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INTRODUCTION: Nicorandil, a vasodilatory drug used to treat angina, was reported to protect against myocardial ischemia-reperfusion injury in various animal models. However, its cardioprotective action following cardiac arrest is unknown. We examined the cardioprotective effects of nicorandil in a porcine model of cardiac arrest and resuscitation. METHODS: Ventricular fibrillation was induced electrically for 4min in anesthetized domestic swine, followed by cardiopulmonary resuscitation. Sixteen successfully resuscitated animals were randomized to saline control (n=8) or nicorandil (n=8) groups. Nicorandil (150µg/kg) was administered by central intravenous injection at onset of restoration of spontaneous circulation (ROSC), followed by 3µg/kg/min infusion until reperfusion end. Sham-operated animals received surgery only (n=4). Hemodynamic parameters were monitored continuously. Blood samples were taken at baseline, 5, 30, 180, and 360min after ROSC. Left ventricular ejection fraction was assessed by echocardiography at baseline and 6h after ROSC. The animals were euthanized 6h after ROSC, and the cardiac tissue was removed for analysis. RESULTS: 6 h after ROSC, nicorandil had significantly improved all hemodynamic variables (all P<0.05) except the maximum rate of left ventricular pressure decline and heart rate (P>0.05) compared with the control group. Control animals showed elevated cardiac troponin I and lactate levels compared with sham animals, which were significantly decreased following nicorandil treatment (P<0.05). In the saline control group, the adenosine triphosphate (ATP) content was largely reduced but subsequently rescued by nicorandil (P<0.05). Histopathologic injury was reduced with nicorandil treatment. Nicorandil reduced cardiomyocyte apoptosis as evidenced by reduced terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL)-positive cells, decreased Bax and caspase-3 expression, and increased Bcl-2 expression in the myocardium (all P<0.05). CONCLUSION: Nicorandil exhibited cardioprotective effects on myocardial injury following cardiac arrest via improvement in post-resuscitation myocardial dysfunction and energy metabolism, reduction in myocardial histopathologic injury, and antiapoptotic effects.
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Cardiotónicos/farmacología , Paro Cardíaco/patología , Nicorandil/farmacología , Daño por Reperfusión/prevención & control , Fibrilación Ventricular/patología , Animales , Modelos Animales de Enfermedad , Inyecciones Intravenosas , Masculino , PorcinosRESUMEN
A nonrandomized controlled study was conducted to evaluate the effect of lipo-prostaglandin E1 (lipo-PGE1) on cystatin C (CysC), ß2-microglobulin (B2MG), and estimated glomerular filtration rate (eGFR) in patients with decompensated heart failure (DHF) and renal dysfunction. A total of 286 enrolled patients with DHF and renal dysfunction were nonrandomly assigned a 7-day standard treatment without (n = 146) or with (n = 140) lipo-PGE1 intervention. According to the baseline eGFR, patients were further classified into mild, moderate, and severe renal dysfunction subgroups. By the end of study period, there was no evidence of an immense improvement in B2MG, CysC, and eGFR in response to standard treatment (all P > 0.05). On the contrary, a noticeable decrease of B2MG and CysC was observed in patients receiving lipo-PGE1 intervention, as well as an increase in eGFR (all P < 0.05). Moreover, lipo-PGE1 intervention led to greater changes in renal function variables from baseline than with standard management (all P < 0.05). Most important, the favorable renal protective effects of lipo-PGE1 were maintained in three subgroups. Lipo-PGE1 intervention brought a substantial renoprotective benefit to hospitalized DHF patients as compared with standard therapy, suggesting it might offer a promising therapeutic option for the management of renal dysfunction associated with DHF.
