[Horizontal sound localization in presence of noise in normal-hearing young adults].

Objective: This study investigates the effect of signal-to-noise ratio (SNR), frequency, and bandwidth on horizontal sound localization accuracy in normal-hearing young adults. Methods: From August 2022 to December 2022, a total of 20 normal-hearing young adults, including 7 males and 13 females, with an age range of 20 to 35 years and a mean age of 25.4 years, were selected to participate in horizontal azimuth recognition tests under both quiet and noisy conditions. Six narrowband filtered noise stimuli were used with central frequencies (CF) of 250, 2 000, and 4 000 Hz and bandwidths of 1/6 and 1 octave. Continuous broadband white noise was used as the background masker, and the signal-to-noise ratio (SNR) was 0, -3, and -12 dB. The root-mean-square error (RMS error) was used to measure sound localization accuracy, with smaller values indicating higher accuracy. Friedman test was used to compare the effects of SNR and CF on sound localization accuracy, and Wilcoxon signed-rank test was used to compare the impact of the two bandwidths on sound localization accuracy in noise. Results: In a quiet environment, the RMS error in horizontal azimuth in normal-hearing young adults ranged from 4.3 to 8.1 degrees. Sound localization accuracy decreased with decreasing SNR: at 0 dB SNR (range: 5.3-12.9 degrees), the difference from the quiet condition was not significant (P>0.05); however, at -3 dB (range: 7.3-16.8 degrees) and -12 dB SNR (range: 9.4-41.2 degrees), sound localization accuracy significantly decreased compared to the quiet condition (all P<0.01). Under noisy conditions, there were differences in sound localization accuracy among stimuli with different frequencies and bandwidths, with higher frequencies performing the worst, followed by middle frequencies, and lower frequencies performing the best, with significant differences (all P<0.01). Sound localization accuracy for 1/6 octave stimuli was more susceptible to noise interference than 1 octave stimuli (all P<0.01). Conclusions: The ability of normal-hearing young adults to localize sound in the horizontal plane in the presence of noise is influenced by SNR, CF, and bandwidth. Noise with SNRs of ≥-3 dB can lead to decreased accuracy in narrowband sound localization. Higher CF signals and narrower bandwidths are more susceptible to noise interference.

[Chinese expert guidance on overall application of lenvatinib in hepatocellular carcinoma].

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

[The development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children].

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing abilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlation at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.

[Clinical characteristics of patients with odontogenic sinusitis underwent endoscopic sinus surgery].

Objective: To analyze the clinical features of patients with odontogenic sinusitis (OS) treated by endoscopic sinus surgery (ESS). Methods: A retrospective investigation was carried out in our 27 (16 males and 11 females) cases with OS aged (49.74±14.42) years old. Subjects were hospitalized between January 2018 and November 2020 from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital. The medical history, symptoms, result of nasal endoscopy and paranasal sinus computed tomography (CT) were analyzed statistically by SPSS 19.0. Results: OS mainly occured on unilateral sinuses, with a duration of (8.56±11.79) months. Seventy point four percent (19/27) of the patients had a course within six-month, only 11% was over 12 months (3/27). Symptoms mostly showed as nasal obstruction (88.9%; 24/27), runny nose (81.5%; 22/27), nasal stinks (16/19) and postnasal drip (10/10). Sixty-three percent (17/27) of the OS patients had a dental history. Nasal endoscopic examination revealed a swelling of the ostiomeatal complex (77.8%; 21/27), medial wall interhal displacement of maxillary sinus (55.6%; 15/27), white emulsion-like purulent secretion in the middle meatus (70.4%; 19/27) and nasal polyps (59.3%; 16/27). Etiology of OS included implant-related problems (14.8%; 4/27) and periodontal disease (85.2%; 23/27). Conclusions: OS is usually unilateral sinusitis with a short history. Its clinical features show nasal stinks, white emulsion-like purulent secretion in the middle meatus and imaging findings of unilateral maxillary sinusitis with tooth-related lesions.

Feasibility and acceptability of a remotely-delivered behavioural health coaching intervention to limit gestational weight gain.

