Abstract Introduction: Propofol is a widely used anesthetic and its dose is closely related to aging. Telomere length (TL) is a unique heritable trait, and emerging as a biomarker of aging, health and disease. Telomerase RNA component (TERC) plays an important role in maintaining TL. We proposed a hypothesis that propofol dose in general anesthesia can be predicted by measuring TL before operation, which greatly reduced the risk of anesthesia, especially the elderly. Methods: The association between the propofol dose in anesthesia induction and: TL in the DNA of peripheral blood leukocytes; body weight; sex; difference of the Bispectral Index (BIS) before and after anesthesia induction in patients was evaluated by multivariable linear regression analyses. The mutation at the 5’end or 3’end of TERC was detected. We recruited 100 patients of elective surgery. Results: We found that propofol dose in anesthesia induction was clearly correlated significantly with TL (r = 0.78, p < 0.001), body weight (r = 0.84, p = 0.004), sex (r = 0.83, p= 0.84, p = 0.004), sex (r = 0.83, p = 0.004), and difference of BIS before and after anesthesia induction (r = 0.85, p = 0.029). By comparing the absolute values of standardized regression coefficients (0.58, 0.21, 0.19, and 0.12) of the four variables, it can be seen that TL contributes the most to the propofol dose in anesthesia induction. However, the mutation at the 5’ end or 3’ end of TERC was not found. Conclusions: These findings provide preliminary evidence that the propofol dose in anesthesia induction was clearly correlated with genetically determined TL. TL may be a promising predictor of the propofol dose, which is beneficial to improve the safety of anesthesia and reduce perioperative complications.

ABSTRACT Finger citron (Citrus medica L. var. sarcodactylis (Hoola van Nooten) Swingle; Rutaceae: Citrus) is an important plant for both medicine and food. Due to the lack of suitability analysis, many problems have arisen in its planting. According to the daily observation data, Kriging interpolation was selected to spatialize precipitation and temperature data. MaxEnt and ArcGIS were applied to simulate the suitable areas of finger citron in China from the perspectives of bioclimate, soil, topographic factors and human activities in 2050s and 2090s. Results showed that temperature annual range (Bio7), annual precipitation (Bio12), human footprint (Hf), elevation (El) and precipitation seasonality (Bio15) were identified as the dominant environmental variables related to the distribution of finger citron. Spatiotemporal distribution of annual precipitation (Bio12) showed that in the future, the precipitation in South China tends to decrease first (2050s) and then increase (2090s). The spatio-temporal analysis of temperature annual range (Bio7) showed that the 20-30 ℃ region was relatively stable in the Sichuan Basin and the middle and lower reaches of the Pearl River Basin. Under the future climate change scenarios, the total suitable area showed a significant increase trend in 2090s, and the change of most, moderately and poorly suitable habitats showed no obvious law. Under SSP1-2.6, SSP2-4.5 and SSP5-8.5 scenarios, the centroid of the most suitable habitat of finger citron would move to the northwest, southeast and southwest respectively. Our results can effectively carry out to promote the recovery of its population.

ABSTRACT Introduction: Acute type A aortic dissection (AAAD) in late pregnancy is a rare but severe disease. Lack of clinical experience is the main cause of high mortality. This study tries to investigate the multidisciplinary therapeutic strategy for these patients. Case presentation: We reported three patients with AAAD in late pregnancy. Sudden chest pain was the main clinical symptom before operation. All three patients and their newborns survived through multidisciplinary approach in diagnosis and treatment. No serious complications occurred during the mid-term follow-up. Conclusion: Multidisciplinary diagnosis and treatment strategy play a crucial role in saving the lives of pregnant women with AAAD. Introduction (AAAD disease mortality presentation operation midterm mid term followup. followup follow up. up follow-up Conclusion

Abstract To study the stability of meat color in the post-slaughter storage process of Qinchuan cattle, three different bovine muscles, including longissimus dorsi (LD), knee round (KR) and psoas major (PM) muscles of Qinchuan cattle, were selected as research objects to determine the changes in meat color, myoglobin (Mb) relative content, pH, oxygen consumption rate (OCR), total iron, heme iron (HI) and other contents during storage. With the prolongation of the storage time, the relative content of oxymyoglobin (OxyMb) decreased, the relative content of metmyoglobin (MetMb) gradually increased, and muscle browning was due to the increase of a* value and hue value; Among them, HI and non-heme iron (NHI) reduced the stability of meat color by accelerating lipid oxidation, which was consistent with the results of Mb content and meat color index determining meat color stability. Therefore, the total iron content in muscles can also be used as an indicator of meat color stability.