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Alprostadil/uso terapéutico , Fármacos Cardiovasculares/uso terapéutico , Cistatina C/sangre , Tasa de Filtración Glomerular/efectos de los fármacos , Insuficiencia Cardíaca/tratamiento farmacológico , Enfermedades Renales/tratamiento farmacológico , Riñón/efectos de los fármacos , Microglobulina beta-2/sangre , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , China , Femenino , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/fisiopatología , Hospitalización , Humanos , Riñón/fisiopatología , Enfermedades Renales/sangre , Enfermedades Renales/diagnóstico , Enfermedades Renales/fisiopatología , Masculino , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To explore the clinical profiles of juvenile sudden sensorineural hearing loss (JSSNHL) and examine its clinical characteristics and prognosis. METHODS: A retrospective review was conducted for the clinical symptoms, audiological characteristics, hematological indices and prognosis in JSSNHL during the past 2 years (from June 2008 to November 2010). All patients were divided into 2 groups according to age, that is group childhood (A, 0-12 years old) and group adolescence (B, 13-18 years old). RESULTS: JSSNHL patients were rarely associated with "aural fullness" symptoms. Two groups of patients with "tinnitus" symptom accounted for 88.2% and 89.5%. Those with "vertigo" symptom accounted for 47.1% and 44.4% respectively. Most patients (81.6%) showed severe and profound hearing loss. The most common types of audiometric curve were flat and total deafness. Some obvious differences existed between two groups in hematological indices, such as platelet count, concentrations of electrolyte ions, mean corpuscular volume and mean corpuscular hemoglobin. Almost half of them (42.1%) improved hearing level during systemic medical treatment. The patients of two groups showed no significant difference in efficacies. And the hearing enhancement degree of patients in group B was more apparent than that of group A. CONCLUSIONS: JSSNHL has different clinical features in different age groups. And the outcomes of personalized treatment regimens may be further improved through classification and grading.
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Pérdida Auditiva Súbita/diagnóstico , Pérdida Auditiva Súbita/terapia , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare the spatial resolutions of dynamic optotypes at different speed levels among age-related cataract patients, older people with clear crystalline lenses and senile individuals implanted with intraocular lenses (IOL). METHODS: The control study recruited 24 patients (48 eyes) with age-related cataract scheduled for phacoemulsification surgery in our hospital between Jul. 2011 and Dec. 2011 in the cataract group. Twenty-three older volunteers (46 eyes) with clear crystalline lenses were enrolled in the normal group. The postoperative group consisted of 23 contemporary cases implanted with spherical monofocal non-yellow-tinted IOL and followed up for 3 months postoperatively, of which 5 cases undertook unilateral surgery for normal visual acuity of the contralateral eye. Monocular and binocular best corrected visual acuity at static condition and binocular spatial resolution of optotypes at speeds of 15, 30, 60 and 90 degrees per second (dps) were measured by a logarithmic visual acuity chart. Statistical analysis was performed with student's t test (with Bonferroni correction). RESULTS: Binocular spatial resolutions at speeds of 15, 30, 60 and 90 dps were (0.29 ± 0.16), (0.34 ± 0.17), (0.47 ± 0.19) and (0.52 ± 0.17), respectively, in the cataract group, and (0.04 ± 0.06), (0.06 ± 0.06), (0.12 ± 0.09) and (0.15 ± 0.11), respectively, in the normal group. Resolution of dynamic optotypes at the four speed levels were statistically lower in the cataract group than in the normal group (t = -6.952, -7.558, -8.235, -8.737; P < 0.01). Velocity dependent spatial resolution changes manifested statistically higher values in the cataract group than in the normal group, with (0.14 ± 0.13) versus (0.03 ± 0.05) at the interval between static and 15 dps (t0-15 dps = -3.874, P = 0.001) and (0.13 ± 0.09) versus (0.06 ± 0.07) at the interval between 30 dps and 60 dps (t30-60 dps = -3.113, P = 0.003). In the postoperative group, resolutions of dynamic optotypes at speeds of 15, 30, 60 and 90 dps were (0.03 ± 0.05), (0.05 ± 0.07), (0.11 ± 0.10) and (0.16 ± 0.11), respectively. Dynamic visual acuities at all the four speed levels were statistically higher in the postoperative group than in the cataract group (t = -7.336, -7.673, -8.328, -8.583; P < 0.01) and compatible to that in the normal group (t = 0.669, 0.400, 0.372, -0.504; P > 0.05). Visual acuity differences between consecutive speed levels were comparable between the postoperative group and the normal group (t = 0.586, -0.326, 0.133, -1.600; P > 0.05), while at the interval between static and 15 dps and the interval between 30 dps and 60 dps, the postoperative group exhibited lower visual acuity changes than the cataract group, with (0.03 ± 0.04) versus (0.14 ± 0.13) (t0-15 dps = -4.182, P < 0.01) and (0.05 ± 0.06) versus (0.13 ± 0.09) (t30-60 dps = -3.334, P = 0.002), respectively. CONCLUSIONS: As the optotype's moving speed increased, spatial resolutions declined more rapidly in patients with age-related cataract. Phacoemulsification combined with IOL implantation could effectively restore the spatial resolution of dynamic optotypes.