INTRODUCTION: Gestational weight gain (GWG) and postpartum weight retention (PPWR) are significant, potentially modifiable, contributors to women's future weight and health trajectories. There is a need for feasible and patient-centered (i.e., convenient, remotely-delivered, technology-enhanced, and accessible through the prenatal care setting) behavioural interventions that limit GWG and PPWR. This study tests the feasibility and acceptability of a remotely-delivered behavioural health coaching intervention to limit gestational weight gain and postpartum weight retention. METHODS: Pregnant women (11-16 weeks gestation) were recruited from two prenatal clinics and randomized to the active intervention or health education comparison group. Completion of the program was monitored and perceived helpfulness was rated (0-100). RESULTS: Twenty-six women were randomized (n = 13 per arm; mean age = 31.6 years, SD = 3.6; mean BMI = 26.7 kg/m2, SD = 7.4). Participants completed a median of 18 coaching calls and 16/19 learning activities during pregnancy, and a median of 6 calls and 5/6 learning activities postpartum. They logged weights at least once/week for a median of 36/38 expected weeks and tracked daily calories and exercise for a median of 154/266 days and 72/266 days, respectively. Median (Q1, Q3) helpfulness ratings of the program during pregnancy were 80 (64, 91) and 62 (50, 81) postpartum; helpfulness ratings of coaching calls were 85 (58, 98). At 37 weeks gestation, 77% of participants achieved IOM weight gain recommendations compared to 54% in the comparison group. CONCLUSIONS: This study provides evidence for the feasibility and acceptability of a remotely-delivered behavioural weight control intervention in pregnancy and postpartum.

Circ_0032627 accelerates proliferation of gastric cancer cells through regulating miR-502-5p expression.

OBJECTIVE: To explore the biological functions of circ_0032627 in the progression of gastric cancer (GC). MATERIALS AND METHODS: The expression level of circ_0032627 in GC cell lines and gastric mucosal cell lines was measured via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Methyl thiazolyl tetrazolium (MTT) assay, colony formation assay, and FACS were performed to examine the influences of circ_0032627 on the proliferation and apoptosis of GC cells. The relationship between circ_0032627 and micro ribonucleic acids (miRNAs) was predicted on-line using StarBase software, and whether circ_0032627 can act as the sponge of the selected miRNAs was verified via Dual-Luciferase reporter assay and qRT-PCR. Finally, MTT assay was conducted to detect the influences of the co-knockdown of circ_0032627 and the selected miRNAs on the proliferation of GC cells. RESULTS: Compared with that in gastric mucosal cell lines, the expression level of circ_0032627 was upregulated in the selected four GC cell lines, and circ_0032627 knockdown substantially inhibited the proliferation of GC cells, but promoted their apoptosis. Circ_0032627 could act as a sponge of miR-502-5p, and miR-502-3p knockdown reversed the inhibitory effect of circ_0032627 on the proliferation of GC cells. CONCLUSIONS: The expression level of circ_0032627 is raised in GC cells, and circ_0032627 affects the proliferation and apoptosis of GC cells by sponging miR-502-5p.

Survival prediction with score model based on clinical characteristics in advanced HCC patients receiving oxaliplatin-containing regimens.

A score model based on clinical characteristics in advanced hepatocellular carcinoma (HCC) patients treated with systemic chemotherapy of oxaliplatin-containing regimens was established to evaluate progression-free survival (PFS) and overall survival (OS). Thirty HCC patients eligible for radical resection were involved in the retrospective study, and these were divided into the good response group (complete response (CR)/partial response (PR) and the poor response group (stable disease (SD)/progression disease (PD). The median PFS and OS were compared in the two groups. PFS and OS combined with clinical characteristics were evaluated by univariate and multivariate analyses. The score model was defined with 1 score for each characteristic, and score model cut-off values were determined by the receiver operating characteristic curve (ROC) which describes treatment response. The median PFS was 10 and 2 months (p<0.001), and the median OS was 13 and 4 months (p=0.011) for the CR/PR and SD/PD groups, respectively. The score of 1 was the optimal cutoff value, with sensitivity ranging from 52.6 to 63.2% and specificity from 81.8 to 100% (AUC= 0.773, p=0.014). The median PFS for good and poor response groups was 9 months and 1month (p<0.001) and the median OS was 22 and 3months at p<0.001, respectively. Patients with scores above 1 had poor response, with median 3 months OS and 1 month PFS, and patients with scores of 0 and 1 established good response, with median 22 months OS and 9 months PFS, respectively.

