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Objective:To evaluate the efficacy of electroacupuncture(EA)in enhancing the recovery of gastrointestinal function after laparoscopic cholecystectomy(LC). Methods:Randomized controlled trials(RCTs)of EA treatment in the postoperative period of patients undergoing LC were searched.Studies were obtained from Excerpta Medica Database(EMBASE),PubMed,Cochrane Library,Wanfang Academic Journal Full-text Database(Wanfang),China National Knowledge Infrastructure(CNKI),China Biology Medicine Disc(CBM),and Chongqing VIP Database(CQVIP)from inception to December 10th,2022.RevMan 5.4.1 was used to perform the meta-analysis.The Cochrane tool was used to assess the risk of bias.Mean difference(MD)and confidence interval(CI)were used for statistical descriptions. Results:A total of 7 studies were included in the meta-analysis.The meta-analysis found that the EA group had a shorter time to the first flatus[P<0.001,MD=-5.32,95%CI(-6.42,-4.21)],bowel movement recovery[P<0.001,MD=-6.22,95%CI(-8.11,-4.34)],and the first defecation(P<0.001,MD=-11.08,95%CI(-15.78,-6.39)]than the control group. Conclusion:EA treatments can promote the recovery of gastrointestinal function after LC.
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OBJECTIVE@#To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology.@*METHODS@#The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package.@*RESULTS@#Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031).@*CONCLUSION@#EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.
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Humans , Neuroma, Acoustic/complications , Electroencephalography , Patients , Probabilityالملخص
Objective@#To elucidate the clinical behavior, causes of misdiagnosis, surgical management, and outcomes of facial nerve schwannomas (FNS).@*Methods@#A retrospective review in Chinese People′s Liberation Army General Hospital from January 1, 2002 to December 31, 2015 was carried out and evaluated 110 patients with FNS, including 50 males and 60 females, aged 16-67 years old. The appropriate surgical strategy was selected based on each patient′s clinical manifestations, facial nerve function, and imaging characteristics. After surgery, patients received follow-up visits to assess their facial nerve functions, with the effect of treatment compared to the reality before surgery. The Kruskal-Wallis H test was used to distinguish between the pre- and post-operation facial nerve functions in patients who had different facial nerve functions before the operations.@*Results@#110 cases of FNS mainly presented with facial paralysis, hearing loss, tinnitus, otalgia, dizziness, and facial spasm. 20 of the cases were misdiagnosed as Bell′s Palsy, 6 were mistaken for chronic otitis media/cholesteatoma with radical mastoidectomy, 3 were mistaken for Meniere′s disease, 1 was misdiagnosed as petrous bone cholesteatoma, and 4 were mistaken for acoustic neuroma. 81.8 % (90/110) of the patients had multiple segments of the facial nerve, including the vertical segment of the facial nerve, accounting for 65.5% (72/110), followed by the labyrinthine/geniculate segment, for 61.8% (68/110), and the horizontal segment, for 55.5% (61/110). The appropriate surgical approaches were chosed based on the sizes and scopes of the tumors evaluated by imaging: transmastoid approach in 73 cases, translabyrinthe approach in 14 cases, middle cranial fossa approach in 13 cases, retrosigmoid approach in 3 cases, transmastoid-middle cranial fossa approach in 3 cases, and transmastoid-neck approach in 4 cases, with all the patients undergoing a total/subtotal resection of the tumor. Eighty-seven patients had their facial nerves reconstructed. Among them, 6 received facial nerve end-to-end anastomosis, 55 received great auricular nerve graft, and 26 were subjected to facial nerve-hypoglossal nerve anastomosis. Because of long histories, facial muscle atrophies, or other reasons, the remaining patients were not received facial nerve reconstruction. The House-Brackmann(H-B) grading scale was used to evaluate the facial nerve function pre- and post-operation. Patients with better facial nerve functions and shorter history of facial paralysis before operation would get relatively better facial nerve function. The before and after operation comparisons revealed that the recovery of the facial nerve functions in patients with H-B Ⅰ-Ⅲ was better than the improvement in patients with H-B Ⅳ-Ⅴ. The difference was statistically significant (Kruskal-Wallis H test, H=8.508, P<0.05).@*Conclusions@#The diagnosis of patients with unknown facial paralysis, hearing loss, and tinnitus should take into account the possibility of FNS. CT and other imaging examinations of the temporal bone can avoid misdiagnosis and determine the tumor size and extent of lesions, as well as provide the basis for the choice of the surgical approach. After tumors have been completely resected, facial nerve reconstruction can be performed simultaneously, according to the defect of the nerve.