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Catarata/terapia , Implantación de Lentes Intraoculares , Facoemulsificación , Agudeza Visual , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Osteoporosis is one of the most common metabolic bone disease among pre- and postmenopausal women. As the precursors of osteoclast cells, circulating monocytes play important role in bone destruction and remodeling. The aim of study is to identify potential key genes and pathways correlated with the pathogenesis of osteoporosis. Then we construct novel estimation model closely linked to the bone mineral density (BMD) with key genes. Weighted gene co-expression network analysis (WGCNA) were conducted by collecting gene data set with 80 samples from gene expression omnibus (GEO) database. Besides, hub genes were identified by series of bioinformatics and machine learning algorithms containing protein-protein interaction (PPI) network, receiver operating characteristic curve and Pearson correlation. The direction of correlation coefficient were performed to screen for gene signatures with high BMD and low BMD. A novel BMD score system was put forward based on gene set variation analysis and logistic regression, which was validated by independent data sets. We identified six modules correlated with BMD. Finally 100 genes were identified as the high bone mineral density signatures while 130 genes were identified as low BMD signatures. Besides, we identified the significant pathway in monocytes: ribonucleoprotein complex biogenesis. What's more, our score validated it successfully.
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Densidad Ósea/genética , Monocitos/metabolismo , Osteoporosis/genética , Ribonucleoproteínas/biosíntesis , Biología Computacional/métodos , Conjuntos de Datos como Asunto , Femenino , Perfilación de la Expresión Génica , Redes Reguladoras de Genes , Humanos , Aprendizaje Automático , Análisis de Secuencia por Matrices de Oligonucleótidos , Osteoporosis/sangre , Posmenopausia/sangre , Posmenopausia/genética , Premenopausia/sangre , Premenopausia/genética , Mapeo de Interacción de Proteínas , Mapas de Interacción de Proteínas/genética , TranscriptomaRESUMEN
To improve the ineluctable agglomeration and weak inherent conductivity of MgAl2O4 electrode materials, MgAl2O4/rGO composite is synthesized by a facile method and it shows large specific surface area and enhanced conductivity. Its particular framework can availably hold back the aggregation of MgAl2O4 and restacking of rGO, and accelerate reversible redox reactions. The MgAl2O4/rGO composite shows a specific capacity of 536.6â¯F/g at 1â¯A/g (257.3â¯F/g at 40â¯A/g) and retains 96.9% after 10,000 cycles at 5â¯A/g. An asymmetric supercapacitor is developed with MgAl2O4/rGO composite and activated carbon. An energy density of 16.2â¯Wh/kg is obtained at a power density of 400â¯kW/kg. Additionally, this device has successfully lighted up a LED, demonstrating its promising application in energy storage.
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In order to investigate the toxic effect of intermittent high glucose (IHG) and sustained high glucose (SHG) on rat pancreatic beta cell functions and the potential involved mechanisms, isolated rat islets and INS-1 beta cells were exposed to SHG (25 mmol/l) or IHG (11.1 and 25 mmol/l glucose alternating every 12 h) for 72 h. The results showed that IHG induced a more significant impairment of insulin release response in rat islets and INS-1 cell than SHG. Simultaneously, the intracellular levels of endoplasmic reticulum and oxidative stress were more markedly increased in islets and INS-1 cells exposed to IHG. However, there was no significant difference between reducing cell viability, insulin content and gene expression induced by SHG and IHG. Taken together, this study suggested the more serious toxic effect on rat pancreatic beta cell function induced by IHG treatment may be due to excessive activation of cellular stress.
