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CONTEXT: To avoid excessive chemical-fertilizer application and improve agricultural productivity in rice, a fertilizer recommendation system called Nutrient Expert® (NE) was designed. However, the ability of NE to balance yield, profitability and environmental sustainability in rice production needs to be further evaluated, as it is still difficult for farmers to assess the proper nitrogen (N) application rate. OBJECTIVE: The objective of this study was to demonstrate the advantages of the NE system in balancing yield, profitability and N loss in rice production, and recommend proper N application rates for different cropping seasons of rice. METHODS: This study describes results from field experiments conducted in five main rice cropping provinces from 2017 to 2020 in China, to investigate any advantages of NE compared with local farmers' practice (FP), and to determine the proper N application rates for different cropping seasons of rice. RESULTS AND CONCLUSIONS: Compared with FP, NE had 12.1% lower N-fertilizer application, but increased rice grain yield by 4.3% and net profit by 7.4%, and decreased yield-scaled N loss by 20.7%. We showed how yield, profitability and N loss were affected by N balance (i.e., N applied to the field minus N removed from the field by the harvested crop biomass), and quantified relationships between N balance and N application rate, and between N output and input. Based on relationships between N balance and N application rate, we recommend N application rates in a range from 122 to 214 kg ha−1, depending on cropping seasons of rice. We demonstrated that NE can simultaneously improve yield, profitability and environmental sustainability. SIGNIFICANCE: Our study provided quantitative support for NE-based recommendations on the N application rate for smallholders farming in different rice cropping systems, and these recommendations can serve as a reference for avoiding excessive N application rate in paddy fields in other regions with similar eco-environment.

In the bid to stay competitive, online shopping platforms often offer a variety of shipping options to meet the preferences of consumers. While faster delivery might be desirable for consumers, this may be detrimental to the environment. Limited studies have evaluated the comparative environmental impact of different shipping options offered by e-commerce platforms. To fill this gap, this study aims to conduct a comparative carbon footprint assessment of the shipping options available in Taobao, a highly popular Chinese online shopping website. The case of cross-border e-commerce is evaluated, where goods are ordered from China to Singapore as the shipment destination. Thereafter, a shipping choice preference survey is conducted to evaluate the impact of carbon labelling on consumers’ shipping preferences. From the perspective of the consumer, when offered a variety of shipping options to choose from, there is always a trade-off between the cost and the speed of delivery. Additional information on the carbon impact of different options could influence consumers’ decision-making. The shipping options from Taobao are referenced to determine the cost, speed, and carbon emission values for the scenarios presented in the survey. Out of 188 survey respondents, slightly more than half (55%) were found to be willing to compromise the speed of delivery for a less carbon-intensive alternative. Given this finding, the study advocates for carbon labelling to be introduced for e-commerce shipping options.

Many people buy things online these days, like the latest sneakers or electronic gadgets. These goods may be sent to us over very long distances. The various ways of shipping those goods to us, whether by air, sea, or land, produce different amounts of greenhouse gases and therefore have different impacts on global warming. If we compare different ways to ship goods from China to Singapore, we find that shipping by air is faster than by sea, but it is also more expensive and contributes more to climate warming. We asked 188 people which shipping method they would choose if they knew about the greenhouse gas impact of each method. Slightly more than half were willing to accept slower deliveries for less polluting alternatives. Offering carbon labels on online shopping websites could help to reduce the environmental impact of home deliveries.

Pulmonary artery vascular endothelial dysfunction plays a pivotal role in the occurrence and progression of pulmonary vascular remodeling (PVR). To address this, aberrantly expressed non-coding microRNAs (miRNAs) are excellent therapeutic targets in human pulmonary artery endothelial cells (HPAECs). Here, we discovered and validated the overexpression of miRNA-152 in HPAECs under hypoxia and its role in endothelial cell dysfunction. We constructed a framework nucleic acid nanostructure that harbors six protruding single-stranded DNA segments that can fully hybridize with miRNA-152 (DNT-152). DNT-152 was efficiently taken up by HPAECs with increasing time and concentration; it markedly induced apoptosis, and inhibited HPAEC growth under hypoxic conditions. Mechanistically, DNT-152 silenced miRNA-152 expression and upregulated its target gene Meox2, which subsequently inhibited the AKT/mTOR signaling pathway. These results indicate that miRNA-152 in HPAECs may be an excellent therapeutic target against PVR, and that framework nucleic acids with carefully designed sequences are promising nanomedicines for noncancerous cells and diseases.

