Cervical vertigo due to rotational fixation of atlantoaxial joint combined with benign paroxysmal positional vertigo: A case report and literature review.

INTRODUCTION: Vertigo is the most common clinical complaint, misdiagnosed patients are not rare, so it is very important to exclude and identify vertigo. For vertigo caused by multiple causes, including cervical vertigo with atlantoaxial rotation fixation combined with benign paroxysmal positional vertigo (BPPV), tuina can correct joint misalignment. The reduction technique will return the fallen otolith to the correct position. The use of massage and reduction can improve clinical symptoms and improve quality of life and may be a simple, safe, and effective treatment strategy for this disease. PATIENT CONCERNS: We report on a patient with both cervical vertigo due to atlantoaxial rotational fixation and BPPV, including his imaging examination, clinical manifestations, and treatment methods. DIAGNOSIS: Cervical vertigo (atlantoaxial rotatory fixation) and BPPV. INTERVENTION: Tuina combined with atlantoaxial directional inverted reduction technique and reduction manipulation. OUTCOMES: The patient's vertigo symptoms improved significantly, nystagmus disappeared, cervical occipital pain, nausea, head distension, and other symptoms disappeared, and cervical motion rotation reached 60°. CONCLUSION: This study proved the effectiveness of massage combined with a reduction in the treatment of cervical vertigo and BPPV, as well as the importance of vertigo diagnosis and differential diagnosis, and provided a new treatment idea for the future diagnosis and treatment of vertigo caused by a variety of causes.

Systematic Study of Heteroarene Stacking Using a Congeneric Set of Molecular Glues for Procaspase-6.

Heteroaromatic stacking interactions are important in drug binding, supramolecular chemistry, and materials science, making protein-ligand model systems of these interactions of considerable interest. Here we studied 30 congeneric ligands that each present a distinct heteroarene for stacking between tyrosine residues at the dimer interface of procaspase-6. Complex X-ray crystal structures of 10 analogs showed that stacking geometries were well conserved, while high-accuracy computations showed that heteroarene stacking energy was well correlated with predicted overall ligand binding energies. Empirically determined KD values in this system thus provide a useful measure of heteroarene stacking with tyrosine. Stacking energies are discussed in the context of torsional strain, the number and positioning of heteroatoms, tautomeric state, and coaxial orientation of heteroarene in the stack. Overall, this study provides an extensive data set of empirical and high-level computed binding energies in a versatile new protein-ligand system amenable to studies of other intermolecular interactions.