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Glucosa/toxicidad , Células Secretoras de Insulina/efectos de los fármacos , Células Secretoras de Insulina/metabolismo , Estrés Psicológico , 8-Hidroxi-2'-Desoxicoguanosina , Factor de Transcripción Activador 4/genética , Factor de Transcripción Activador 4/metabolismo , Animales , Supervivencia Celular , Células Cultivadas , Desoxiguanosina/análogos & derivados , Desoxiguanosina/metabolismo , Retículo Endoplásmico/metabolismo , Activación Enzimática , Factor 2 Eucariótico de Iniciación/genética , Factor 2 Eucariótico de Iniciación/metabolismo , Glucosa/metabolismo , Células Secretoras de Insulina/citología , Masculino , Ratas , Ratas Sprague-Dawley , Transducción de Señal/fisiología , Factor de Transcripción CHOP/genética , Factor de Transcripción CHOP/metabolismo , Tirosina/análogos & derivados , Tirosina/metabolismo , eIF-2 Quinasa/genética , eIF-2 Quinasa/metabolismoRESUMEN
OBJECTIVE: To investigate the effect of intermittent high glucose (IHG) on the pancreatic islet beta-cell function and mechanism thereof. METHODS: Rat pancreatic islet p-cells of the line INS-1 were cultured and randomly divided into 3 groups: IHG group exposed to fluctuating concentrations of glucose, stable high glucose (SHG) group exposed to 16. 7 mmol/L glucose, and control group exposed to normal concentration (5.5 mmol/L) glucose. 24, 48, and 72 hours later radioimmunoassay was used to detect the insulin secretion index (ISI). 72 h later, the concentration of insulin in the cells was detected with radioimmunoassay. The contents of oxidative stress markers, nitrotyrosine (NT) and 8-hydroxy-2-deoxyguanosine (8-OHdG) were detected. Real-time PCR was used to detect the mRNA expression of peroxiredoxin 1 (PDX-1), ATF-4, one of the transcription factors of the family bZIP, and insulin. Western blotting was used to detect the protein expression of ATF-4. RESULTS: The ISI of the IHG and SHG groups decreased time-dependently, The ISI of IHG and SHG groups were 0.64 +/- 0.11 and 1.31 +/- 0. 04 respectively, both significantly lower than that of the control group (1.67 +/- 0.23, both P < 0.05). The intracellular insulin contents of the IHG and SHG groups were (10.91 +/- 0.14) and (11.08 +/- 0.03) +/- U/microg respectively, both significantly lower than that of the control group [(12.37 +/- 0.37) microU/microg, both P < 0.05]. The intracellular concentrations of 8-OHdG and NT of the SHG and IHG groups, were significantly higher than those of the control group (all P < 0.01), and those of the IHG group were significantly higher than those of the SHG group (both P < 0.05). The mRNA and protein expression levels of ATF-4 of the IHG group were all significantly higher than those of the control group (all P < 0.05) and those of the IHG group were significantly higher than those of the SHG group (both P < 0.05). CONCLUSION: IHG and SHG induce severe impairment in pancreatic islet beta cell functions, especially IHG, which is closely associated with the aggravation of oxidative stress and endoplasmic reticulum stress triggered by intermittent high glucose.
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Retículo Endoplásmico/metabolismo , Glucosa/farmacología , Células Secretoras de Insulina/efectos de los fármacos , Estrés Oxidativo , 8-Hidroxi-2'-Desoxicoguanosina , Animales , Western Blotting , Línea Celular Tumoral , Desoxiguanosina/análogos & derivados , Desoxiguanosina/metabolismo , Relación Dosis-Respuesta a Droga , Insulina/metabolismo , Células Secretoras de Insulina/metabolismo , Células Secretoras de Insulina/patología , Peroxirredoxinas/genética , Radioinmunoensayo , Ratas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tirosina/análogos & derivados , Tirosina/metabolismoRESUMEN
OBJECTIVE: To compare efficacy and safety of minimally invasive sinus tarsal approach versus conventional L-shaped lateral approach in treating calcaneal fractures. METHODS: The studies concerning about randomized controlled trial and non-randomized controlled trial of minimally invasive sinus tarsal approach versus conventional L-shaped lateral approach in treating calcaneal fractures from the time of creating database to March, 2017 were searched from PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMbase, ISI Web of Knowledge databases, VIP, CNKI, CBM and Wan Fang. The literatures which screened by randomized controlled trial and non- randomized controlled trial were extracted and performed quality assessment by two people. Meta analysis were performed by RevMan 5.3 software and GRADE system were used to evaluate quality. RESULTS: Four randomized controlled trial and 4 non-randomized controlled trial were included, totally 493 patients. Meta-analysis results showed compared with conventional L-shaped lateral approach, minimally invasive sinus tarsal approach had shorter operative time [MD=-5.41, 95%CI(-6.71, -4.12), P<0.000 01], lower incidence of postoperative complications[OR=0.10, 95%CI(0.05, 0.21), P<0.000 01], and higher AOFAS score [MD=-3.09, 95%CI(-1.72, 4.46), P<0.000 01] at the final follow-up. Böhler angle in conventional L-shaped lateral approach was better than that of minimally invasive sinus tarsal approach [MD=-0.80, 95%CI(-1.45, -0.14), P<0.05]. While there were no significant differences in postoperative Gissanes angle [MD=0.35, 95%CI(-0.77, 1.47), P>0.05] and Maryland score[MD=2.12, 95%CI(-0.71, 4.95), P>0.05] between two groups. CONCLUSIONS: Minimally invasive sinus tarsal approach and conventional L-shaped lateral approach has similar clinical effect for the treatment of calcaneal fractures. However, minimally invasive sinus tarsal approach has advantages of shorter operation time, lower incidence of complication and better safety. For the limited quantity of the original studies, operative approach should be chosen according to the patient.
