[Research progress on the questionnaire related to persistent postural-perceptual dizziness].

Persistent postural-perceptual dizziness（PPPD） is the most common chronic vestibular disease, the clinical manifestation is dizziness, unstable and non-rotational dizziness for three months or more. And the symptom is exacerbated by upright posture, active or passive movement, and complex visual stimuli. In addition, PPPD is a functional disease, so routine vestibular function tests and imaging tests are often negative. According to the diagnostic criteria established by the Barany Association, the diagnosis of PPPD often relies on history. This article provides a review of PPPD-related questionnaires.

[Clinical application progress of subjective visual vertical test].

Subjective visual vertical test is considered as an effective technique to evaluate otolith organ function and central pathway of gravity perception. This test is non-invasive, easy to operate and has little stimulation. At present, there are few such studies in China. This paper reviews the concept, measurement principle and method, influencing factors, application, advantages and disadvantages of subjective visual vertical test.

[Application of computerized cognitive behavioral therapy in patients with persistent postural-perceptual dizziness].

Objective:A computerized cognitive behavioral therapy intervention program was constructed for patients with persistent postural-perception dizziness（PPPD） and its effects on dizziness symptoms, negative emotions and balance function were investigated. Methods:A randomized controlled trial design was used to select 86 patients with PPPD who were seen in the Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University from July 2020 to July 2021. Randomly assigned to the control group（43 patients） and the experimental group（43 patients）. The control group was routinely treated with medication and vestibular rehabilitation, while the experimental group underwent computerized cognitive behavioral therapy for a total of 9 sessions over 8 weeks; their dizziness symptoms（DHI）, negative affect（GAD-7, PHQ-9） and balance function（BBS） were compared at baseline, 4 and 8 weeks later. Results:After 4 and 8 weeks of intervention, the improvement of dizziness symptoms and negative mood in both groups had a between-group effect, time effect, and interaction effect（P<0.05）. The improvement of balance function had only a time effect and interaction effect（P<0.05）, and no difference in between-group effect was seen（P>0.05）. Conclusion:Computerized cognitive behavioral therapy can be used as an adjunctive treatment to alleviate patients' dizziness, negative affect, and balance function, but no additional benefit has been seen in terms of balance function improvement.

[Serum 25-hydroxyvitamin D expression and its correlation in patients with vestibular neuritis].

Objective:To investigate the expression level of serum 25-（OH） D and its correlation in patients with vestibular neuritis（VN）. Methods:30 acute VN patients and 50 age-and sex-matched healthy controls who attended the Otolaryngology, Head and Neck Surgery Department of the First Hospital of Shanxi Medical University from October 2020 to October 2021 were selected. The demographic and clinical data of all subjects were recorded, the levels of serum 25-（OH） D and inflammatory markers were measured and compared, and the changes of serum 25-（OH） D levels in convalescent patients with VN were followed up. Results:The serum level of 25-（OH） D in the acute phase VN group was significantly lower than that in healthy controls[（10.14±2.92） ng/mL vs （20.61±4.70） ng/mL, P<0.01], and the deficiency rate of 100.0%（30/30） was significantly higher than 54.0%（27/50）. Moreover, the serum level of 25-（OH） D in the recovery period（3 months later） was significantly higher[（10.14±2.92） ng/mL vs （15.94±4.88） ng/mL, P<0.01], and the deficiency rate was significantly decreased by 76.7%（23/30）. However, the serum 25-（OH） D level was significantly lower in both the VN group than that in both the acute period and the recovery group, and the deficiency rate was significantly higher than that in the control group. Multivariate binary Logistic regression model analysis showed that low-level serum 25-（OH） D was associated with the onset of VN, with an OR value of 0.193（95%CI=0.043-0.861, P=0.031）. In addition, the results of this study showed that peripheral blood leukocyte（WBC） and neutrophil / lymphocyte ratio（NLR） levels in the acute VN group were significantly higher than in healthy controls[（7.65±3.02） ×108/L vs （5.50±2.50） ×108/L, P<0.01; （2.46±2.95） ×100% vs（1.67±0.92） ×100%, P<0.01 ], and there was no significant difference in Platelet / lymphocyte ratio（PLR） and and average platelet volume（MPV） levels in the two groups（P>0.05）. There were no significant differences in age distribution, sex ratio, body mass index, persistent health problems, or lifestyle groups（P>0.05）. Conclusion:This study is the first to detect serum 25-（OH） D level and inflammation index level, and dynamically assess the serum 25-（OH） D level in different stages, found that low serum 25-（OH） D is associated with the onset of VN, physiological concentration of serum 25-（OH） D is a protective factor of VN, vitamin D supplementation therapy may be a new target of VN treatment.

[The research progress of residual dizziness after reduction of benign paroxysmal positional vertigo].