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OBJECTIVE@#To observe the effects of conventional drug therapy combined with acupuncture and conventional drug therapy on the morbidity of post-stroke depression and recovery of neurological function in patients with acute stroke, and provide new ideas for prevention and treatment of post-stroke depression.@*METHODS@#Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one.Conventional drug therapy was given in the control group;on the basis of conventional drug therapy,acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN1), Neiguan (PC 6), Hegu (LI 4), Taixi (KI 3), etc. The treatment was given once every day, 6 times a week for 4 weeks in the two groups. The 24 Hamilton depression rating scale (HAMD), modified Edinburgh-Scandinavian stroke scale (MESSS) scores were recored before treatment, after 1 week of treatment, and after 4 weeks of treatment in the two groups,and the morbidity of post-stroke depression was compared between the two groups.@*RESULTS@#After 1 week of treatment, the HAMD scale scores of the two groups were higher than those before treatment (both 0.05). The MESSS scores were lower than those after 1 week of treatment in the two groups (both <0.05), and the score in the observation group was significantly lower than that in the control group (<0.01). After 4 weeks of treatment, the morbidity of post-stroke depression in the observation group was 23.3% (7/30), which was lower than 66.7% (20/30) in the control group (<0.05).@*CONCLUSION@#Early acupuncture intervention on stroke patients can not only promote the recovery of neurological function, but also reduce the morbidity of post-stroke depression effectively.
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Humans , Acupuncture Therapy , Depression , Therapeutics , Stroke , Treatment Outcomeالملخص
Background:In recent years, the incidence of ulcerative colitis (UC) has increased year by year in China, and the number of elderly patients with UC is growing significantly.However, the difference in clinical characteristics between elderly and non-elderly UC patients was not fully clarified.Aims:To investigate the difference in clinical characteristics between elderly and non-elderly UC patients.Methods:A total of 163 UC patients admitted from Jan.2012 to Jun.2015 at the Affiliated Jiangyin Hospital of Southeast University Medical College were retrospectively recruited and divided into elderly group (no less than 60-year-old, n=32) and non-elderly group (less than 60-year-old, n=131) according to the age of onset.The clinical data were collected, and the general conditions, clinical manifestations and extent of the disease were compared between the two groups.Results:There were no significant differences in gender, family history of inflammatory bowel disease, history of smoking and appendectomy between elderly and non-elderly groups (P>0.05).Hematochezia and mucous bloody stool were less prevalent in elderly group than in non-elderly group (P0.05).More extraintestinal manifestations were seen in non-elderly group, but the difference was not statistically significant (P>0.05).Lesions in elderly group mainly located in left hemicolon, while pancolitis was predominant in non-elderly group (P<0.05).Conclusions:In elderly patients with UC, hematochezia and mucous bloody stool are not frequently seen, and the disease is not extensive and mainly located in left hemicolon.