[A long term effect on speech recognition in the patients with simultaneous bilateral cochlear implants].

Objective: To investigate an effect on speech recognition after bilateral cochlear implants(CI) simultaneously. Methods: Nine subjects who underwent bilateral CI operation simultaneously in Peking Union Hospital in 2007 were assigned as bilateral group, another 9 subjects with unilateral CI were chosen as unilateral group according to the age, gender, duration of deafness. Hearing threshold, speech recognition of phrases, disyllabic words, single word in quiet and noise environment were calculated, respectively. Three different sound source positions were set up to simulate the three effects of binaural hearing (head shadow, binaural redundancy and binaural squelch) in noise environment. The speech signal intensity was 70 dBSPL, the signal to noise ratio (SNR) was 0 dB, + 4 dB, + 8 dB, and the speech recognition of phrases were examined in bilateral CI group. All the data was analyzed by SPSS 19.0 software. Results: In quiet environment, the average aid-hearing threshold was significantly reduced as (7.2±3.0)dB in bilateral CI group compared to unilateral CI group(P<0.05). However, the speech recognition of phrases, disyllabic words, and single word in quiet and noise environment did not show significant differences between bilateral CI and unilateral CI groups (P>0.05). In the testing under noise environment, the speech recognition of bilateral CI group was significantly higher than that of unilateral CI group (P<0.05). In the estimation of noise environment (SNR=+ 8), the phrase test and speech recognition of head shadow model in bilateral groups were significantly better than that of unilateral group (P<0.01). Further, bilateral CI group showed statistical significances in binaural redundancy and binaural squelch models(P<0.01), there was statistically significant were also found difference between two groups (P<0.01); Bilateral CI group did not reveal significant difference compared with unbilateral CI group in binaural squelch model(P>0.05). Under different signal-to-noise ratio (SNR=+ 8, + 4) noise environment, all the three given models in bilateral CI group show higher signal-to-noise ratio, higher speech recognition rate (Independent-Samples t test, P<0.01). In addition, head shadow model presented negative influences on speech recognition rate compared with binaural redundancy and binaural squelch model by SNR(P<0.05). SNR influences on binaural redundancy and binaural squelch model were almost identical, F=0.371, P=0.549. Conclusion: The subjects who underwent simultaneous bilateral cochlear implantation could significantly reduce aid-hearing threshold, and greatly improve the speech recognition of phrases, disyllabic words, and single word under noise environment.

The activities of the international precipitation working group.

The International Precipitation Working Group (IPWG) is a permanent International Science Working Group (ISWG) of the Coordination Group for Meteorological Satellites (CGMS), co-sponsored by CGMS and the World Meteorological Organization (WMO). The IPWG provides a focal point and forum for the international scientific community to address the issues and challenges of satellite-based quantitative precipitation retrievals, and for the operational agencies to access and make use of precipitation products. Through partnerships and biennial meetings, the group supports the exchange of information on techniques for retrieving and measuring precipitation and for enhancing the impact of space-borne precipitation retrievals in numerical weather and hydrometeorological prediction and climate studies. The group furthers the refinement of current estimation techniques and the development of new methodologies for improved global precipitation measurements, together with the validation of the derived precipitation products with ground-based precipitation measurements. The IPWG identifies critical issues, provides recommendations to the CGMS and supports upcoming precipitation-oriented missions. Training activities on precipitation retrieval from space are also part of the IPWG mandate in cooperation with WMO and other bodies.

The next chapter for group B meningococcal vaccines.

