Otoendoscopic Tympanic Repair of Tympanic Perforations Secondary to Chronic Otitis Media Using Porcine Small-intestine Membrane.

Context: The most common cause of hearing loss is chronic otitis media. Patients often exhibit ear tightness, ear plugging, conductive hearing loss, and even secondary perforation of the tympanic membrane. Patients require antibiotics to improve symptoms, and some patients need surgical repair of the membrane. Objective: The study intended to examine the effects of two methods of surgical transplantation using porcine mesentery under an otoscope on the surgical outcomes of patients with tympanic-membrane perforation secondary to chronic otitis media, with the intent to provide a basis for clinical practice. Design: The research team conducted a retrospective case-controlled study. Setting: The study took place at the Sir Run Run Shaw Hospital of the College of Medicine at Zhejiang University in Hangzhou, Zhejiang, China. Participants: Participants were 120 patients with tympanic membrane perforations that were secondary to chronic otitis media who had been admitted to the hospital between December 2017 and July 2019. Intervention: The research team divided the participants into two groups according to the surgical indications for repair of their perforations: (1) for patients with the central type of perforations with a rich residual tympanic membrane, the surgeon used the internal implantation method, and (2) for patients with a marginal or central perforation with a low residual tympanic membrane, the surgeon used the interlayer implantation method. Both groups received the implantations under conventional microscopic tympanoplasty, and the Department of Otolaryngology Head & Neck Surgery at the hospital provided the porcine mesenteric material. Outcome Measures: The research team compared the differences between the groups in operation time, blood loss, changes in the level of hearing loss between baseline and postintervention, air-bone conductivity, treatment effects, and surgical complications. Results: The operation time and blood loss of the internal implantation group were significantly greater than those of interlayer implantation group (P < .05). At 12 months postintervention, one participant in the internal implantation group had perforation recurrence, and two participants in the interlayer implantation group had infections and two had perforation recurrence. No significant difference existed between the groups in the complication rate (P > .05). Conclusions: Endoscopic repair of tympanic membrane perforations that were secondary to chronic otitis media, using porcine mesentery as the material for implantation, is a reliable treatment with few complications and good postoperative hearing recovery.

[A cross-sectional study on health management service for hypertension and diabetes, Sichuan province, 2014].

OBJECTIVE: To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. METHODS: 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't. RESULTS: 33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087). CONCLUSION: The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Hsa_circ_0028007 regulates the progression of nasopharyngeal carcinoma through the miR-1179/SQLE axis.

Nasopharyngeal carcinoma (NPC) is one of the most ordinary malignant tumors. Current research has suggested that circular RNAs play an important role in tumor genesis and progression. The purpose of this study is to explore the function and underlying mechanisms of circ_0028007 in NPC. The levels of circ_0028007, miR-1179, and Squalene epoxidase (SQLE) were detected by quantitative real-time polymerase chain reaction. Cell proliferation was detected by colony formation assay and thymidine analog 5-ethynyl-2'-deoxyuridine assay. Cell apoptosis was detected by flow cytometry. Relevant kits detected caspase-3, glucose, and lactate levels. Western blot assay was used to detect the related protein content. Dual-luciferase reporter assay and RNA pull-down assay were used to examine the target relationship between miR-1179 and circ_0028007 or SQLE. circ_0028007 and SQLE were highly expressed in NPC, while miR-1179 was lowly expressed. circ_0028007 silencing inhibited NPC cell proliferation and promoted apoptosis. However, the effect of circ_0028007 down-regulation on NPC cells was partially restored by co-transfection with miR-1179 inhibitor. Overexpression of SQLE partially restored the cell proliferation inhibited by circ_0028007 knockdown. circ_0028007 could regulate NPC progression via the miR-1179/SQLE axis. Therefore, circ_0028007 might be a new therapeutic target for NPC.

Analysis of Bone Mineral Density and Bithermal Caloric Test Results in Unilateral Idiopathic Benign Paroxysmal Positional Vertigo Patients.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is the most frequently diagnosed type of peripheral vestibular vertigo. Studies have reported a possible association between BPPV and osteoporosis; however, there is still a lack of evidence. This study aimed to investigate the characteristics of bone mineral density (BMD) and bithermal caloric test results in patients with unilateral posterior canal idiopathic benign paroxysmal positional vertigo (pc-iBPPV). METHODS: BMD was measured in 65pc-iBPPV menopausal female patients and 65 healthy controls using dual-energy xray absorptiometry and then compared the T-score of BMD between the two groups. The bithermal caloric test was also performed with video nystagmography and the relationship between canal paresis, directional preponderance, T-score, and recurrence were analyzed. RESULTS: Lower T-scores were observed in pc-iBPPV patients compared with the normal subjects. Among 65 pc-iBPPV patients, free recurrence was observed in 38 (58.5%), single recurrence was noted in 14 (21.5%), and multiple recurrences were seen in 13 (20%) patients. The proportion of positive T-score and CP value increased with the pc-BPPV recurrence frequency. Statistically, a significant difference was found only in T-score, indicating that recurrence was raised with a decrement of T-score. The proportion of positive CP values tended to increase as BMD decreased. CONCLUSION: The decrement of BMD might be one of the pathogeneses in patients with unilateral pc-iBPPV and associated with multiple recurrences. Moreover, positive CP value cannot be regarded as a predictive factor for recurrence; however, there is a clear association between CP and BMD.