In this study, we have fabricated poly(acrylamide-co-acrylic acid)–Al3+/poly(vinyl alcohol)/graphene oxide (PAmAA–Al3+/PVA/GO) double network nanocomposite hydrogels by free-radical polymerization and a freeze–thaw cycle in the presence of graphene oxide and aluminum ions. The pH-sensitivity, surface morphology and mechanical properties can be tuned by adjusting the contents of GO, PVA and Al3+. The resulting hydrogels exhibit significant pH-sensitivity and an interconnected pore channel. The PAmAA–Al3+/PVA/GO hydrogels also exhibit high tensile strength, a large elongation at break and high toughness, which is due to the introduction of GO and formation of dynamic reversible bonds. These dynamic reversible bonds formed in the synthesized double network nanocomposite hydrogels could efficiently dissipate energy and recover the three-dimensional network. The combination of nanoparticles, dynamical reversible bonds and the double network structure significantly improves the physicochemical properties of these hydrogels. Finally, subcutaneous implantation of the synthesized nanocomposite hydrogels in mice showed no local inflammatory response, indicating good biocompatibility in vivo. In conclusion, PAmAA–Al3+/PVA/GO double network nanocomposite hydrogels with tunable three-dimensional network structures, mechanical properties, good pH-sensitivity, self-healing ability and biocompatibility are promising biomaterials for tissue engineering.

The Nutrient Expert system (NE) has been proposed to improve yield and nitrogen (N) use efficiency (NUE) in the double rice cropping systems in China. However, the advantage of the NE system has yet to be quantified experimentally. A four-year field experiment was conducted in a double rice cropping system in China, to evaluate the ability of NE in improving yield and NUE. The experimental treatments consisted of NE based fertilization, current farmers’ practices (FP) and soil test based fertilizer recommendation (ST), and a series of nitrogen (N) rate treatments. The NUE decreased with increasing N application, while the yield did not increase significantly beyond N application rates of about 140 kg ha−1 (corresponding to the amount proposed by NE) in both early and late rice. NE increased grain yield (by 10.3% and 6.3%) and N uptake (by 5.7% and 4.0%) compared with FP and ST, respectively. NE significantly increased NUE compared with FP, and decreased the N surplus in comparison to FP and ST. The N dilution curve was Nc = 34.50 W−0.55 for early rice and Nc = 37.71 W−0.59 for late rice (where Nc is the N concentration in g kg−1, and W is the dry matter accumulation in t ha−1). The relationship between relative yield and the nitrogen nutrition index derived from the dilution curves confirmed that NE offered an optimum N application rate (approximately 140 kg ha−1) for both early and late rice. Carbon (C) and N translocation from vegetative organs to grains was enhanced with increasing N rate, while NE significantly increased C and N translocation compared with FP. Overall, the NE system ensured a high rice yield, increased N uptake and NUE. Therefore, the NE, as a user-friendly tool, is a sustainable fertilizer recommendation approach suitable for double rice cropping system, especially when soil testing is not available or timely for smallholders.

Age-related hearing loss (AHL) is typically caused by the irreversible death of hair cells (HCs). Autophagy is a constitutive pathway to strengthen cell survival under normal or stress condition. Our previous work suggested that impaired autophagy played an important role in the development of AHL in C57BL/6 mice, although the underlying mechanism of autophagy in AHL still needs to be investigated. SIRT1 as an important regulator involves in AHL and is also a regulator of autophagy. Thus, we hypothesized that the modulation between SIRT1 and autophagy contribute to HC death and the progressive hearing dysfunction in aging. In the auditory cell line HEI-OC1, SIRT1 modulated autophagosome induction because of SIRT1 deacetylating a core autophagy protein ATG9A. The deacetylation of ATG9A not only affects the autophagosome membrane formation but also acts as a sensor of endoplasmic reticulum (ER) stress inducing autophagy. Moreover, the silencing of SIRT1 facilitated cell death via autophagy inhibition, whereas SIRT1 and autophagy activation reversed the SIRT1 inhibition media cell death. Notably, resveratrol, the first natural agonist of SIRT1, altered the organ of Corti autophagy impairment of the 12-month-old C57BL/6 mice and delayed AHL. The activation of SIRT1 modulates the deacetylation status of ATG9A, which acts as a sensor of ER stress, providing a novel perspective in elucidating the link between ER stress and autophagy in aging. Because SIRT1 activation restores autophagy with reduced HC death and hearing loss, it could be used as a strategy to delay AHL.