The majority of invasive meningococcal disease (IMD) in the developed world is caused by capsular group B Neisseria meningitidis, however success with vaccination against organisms bearing this capsule has previously been restricted to control of geographically limited clonal outbreaks. As we enter a new era, with the first routine program underway to control endemic group B meningococcal disease for infants in the UK, it is timely to review the key landmarks in group B vaccine development, and discuss the issues determining whether control of endemic group B disease will be achieved. Evidence of a reduction in carriage acquisition of invasive group B meningococcal strains, after vaccination among adolescents, is imperative if routine immunization is to drive population control of disease beyond those who are vaccinated (i.e. through herd immunity). The need for multiple doses to generate a sufficiently protective response and reactogenicity remain significant problems with the new generation of vaccines. Despite these limitations, early data from the UK indicate that new group B meningococcal vaccines have the potential to have a major impact on meningococcal disease, and to provide new insight into how we might do better in the future.

[Evaluation of the modified test system for children sound localization].

Objective: To evaluate the feasibility of modified test system for sound localization (SL) in children. Methods: Modified system (6 male, 9 female) and traditional method ( 5 male, 5 female) were used for evaluation of minimum audible angle(MAA) and root-mean-square error(RMS) error of 4 to 6 years old children, and the results were compared to verify the accuracy and effectiveness of the modified test system for children sound localization.SPSS 17.0 software was used to analyze the data(t test). Results: (1) Comparison of veracity of modified system and traditional test: when tested at the positive front position using modified system, MAA and RMS error were(3.23±1.00)° and (13.68±5.18)° respectively.When using traditional method, MAA and RMS error were(3.17±0.59)°and (13.96±4.56)° respectively. No statistical differences were found between two groups(t value was 0.16, -0.14, both P>0.05). (2) Comparison of time used were as followed: when using modified system, it was (14.67±1.95) min for MAA, and (6.67±1.35) min for RMS error. When using traditional method, it was (36.30±6.81) min for MAA, and (21.00±3.50) min for RMS error. Time used were significant shorter in modified system than in traditional method (t value was-9.78, -12.37, both P<0.05). Conclusion: Modified test system for children sound localization is useful and reliable in children's horizontal SL test.The time used of modified test system is shorter than that of traditional test system.

[Advances in effect of unilateral auditory deprivation on sound localization].

In patients with single-sided deafness (SSD), the interaural time difference and the interaural level difference signals are insufficient or missing, which result in the lack of sound localization ability and the decrease of speech comprehension in the noise environments. SSD can also cause the morphological and functional changes of the central auditory system, resulting in auditory deprivation. In early stage of the development, the auditory center is more susceptible to ambient environment and auditory inputs. It is a critical period of auditory function and morphological refinement. It is also sensitive period of central adaptability after auditory deprivation. SSD in the sensitive period of development can cause significant laterality activities of bilateral sound localization pathway. Unilateral auditory deprivation can distort tonotopic maps, disrupt the binaural integration, reorganize the neural network and change the synaptic transmission in the primary auditory cortex or sub cortex. In order to compensate for the deficiency of the interaural time difference and interaural level difference cues, the auditory pathway is used to improve the ability of sound source localization by using the spectral-shape cues remaining unchanged. In order to improve the effectiveness of the functional areas of the cortex, auditory center is also reorganized by cross-modal. However, central compensation after SSD is a double-edged sword. If SSD onset in the sensitive period, the laterality of auditory pathway will be continued and difficult to reverse by even long term bilateral hearing in the post-sensitive period. Therefore, in order to improve the understanding of the characteristics of unilateral auditory deprivation, this paper reviewed the evidence for adaptive changes in spatial hearing following a developmental hearing loss in one ear.

[Speech evoked auditory brainstem response and cognitive disorders].

Speech evoked auditory brainstem response(s-ABR)is evoked by compound syllable, and those stimulus are similar to the daily language which convey both semantic information and non-semantic information. Speech coding program can take place at brainstem. As a new method, s-ABR may reveal the mystery of speech coding program. Many tests have proved that s-ABR is somehow related to cognitive ability. We mainly illustrated the possibility of grading the cognitive ability using s-ABR, the abnormal test result from those cognitive disorders, and the family factors that contribute to cognitive disorder.

[The sex difference of speech evoked auditory brainstem responses in children and young adults].