ABSTRACT Purpose: Myocardial ischemia/reperfusion injury (MIRI) leads to myocardial tissue necrosis, which will increase the size of myocardial infarction. The study examined the protective effect and mechanism of the Guanxin Danshen formula (GXDSF) on MIRI in rats. Methods: MIRI model was performed in rats; rat H9C2 cardiomyocytes were hypoxia-reoxygenated to establish a cell injury model. Results: The GXDSF significantly reduced myocardial ischemia area, reduced myocardial structural injury, decreased the levels of interleukin (IL-1β, IL-6) in serum, decreased the activity of myocardial enzymes, increased the activity of superoxide dismutase (SOD), and reduced glutathione in rats with MIRI. The GXDSF can reduce the expression of nucleotide- binding oligomerization domain, leucine-rich repeat and pyrin domain containing nod-like receptor family protein 3 (NLRP3), IL-1β, caspase-1, and gasdermin D (GSDMD) in myocardial tissue cells. Salvianolic acid B and notoginsenoside R1 protected H9C2 cardiomyocytes from hypoxia and reoxygenation injury and reduced the levels of tumor necrosis factor α (TNF-α) and IL-6 in the cell supernatant, decreasing the NLRP3, IL-18, IL-1β, caspase-1, and GSDMD expression in H9C2 cardiomyocytes. GXDSF can reduce the myocardial infarction area and alleviate the damage to myocardial structure in rats with MIRI, which may be related to the regulation of the NLRP3. Conclusions: GXDSF reduces MIRI in rat myocardial infarction injury, improves structural damage in myocardial ischemia injury, and reduces myocardial tissue inflammation and oxidative stress by lowering inflammatory factors and controlling focal cell death signaling pathways.

Abstract A total of 83 acid-producing strains were isolated from fresh Lentinus edodes, Pleurotus eryngii, Flammulina velutipes, Agaricus bisporus, Pleurotus ostreatus, Pleurotus djamor, Pleurotus abalones, and Pleurotus citrinopileatus by CaCO3-MRS plate medium. These 83 strains were divided into 9 species, including 52 strains of Lactococcus lactis, 13 strains of Pediococcus pentosaceus, 8 strains of Enterococcus faecium, 3 strains of Lactococcus garvieae, 2 strains of Enterococcus casseliflavus, 2 strains of Lactobacillus plantarum, 1 strain of Enterococcus lactis, 1 strain of Pediococcus acidilactici, and 1 strain of Lactobacillus pentosus based on the catalase test, Gram staining, and 16S rDNA molecular identification. Among these P. acidilactici, P. pentosus, and L. plantarum could be used in food. P. acidilactici had a strong acid-producing capacity and fast growth rate, thus showing preferable fermentation characteristics in MRS broth and edible mushroom medium than P. pentosus and L. plantarum. In the medium of L. edodes, P. eryngii, and F. velutipes, the best sensory state can be reached within 12-24 h, among them P. eryngii had the best fermentation effect, which was characterized by uniform and bright color, moderate acidity, good flavor, and tight tissue state. This study investigated the types and fermentation characteristics of lactic acid bacteria (LAB) derived from edible mushrooms, enriched the resources of LAB suitable for the fermentation, and provided a theoretical reference for the application of LAB fermentation technology of edible mushrooms.

The mutations of breast cancer susceptibility gene 1 (BRCA1) play an important role in inherited breast cancers. Thus, the sensitive assay of the BRCA1 gene is extremely important for disease diagnosis and human health. Herein, a fast, sensitive and selective assay technique has been constructed based on fluorescent copper nanoclusters (CuNCs). The CuNCs were successfully formed with poly(AT-TA) double stranded DNA (dsDNA) as template. In the absence of the target, a strong red emission was observed under 365 nm ultraviolet (UV) lamp and a big fluorescence response was obtained. However, in the presence of BRCA1 gene, there was only weak red emission and a low response signal was produced because of the target-proximity induced quenching of the fluorescence of CuNCs. The linear range for the BRCA1 gene assay was 2-600 nM, and the limit of detection was 2 nM. The assay technique showed good selectivity, good stability and satisfactory recoveries for the detection of BRCA1 gene in diluted serum samples. Moreover, by integrating a UV lamp and a smartphone, the fluorescence sensor would be transferred to a microfluidic chip, providing a prospective application in point-of-care for monitoring breast cancer risk.