OBJECTIVES The aim of the study was to investigate (a) postural control, especially trunk and head control, in patients with unilateral vestibular hypofunction and healthy controls during walking on firm and foam surface and (b) the difference between the impact of left and right unilateral vestibular hypofunction, and correlation between trunk/head control and vestibular function in the patients. DESIGN Thirteen patients and 13 healthy controls were recruited. Vestibular function was examined based on the canal paresis value. Participants walked on a treadmill on firm and foam surface. Peak-to-peak trunk (Troll and Tpitch) and head roll and pitch angle (Hroll and Hpitch) were calculated as primary outcome measures. RESULTS In the unilateral vestibular hypofunction group but not healthy controls, Troll was significantly higher on foam than firm surface (P = 0.03). Tpitch was significantly higher on foam than firm surface in both groups (P = 0.02). Patients had significantly lower Hroll (P = 0.03) and Hpitch (P = 0.02) and lower head-trunk correlation in both medio-lateral (P = 0.05) and anteroposterior direction (P = 0.03) than those in the healthy control group. CONCLUSIONS Patients with unilateral vestibular hypofunction seemed to rely more on lower limb somatosensory input for trunk control especially in the medio-lateral direction compared with healthy controls. Lower head sway and head-trunk correlation may suggest a more independent and successful head control strategy in patients.

To make otolaryngologists aware of the variant types of auricular sinus, we have performed a systematic review of patient diagnoses and presented our operative experiences. From 2009 to 2013 in Sun Yat-Sen Memorial Hospital, there was a total of 20 children with the variant type of auricular sinuses including the comprehensive group. Postauricular sinuses have pits located posterior to the imaginary vertical line that is tangent to the external auditory canal. Sinuses that penetrate the cartilage and cause postauricular swelling or skin defects characterize type 1 of the variant type, while sinuses that adhere to the cartilage and cause preauricular or auricular swelling or skin defects characterize type 2. Patients with pits both anterior to and posterior to the imaginary vertical line comprise the comprehensive group. The patients who had infected underwent auricular sinusectomy using a dual approach, with accurate fistula tracing and proper cartilage removal. Sixteen children who had infected sinus underwent surgery, while the other four were asymptomatic. Ten children (62.5%) of 16 patients were diagnosed as type 1 of the variant type, 2 (12.5%) as type 2. Four children (25%) were diagnosis as the comprehensive group. The asymptomatic could not be defined as the sinuses location were unknown. Sixteen children (100%) of 16 patients who underwent surgery had a history of misdiagnosis and treatment. These patients did not experience recurrence over a 5-year follow-up period. The locations of pits and sinuses help to categorize the different types of auricular sinus. The effective method that we have described should be considered a viable way to reduce recurrence.

The direct diastereo- and enantioselective 1,8-conjugate additions of thiazolones and azlactones, respectively, to para-quinone methides generated in situ from propargylic alcohols have been achieved in the presence of chiral phosphoric acids. The remote stereocontrolled activation protocol provides an efficient and facile approach for the construction of vicinal axially chiral tetrasubstituted allenes and heteroatom-functionalized quaternary carbon stereocenters, which expands the synthetic potential of chiral phosphoric acids.

Bcl-2, the first gene shown to be involved in apoptosis, is a potent regulator of cell survival and known to have protective effects against a variety of age-related diseases. However, the possible relationship between hearing and Bcl-2 expression in the cochlea or auditory cortex of C57BL/6 mice, a mouse model of age-related hearing loss, is still unknown. Using RT-PCR, immunohistochemistry, and Western blot analysis, our results show that Bcl-2 is strongly expressed in the inner hair cells and spiral ganglion neurons of young mice. In addition, moderate Bcl-2 expression is also detected in the outer hair cells and in the neurons of the auditory cortex. A significant reduction of Bcl-2 expression in the cochlea or auditory cortex is also associated with elevated hearing thresholds and hair cell loss during aging. The expression pattern of Bcl-2 in the peripheral and central auditory systems suggests that Bcl-2 may play an important role in auditory function serving as a protective molecule against age-related hearing loss.