OBJECTIVE: The aim of this study was to compare the sex difference of the speech-ABR in young adults and school age children. METHODS: Speech-ABR of eighty normal hearing subjects including twenty four school-age children(12 girls and boys, age from 6 to 12 years old) and fifty six young adults(male 29, female 27, age from 20 to 34 years old) were recorded. The speech syllable /da/ as stimulus sound was transmitted to right ear by insert earphones in speech-ABR test. RESULTS: ① Females had a shorter latency than males in transient response (waves V, A and O) and sustained response (waves D, E and F) of speech-ABR (P<0.05, respectively). The amplitudes of transient response (waves V and A) and sustained response (waves D, E and F) in females were also significantly larger than those in males (P<0.05, respectively), except for amplitude of peak O (P>0.05). The V/A slope in females was significantly steeper than that in males[(-0.43±0.13)vs(-0.25±0.08), P<0.01]. ②The amplitude and latency of speech-ABR in transient response (waves V, A and O) and sustained response (waves D, E and F) were not significantly different between boys and girls. Only the V/A slope in girls was significantly steeper than that in boys [(-0.46±0.12)vs(-0.35±0.15), P<0.05]. ③The latency of speech-ABR was significantly prolonged in young men when compared with boys in both transient response (waves V, A and O) (P<0.05, respectively) and sustained response (waves D and F, P<0.05, respectively), except for wave E (P>0.05). The amplitude of speech-ABR showed a statistically significant decrease (P<0.05, respectively) only in wave A, D and F. Contrarily, the decrease in response amplitudes of waves V, E and O were not statistically significant (P>0.05, respectively). The V/A slope was steeper in boys than in young men, which was statistically significant (P<0.05). ④ In girls and young women, peak latency and magnitude of speech-ABR showed similar characteristics. No significant differences were found in either transient response or sustained response. The V/A slope between girls and young women was similar without significant difference (P>0.05). CONCLUSIONS: The female adults have shorter wave latency and larger amplitude of speech-ABR than males, which suggests that females have better speech encoding in brainstem. There are few differences between female and girls in wave latency and amplitude. The speech encoding in brainstem in young men tends to become worse than in boys. It implies that the increase of androgen might weaken the ability of the speech encoding in brainstem.

[Effect of cochlear implantation on sound localization for patients with unilateral sensorineural hearing loss].

The aim of this review was to examine the current literature regarding application of cochlear implantation on patients with unilateral sensorineural hearing loss (USNHL) for improvement on sound localization. The literature were searched in the PubMed database with 'cochlear implantation AND single-sided deafness' or 'cochlear implantation AND unilateral deafness' as keywords. The publication date of the articles was up to 2015-2-12. A total of 12 articles were included. The results show that the ability of sound localization for most of the USNHL subjects (90%) with cochlear implantation was significantly improved than that without CI, which suggests that CI is a superior auditory rehabilitation treatment than BAHA and CROS hearing aids for patients with USNHL, because of the re-establishment of the benefits of binaural hearing. In addition, the benefit of CI for USNHL requires a period of auditory experience or training. About 30% subjects showed significantly improvement on sound localization ability after CI worked for three months. For most of the patients (90%), the sound localization ability improved after CI worked for six months. When CI worked for nine months, all the subjects would show improvement on sound localization ability. Sound localization of the USNHL subjects with a CI is based primarily on interaural level differences (ILD) while interaural time differences (ITD) provide little advantage or probably not perceptible at all. The younger subject suffers from USNHL, the stronger the plasticity of the auditory center shows, which results in more obvious degeneration of the affected side and adaptive enhancement of the contralateral side of the auditory pathway. Similarly, the longer duration of USNHL lead to more obvious degeneration of the affected side and adaptive enhancement of the contralateral side. An adaptive enhancement of auditory pathway corresponding to the healthy ear will rely more on the monaural spatial cues that available to the intact ear to improve the sound localization in the horizontal plane. Contrarily, the degeneration of auditory pathway corresponding to the USNHL may be limited to re-reorganize from auditory deprivation even after CI, which may increase the risk that a few subjects cannot re-establish the binaural benefits after CI. Therefore, patients with USNHL should accept CI as soon as possible to obtain good binaural benefits, especially for sound localization.