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Calcáneo/lesiones , Fracturas Óseas/cirugía , Traumatismos del Tobillo , Fijación Interna de Fracturas , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
In this study we sequenced the complete mitochondrial genome sequencing of a heart failure model of cardiomyopathic Syrian hamster (Mesocricetus auratus) for the first time. The total length of the mitogenome was 16,267 bp. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region.
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Cricetinae/genética , Genoma Mitocondrial/genética , Animales , Composición de Base/genética , Secuencia de Bases/genética , Cardiomiopatías , ADN Mitocondrial/genética , Modelos Animales de Enfermedad , Orden Génico/genética , Genoma/genética , Insuficiencia Cardíaca/genética , Mesocricetus/genética , Análisis de Secuencia de ADN/métodos , Secuenciación Completa del Genoma/métodosRESUMEN
BACKGROUND: Mutations in PAX6 gene have been shown to be the genetic cause of aniridia, which is a severe panocular eye disease characterised by iris hypoplasia. However, there is no study to do genetic analysis of aniridia, although there are several case reports in China. Here, we describe a mutation analysis of PAX6 in a large Chinese family with aniridia. METHODS: Genomic DNA from venous blood samples was prepared. Haplotype analysis was performed with two genetic markers (D11S904 and D11S935). Fourteen exons of the PAX6 gene were amplified from genomic DNA. Polymerase chain reaction (PCR) products of each exon were analysed by single strand conformational polymorphism (SSCP). The PCR products having an abnormal pattern were sequenced to confirm the mutation. RESULTS: Significant evidence for allele sharing in affected patients was detected suggesting that PAX6 mutation links to aniridia in this family. An extra band corresponding to exon 9 in PAX6 was found by single strand conformational polymorphism analysis in all the aniridia patients in this family, but not detected in the unaffected members. A mutation of C to T was detected by sequencing at the nucleotide 1080 that converts the Arg codon (CGA) to the termination codon (TGA). CONCLUSIONS: Aniridia is caused by a nonsense mutation of PAX6 gene in the large Chinese kindred. Genetic test is important to prevent the transmission of aniridia to their offsprings in the kindred by prenatal diagnosis.
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Aniridia/genética , Proteínas del Ojo/genética , Proteínas de Homeodominio/genética , Mutación , Proteínas Represoras/genética , Femenino , Humanos , Masculino , Factor de Transcripción PAX6 , Factores de Transcripción Paired Box , LinajeRESUMEN
OBJECTIVE: To observe the pathological changes of the lens and anterior lens capsule of the patients with familial congenital aniridia, and discuss the histopathological etiology of the fragility of the anterior capsule and the significance of surgical project. METHODS: Anterior lens capsules and lens specimens were obtained from aniridic patients during cataract surgery. The intraoperative behavior of each capsule was noted, after which the specimens were submitted for histopathologic evaluation and electron microscope examination. RESULTS: The anterior lens capsule was extremely fragile and remarkably thin. Degenerative changes(degeneration, necrosis, loss) of the lens epithelium and discontinuity of the lens epithelium were found in some specimens. Proliferation and double layer of the epithelial cells in some area of the specimens can be seen also. Ply structure of the anterior capsule became thin or disappeared. CONCLUSION: Degenerative or proliferative changes of the lens epithelial cells were associated with the thinness and extreme intraperative fragility of the anterior lens capsules in familial aniridia with cataract. Greater awareness of anterior capsule fragility in some aniridic patients with cataract may reduce the risk of capsule complications and lead to safer surgical outcomes.
