5)°/s respectively, the difference was statistically significant (t=20.153, P<0.05). However, no nystagmus was induced in PSC-Can roll test. Horizontal nystagmus in the same direction with turning was induced in 60 HSC-Can roll test. The intensity of nystagmus at turning to lesion side and normal side was (42.0±18.0)°/s and (20.3±8.7)°/s respectively, the difference was statistically significant (t=12.731, P<0.05). Furthermore, horizontal nystagmus in the same direction with turning was induced in 57 HSC-Can Dix-Hallpike. The coherence was 95% with the results of roll test. Conclusions: Dix-Hallpike test can not only be used to diagnose PSC-Can, but also induce nystagmus in HSC-Can effectively. Whereas the roll test only show significance in diagnosing HSC-Can. To avoid uncomfortable stimulation to patients as much as possible, we suggest to use Dix-Hallpike test at first, and to judge whether using roll test based on the result of the horizontal nystagmus.

Radiographic progression with nonrising PSA in metastatic castration-resistant prostate cancer: post hoc analysis of PREVAIL

BACKGROUND

Advanced prostate cancer is a phenotypically diverse disease that evolves through multiple clinical courses. PSA level is the most widely used parameter for disease monitoring, but it has well-recognized limitations. Unlike in clinical trials, in practice, clinicians may rely on PSA monitoring alone to determine disease status on therapy. This approach has not been adequately tested.

METHODS

Chemotherapy-naive asymptomatic or mildly symptomatic men (n=872) with metastatic castration-resistant prostate cancer (mCRPC) who were treated with the androgen receptor inhibitor enzalutamide in the PREVAIL study were analyzed post hoc for rising versus nonrising PSA (empirically defined as >1.05 vs ⩽1.05 times the PSA level from 3 months earlier) at the time of radiographic progression. Clinical characteristics and disease outcomes were compared between the rising and nonrising PSA groups.

RESULTS

Of 265 PREVAIL patients with radiographic progression and evaluable PSA levels on the enzalutamide arm, nearly one-quarter had a nonrising PSA. Median progression-free survival in this cohort was 8.3 months versus 11.1 months in the rising PSA cohort (hazard ratio 1.68; 95% confidence interval 1.26-2.23); overall survival was similar between the two groups, although less than half of patients in either group were still at risk at 24 months. Baseline clinical characteristics of the two groups were similar.

CONCLUSIONS

Non-rising PSA at radiographic progression is a common phenomenon in mCRPC patients treated with enzalutamide. As restaging in advanced prostate cancer patients is often guided by increases in PSA levels, our results demonstrate that disease progression on enzalutamide can occur without rising PSA levels. Therefore, a disease monitoring strategy that includes imaging not entirely reliant on serial serum PSA measurement may more accurately identify disease progression.

[The analysis of the value of spontaneous nystagmus in peripheral vestibular hypofunction]

Objective:To study the characteristics and clinical value of spontaneous nystagmus in patients with peripheral vestibular dysfunction.Method:Sixty cases with acute unilateral peripheral vestibular dysfunction were studied.All were diagnozed as vestibular neuritis(VN) . The relationship between SN and disease duration,DP and UW were analyzed.Result:SN was present in49 patients(81.7%)and absent in the remaining 11(18.3%).The intensity of SN ranged from 0.5°/s-20.4°/s and had negative correlation with the disease duration(r=-0.478，P<0.01). The patients were divided into 3 groups (mild,medium and severe) according to SN intensity,with median duration of disease being 6.5 d，5 d and 3 d respectively. The difference between groups was statistically significant(χ²=9.071，P<0.01).The result of the caloric test were as following：caloric test revealed DP in 44 cases（89.8%） of SN ;DP values were normal in 8 cases（10.2%）;SN intensity was positively correlated with DP value（r=0.513,P<0.01） ;unilateral weakness was found in 35 cases（71.4%）,with the direction of SN towards the weakness side in 4 cases and towards the opposite direction in the remaining 31 cases; 7 cases（14.3%）had bilateral weakness and 7 cases（14.3%）normal. There were no relationship between the intensity of SN and UW value（r=-0.321,P>0.05）.The UW value of patients with SN (40.9±26.3）% was compared to the group without SN（29.9±18.2）% . The difference was statistically significant (F=4.497,P<0.05).Conclusion:The intensity of SN in patients with acute unilateral peripheral vestibular dysfunction was often moderate and severe. The intensity of SN waned as the disease progressed or the direction reversed,The vestibular injury in patient with SN was more severe than those without. SN is useful in clinical assessment of vestibular injury and compensatory status.

Recent advances in the detection of specific natural organic compounds as carriers for radionuclides in soil and water environments, with examples of radioiodine and plutonium

Among the key environmental factors influencing the fate and transport of radionuclides in the environment is natural organic matter (NOM). While this has been known for decades, there still remains great uncertainty in predicting NOM-radionuclide interactions because of lack of understanding of radionuclide interactions with the specific organic moieties within NOM. Furthermore, radionuclide-NOM studies conducted using modelled organic compounds or elevated radionuclide concentrations provide compromised information related to true environmental conditions. Thus, sensitive techniques are required not only for the detection of radionuclides, and their different species, at ambient and/or far-field concentrations, but also for potential trace organic compounds that are chemically binding these radionuclides. GC-MS and AMS techniques developed in our lab are reviewed here that aim to assess how two radionuclides, iodine and plutonium, form strong bonds with NOM by entirely different mechanisms; iodine tends to bind to aromatic functionalities, whereas plutonium binds to N-containing hydroxamate siderophores at ambient concentrations. While low-level measurements are a prerequisite for assessing iodine and plutonium migration at nuclear waste sites and as environmental tracers, it is necessary to determine their in-situ speciation, which ultimately controls their mobility and transport in natural environments. More importantly, advanced molecular-level instrumentation (e.g., nuclear magnetic resonance (NMR) and Fourier-transform ion cyclotron resonance coupled with electrospray ionization (ESI-FTICRMS) were applied to resolve either directly or indirectly the molecular environments in which the radionuclides are associated with the NOM.