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Objective To explore the optimal acupuncture scheme in intervening hypermyotonia of the affected limbs in stroke.Method Eighty eligible stroke patients were randomly grouped by using the orthogonal experimental design, by adopting electroacupuncture (A), daily acupuncture frequency (B), and acupoint (C) as three factors, and two levels. A total of 20 treatment sessions were conducted. Each group was scored by using the Modified Ashworth Scale (MAS) before and after the treatment, and the safety was also evaluated.Result There was a significant difference in comparing the MAS score between the two different levels of factor A (P<0.05), while there were no significant differences in comparing the MAS scores between different levels of factor B and factor C (P<0.05). Concerning the improvement of the MAS scores of wrist, elbow, knee, and ankle joints, A2B1C1(i.e. electroacupuncture twice a day with acupoints from yin meridians) was the optimal treatment scheme.Conclusion Electroacupuncture twice a day is the optimal treatment scheme for hypermyotonia of the affected limbs in stroke, as it can effectively ease the hypermyotonia, improve the function and symptoms of the limbs, and has a satisfactory security evaluation.
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<p><b>OBJECTIVE</b>To report on a novel human leukocyte antigen (HLA) allele.</p><p><b>METHODS</b>Polymerase chain reaction-sequence based typing was used for routine HLA typing. For one sample, the result of B locus typing showed mismatch of one base with B*46:01:01, B*15:25:01 at locus 384. The group specific sequencing primers, which target at B*46 and B*15, were used to confirm the difference between the novel allele and the highest homologous allele.</p><p><b>RESULTS</b>The sequencing results showed that the highest homologous allele to the novel allele was B*46:01:01. The two sequences only differed for position 384 within the exon 3 (384G>T), which resulted in a codon change (GGG>GGT), though the amino acid sequence of the novel allele at position 104 was still Glycine (G). Investigation of the family showed that the novel allele was inherited from the father.</p><p><b>CONCLUSION</b>The novel HLA-B allele, discovered in ethnic Zhuangs from Guangxi, has been designated as HLA-B *46:01:18 by the World Health Organization (WHO) HLA Nomenclature Committee.</p>
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Adult , Female , Humans , Male , Young Adult , Alleles , Asian People , Genetics , Base Sequence , China , Exons , HLA-B Antigens , Genetics , Molecular Sequence Dataالملخص
Objective To observe the clinical efficacy of acupuncture plus activator method chiropractic technique (AMCT) in treating lumbar facet joint disorders.Method A total of 40 patients with lumbar facet joint disorders were randomized into a treatment group and a control group, 20 cases in each group. The treatment group was intervened by acupuncture plus AMCT, while the control group was treated with AMCT alone. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) were observed in the two groups before and after 3 treatment sessions, and the clinical efficacies were compared between the two groups.Result The VAS score and JOA score were significantly changed right after the 1st treatment and after 3 treatment sessions in the two groups (P<0.05). Right after the 1st treatment and after 3 treatment sessions, there were statistically significant differences in the VAS score and JOA score between the two groups (P<0.05). The total effective rate was 90.0% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.05). The relapse rate was 22.2% in the treatment group versus 50.0% in the control group 3 months after the treatment, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus AMCT is an effective approach in treating lumbar facet joint disorders.
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Objective@#To investigate the choice of surgical approach of petrous bone cholesteatoma (PBC)and surgical outcomes.@*Methods@#A retrospective study was performed on 90 patients diagnosed and treated for PBC from January 2000 to December 2014 by the Chinese People′s Liberation Army General Hospital otolaryngologists. According to Sanna′s classification, 40 out of the 90 cases were supralabyrinthine, five infralabyrinthine, four infralabyrinthine-apical, 25 massive and 16 apical. Five cases underwent transmastoid and retrolabyrinthine approach, translabyrinthine approach was performed on six patients, 19 cases underwent subtotal petrosectomy, seven cases underwent transotic approach, 41 cases underwent middle fossa approach, combined transmastoid/middle fossa approach was performed on 11 cases, translabyrinthine and sphenoid sinus approach were performed on one case. Supralabyrinthine cases mainly applied middle fossa approach (77.5%, 31/40) and combined transmastoid and middle-fossa approach(20.0%, 8/40). Combined transmastoid-retrolabyrinthine approach were applied for all the infralabyrinthine cases (100.0%, 5/5). Infralabyrinthine-apical cases mainly applied subtotal petrosectomy (75.0%, 3/4). Massive cases mainly applied subtotal petrosectomy (60.0%, 15/25), transcochlear approach (20.0%, 5/25), and translabyrinthine approach (16.0%, 4/25). Apical cases mainly applied middle fossa approach (62.5%, 10/16).@*Results@#Ninty percent (18/20) of the patients who had preoperative grade Ⅰ facial nerve function maintained in the postoperative period. Out of 90 cases, only 11 cases received open cavity, and the rest cases received cavityobliteration. There were three cases of recurrence, four cases of cavity infection, three cases of cerebrospinal fluid leakage, and one case of epidural hematoma, who all received surgeries.@*Conclusions@#Sanna′s classification should be used to classify different kinds of PBC cases, choose the best surgical approach for different cases, and preserve or repair facial function during removal of PBC, and thus reduce recurrence and complications.