Pilot trials have suggested that repetitive transcranial magnetic stimulation (rTMS) may reduce limb spasticity in multiple sclerosis (MS). We carried out the current meta-analysis to synthesize currently available evidence regarding such correlation. Up to November 2022, five international electronic databases (Cochrane CENTRAL, PubMed, Embase, Web of Science, and CINAHL) and four Chinese electronic databases (CBM, CNKI, WanFang Data, and VIP) were systematically searched to identify randomized trials comparing active rTMS and sham stimulation in patients with MS-related spasticity. Two reviewers independently selected studies and extracted data on study design, quality, clinical outcomes, and time points measured. The primary outcome was clinical spasticity relief after intervention. Secondary outcomes included spasticity at the follow-up visit 2 weeks later and post-treatment fatigue. Of 831 titles found, we included 8 studies (181 participants) in the quantitative analysis. Pooled analyses showed that rTMS therapy was associated with significant spasticity relief in the early post-intervention period [standardized mean differences (SMD): -0.67; 95%CI: -1.12 to -0.21], but there was insufficient evidence for rTMS in reducing spasticity at the follow-up visit 2 weeks later (SMD: -0.17; 95%CI: -0.52 to 0.17) and fatigue (SMD: -0.26; 95%CI: -0.84 to 0.31). This evidence supports the recommendations to treat MS-related spasticity with rTMS, but underlines the need for further large randomized trials.

ABSTRACT Introduction: It is believed that weight training on the lower limbs in martial arts athletes can contribute to a better performance of the whiplash, a specific movement that encompasses pliometry, balance and strength. Objective: Study the effects of weight training on lower limb strength in martial arts athletes when performing the whiplash. Methods: A controlled experiment was conducted involving 100 martial arts athletes, randomly divided into two groups of characteristics without statically relevant differences. The experimental group received weight training, while the control group received no additional intervention to their daily training. Results: The vertical jump in the experimental group increased from 31.24 ± 6.65 cm to 36.00 ± 9.62 cm; the vertical jump in horizontal standing position increased from 195.49 ± 4.16 cm to 196.51 ± 7.49 cm; the approach vertical jump varied from 32.94 ± 9.21 cm to 37.60 ± 11. 50 cm; the jump from the local half squat position was from 34.55 ± 6.40 cm to 40.30 ± 8.14 cm; the maximum force of a squat with weights was from 140.81 ± 10.05 kg to 142.06 ± 10.23 kg; the maximum number of supine leg raises in one minute increased from 43.43 ± 6.15 to 48.05 ± 7.29. Conclusion: Weight training positively influenced lower limb strength in martial arts athletes, whiplash performance was elevated. Weight training is recommended in the daily training of martial arts athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMEN Introducción: Se cree que el entrenamiento con pesas sobre los miembros inferiores en atletas de artes marciales puede contribuir para una mejor ejecución del whiplash, un movimiento específico que engloba pliometría, equilibrio y fuerza. Objetivo: Estudiar los efectos del entrenamiento con pesas en la fuerza de los miembros inferiores en atletas de artes marciales al realizar el whiplash. Métodos: Se realizó un experimento controlado con 100 atletas de artes marciales, divididos aleatoriamente en dos grupos de características sin diferencias estadísticamente relevantes. El grupo experimental recibió entrenamiento con pesas, mientras que el grupo de control no recibió ninguna intervención adicional a su entrenamiento diario. Resultados: El salto vertical en el grupo experimental aumentó de 31,24 ± 6,65 cm a 36,00 ± 9,62 cm; el salto vertical horizontal de pie aumentó de 195,49 ± 4,16 cm a 196,51 ± 7,49 cm; el salto vertical de aproximación varió de 32,94 ± 9,21 cm a 37,60 ± 11. 50 cm; el salto desde la posición de media sentadilla local fue de 34,55 ± 6,40 cm a 40,30 ± 8,14 cm; la fuerza máxima de una sentadilla con pesas fue de 140,81 ± 10,05 kg a 142,06 ± 10,23 kg; el número máximo de elevaciones de piernas en decúbito supino en un minuto aumentó de 43,43 ± 6,15 a 48,05 ± 7,29. Conclusión: El entrenamiento con pesas influyó positivamente en la fuerza de las extremidades inferiores de los atletas de artes marciales y elevó el rendimiento de los whiplashs. Se recomienda el entrenamiento con pesas en el entrenamiento diario de los atletas de artes marciales. Nivel de evidencia II; Estudios terapéuticos-investigación de los resultados del tratamiento.