Risk factors for residual dizziness in patients successfully treated for unilateral benign posterior semicircular canal paroxysmal positional vertigo.

OBJECTIVE: The risk factors for residual dizziness (RD) after successful treatment of benign paroxysmal positional vertigo (BPPV) are poorly characterized. We determined the risk factors for RD in patients with benign unilateral posterior semicircular canal paroxysmal positional vertigo (pc-BPPV) after successful treatment. METHODS: We conducted a prospective study of patients diagnosed with unilateral pc-BPPV between March 2015 and January 2017. Bone mineral density (BMD) was measured by dual-energy X-ray bone mineral densitometry. Participants underwent bithermal caloric testing (C-test) using videonystagmography and a canalith repositioning procedure (CRP). The occurrence of RD was the primary outcome. The participants underwent follow-up 1 week, 1 month, and 1 year after successful CRP, consisting of outpatient visits, questionnaires, and telephone interviews. RESULTS: We assessed 115 participants with unilateral pc-BPPV (31 men and 84 women) who were 53.2 ± 8.8 years old. RD occurred in 60 (52.2%) participants. The participants who experienced RD were older, had vertigo for longer before treatment, and were more likely to show a positive C-test and significant BMD loss. CONCLUSIONS: We found that a significant reduction in BMD (T-score < -1 standard deviation), a positive C-test, and older age are independently associated with RD in patients with pc-BPPV after successful CRP.

Three-dimensional analysis of the vestibulo-ocular reflex and the ability to distinguish the direction of centripetal acceleration in humans during eccentric rotation with the right ear facing downwards.

This study was conducted to evaluate the linear vestibulo-ocular reflex (lVOR) mediated by the saccule, and to investigate the relationship between the lVOR and the ability to distinguish the direction of centripetal acceleration during centric and eccentric rotation. Participants sat on a chair in darkness, with the right ear facing downwards, either directly above the center of rotation, or with their nose out, nose in, right shoulder out, or left shoulder out against the center of rotation (eccentric rotation). Participants were given no information about the chair position, and were rotated sinusoidally at 0.1-0.7 Hz. Three-dimensional eye movements during rotation were analyzed. Participants were asked to describe the position of the chair after rotation. Correctly reporting the five possible chair positions requires recognition of the direction of centripetal acceleration. We analyzed the rate of correct answers to assess participants' ability to identify the direction of centripetal acceleration. lVOR mediated by the saccule was observed only at high rotational frequencies. The rate of correct answers was higher at high rotational frequencies than that at low rotational frequencies. These results indicate that high rotational frequency is important for both lVOR mediated by the saccule and distinguishing the direction of centripetal acceleration.

[Fibrotic remodeling of nasal mucosa in rat model after radiation injury].

OBJECTIVE: To investigate the role of nasal mucosa fibrosis on radiation induced nasal mucosa injury. METHODS: Seventy two male rats were randomly divided into two groups, control group and irradiation injured group (radiation dose were 40 Gy); the rats were killed 1 week, 2 weeks, 4 weeks, 8 weeks, 3 months and 6 months after the finish of radiation. The middle turbinates of the animals were removed. The pathological change of the nasal mucosa were observed with scanning electron microscope, transmission electron microscope, hematoxylin and eosin (HE), alcian blue-periodic acid-Schif (AB-PAS), and Masson Trichrome (MT). The Hyp content in nasal mucosa was measured with chemo-chromatometry. RESULTS: After radiation, the pathological characteristics in early stage (within 4 weeks) was acute inflammatory reaction. The repair of nasal mucosa started 4 weeks after radiation, lasted to 6 months. The deposition of collagen in nasal mucosa could be found 1 week after irradiation and increased gradually. CONCLUSION: Irradiation could induce a serials of pathological changes on nasal mucosa. The nasal mucosa fibrosis may be one of the reasons of persistent irradiation induced nasal mucosa injury.

[Nasopharyngeal carcinoma and cervical masses].

OBJECTIVE: To study the clinical characteristic of cervical metastatic lymph nodes in patients with nasopharyngeal carcinoma (NPC) and the relation between NPC and cervical masses. METHOD: The clinical material of 246 cases with NPC was analyzed retrospectively. RESULT: One hundred and eighty-three of 246 cases suffered from cervical masses and 101 cases began with them. In all cases, 134 cases had cervical masses on the same lateral of lesion, 44 cases on both sides, and others on the opposite sides. In 172 cases, the masses were found to be the involved superior deep cervical lymph nodes. There was no remarkable difference between the NPC with cervical masses and without cervical masses in EBV VCA-IgA and EA-IgA titers. Large masses were relative to metastases. CONCLUSION: Superior deep cervical lymph nodes were involved in most of the patients with NPC, usually on the same lateral of lesion. The EBV titers were not relative to cervical masses. Distant metastases were more likely to be detected in patients with large masses.