[The clinical characteristics of the evoked nystagmus in the non-affected side during Dix-Hallpike test in the unilateral posterior semicircular canal benign paroxysmal positional vertigo].

Objective: To investigate the clinical characteristics of the evoked nystagmus in the non-affected side during Dix-Hallpike test(D-H test)in unilateral posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV). Method: Two hundred and thirty-six patients were diagnosed with unilateral PC-BPPV in the Tinnitus and Dizziness clinic.Among them,14 patients exhibited positive nystagmus when the non-affected side was stimulated by D-H test. The clinical data from this subgroup of patients were retrospectively analyzed. Result: The upbeat and torsional nystagmus of 14 patients were all evoked by D-H test in the affected side. 11 cases were right PC-BPPV and 3 cases were left PC-BPPV. Among these 14 patients, 5 patients exhibited the upbeat and torsional nystagmus during D-H test in the non-affected side, which was in the same direction as that evoked in the affected side. Among them, 4 cases were right PC-BPPV and 1 case was left PC-BPPV. However, the downbeat nystagmus of the remaining 9 patients were evoked by D-H test in the non-affected side, in which 7 cases were right PC-BPPV and 2 cases were left PC-BPPV.The nystagmus and vertigo of all patients completely disappeared after performing the Epley or Semont repositioning maneuvers on the affected side. Conclusion: The bilateral positive nystagmus of unilateral PC-BPPV can be evoked by D-H test. The form of nystagmus on the non-affected side is related with the initial position of otoconia in affected semicircular canal and the moving direction of otoconia during the positional test. It is effective to perform Epley or Semont repositioning maneuvers on the affected side. Meanwhile, both the effect of maneuvers and the type of nystagmus evoked by D-H test can verify which side is affected.

[Preliminary analysis of the effects of individualized sound therapy on chronic subjective tinnitus].

Objective:To explore the effect of individualized multi-compound sound therapy on chronic subjective tinnitus and the relationship between tinnitus frequency," notch " hearing loss and the treatment effect of sound therapy.Method: Seventy-eight cases of chronic subjective tinnitus with the pure tone test threshold (PTA)in normal range (≤25 dB HL)were enrolled in this study. Their hearing threshold were re-evaluated using the precise pure-tone audiogram (P-PTA).Tinnitus was evaluated on pitch and loudness matching, and the effectiveness of tinnitus was measured using Tinnitus Handicap Inventory (THI) before they received the individualized customized multi-compound sound therapy for 3 months. THI were re-evaluated on the 30th day and 90th day after treatment.Result: ①The averaged THI score of these patients before the sound treatment was 24.62±15.65 (n=78). The score dropped significantly to 15.82±13.02 and 13.62 ±10.98 on the 30th day and 90th day after treatment, respectively (P<0.01). ②Patient' s gender, age, and the side of tinnitus has no effect on the sound treatment of tinnitus. ③Of these 78 tinnitus patients, 31 patients who showed "notch " hearing loss and 47 patients without "notch " hearing loss in the P-PTA. The averaged THI score between the patients with and without "notch " showed no statistical difference after the treatment (P>0.05).These data suggested that "notch " hearing loss in P-PTA has no effect on the sound therapy.④Of 31 tinnitus patients with "notch " hearing loss, the tinnitus frequency of 22 cases was at the "notch " hearing loss and that of 9 cases was not at the "notch " hearing loss. Sound treatment showed significant between the former and the latter(P<0.05). After 30 days of treatment, tinnitus frequency of four patients whose tinnitus was not at the notch hearing loss drifted to the "notch " hearing loss frequency. Conclusion: Customized multi-compound sound therapy can reduce the THI score of chronic subjective tinnitus patients.The treatment reduced patient's anxiety and improved their quality of life.Sound treatment showed a better improvement in the patients whose tinnitus frequency was located at their notch hearing loss.

[Effect of specific immunotherapy on the psychological health level and quality of life in patients with allergic rhinitis].

Objective: To study the effect of specific immunotherapy on the psychological health level and quality of life in patients with allergic rhinitis(AR).Method:Selected 97 cases diagnosed as moderate to severe persistent AR patients, were treated with specific immunotherapy for one year. All patients received the evaluation with symptom check list 90(SCL-90) and rhinoconjunctivitis quality of life questionnaire(RQLQ) before specific immunotherapy, six, and 12 months after specific immunotherapy.Result:The total scores, scores of somatization, obsessive, anxiety, depression and phobia in SCL-90 of AR patients after 12 months treatment were significantly lower than that before treatment（P < 0.05）. Total score of quality of life and subitem score in RQLQ of AR patients after 12 months treatment were obviously lower than that before treatment (P < 0.05）.Conclusion:Specific immunotherapy can effectively alleviate the clinical symptoms and improve psychological health level and quality of life of AR patients.