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Aniridia/patología , Catarata/patología , Cápsula del Cristalino/anomalías , Adolescente , Adulto , Anciano , Aniridia/complicaciones , Catarata/complicaciones , Niño , Preescolar , Células Epiteliales/patología , Células Epiteliales/ultraestructura , Femenino , Humanos , Lactante , Cápsula del Cristalino/ultraestructura , Masculino , Microscopía Electrónica de Transmisión , Persona de Mediana Edad , LinajeRESUMEN
BACKGROUND: Only limited data of the long-term effect of levosimendan on renal dysfunction in patients with decompensated heart failure (DHF) have been published previously. To date, there has been no similar study carried out in a Chinese population. DESIGN AND METHODS: A prospective, randomized, placebo-controlled, and double-blind study was performed to investigate the effect of levosimendan on estimated glomerular filtration rate (eGFR) in DHF patients with renal dysfunction during a 30-day period. Sixty-six patients with left ventricular ejection fraction (LVEF) ≤40% and eGFR 15-89 mL/min/1.73 m(2) were randomized in a 1:1 ratio to receive a 24-h infusion with levosimendan or placebo. The B-type natriuretic peptide (BNP) and eGFR were determined at baseline and day 1, 3, 7, 14, 30 after the start of treatment. RESULTS: The eGFR levels were obviously enhanced following levosimendan, peaked at 3 days, sustained for at least 14 days, and returned to baseline by day 30 after starting infusion. In contrast, placebo did not induce any significant changes in eGFR levels during the follow-up. In addition, levosimendan resulted in a distinct decrease in BNP levels in comparison with placebo, and the beneficial effect returned to baseline by day 14 and remained so at day 30 postinfusion. CONCLUSIONS: A 24-h infusion with levosimendan transiently improved the renal dysfunction compared with placebo in patients with DHF, and its beneficial effects persisted for at least 14 days after the initiation of treatment.
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Cardiotónicos/uso terapéutico , Tasa de Filtración Glomerular/efectos de los fármacos , Insuficiencia Cardíaca/tratamiento farmacológico , Hospitalización , Hidrazonas/uso terapéutico , Enfermedades Renales/fisiopatología , Piridazinas/uso terapéutico , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Biomarcadores/sangre , Presión Sanguínea/efectos de los fármacos , Cardiotónicos/administración & dosificación , Distribución de Chi-Cuadrado , China , Método Doble Ciego , Femenino , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hidrazonas/administración & dosificación , Infusiones Intravenosas , Enfermedades Renales/sangre , Enfermedades Renales/complicaciones , Modelos Lineales , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre , Estudios Prospectivos , Piridazinas/administración & dosificación , Simendán , Volumen Sistólico , Factores de Tiempo , Resultado del Tratamiento , Micción/efectos de los fármacos , Función Ventricular Izquierda/efectos de los fármacosRESUMEN
OBJECTIVE: To investigate the clinical materials of sudden sensorineural hearing loss (SSNHL) in different ages of patients, and explore their clinical characteristics and prognosis. METHODS: A retrospective review was conducted by the clinical symptoms, predisposing factors and prognosis in SSNHL patients with different ages in the past two years (from 2008 to 2010). All patients were divided into three groups according to age, including Group 1 (0-18 years old), Group 2 (19-59 years old), and Group 3 (over 60 years old). RESULTS: Part of patients (28.1%) had a clear history of virus infection in Group 1. Some patients (18.7%) had obvious history of emotional fluctuations or fatigue before the onset of SSNHL. Three groups of patients with "aural fullness" symptom accounted for 3.1%, 41.3% and 29.4% respectively. The proportions of patients with profound hearing loss in three groups were 62.5%, 40.0% and 33.3% respectively. Most patients improved hearing level during systemic internal medicine treatment. However, many patients (68.8%) in Group 1 showed poor therapeutic effect. CONCLUSIONS: SSNHL in different age stages has different clinical features. We can improve the personalized treatment program to this disease through the classification and grading treatment.