RESUMO Introdução: Acredita-se que o treinamento com pesos nos membros inferiores em atletas de artes marciais possa contribuir para um melhor desempenho do whiplash, um movimento específico que engloba pliometria, equilíbrio e força. Objetivo: Estudar os efeitos do treinamento com pesos sobre a força dos membros inferiores em aletas de artes marciais na execução do whiplash. Métodos: Foi conduzida uma experiência controlada envolvendo 100 atletas de artes marciais, divididos aleatoriamente em dois grupos de características sem diferenças estaticamente relevantes. O grupo experimental recebeu treinamento com pesos, enquanto o grupo de controle não recebeu nenhuma intervenção adicional ao treino cotidiano. Resultados: O salto vertical no grupo experimental elevou-se de 31,24 ± 6,65 cm para 36,00 ± 9,62 cm; o salto vertical em pé horizontal elevou-se de 195,49 ± 4,16 cm para 196,51 ± 7,49 cm; o salto vertical de aproximação variou de 32,94 ± 9,21 cm para 37,60 ± 11. 50 cm; o salto da posição de meio agachamento local foi de 34,55 ± 6,40 cm para 40,30 ± 8,14 cm; a força máxima de um agachamento com pesos foi de 140,81 ± 10,05 kg para 142,06 ± 10,23 kg; o número máximo de elevações de pernas supinas em um minuto elevou-se de 43,43 ± 6,15 para 48,05 ± 7,29. Conclusão: O treinamento com pesos influenciou positivamente na força dos membros inferiores em atletas de artes marciais, o desempenho do whiplash foi elevado. Recomenda-se o treinamento de pesos no treinamento diário dos atletas de artes marciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

ABSTRACT Top-quality pellets can significantly increase density and durability of agricultural residues, reducing logistic costs. However, these pellets depend on numerous parameters, including feedstock properties and production conditions. To ensure high-quality pellets, a single-factor experiment and the response surface methodology were used to investigate the effects of particle size, moisture content, molding pressure, pelleting time, ultrasonic power, and interaction effects between variables on density and durability of pellets for ultrasonic vibration-assisted pelleting of corn stover. The response surface models between variables and response were established. The results showed that all variables affect the density and durability of pellets. An optimal condition for density and durability was obtained, and a further experiment was conducted to validate the values. The results suggested that desirability (0.999) under optimal conditions confirmed the validation of models. The optimal combination of process parameters included particle size of 1.5 mm, moisture content of 10 %, molding pressure of 379 kPa, pelleting time of 80 s, ultrasonic power of 250 W, with values of 1,381.14 kg m–3 and 97.58 % for density and durability of pellets, respectively.

ABSTRACT Purpose: Oxidative stress and apoptosis contribute to the pathological basis of doxorubicin (DOX)-induced cardiotoxicity. Columbianadin (CBN) is one of the main bioactive constituents isolated from the root of Angelica pubescens. Herein, we intended to explore the potential role and molecular basis of CBN in DOX-induced cardiotoxicity. Methods: C57BL/6 mice were subjected to DOX (15 mg/kg/day, i.p.) to generate DOX-induced cardiotoxicity. CBN (10 mg/kg/day, i.p.) was administered for four week following DOX injection. Results: DOX administered markedly dampened cardiac function, increased cardiac injury, excessive reactive oxygen species (ROS) production, and cardiomyocyte loss. These alterations induced by DOX significantly alleviated by CBN treatment. Mechanistically, our results demonstrated that the CBN exerts cardioprotection role against DOX by up-regulating silent information regulator 1 (Sirt1) and decreasing acetylation of forkhead box O1 (FOXO1). Moreover, Sirt1 inhibition with Ex-527 significantly blunt the beneficial effect of CBN on DOX-induced cardiotoxicity, including cardiac dysfunction, ROS, and apoptosis. Conclusion: Collectively, CBN attenuated oxidative stress and cardiomyocyte apoptosis in DOX-induced cardiotoxicity through maintaining Sirt1/FOXO1 signaling pathway. Our results demonstrated that CBN might be used to treat DOX-related cardiotoxicity.