Head and trunk control during standing in patients with vestibular disorder may depend on intact visual signal to override vestibular disturbance. It is unknown if such process during walking would change. Therefore, the aims of this study were to quantify (1) head and trunk control in healthy participants (HPs) and patients with unilateral vestibular hypofunction (UVH) during walking with and without visual manipulation; and (2) the correlation/association between vestibular function and head/trunk control during walking with visual manipulation in patients. Seventeen UVH patients and 15 HPs completed all the tests. They participated in the caloric test, which was used to examine vestibular function, and walked on a treadmill with and without visual manipulation. Head and trunk angular displacement and velocity were primary outcome measures, deviation of center of mass and step variability were secondary. Head roll angular displacement (7.38° ± 1.38 [mean ± SE] v.s. 12.95° ± 1.48, p = 0.004) and head-trunk correlation (in the pitch/sagittal plane: 0.22 ± 0.05 v.s. 0.38 ± 0.05, roll/frontal plane: 0.35 ± 0.06 v.s. 0.55 ± 0.06, p 0.05) were significantly lower in patients compared to HPs. Head pitch angular velocity (8.58°/s ± 2.17 v.s. 14.23°/s ± 1.22, p = 0.026) and step width variability (0.075 ± 0.010 v.s. 0.083 ± 0.009, p = 0.04) increased with visual manipulation only in patients. No significant correlation/association was found between vestibular function and head/trunk control. Lower head-trunk correlation in patients suggests an independent head-trunk control strategy in response to vestibular impairment. Visual input could be used by patients to compensate for vestibular disturbance for head control and foot placement. Severe UVH may not lead to worse postural control compared to mild disorder.

The molecular mechanisms underlying age-related hearing loss are not fully understood, and currently, there is no treatment for this disorder. MicroRNAs have recently been reported to be increasingly associated with age-related diseases and are emerging as promising therapeutic targets. In this study, miR-34a/Sirtuin 1 (SIRT1)/p53 signaling was examined in cochlear hair cells during aging. MiR-34a, p53 acetylation, and apoptosis increased in the cochlea of C57BL/6 mice with aging, whereas an age-related decrease in SIRT1 was observed. In the inner ear HEI-OC1 cell line, miR-34a overexpression inhibited SIRT1, leading to an increase in p53 acetylation and apoptosis. Moreover, miR-34a knockdown increased SIRT1 expression and diminished p53 acetylation, and apoptosis. Additionally, resveratrol, an activator of SIRT1, significantly rescued miR-34a overexpression-induced HEI-OC1 cell death and significantly reduced hearing threshold shifts and hair cell loss in C57BL/6 mice after a 2-month administration. Our results support a link between age-related cochlear hair cell apoptosis and miR-34a/SIRT1/p53 signaling, which may serve as a potential target for age-related hearing loss treatment.

The sirtuin SIRT1 is a highly conserved nicotinamide adenine dinucleotide (NAD)-dependent protein deacetylase known to have protective effects against a wide range of neurological disorders. In the present study, we discovered that C57BL/6 mice fed a long-term diet supplemented with high-dose resveratrol exhibited increased cochlear SIRT1 activity and presented a better recovery of hearing and less loss of hair cells after intense noise exposure compared with those fed a standard chew. Moreover, resveratrol attenuated cochlear SIRT1 decrease and reduced oxidative stress in the cochlea after noise exposure. These results suggest a considerable therapeutic potential of resveratrol for the treatment of noise-induced hearing loss.

Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.

Here, we aimed to compare the unstable gait caused by unilateral vestibular hypofunction (UVH) with the normal gait. Twelve patients with UVH and twelve age-matched control subjects were enrolled in the study. Thirty-four markers were attached to anatomical positions of each participant, and a three-dimensional (3D) motion analysis system was used to capture marker coordinates as the participants walked on a treadmill. The mean standard deviation of the rotation angles was used to represent gait variability. To explore gait stability, local dynamic stability was calculated from the trunk trajectory. The UVH group had wider step width and greater variability of roll rotation at the hip than the control group (P<0.05). Also, the UVH group had lower local dynamic stability in the medial-lateral (ML) direction than the control group (P<0.05). By linear regression analysis, we identified a linear relationship between the short-term Lyapunov exponent and vestibular functional asymmetry. The result implies that UVH-induced asymmetry can increase posture variability and gait instability. This study demonstrates the potential for using kinematic parameters to quantitatively evaluate the severity of vestibular functional asymmetry. Further studies will be needed to explore the clinical effectiveness of such approaches.