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Purpose To investigate the relationship between ultrasonic manifestations in prostate cancer (PCa) and Gleason score,and improve the clinical value of transrectal ultrasound (TRUS) examination of PCa.Materials and Methods 362 patients with PCa treated in the First Affiliated Hospital of Soochow University from September 2009 to January 2015 were analyzed retrospectively,according to TRUS examination,the ultrasonic manifestations of PCa were divided into the localized type,diffuse type and negative type.Gleason score of pathological tissue divided the risk factor of PCa into low risk (<7 points),medium risk (=7 points),and high risk (>7 points).The relationship between ultrasonic manifestations of PCa and risk factor was analyzed.Results Ultrasonic results showed that,for the 362 patients with PCa,patients with ultrasonic negative manifestations accounted for 32.9% (119/362) and those with ultrasonic positive manifestations accounted for 67.1% (243/362),including 38.7% (140/362) localized type and 28.4% (103/362) diffuse type.In localized and diffuse PCa,the number of patients in high risk group was significantly more than the low risk group,and the difference among the high risk,medium risk and low risk groups was statistically significant (P<0.05);in the low risk group,the ultrasonic negative manifestations were more than the positive manifestations,and the difference was statistically significant (P<0.05);in high risk group,the localized and diffuse manifestations were more than the negative manifestations and the difference was statistically significant (P<0.05).Conclusion TRUS shows more clinical values in the diagnosis and treatment of PCa,and the ultrasonic positive manifestations can preliminarily evaluate the risk factor of PCa.
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<p><b>OBJECTIVE</b>To observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.</p><p><b>METHODS</b>One hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No.1 group (48 cases), the conventional intravenous general anesthesia was applied. In the No.2 group (50 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Neiguan (PC 6), Shenmen (HT 7), Shangliao (BL 31) and Ciliao (BL 32). operation in the No.2 and No.3 groups were lower apparently than that in the No.1 group (<0.05,<0.01).</p><p><b>CONCLUSIONS</b>During the general anesthesia anorectal operation, the acupoint transcutaneous electric stimulation achieves analgesic anesthesia through effectively promoting the release of body analgesic substance and reducing the stress level in the operation. With the comprehensive acupoint selection as Neiguan (PC 6) and Shenmen (HT 7) and the local acupoints, the therapeutic effects are better in comparison with the simple selection of local acupoints. In the No.3 group (48 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Shangliao (BL 31) and Ciliao (BL 32). The electric stimulation was maintained till the end of operation. The patients' saliva was collected 0.5 h before operation and 1 h after operation separately. The indices that reflect the body pain regulation and nerve-immune-endocrine secretion were detected, such as opiophin protein (OPI), secretory immunoglobulin A (SIgA), saliva amylase (sAA), cortisol (Cor) and tumor necrosis factor α (TNF-α). The pain degree was observed 1 h after operation.</p><p><b>RESULTS</b>In the No.2 group, OPI after operation was higher than that before operation (<0.05). The difference value of OPI in the No.2 group was higher apparently than that in the No.1 group and the No.3 group (both<0.05). SIgA after operation was higher than that before operation in the No.1 group (<0.05). The difference values of SIgA, sAA, Cor in the No.2 group were lower apparently than those in the No.1 group (<0.05,<0.01). TNF-αbefore and after operation and its difference value among the groups were not significant statistically (all>0.05). The pain degrees in 1 h after.</p>
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Objective To investigate gene polymorphism of Kell blood group in different Zhuang population from Guangxi region .Methods The genotypes of Kell blood group of 1025 non‐related individuals in different areas of Guangxi Zhuang popula‐tion were analyzed by PCR‐SSP .Results The Kell antigen in all individuals was homozygous ,the gene frequency of K and Jsa was 0 ,while that of k and Jsb was 1 .000 .Conclusion The distribution characteristic of Kell blood group in Guangxi Zhuang population was monomorphism ,which was similar to other Chinese population reported by literatures .