ABSTRACT PreS/S gene mutations could impact virus secretion, infection and immune evasion. However, the relationship between PreS/S mutations and intrauterine transmission has not yet been clarified. Thus, we aimed to explore the associations between PreS/S gene mutations of HBV isolated from mothers and intrauterine transmission. We analyzed the mutations of PreS/S regions of the HBV genome in mothers with HBV DNA levels ≥ 106 IU/mL whose neonates experienced HBV intrauterine transmission (transmission group, GT) and those whose neonates did not experience intrauterine transmission (control group, GC) analyzed using clone-based sequencing. In total, 206 sequences were successfully amplified, including 98 sequences (from 21 mothers) from GT and 108 sequences (from 20 mothers) from GC of genotype C for mutational analysis. Among the 1203 nucleotides of PreS/S regions, there were 219 (18.20%) base substitutions, of which 103 (47.03%) base mutations caused amino acid changes. F80S, A90V and I68T were mutation hotspots. Mothers in GT had a higher mutation rate of A90V in the PreS1 gene than mothers in GC. The A90V mutation increased the risk of HBV intrauterine transmission after adjusting the maternal age and the mode of delivery (OR = 6.23, 95% CI: 1.18–32.97). Moreover, the area under the ROC curve (AUC) for intrauterine transmission due to A90V and a combination of A90V with the mode of delivery were 0.723 (95% CI: 0.575 to 0.891, P = 0.011) and 0.848 (95% CI: 0.723 to 0.972, P < 0.001), respectively. Mothers with the A90V mutation in the PreS1 gene may be a potential risk factor for HBV intrauterine transmission.

Abstract Adaptation of photoperiod-sensitive japonica rice varieties from long-day (LD) to short-day (SD) conditions is impeded by their extremely early flowering in response to photoperiod change, but the genetic factor underlying this is still elusive. We detected mutations in Hd1 in Zhenjing2400 through gene mapping and sequencing analysis. Genome resequencing of the varieties Zhenjing2400 and Jiahe218 identified single nucleotide polymorphisms (SNPs) in the other flowering-related genes Ehd1, SDG725, OsCOL15, DTH2, and DTH7. We constructed recombinant inbred lines (RILs) derived from a cross between Zhenjing2400 and Jiahe218, and selected homozygous lines with these six genes. We established that photoperiod insensitivity is caused by a defective Hd1 gene. In addition, the effect of Hd1 and Ehd1 on heading date was stronger than that of the other four genes. Measurements of agronomic traits and quality traits in homozygous lines demonstrated the superiority of the hd1 ehd1 genotype for eating quality and photoperiod-insensitive high yield. photoperiodsensitive sensitive longday long day LD (LD shortday short SD (SD change elusive Hd Zhenjing Zhenjing240 analysis Jiahe Jiahe21 SNPs (SNPs floweringrelated related Ehd SDG725 SDG OsCOL15 OsCOL DTH2 DTH DTH7 RILs (RILs addition hd ehd photoperiodinsensitive insensitive yield Zhenjing24 Jiahe2 SDG72 OsCOL1 Zhenjing2 SDG7

Abstract Objective: To investigate the clinical features of patients with definite vestibular migraine (dVM). Methods: A total of 91 patients with vestibular symptoms accompanied by migraines/migrainelike symptoms were enrolled and diagnosed according to the criteria of the Bárány Society and the International Headache Society. Baseline data were collected. Videonystagmography and immune-related laboratory tests were performed. Results: Among the 91 patients, 62 (68.1%) had dVM (11 men, 51 women). Among dVM patients, migraine occurred earlier than vestibular symptoms in 42 (67.7%) patients. Spontaneous vertigo occurred in 41 (66.1%) patients. Induced vertigo occurred in 21 (33.9%) patients. Motion sickness occurred in 33 (53.2%) patients. Central oculomotor dysfunction was observed in 11 (17.7%) patients. Caloric test revealed unilateral horizontal semicircular canal dysfunction in 12 (19.4%) patients. Severe intolerance during the test occurred in 44 (71.0%) patients with dVM. 12 (19.4%) patients showed abnormal immune-related indicators. Conclusion: dVM is more common in women. The onset of migraine precedes that of vestibular symptoms, which are often accompanied by photophobia and phonophobia. Motion sickness and severe caloric test intolerance can contribute to the diagnosis of dVM. Immunological indicators are abnormal in some patients with dVM, dVM may be secondary or an accompanying disorder, but the causal relationship needs further investigation. Level of evidence: IV.