Triggering receptor expressed on myeloid cells (TREM) has been broadly studied in inflammatory disease. However, the expression and function of TREM-2 remain undiscovered in acquired cholesteatoma. The expression of TREM-2 was significantly higher in human acquired cholesteatoma than in normal skin from the external auditory canal, and its expression level was positively correlated with the severity of bone destruction. Furthermore, TREM-2 was mainly expressed on dendritic cells (DCs). In human acquired cholesteatoma, the expression of proinflammatory cytokines (IL-1β, TNF-α and IL-6) and matrix metalloproteinases (MMP-2, MMP-8 and MMP-9) were up-regulated, and their expression levels were positively correlated with TREM-2 expression. Osteoclasts were activated in human acquired cholesteatoma. In an animal model, TREM-2 was up-regulated in mice with experimentally acquired cholesteatoma. TREM-2 deficiency impaired the maturation of experimentally acquired cholesteatoma and protected against bone destruction induced by experimentally acquired cholesteatoma. Additional data showed that TREM-2 up-regulated IL-1β and IL-6 expression via TLR4 instead of the TLR2 signaling pathway and promoted MMP-2 and MMP-8 secretion and osteoclast activation in experimentally acquired cholesteatoma. Therefore, TREM-2 might enhance acquired cholesteatoma-induced bone destruction by amplifying the inflammatory response via TLR4 signaling pathways and promoting MMP secretion and osteoclast activation.

The C57BL/6 strain is considered an excellent model to study age-related hearing loss (AHL). Aging C57BL/6 mice are characterized by profound hearing loss but conservation of the endocochlear potential (EP). Here we show 12-month-old C57BL/6 mice display a notable hearing loss at 4, 8, 16 and 32 kHz while the EP is maintained at normal level. Morphological examination shows significant outer hair cells loss in the cochlear basal turn and atrophy of the stria vascularis (SV). Fluorescence immunohistochemical studies reveal that potassium channel KCNJ10 and KCNQ1 expression dramatically decreased in the SV. Concomitant with this, mRNA levels of KCNJ10 and KCNQ1 are also reduced. In addition, three other potassium transporters, including α1-Na,K-ATPase, α2-Na,K-ATPase and NKCC1, reduce their expression at mRNA levels as well. These observations suggest that conservation of the EP in aging C57BL/6 mice is attributable to the SV generating a new balance for potassium influx and efflux at a relatively lower level.

MicroRNAs, such as miR-34, have been reported to influence age-related diseases. In this study, we explored the role of the miR-34a/Bcl-2 signaling pathway in age-related hearing loss (AHL). Using an AHL mouse model (C57BL/6), we found that the expression of miR-34a in the cochlea increased with age, whereas expression of Bcl-2 decreased. Increasing the amount of a miR-34a mimetic in a mouse auditory cell line (HEI-OC1) inhibited Bcl-2, leading to enhanced apoptosis; in contrast, miR-34a inhibition produced the opposite effect. Our results support a link between age-related cochlear hair cell apoptosis and miR-34a/Bcl-2 signaling. The latter may thus serve as a potential target for AHL therapy.

Hypothesis: The miR-34a/Bcl-2 signaling pathway may play a role in the mechanisms related to age-related hearing loss (AHL) in the auditory cortex. Background: The auditory cortex plays a key role in the recognition and processing of complex sound. It is difficult to explain why patients with AHL have poor speech recognition, so increasing numbers of studies have focused on its central change. Although micro (mi)RNAs in the central nervous system have recently been increasingly reported to be associated with age-related diseases, the molecular mechanisms of AHL in the auditory cortex are not fully understood. Methods: The auditory brainstem response was used to assess the hearing ability of C57BL/6 mice, and q-PCR, immunohistochemistry, and Western blotting were used to detect the expression levels of miR-34a and Bcl-2 in the mouse auditory cortex. TUNEL and DNA fragmentation were adopted to detect the apoptosis of neurons in the auditory cortex. To verify the relationship of miR-34a and Bcl-2, we transfected an miR-34a mimic or miR-34a inhibitor into primary auditory cortex neurons. Results: In this study, miR-34a/Bcl-2 signaling was examined in auditory cortex neurons during aging. miR-34a and apoptosis increased in the auditory cortex neurons of C57BL/6 mice with aging, whereas an age-related decrease in Bcl-2 was determined. In the primary neurons of the auditory cortex, miR-34a overexpression inhibited Bcl-2, leading to an increase in apoptosis. Moreover, miR-34a knockdown increased Bcl-2 expression and diminished apoptosis. Conclusion: Our results support a link between age-related apoptosis in auditory cortex neurons and miR-34a/Bcl-2 signaling, which may serve as a potential mechanism of the expression of AHL in the auditory cortex.