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Pérdida Auditiva Súbita/epidemiología , Adolescente , Adulto , Niño , Preescolar , Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita/diagnóstico , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To analyze the therapeutic effect of treatment for intermediate and high-frequency sudden sensorineural hearing loss (SSNHL). METHODS: A prospective clinical multicentre research was conducted using international standardized approach of clinical research. SSNHL Cases with intermediate and high-frequency hearing loss, that accepted no medication from onset of hearing loss within two weeks duration and ages ranged between 18 and 65, were collected. All patients were treated by one of four treatments plans chosen by unified random table. RESULTS: 141 patients with intermediate and high-frequency SSNHL were recruited in the research. Twenty subjects were treated with lidocaine, 21 cases with lidocaine and hormone, 40 cases with Ginaton, and 60 cases with Ginaton and hormone. 42 out of 141 (29.79%) patients were total recovery, 24 (17.02%)achieved excellent recovery, 27 (19.15%)achieved partial recovery, and 48 (34.04%) were ineffective. The total effective rate was 65.96%. In lidocaine group, the total effective rate was 55.00%, 66.67% in lidocaine and hormone group, 67.50% in Ginaton group, and 68.33% in Ginaton and hormone group. Considering the total effective rate, there was no statistical difference between four groups (P > 0.05). However, the recovery rate in Ginaton group was significant difference comparing with that in lidocaine group (P = 0.0496). 119 had concomitant symptom of tinnitus, and the tinnitus was improved in patients of 81.51%. With regard to total effective rate of tinnitus in four treatment groups, it was 57.89% (11/19) in lidocaine group, 100.00% (18/18) in lidocaine and hormone group, 88.57% (31/35) in Ginaton group, 78.72% (37/47) in Ginaton and hormone group. There was significant ascendancy in lidocaine and hormone group versus that in lidocaine group (P = 0.002) and Ginaton and hormone group (P = 0.029). And the difference between lidocaine and Ginaton groups was statistical significance (χ(2) = 6.705, P < 0.05). In 43 patients with muffled symptom in aural region, 90.70% was partial recovery. There was no statistical difference between each groups (χ(2) = 5.97,P = 0.74). There were 17 with dizziness or vertigo improved in all cases. Another 10 patients accompanied other complaints all improved. CONCLUSIONS: for the treat of intermediate and high-frequency SSNHL, the therapeutic effect in hearing has no significantly different between single and combined drug therapies. Considering the recovery rate, there is an obvious advantage in Ginaton group compared with lidocaine group. Tinnitus is the major concomitant symptom in intermediate and high-frequency SSNHL, and lidocaine and hormone therapy should be used.
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Pérdida Auditiva Sensorineural/diagnóstico , Pérdida Auditiva Súbita/diagnóstico , Adulto , Anciano , Quimioterapia Combinada , Medicamentos Herbarios Chinos , Audición , Pérdida Auditiva de Alta Frecuencia , Pérdida Auditiva Sensorineural/epidemiología , Pérdida Auditiva Sensorineural/terapia , Pérdida Auditiva Súbita/epidemiología , Pérdida Auditiva Súbita/terapia , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Acúfeno , Vértigo , Adulto JovenRESUMEN
Sigmoid sinus diverticulum-induced pulsatile tinnitus is a rare medical problem. Here we report a case where pulsatile tinnitus occurred in the perimenopause with evidence of sigmoid sinus diverticulum. The tinnitus disappeared with the restoration of hearing after surgery. While diagnosis is critical for the treatment, this disorder can be diagnosed relatively easily, and a satisfactory therapeutic outcome can be achieved using a simple surgical approach. The sigmoid sinus diverticulum may be a clinical manifestation of osteoporosis occurring in the perimenopausal period.
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Angiografía de Substracción Digital/métodos , Senos Craneales , Divertículo/complicaciones , Imagen por Resonancia Magnética/métodos , Perimenopausia , Acúfeno/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Diagnóstico Diferencial , Divertículo/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Acúfeno/etiologíaRESUMEN
Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy, but its prevalence is very low. It is conjectured that SSNHL is closely related to the changes in the cardiovascular system, hematological system, endocrine system, and/or some other systems due to pregnancy. These changes possibly evoke disorders of cochlear circulation or cochlear fluid homeostasis leading to SSNHL. Two SSNHL cases were observed in our clinic, and their clinical features were analyzed. In one patient the SSNHL was likely to be related to the disturbance of cochlear fluid homestasis and in the other it might be induced by some disorders in cochlear circulation. Based on their distinct clinic profiles, we defined a new disease, called "pregnancy-induced sudden sensorineural hearing loss," similar to the definition of "pregnancy-induced hypertension." This study also deepened our understanding of the etiology of SSNHL.