Increased risk of breast cancer in individuals carrying the TNRC9 rs3803662 C>T polymorphism: a meta-analysis of case-control studies.

Currently, the relationship between the trinucleotide repeat containing 9 (TNRC9) rs3803662 C>T polymorphism and risk of breast cancer (BC) is uncertain. Here, we attempted to obtain a more accurate assessment of this association by conducting a meta-analysis of all eligible case-control investigations, comprising 44,820 cases and 58,316 controls. A comprehensive search was performed to identify all suitable studies involving the TNRC9 rs3803662 polymorphism and BC risk. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated using fixed- or random-effect models. Heterogeneity, publication bias, and sensitivity analyses were also carried out. We found that the variant T allele of rs3803662 C>T greatly increases BC risk (CT vs CC: OR = 1.14, 95%CI = 1.07-1.22, P < 0.001; TT vs CC: OR = 1.38, 95%CI = 1.25-1.53, P < 0.001; CT/TT vs CC: OR = 1.19, 95%CI = 1.11-1.28, P < 0.001; TT vs CT/CC: OR = 1.28, 95%CI = 1.19-1.38, P < 0.001). Stratified analysis based on ethnicity also revealed a markedly increased risk in Asian and Caucasian populations. Moreover, studies with hospital-based control groups showed elevated risk under the four genetic models employed, as did those using population-based controls, except under heterozygote comparison. The TNRC9 rs3803662 C>T polymorphism is greatly related to increased risk of BC, in both Asian and Caucasian populations.

[The CT observation and clinical significance of pneumatization of the anterior maxillary sinus].

Objective:To discuss the clinical significance of the pneumatization of the maxillary sinus by sinus CT.Method:One hundred patients encountered in our hospital during March 2012 and December 2012 were included in this study.The pneumatization of the anterior part of the maxillary sinus were observed.Result:①The pneumatization of prelacrimal recess was divided into 3 types. TypeⅠ: The pneumatization of maxillary sinus frontal process did not reach into the front of the nasolacrimal duct(42% of the left, 42% of the right); Type Ⅱ: The pneumatization of maxillary sinus frontal process extended into the front of the nasolacrimal duct,but not exceeding ½of the nasolacrimal duct circumference(39% of the left,37% of the right); Type Ⅲ: The pneumatization of maxillary sinus frontal process extended into the front of the nasolacrimal duct more than ½ of the circumference(19% of the left, 21% of the right).②The pneumatization of maxillary sinus palatal process was divided into 3 types. TypeⅠ: maxillary sinus palatal process non gasified (49% of the left, 53% of the right); Type Ⅱ: palatal process gasification into the nasal floor, but not more than ½of the width of nasal floor(45% of the left and 43% of the right);Type Ⅲ: palatal process gasification into the nasal floor more than ½ of the width of nasal floor(6% of the left, 4% of the right).③The pneumatization of maxillary sinus extended into alveolar process was divided into 3 types.Type Ⅰ: the bottom of the maxillary sinus is higher than the oral surface of hard palate(49% of the left and 51% of the right); Type Ⅱ: the bottom of the maxillary sinus is lower than the oral surface of hard palate and non tooth root protruding into the maxillary sinus(44% of the left and 39% of the right); Type Ⅲ: the tooth root process was protruded into maxillary sinus(7% of the left and 11% of the right).④The pneumatization of maxillary sinus extended into the zygomatic process was divided into 3 types. Type Ⅰ: the gasification of the zygomatic process is not more than the orbital lateral wall(80% of the left, 82% of the right); Type Ⅱ: the gasification of the zygomatic process is more than the orbital lateral wall, (20% of the left, right 18% of the right);Type Ⅲ: the gasification of the zygomatic process is also more than the inferior orbital wall, this paper is not observed Ⅲ type pneumatization.⑤The pneumatization of of the anterior wall of the maxillary sinus was divided into 3 types. Type Ⅰ: infraorbital nerve tube completely in the bone wall of the maxillary sinus(51% of the left, 57% of the right); Type Ⅱ: the half of the infraorbital neural tube was inburst into the maxillary sinus(39% of the left and 31% of the right); Type Ⅲ: infraorbital neural tube was totally protruding into to the cavity of the maxillary sinus(10% of the left and 12% of the right). Conclusion:The pneumatization of the anterior part of the maxillary sinus varies considerably and requires attention during ESS. The pneumatization degree of maxillary sinus should be confirmed accurately in preparation. It is foundamental for selecting the suitable surgical approach for Nasal endoscopic maxillary sinus surgery. It is also important for completely removed the maxillary lesions in operation.

