The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation

Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.

Enhanced but hypofunctional osteoclastogenesis in an autosomal dominant osteopetrosis type II case carrying a c.1856C＞T mutation in CLCN7

Type II autosomal dominant osteopetrosis(ADO2), which is the most common form of osteopetrosis, is caused by heterozygous mutations in the chloride channel 7(CLCN7) gene. The osteopetrosis of ADO2 has been attributed to hypofunctional osteoclasts. The mechanism underlying the abnormality in osteoclast function remains largely unknown. This study was designed to investigate gene mutations and osteoclast function in a case that was clinically diagnosed as ADO2. Genomic DNA was extracted from blood samples of this patient, and the 25 exons of CLCN7 were amplified. Peripheral blood from the ADO2 subject and a healthy age- and sex-matched control was used to evaluate osteoclastogenesis, osteoclast morphology, and bone resorption. Analysis of DNA from the patient showed a germline heterozygous missense mutation,c.1856C>T(p.P619L), in exon 20 of CLCN7. A similar homozygous mutation at this site was previously reported in a patient with autosomal recessive osteopetrosis. When cultured, the peripheral blood mononuclear cells(PBMCs) from the ADO2 patient spontaneously differentiated into mature osteoclasts in vitro. The ADO2 patient’s PBMCs formed enhanced, but heterogeneous, osteoclasts in both the presence and absence of macrophage-colony stimulating factor, and nuclear factor-?B ligand. Bone resorption was reduced in the ADO2 patient’s osteoclasts, which exhibited aberrant morphology and abnormal distribution of integrin avβ3. Gene analysis found increased c-fos expression and reduced Rho A and integrin beta 3expression in ADO2 cells. In conclusion, our data suggest that enhanced, heterogeneous osteoclast induction may be an intrinsic characteristic of ADO2.

Influence of Copper Deficit on Structural and Metabolic Features of Myocardium of Rats in Conditions of ThyroidHypofunction

The research was carried on 60 rats,which were divided into two experimental groups animals with thyroid hypofunction against iodine deficiency and on the background of combined iodine and copper deficit.The control group included 30 intact rats.For evaluation of copper balance its content was determined in erythrocyte mass and myocardium.Prooxidant-antioxidant system was examined by the level of peroxide oxidation of proteins and lipids and due to the activity of antioxidant enzymes.Structural features of the myocardium were examined by light-optical microscopy with subsequent morphometry.In the result of the experiment in rats with thyroid hypofunction on the background of combined iodine and copper deficit the redistribution of copper content in the studied tissues was established(accumulation in blood).The results of the study confirm the activation of oxygen-dependent processes in the myocardium of experimental animals,primarily due to peroxide oxidation of proteins,which is especially manifested in the context of combined iodine and copper deficiency.Metabolic changes in the myocardium were confirmed by histology.So,the development of thyroid hypofunction on the background of combined iodine and copper deficiency increases the probability of cardiovascular pathology due to disorders of prooxidant-antioxidant balance and structural changes in the myocardium.

Application progress of acupuncture in treatment of ovarian hypofunction

The decline of ovarian reserve is an important cause of female infertility.More and more older women want to be pregnant again,especially because of the liberal birth policy.But the main reason for limiting fertility in older women is the decline of ovarian reserve.At the same time,due to the change of social environment,the incidence of ovarian function decline has a trend of youth.Therefore,in the infertile women,ovarian dysfunction was found to account for a higher proportion.Finding ways to improve ovarian function is especially important for improving female fertility.Modern medicine has no clear treatment for the disease,only some health products such as coenzyme Q10,dehydroepiandrosterone are used to maintain the ovaries.As a simple and convenient non-drug therapy,acupuncture has been widely used in improving the ovarian function of infertile women in recent years,and its effect has been explored by many researchers.Therefore,this article will start from the human body research and the animal experiment two aspects,discusses the acupuncture improvement ovary function.

Role of Wnt signaling pathway hypofunction mediated by dephosphorylation of β-catenin in impaired wound healing of type 1 diabetic rats

Objective To investigate the role of Wnt signaling pathway hypofunction mediated by dephosphorylation ofβ-catenin in the impaired wound healing of type 1 diabetic rats.Methods The back skin defect wounds were produced in rats with type 1 diabetes.These rats were divided into control,diabetes,lithium chloride treatment,and epidermal growth factor(EGF)

Repeated video head impulse testing in patients is a stable measure of the passive vestibulo-ocular reflex