The hypoxia-inducible factor and vascular endothelial growth factor (HIF-VEGF) pathway in hypoxic conditions of the middle ear due to dysfunction of the eustachian tube is still unknown, but it is considered as one pathogenetic mechanism in otitis media. This study was designed to investigate the possible involvement of the HIF-VEFG pathway in otitis media with effusion induced by dysfunction of the eustachian tube. We adopted a soft palate approach to obstruct the orifice of the eustachian tube to establish otitis media in a rat model. Auditory evoked brainstem response and tympanometry were used as hearing function tests, hypoxia-related factors were examined by reverse transcriptase polymerase chain reaction (RT-PCR). The expression of hypoxia-related proteins was detected by Western blot and immunostaining. The model of otitis media with effusion was successfully induced by cauterizing the orifice of the eustachian tube. RT-PCR showed up-regulation of hypoxia-related factors in cauterized ears. Western blot and immunostaining showed that the expression of hypoxia-related proteins in cauterized ears was increased. Hypoxia-induced vascular proliferation and an increase in permeability may be one pathogenetic mechanism of otitis media due to dysfunction of the eustachian tube.

Age-related hearing loss (AHL) is a progressive neurodegenerative disease that is largely silent in its initial stages. There is no sensitive blood biomarker for diagnosis or early detection of AHL. MicroRNAs (miRNAs or miRs) are abundant and highly stable in blood, and have been recently described as powerful circulating biomarkers in a wide range of diseases. In the present study, we identified concordant increases in miR-34a levels in the cochlea, auditory cortex, and plasma of C57BL/6 mice during aging. These increases were accompanied by elevated hearing thresholds and greater loss of hair cells. Levels of miR-34a targets, silent information regulator 1 (SIRT1), B-cell lymphoma-2 (Bcl-2), and E2F transcription factor 3 (E2F3), in the cochlea, auditory cortex, and plasma decreased with aging inversely to miR-34a. Moreover, plasma miR-34a levels were significantly higher in patients with AHL compared with controls who had normal hearing and had a receiver-operating characteristic curve that distinguished AHL patients from controls. However, SIRT1, Bcl-2, and E2F3 showed no correlation with AHL in humans. In summary, circulating miR-34a level may potentially serve as a useful biomarker for early detection of AHL.

To investigate the risk factor,type and characteristic nystagmus of the otolith abnormal migration during diagnosis and treatment for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV). The therapy and prevention is also discussed.Four hundred and seventy-nine patients with PSC-BPPV were treated by Epley's canalith repositioning procedures(CRP) from March 2009 to March 2012. We observed otolith abnormal migration complicating during diagnosis and treatment. According the type of otolith abnormal migration, the additional repositioning maneuver was performed.The rate of complication was 8. 1%(39/479), with canal conversion in 5.4%(26/479) and primarily canal reentry in 2.7%(13/479). The rate of incidence of conversion to horizontal canal conversion and anterior canal were 4. 8%(23/479)and 0. 6%(3/479) respectively. All the patient was cured in follow up. The risk factors were unappropriated head movement during or after CRP, including another Dix-Hallpike were performed immediately.To prevent the complications,the pathognostic positioning sequence and angle of head rotation are commenced during CRP. Appropriate short time postural restrictions post-treatment is necessary. Careful observation of nystagrnus variation is crucial to determine the otolith abnormal migration.

Age-related hearing loss is a major unresolved public health problem. We have previously elucidated that the activation of cochlear miR-34a is correlated with age-related hearing loss in C57BL/6 mice. A growing body of evidence points that aberrant autophagy promotes cell death during the development of multiple age-related diseases. The aim of this study was to investigate the role of miR-34a-involved disorder of autophagy in the pathogenesis of age-related hearing loss. Our results showed that miR-34a expression was markedly upregulated in the aging cochlea accompanied with impairment of autophagic flux. In the inner ear HEI-OC1 cell line, miR-34a overexpression resulted in an accumulation of phagophores and impaired autophagosome–lysosome fusion, and led to cell death subsequently. Notably, autophagy-related protein 9A (ATG9A), an autophagy protein, was significantly decreased after miR-34a overexpression. Knockdown of ATG9A inhibited autophagy flux, which is similar to the effects of miR-34a overexpression. Moreover, ursodeoxycholic acid significantly rescued miR-34a-induced HEI-OC1 cell death by restoring autophagy activity. Collectively, these findings increase our understanding of the biological effects of miR-34a in the development of age-related hearing loss and highlight miR-34a as a promising therapeutic target for its treatment.