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Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Súbita/etiología , Hipertensión Inducida en el Embarazo , Adulto , Audiometría de Tonos Puros , Cóclea/fisiopatología , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Pérdida Auditiva Sensorineural/diagnóstico , Pérdida Auditiva Sensorineural/fisiopatología , Pérdida Auditiva Súbita/diagnóstico , Pérdida Auditiva Súbita/fisiopatología , Humanos , EmbarazoRESUMEN
OBJECTIVE: To investigate the suppressive effect and its frequency selection of dopamine on the cochlear auditory afferent nerve activity. To offer an important step in understanding the modulation of dopamine in the inner cell synaptic complex. METHODS: Forty guinea pigs were randomly divided into four groups and the whole intracochlear perfusions were performed: (1) perfused with artificial perilymph solutions; (2) perfused with artificial perilymph solutions containing 10 mmol/L dopamine; (3) perfused with artificial perilymph solutions containing 30 mmol/L dopamine; (4) perfused with artificial perilymph solutions containing 50 mmol/L dopamine. Compound action potential (CAP) evoked by different frequencies (250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz, 16 000 Hz) and cochlear microphonics (CM) evoked by 4000 Hz tone burst were recorded from the round window of guinea pigs before perfusion and 1 hours, 2 hours after perfusions. RESULTS: There was no significant difference in CAP threshold before and after perfusion in the artificial perilymph solutions group (P > 0.05). An increase of CAP threshold of most detecting frequencies were observed in the three dopamine-perfused groups (P < 0.05). The inhibition effect intended with the increasing of the concentration of dopamine in the perfusion solution. There was significant difference in CAP threshold shift between different frequencies, especially in the group perfused with 30 mmol/L dopamine. The maximal threshold shift was found at 4000 Hz and 8000 Hz. No significant changes of CM amplitude and non-linearity of input-output function were observed before and after perfusion with artificial perilymph solutions and dopamine. CONCLUSIONS: Dopamine can inhibit the cochlear auditory afferent nerve, but there is no obvious influence on outer hair cell produced by dopamine. The inhibition effect has frequency selection, the suppression on high frequencies is more stronger than low frequencies.
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Nervio Coclear/fisiología , Dopamina/farmacología , Potenciales Evocados Auditivos/efectos de los fármacos , Animales , Nervio Coclear/efectos de los fármacos , Femenino , Cobayas , MasculinoRESUMEN
OBJECTIVE: To investigate the effect of nifedipine on the non-selective inward current of cochlear Hensen cell induced by ATP in high concentrations. METHODS: The organ of Corti was treated using enzyme, and then dissociated mechanically to isolate Hensen cells. The whole cell patch-clamp technique was used to record ion currents in Hensen cells which had integrated border, round shape and translucent intracellular cytoplasm. Drugs were delivered to the cell by a micro-manifold consisting made by three 100 microm diameter microtubules, including 0.1 mmol/L ATP, 1 mmol/L ATP, 10 mmol/L ATP, 0.1 mmol/L ATP + 0. 1 mmol/L suramin (purinergic antagonist), stimulation of extracellular fluid alone, 140 mmol/L CsCl (replace KCL in intracellular fluid) + 1 mmol/L ATP, 40 mmol/L TEA (blocker of potassium channel) + 1 mmol/L ATP, and 1 mmol/L ATP + 10 micromol/L nifedipine, respectively. RESULTS: When isolated Hensen cell was given 0.1 mmol/L (n = 10), 1 mmol/L (n = 10), 10 mmol/L( n = 6) ATP separately, an inward ion current could be recorded, which enhanced with increased ATP concentration and showed dose-dependence. Further study indicated that the inward ion current could be inhibited by 0.1 mmol/L suramin (n = 5), 140 mmol/L CsCl (n = 5) and 40 mmol/L TEA (n = 5). There was no ion current be recorded when the cell was stimulated with the extracellular fluid alone, neither inward nor outward. However, the inward ion current vanished and an outward ion current appeared instead, when 1 mmol/L ATP and 10 micromol/L nifedipine were given together (n = 5). CONCLUSIONS: An inward current was evoked in isolated Hensen cell by ATP in high concentrations. This inward current seems to be associated closely with potassium channels without the participation of mechanical channels. Nifedipine can inhibit this inward current and induce an outward current, which is similar to the normal potassium current in isolated Hensen cell. It suggests that nifedipine have partly protective effect on the function of cochlea by inducing modulate of the potassium circle of cochlea in Hensen cell's tache.