[Study on the influence of laryngeal lesions on the prognosis of pneumomediastinum in dermatomyositis].

Objective:To investigate the influence of laryngeal lesions on the prognosis of pneumomediastinum in patients with dermotomyositis(DM). Method:The clinical data of patients with DM were retrospectively analyzed. Hoarseness, laryngeal lesions and pneumomediastinum in patients with DM were analyzed to evaluate the influence of laryngeal lesions and hoarseness on the prognoses and diagnosis of pneumomediastinum in patients with DM. Result:Forty-two patients with a diagnosis of DM were included in the study.Twenty of all the patients were diagnosed of interstitial lung disease(ILD) with the incidence of 47.6%. Four of the patients displayed hoarseness with the incidence of 9.5%. Three cases were complicated by pneumomediastinum with the incidence of 7.1%. All patients have normal vocal cord movement. One of the 4 patients with hoarseness showed congestion of her vocal folds, and the other 3 patients showed white change on both of the vocal folds. All the 3 patients with white change on both vocal folds complicated by pneumomediastinum and died on respiratory failure. There were statistical differences(P<0.01) on the prognosis and occurrence of pneumomediastinum between patients with or without hoarseness and laryngeal lesions. Conclusion:Hoarseness and laryngeal lesions may associate with poor prognosis and occurrence of pneumomediastinum in DM.

[Barium sulphate aspiration during upper gastrointestinal examinations: two cases report and review of the literature].

Objective:To investigate the causes of barium aspiration,death rate and the cause of death in the upper gastrointestinal examinations,and to help the doctor selecting a reasonable method in upper gastrointestinal tract examination.Method:Two cases in our hospital was reported,and totally 25 patients in 22 articles were obtained in pubmed or google shchoolar form 1989 to 2014.Purpose of radiologic studies of the upper digestive tract,distribution of the aspirate,clinical presentation and prognosis after aspiration of the sulfate barium in literature were collected.Result:①Aspiration of barium sulfate mainly happened in elderly patients and infant.The age of died group were older than survive group,however,there were no significant difference statistically(F=0.909, P=0.355).②The directly mortality rate associated with barium aspiration was up to 38.1% in adult,and ten patients of them(47.6%) recovered.All the infants were recovered completely form the respiratory distress cause by the aspiration of barium sulfate.③Aspiration may more likelyoccur in certain conditions involving dysphagia and esophageall obstruction by tumor or foreign body.Further,the gastro-esophageal reflux,recent esophageal surgery,eructation and vomiting may also increase the risk of aspiration of the aspiration of barium sulfate.④About 84.0% patients were with initial dyspnea,hypotension,respiratory distress or respiratory failure.A minority of patients without significant reactions,only suffered fever and cough(16.0%).⑤The deposition of barium sulphate were commonly affected both lungs(80.0%).Barium sulfates distributed in unilateral lung only were found in five patients 20.0%.Conclusion:Aspiration may easier occur in certain conditions involving dysphagia and esophageall obstruction by tumor or foreign body.Further,the gastro-esophageal reflux,recent esophageal surgery,eructation and vomiting may also increase the risk of aspiration of the aspiration of barium sulfate.Most of the patients after aspiration of barium were presented with initial dyspnea,hypotension,respiratory distress or respiratory failure.When considerable amounts of barium sulfate are aspirated into the lung leading to arterial hypoxemia and dyspnea,it is mandatory that aggressive treatment with steroids,antibiotics,respiratory physiotherapy,oxygen,and bronchoalveolar lavage is initiated without delay.