Benign paroxysmal positional vertigo（BPPV） is the most common peripheral vestibular disease that causes vertigo. Manual reduction can be used for treatment, but even after successful reduction, some patients still have residual dizziness, which severely affects the physical and mental health and quality of life of patients, especially those elderly patients with mental and psychological disorders. This article reviews the possible pathogenesis and related risk factors of residual dizziness, and summarizes the prevention and treatment of residual dizziness, in order to provide reference for standardized treatment of residual dizziness.

[Research progress on the screening questionnaire related to benign paroxysmal positional vertigo].

Benign paroxysmal positional vertigo（BPPV） is the most common peripheral vestibular disease in clinical practice, which can easily lead to missed diagnosis and misdiagnosis. Many guidelines have emphasized that detailed medical history and Dix-Hallpike test are sufficient to complete the diagnosis of BPPV. However, when the patient is unable or refused to undergo the displacement test due to obesity, physical weakness, cervical or lumbar dysfunction, fear of dizziness, and the displacement test does not induce nystagmus or weak nystagmus, the detailed medical history provides a supplementary basis for the diagnosis of BPPV, and compulsive posture therapy and drug treatment can be carried out accordingly. In order to standardize consultations, shorten the time for patients to visit, and help clinicians make more accurate diagnoses, many scholars at home and abroad have designed relevant screening questionnaires based on the history of BPPV, which has achieved good results.This article is summarized as follows, in order to provide ideas and references for clinical inquiry.

[The diagnosis and treatment of pediatric vertigo diseases: interpretation of the Bárány Society's consensus document].

The diagnostic criteria for "Vestibular Migraine of Childhood", "Probable Vestibular Migraine of Childhood" and "Recurrent Vertigo of Childhood" is put forth by the Committee for the Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification subgroup of the International Headache Society at the beginning of 2021. It provides directions for the diagnosis and treatment of these syndromes to international community of pediatricians, otolaryngologists, neurologists, neurosurgeons, neuro-otologists physiotherapists, neurophysiologists, and audiologists. The paper concludes the current situation and research progress of diagnosis and treatment of children vertigo diseases.

[Climatic variations and vertigo diseases in outpatients clinic of ENT].

Objective:The aim of this study is to analyze the relationship between climatic variations and vertigo diseases in outpatients clinic of ENT. Methods:A retrospective analysis of patients in the vertigo clinic of the First Hospital of Shanxi Medical University in 2019 was performed, and basic information, onset date and related data were recorded, and 12 months of meteorological data were recorded. Spearman rank correlation was used for data analysis. To analyze the relationship between climatic variations and benign paroxysmal positional vertigo （BPPV） vestibular migraine （VM）, Meniere's disease （MD）. Results:There were correlations between BPPV patients and change in atmospheric pressure, the average water atmospheric pressure, minimum relative humidity or change in temperature. There was no correlation between BPPV patients and sunshine exposure or wind speed. There were correlations between VM patients and change in atmospheric pressure or change in temperature. There was no correlation between VM patients and humidity, sunshine exposure or wind speed. There were correlations between MD patients and change in atmospheric pressure, minimum relative humidity or average relative humidity. There was no correlation between MD patients and change in temperature, sunshine exposure or wind speed. Conclusion:The onset of BPPV, VM, and MD are all related to changes in air pressure. Two or three diseases in the same patient may have a common cause. In the future, we can learn more about the pathophysiological correlation of the three. Patients with vertigo should pay attention to weather changes and prepare medications in advance.

[Research advances on mechanism and lesion location of vertical nystagmus].

Vertical nystagmus is a vertical nystagmus caused by structural abnormalities and/or dysfunction of the central vestibular system and observed in situ in the center of the eyeball. There are two kinds of nystagmus （UBN） and downbeat nystagmus （DBN） according to the direction of nystagmus. The diagnosis of UBN is mainly made by naked eye or electronystagmography/viewer. It is a common neuro-ophthalmologic sign in the field of vestibular medicine. In this paper, the mechanism of vertical nystagmus formation and the location of lesions were briefly introduced, in order to provide help for the diagnosis and treatment of Vertigo.

[The expression and clinical significance of Bax and PHF20 in laryngeal squamous cell carcinoma].