Resumo Introdução A vertigem posicional paroxística benigna multicanal é considerada um tipo raro e controverso nas novas diretrizes de diagnóstico da Bárány Society, porque o nistagmo é mais complicado ou atípico, o que é digno de mais estudos. Objetivo Com base nos critérios diagnósticos para a vertigem posicional paroxística benigna multicanal proposta pela International Bárány Society, o estudo teve como objetivo investigar as características clínicas, o diagnóstico e o tratamento da vertigem posicional paroxística benigna multicanal. Método Foram incluídos 41 pacientes com vertigem posicional paroxística benigna multicanal e diagnosticados pelo teste de Dix-Hallpike, roll test ou e teste straight head hanging A redução manual foi feita de acordo com o envolvimento dos canais semicirculares. Resultados Entre os 41 casos, 19 (46,3%) pacientes apresentaram nistagmo de batimento ascendente vertical com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal horizontal-posterior. Onze (26,8%) pacientes apresentaram nistagmo vertical de batimento ascendente com componente de torção de um lado e nistagmo vertical de batimento descendente com ou sem componente de torção do outro lado durante o teste de Dix-Hallpike ou teste straight head hanging e foram diagnosticados com vertigem posicional paroxística benigna do canal posterior-anterior. Nove (26,8%) pacientes apresentaram nistagmo vertical com batimento descendente com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal anterior-horizontal. Dois (4,9%) pacientes apresentaram nistagmo de torção geotrópico vertical de batimento ascendente em ambos os lados e foram diagnosticados com vertigem posicional paroxística benigna de canal posterior bilateral. Foi revelada alta correlação entre os lados com função vestibular reduzida ou perda auditiva e o lado afetado pela vertigem posicional paroxística benigna multicanal (coeficiente de contingência = 0,602, p = 0,010). Durante o seguimento de uma semana, o nistagmo/vertigem foi significativamente aliviado ou desapareceu em 87,8% (36/41) dos pacientes. Conclusões A vertigem posicional paroxística benigna de canal horizontal e posterior foi o tipo mais comum. A vertigem posicional paroxística benigna multicanal que envolveu canal anterior também não foi incomum. Testes calóricos e audiometria tonal pura podem ajudar na determinação do lado afetado. A redução manual foi eficaz na maioria dos pacientes com vertigem posicional paroxística benigna multicanal.

Abstract Introduction Multi-canal benign paroxysmal positional vertigo is considered to be a rare and controversial type in the new diagnostic guidelines of Bárány because the nystagmus is more complicated or atypical, which is worthy of further study. Objective Based on the diagnostic criteria for multi-canal benign paroxysmal positional vertigo proposed by International Bárány Society, the study aimed to investigate the clinical characteristics, diagnosis and treatment of multi-canal benign paroxysmal positional vertigo. Methods A total of 41 patients with multi-canal benign paroxysmal positional vertigo were included and diagnosed by Roll, Dix-Hallpike and straight head hanging tests. Manual reduction was performed according to the involvement of semicircular canals. Results Among the 41 cases, 19 (46.3%) patients showed vertical up-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with posterior-horizontal canal. 11 (26.8%) patients showed vertical up-beating nystagmus with torsional component on one side and vertical down-beating nystagmus with or without torsional component on the other side during Dix-Hallpike test or straight head hanging test and were diagnosed with posterior-anterior canal benign paroxysmal positional vertigo 9 (26.8%) patients showed vertical down-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with anterior-horizontal canal 2 (4.9%) patients showed vertical geotropic torsional up-beating nystagmus on both sides and were diagnosed with bilateral posterior canal benign paroxysmal positional vertigo. High correlation between the sides with reduced vestibular function or hearing loss and the side affected by Multi-canal benign paroxysmal positional vertigo was revealed (contingency coefficient = 0.602, p = 0.010). During one-week follow up, nystagmus/vertigo has been significantly alleviated or disappeared in 87.8% (36/41) patients. Conclusion Posterior-horizontal canal benign paroxysmal positional vertigo was the most common type. Multi-canal benign paroxysmal positional vertigo involving anterior canal was also not uncommon. Caloric tests and pure tone audiometry may help in the determination of the affected side. Manual reduction was effective in most of Multi-canal benign paroxysmal positional vertigo patients.