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Objective To observe and analyze the mutation characteristics of 17 STR loci among the paternity test cases in Guangxi area .Methods Among 1 786 cases of non—exclusion parentage ,1 430 cases were parental triplet and 356 cases were uniparental diad ,1 001 persons were Han people ,2 102 persons were Zhuang people and 113 persons were other ethnic group in the parents .The genome DNA was extracted by Chelex-100 method .17 short tandem repeat (STR) loci were detected by Power Plex ? 18D System Kit .The paternity testing containing mutant STR loci were screened out from 1786 cases .The locus-specific ,specificity of paternal and maternal ,and allele-specific mutation rates were observed and analyzed ,respectively .The characteristics of the muta-tions were studied .Results In total ,75 mutations events were observed at 16 of the 17 loci .Among them ,73 (97 .34% ) times were one step mutation ,onece(1 .33% ) was two—step mutation ,and once(1 .33% ) was three—step mutation ,no mutation was found at the TPOX locus .The mutation rates ranged 0 .031 1% —0 .404 2% ,and the mean mutation rate was 0 .145 8% .The proportion of the paternal mutations and the maternal mutations was 5 .4:1 .0 ,the difference had statistical significance(P0 .05) .Conclusion STR loci mutation is common phenomenon in paternity test .The data of STR loci mutations should be constantly accumulated for selecting the genetic characteristics in line with the Guangxi population and the genetic markers of STR loci with high identification ability to ensure ac-curate and reliable identification results .
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<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of YANG's pricking-cupping therapy for knee osteoar thritis (KOA). Methods This was a multi-center randomized parallel controlled trial. One hundred and seventy one patients with KOA were randomly allocated to a pricking-cupping group (89 cases) and a conventional acu puncture group (82 cases). Neixiyan (EX-LE 4), Dubi (ST 35) and ashi points were selected in the two groups. Patients in the pricking-cupping group were treated with YANG's pricking-cupping therapy; the seven-star needles were used to perform pricking at acupoints, then cupping was used until slight bleeding was observed. Patients in the conventional acupuncture group were treated with semi-standardized filiform needle therapy. The treatment was given for 4 weeks (from a minimum of 5 times to a maximum of 10 times). The follow-up visit was 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) were adopted for the efficacy assessments.</p><p><b>RESULTS</b>The pain score, stiffness score, physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups (all P<0. 0001). Except that the difference of stiffness score between the two groups was not significant after 4-week treatment (P>0. 05), each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P<0. 0001, P<0. 01). After 2-week treatment, 4-week treatment and during follow-up visit, the VAS was all reduced compared with that before treatment (all P<0. 0001) ; with the increase of the treatment, the reducing trend of VAS was more significant (P<0. 0001). The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P < 0. 01, P <0. 0001). CONCLUSION The YANG's pricking-cupping and conventional acupuncture therapy can both significantly improve knee joint pain and function in patients with KOA, which are relatively safe. The pricking cupping therapy is superior to conventional acupuncture with the identical selection of acupoints.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Arthralgia , Therapeutics , Combined Modality Therapy , Knee Joint , Medicine, Chinese Traditional , Methods , Osteoarthritis, Knee , Therapeutics , Treatment Outcomeالملخص