OBJECTIVE: To investigate the expression of Bax and PHF20 in laryngeal squamous cell carcinoma (LSCC)and to discuss their relevance and the roles in carcinogenesis and development in LSCC. METHOD: The expressions of Bax and PHF20 in the LSCC tissues and normal mucosa tissues adjacent to carcinoma were detected by SP immunohistochemistry assay. The relationship between the expressions of Bax and PHF20 and the clinicopathological characteristics including clinical stage, pathological type, histological grade and lymph node metastasis in LSCC were analyzed according to the clinical data. RESULT: (1) The expressions of Bax and PHF20 were both significantly lower in the LSCC tissue than that in the normal laryngeal tissue (P < 0.01). (2) In clinical stage grouping, there were no statistical differences of the quantity and positive rate of Bax and PHF20 expressions among supraglottic, glottic and subglottic LSCC (P > 0.05). In histological differentiation grouping, the quantity and positive rate of Bax and PHF20 expressions decreased significantly in poorly differentiated LSCC compared with the well and moderately differentiated LSCCs (P < 0.01, P < 0.05, respectively). In T stage grouping, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in T1 + T2 compared with T3 +T4 (both P < 0.01). In addition, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in LSCC with lymph node metastasis compared to that without lymph node metastasis (both P < 0.01). CONCLUSION: The lack of Bax and PHF20 might contribute to the carcinogenesis and development in LSCC. The positive expression of Bax and PHF20 maybe relative to T term degree, differentiation degree and lymphamatic metastasis of LSCC.

Fascin-1, ezrin and paxillin contribute to the malignant progression and are predictors of clinical prognosis in laryngeal squamous cell carcinoma.

AIMS: Fascin-1, ezrin and paxillin, cytoskeleton-associated proteins, have been implicated in several human cancers, but their role in laryngeal squamous cell carcinoma (LSCC) is unknown. We investigated the association of their expression and clinicopathologic factors and their prognostic value in LSCC. MATERIALS AND METHODS: Quantitative RT-PCR and western blot analyses were used to examine mRNA and protein levels in 10 fresh LSCC specimens and 10 corresponding adjacent normal margin (ANM) tissues from patients undergoing surgery in 2012. We used immunohistochemistry to retrospectively study 216 paraffin blocks of LSCC samples from patients (193 men) who had undergone surgery between 2000 and 2006 and had not received special treatment before the diagnosis. Univariate analysis of patient survival involved the Kaplan-Meier method. Multivariate analyses involved the Cox proportional hazards model. RESULTS: The relative mRNA and protein levels of fascin-1, ezrin and paxillin were significantly greater in LSCC than ANM tissue (P<0.05). The high expression of fascin-1, ezrin or paxillin was positively correlated with poor tumor differentiation, cervical lymph node metastasis (N+), and advanced clinical stage (III+IV) (P<0.05) but not sex or metastasis. In addition, a high expression of fascin-1 (P = 0.007) or ezrin (P = 0.047) was associated with advanced tumor stage (T3+T4). The expression of fascin-1 was higher in smokers than non-smokers (P = 0.019). A high expression of fascin-1, ezrin or paxillin was associated with poor prognosis. CONCLUSIONS: Fascin-1, ezrin and paxillin may be prognostic of poor outcome with LSCC after surgery. Our study may lead to establishing new molecular therapeutic targets and/or prognostic biomarkers in LSCC.

[Expressions of key molecules affiliated cytoskeleton in laryngeal squamous cell carcinoma and their implications for prognosis].

OBJECTIVE: To study the expressions of key assemblies of cytoskeleton, Fascin-1, Ezrin and Paxillin, in laryngeal squamous cell carcinoma (LSCC) and their correlation with clinicopathologic characteristics, cancer recurrence and survival of patients with LSCC. METHODS: The expressions of Fascin-1, Ezrin and Paxillin proteins were detected by immunohistochemistry in 199 cases of LSCC. Unconditional Logistic regression model or Cox proportional hazards model was used for the analyses of recurrent risks and prognostic factors. RESULTS: Significantly increased expression of Fascin-1, Ezrin or Paxillin expression was showed in the LSCC with poorly differentiated, positively cervical lymph nodal metastasis, and clinical stage III + IV respectively (P < 0.05). The expressions of three kinds of proteins in the recurrent cases were higher than those in non-recurrent cases respectively (χ(2) were 42.479, 43.673 and 22.261, P < 0.05). The highest recurrence rate (69.1%) was observed in group of cases with the highly co-expression of the three kinds of proteins (P < 0.05). The expression of Fascin-1 (OR = 7.89, 95%CI 2.26 - 27.53, P = 0.001), or Ezrin (OR = 2.51, 95%CI 1.18 - 5.32, P < 0.001) was independent risk for recurrence. Five-year disease-free survival rates of patients with high expression of Fascin-1, Ezrin or Paxillin were lower than those of patients with negative or low expressions for the proteins (P < 0.05). Patients with highly co-expression of three kinds of proteins showed the poorest survival prognosis, with a 5-year disease free survival (DFS) of only 26.4% (P < 0.05), and expressions of three proteins were independent prognostic factors for 5-year DFS (P < 0.05). CONCLUSION: Fascin-1, Ezrin, and Paxillin were correlative with LSCC progression and might be potential predictors for cancer recurrence and survival of patients with LSCC, as well as therapeutic targets for LSCC.