Objectives The video head impulse test(vHIT)is used as a measure of compensation yet it’s stability in patients with vestibular pathology is unknown.Methods 144 patients(n=72 female,mean 54.46±15.8 years)were grouped into one of three primary diagnoses(Peripheral,Central,or Mixed).Subjects were further categorized based on sex(male versus female),ear(left versus right;ipsilesional versus contralesional),age(six groups ranging from 19 to 84 years),and duration between visits(five groups,mean 191.46±SE 29.42 days,median 55.5 days).The gain of the VOR during passive head rotation was measured for each semicircular canal(horizontal,anterior,posterior).Results There was no difference in the VOR gain within any semicircular canal between the two visits(horizontal:p=0.179;anterior:p=0.628;posterior:p=0.613).However,the VOR gain from the horizontal canals was higher than the vertical canals for each visit(p<0.001).Patients diagnosed with peripheral vestibular pathology had significantly lower(p≤0.001)horizontal semicircular canal gains at each visit.There was no difference in VOR gain between sex(p=0.215)or age groupings(p=0.331).Test-retest reliability of vHIT in patient subjects is good(ICC=0.801)and the VOR gain values across two separate visits were significant and positively correlated(r=0.67)regardless of sex,ear,age,or duration between visits.Conclusion The vHIT is a stable measure of VOR gain over two different times across a variety of vestibular patients with no influence of age or sex.

Rare complication of acute adrenocortical dysfunction in adrenocortical carcinoma after transcatheter arterial chemoembolization:A case report

BACKGROUND Adrenocortical carcinoma(ACC)is a rare and highly invasive endocrine malignant tumor with a poor prognosis.Although surgical resection is the main treatment for ACC,postoperative recurrence and metastasis have become the important factors of death.Transcatheter arterial chemoembolization(TACE)is an important option for the treatment of advanced ACC with liver metastasis.However,due to the small number of patients treated for ACC,the safety of the operation is not completely clear and needs to be further studied.CASE SUMMARY A 47-year-old patient with ACC after surgery was admitted for reexamination by abdominal computerized tomography suggesting liver metastasis.Because the patient expressed reluctance to undergo surgery again,we treated her with TACE for the liver lesions.After treatment,symptoms of acute adrenal dysfunction such as decreased blood pressure,anorexia,and fatigue appeared,which were relieved after hydrocortisone treatment.To date,the patient's liver lesion is well controlled and no other metastases are observed.CONCLUSION We report a rare case of acute adrenal hypofunction after TACE.Glucocorticoid supplementation can alleviate the symptoms.

Improving Balance through Virtual Reality and Physical Therapy Integration

Background and Purpose: Virtual reality (VR) is an innovative technology that shows promise in the assistance of physical therapy (PT). This case report explores the use of virtual reality with a patient suffering from unilateral vestibular hypofunction (UVH). Case Description: The patient is a 50-year-old male who was referred to physical therapy following a motor vehicle accident. The patient was diagnosed with having an acute left UVH, accompanied by reports of dizziness, imbalance and gait disturbances which impaired him from his work in construction. Intervention: The patient was seen two to three times a week for 40-minute sessions along with an individualized home exercise program. Interventions included vestibular rehabilitation exercises, balance training, gait training, and VR. The goals of VR were to provide task-specific simulations to improve postural balance, decrease anxiety through exposure therapy, and improve smooth eye pursuits to improve static balance. Outcomes: Outcomes used included subjective questionnaires such as the Activities-Specific Balance Confidence survey and the Dizziness Handicap Inventory (DHI) as well as functional tests like the Sensory Organization Test, Motor Control Test, and the Functional Gait Assessment (FGA). Outcome measures were performed at initial evaluation, at the 10th visit, and again at discharge. Notable improvements were seen on DHI and FGA scores. Conclusion: Dizziness, confidence, balance, and gait improved following vestibular rehabilitation combined with VR. Outcomes of this case suggest that virtual reality in conjunction with vestibular rehabilitation therapy is effective in improving deficits of unilateral vestibular hypofunction. Additionally, the use of VR in this case report suggests this can be an effective tool for intervention to facilitate patient-specific goals.

M1 muscarinic acetylcholine receptor in Alzheimer's disease

The degeneration of cholinergic neurons and cholinergic hypofunction are pathologies associated with Alzheimer＇s disease （AD）. Muscarinic acetylcholine receptors （mAChRs） mediate acetylcholine-induced neurotransmission and five mAChR subtypes （M1-M5） have been identified. Among them, M1 mAChR is widely expressed in the central nervous system and has been implicated in many physiological and pathological brain functions. In addition, M1 mAChR is postulated to be an important therapeutic target for AD and several other neurodegenerative diseases. In this article, we review recent progress in understanding the functional involvement of M1 mAChR in AD pathology and in developing M1 mAChR agonists forAD treatment.