A prospective trial of unilateral grommets for bilateral secretory otitis media in children

Fifty-four children with established chronic secretory otitis media, who had failed to respond to medical measures were treated with adenoidectomy and insertion of 1 grommet on a side chosen at random. Both sides improved and remained significantly improved at 12 months (P <0.001). At 3 months, the side with the grommet improved significantly more than the other side (P <0.05) but at 12 months there was no significant difference between the 2 sides (P< 0.1).     

温阳方治疗慢性心力衰竭的临床研究

目的：探讨温阳方联合西药治疗慢性心力衰竭（ CHF）的临床疗效。方法70例CHF 患者随机分温阳方＋西药治疗组35例（试验组）和西药治疗组35例（对照组）。对照组给予降血压、β受体阻滞剂、利尿剂、强心等药物治疗;试验组在对照组的基础上予以温阳方,2组患者治疗1个月。治疗1个月后评价2组患者神经内分泌指标及左室射血分数（LVEF）。结果治疗1个月后,试验组与对照组血浆去甲肾上腺素（NE）、血管紧张素Ⅱ（AngⅡ）和醛固醇（ALD）均明显降低（P ＜0．05）,左室射血分数（LVEF）均显著升高（P ＜0．05）,但试验组与对照组相比变化更为显著（P ＜0．05）。治疗后试验组总有效率显著高于对照组（P ＜0．05）。结论温阳方联合西药治疗CHF 可显著提高LVEF,改善心力衰竭症状。     

Multiple foci in parietal and frontal cortex activated by rubbing embossed grating patterns across fingerpads: a positron emission tomography study in humans

Somatosensory representations occupy parietal postcentral gyral (S1) and lateral sulcal-opercular cortex (S2). To address the issue of possible multiple activation foci in these regions and possible differences due to stimulating skin directly or through an imposed tool, we studied changes in cerebral blood flow with positron emission tomography during passive tactile stimulation of one or two fingertips. Restrained fingers were rubbed with embossed gratings using a rotating drum stimulator in 11 subjects. For different scans, gratings touched the skin directly for optimal stimulation of cutaneous receptors (called skin mode stimulation) or indirectly through an imposed guitar plectrum snugly fitted to the same fingers (called tool mode stimulation). The latter was expected to stimulate deep receptors better. Subjects estimated roughness after each scan. Direct skin contact activated statistically validated foci in both hemispheres. On the contralateral side these foci occurred in the anterior and posterior limbs of the postcentral gyrus and on the ipsilateral side only in the posterior limb. Tool mode stimulation activated one contralateral focus that was in the posterior limb of the postcentral gyrus. These results suggest at least two maps for distal fingertips in S1 with the anterior and posterior foci corresponding, respectively, to activations in area 3b and the junction between areas 1 and 2. In contralateral S2, skin mode stimulation activated a peak that was anterior and medial to a focus associated with tool mode stimulation. The magnitude of PET counts contralateral to stimulation was greater in the anterior S1 and the S2 regions during initial scans but reversed to more activation in the posterior S1 during later scans. These short- term practice effects suggest changes in neural activity with stimulus novelty.