[Application of narrow band imaging in laryngeal tumor]

Objective:To explore the application of narrow band imaging(NBI) technology in laryngeal tumor.Method:From Appril 2014 to Otober 2016, three hundred and twenty-two patients with suspected laryngeal cancer or precancerous lesions were enrolled in the First Central Hospital of Tianjin. Each patient was examined by electronic nasopharyngolaryngoscope under white light and NBI model. The sensitivity, specificity and accuracy of laryngeal tumor diagnosis under white light mode and NBI mode was compared based on pathological results. Result:The sensitivity, specificity and accuracy of white light mode in laryngeal tumor diagnosis were 77.17%,62.07% and 74.36%, respectively whereas the NBI model were 92.91%,77.59% and 90.06%, respectively.The sensitivity and accuracy of NBI model in laryngeal tumor diagnosis were significantly higer than white light model(P<0.05),but not the specificity. Conclusion:The electronic nasopharyngolaryngoscope of NBI technology not only found early lesions of laryngeal cancer, but also can improve the sensitivity and accuracy of laryngeal tumor diagnosis.

Systems Pharmacology-Based Discovery of Natural Products for Precision Oncology Through Targeting Cancer Mutated Genes

Massive cancer genomics data have facilitated the rapid revolution of a novel oncology drug discovery paradigm through targeting clinically relevant driver genes or mutations for the development of precision oncology. Natural products with polypharmacological profiles have been demonstrated as promising agents for the development of novel cancer therapies. In this study, we developed an integrated systems pharmacology framework that facilitated identifying potential natural products that target mutated genes across 15 cancer types or subtypes in the realm of precision medicine. High performance was achieved for our systems pharmacology framework. In case studies, we computationally identified novel anticancer indications for several US Food and Drug Administration-approved or clinically investigational natural products (e.g., resveratrol, quercetin, genistein, and fisetin) through targeting significantly mutated genes in multiple cancer types. In summary, this study provides a powerful tool for the development of molecularly targeted cancer therapies through targeting the clinically actionable alterations by exploiting the systems pharmacology of natural products.

[Frequency characteristics of the semicicular canals damage in patients with Meniere disease]

Objective: To evaluate semicircular canal damage and its frequency characteristics in Meniere disease patients. Methods: Sixty-seven Meniere disease patients accepted the video-head impulse test(vHIT)which responses to semicircular canal function of high frequency area, head shaking test(HST) which responses to semicircular canal function of middle frequency area, and caloric test(CT) which responses to semicircular canal function of low frequency area.Preferences were recorded including the video head impulse test gain (vHIT-G), head shaking nystagmus (HSN) and parameters of the unilateral weakness (UW) as observation index, and results of all the three tests were analyzed according to Meniere disease patients. SPSS 17.0 software was used to analyzed the data. Results: The positive rate of CT, HSN and vHIT were 70.1%(47/67), 41.8%(28/67) and 23.9%(16/67) respectively. Comparation of the positive rate among CT, HST and vHIT showed statistically significant difference (χ²=10.93, P=0.001; χ²=28.79, P=0.000). Comparation of the positive rate between HST and vHIT showed statistically significant difference(χ²=4.87, P=0.027). Conclusions: Semicircular canal function damage in Meniere disease patients mainly presents in the low frequency area, which indicates a characteristic phenomenon that low-frequency function area (caloric test results) is more predisposed to be involved than that of middle-frequency function area (head shaking testing)and high-frequency function area (video head impulse testing) in Meniere disease patients.

Copy Move Forgery Image Detection via Discrete Radon and Polar Complex Exponential Transform-Based Moment Invariant Features

Copy move forgery with geometric distortions such as the rotational operation, the scaling operation, the mirror operation and the additive noise operation became more common. Existing methods are not competent for the detection of the copy move forgery with these distortions. In fact, the most critical issue for the detection of the forgery is the determination of the geometric features. This paper proposes an efficient Discrete Radon Polar Complex Exponential Transform (DRPCET)-based method for the extraction of the rotational and the scaling invariant features for the copy move forgery detection. First, the features obtained by the Radon transform (RT) and the Polar Complex Exponential Transform (PCET) are fused together. Then, these features are normalized. In order to achieve the scaling invariant property, an auxiliary circular template is introduced. With the auxiliary circular template, the translational moment invariant features, the rotational moment invariant features and the scaling moment invariant features are constructed for the extraction of the planar geometrical features. By further extracting some useful features for the representation of the image background, the interference of the background information can be reduced. After extracting the geometrical features, the lexicographic sorting is applied. Then, a correlation between the same part or similar parts of the image which are copied and moved to another image is computed. Based on the obtained correlations, these forgery parts can be identified and their composed positions can be located. Finally, these images are denoted as the forgery image. Extensive computer numerical simulations have been performed. The obtained results show that the proposed method can detect the copy move region in the forgery image precisely even though the forgery regions are suffered from the mixed geometric distortions.