<p><b>OBJECTIVE</b>To explore the molecular basis for a CD36 deficiency individual and distribution of CD36 gene mutation in Guangxi population.</p><p><b>METHODS</b>A female individual was studied. CD36 phenotype was detected by monoclonal antibody immobilization of platelet antigens assay (MAIPA) and flow cytometry (FCM). The coding regions of the CD36 gene were sequenced. A DNA-based polymerase chain reaction-sequence specific primer (PCR-SSP) assay was used to verify the identified mutation. Cell lines expressing the mutant and wild-type CD36[CD36(MT) and CD36(WT)] were established, with the expression of CD36 determined by Western blotting. The distribution of CD36 gene mutation was investigated among 1010 unrelated individuals with the PCR-SSP assay.</p><p><b>RESULTS</b>Both MAIPA and FCM assays showed that the patient had type II CD36 deficiency. DNA sequencing showed that she has carried a heterozygous mutation T538C (Trp180Arg) in the exon 6 of CD36. Sequencing of cDNA clone confirmed that there was a nucleotide substitution at position 538 (538T>C). Western blotting also confirmed that the CD36 did not express on the CD36(MT) cell line that expressed the 538C mutant, but did express on the CD36(WT) cell line. The novel CD36 mutation T538C was further verified with 100% concordance of genotyping results by DNA-based PCR-SSP assay and 1010 unrelated individuals. No CD36 538C allele was detected among the 1010 individuals.</p><p><b>CONCLUSION</b>This study has identified a novel CD36 mutation T538C(Trp180Arg)(GenBank: HM217022.1), and established a genotyping method for the novel sequence-specific primer PCR. The novel mutation is rare in Guangxi and can cause type II CD36 deficiency.</p>
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Female , Humans , Middle Aged , Base Sequence , Blood Platelet Disorders , Genetics , Blood Platelets , Cell Biology , Metabolism , Blotting, Western , CD36 Antigens , Genetics , Metabolism , Cells, Cultured , DNA Mutational Analysis , DNA Primers , Genetics , Exons , Genetics , Flow Cytometry , Fluorescent Antibody Technique , Genetic Diseases, Inborn , Genetics , Genotype , Genotyping Techniques , Methods , Monocytes , Cell Biology , Metabolism , Mutation, Missense , Polymerase Chain Reaction , Methodsالملخص
<p><b>OBJECTIVE</b>To analyze the clinical characteristics of unilateral conductive hearing loss with intact tympanic membrane, and summarize the key diagnostic points, differential diagnosis and observe the effects of surgical treatment.</p><p><b>METHODS</b>We reviewed data from 82 patients with unilateral conductive hearing loss with intact tympanic membranes who accepted the exploratory tympanotomy from April 2011 to September 2013. There were 41 males and 41 females, aged from 7 to 66( averaged 26.5±13.7)years, with a history of one month to 50 years. The history, clinical symptoms, audiological evaluation, high resolution temporal bone CT, the results of surgical exploration and hearing reconstruction were analyzed.</p><p><b>RESULTS</b>The exploratory tympanotomy revealed 43 cases of congenital middle ear malformations (52.4%), 22 cases of otosclerosis (26.8%), eight cases of congenital cholesteatoma (9.8%), six cases of trauma induced conductive hearing loss (7.3%), three cases of congenital ossicular malformations with congenital cholesteatoma (3.7%). Progressive hearing loss was common in patients with otosclerosis and congenital cholesteatoma, and patients with congenital middle ear malformations described their hearing loss since childhood. High resolution temporal bone CT of congenital middle ear malformation, trauma induced conductive hearing loss, congenital cholesteatoma diagnosis rate was 40.0%, 50.0%, and 83.3% respectively. The preoperative air-conductive threshold of patients with absence of the oval window were increased to (66.9±1.1)dBHL, the preoperative bone-conductive threshold achieved (28.3±10.4)dBHL at 2 000 Hz. While patients with stapes fixation and that with ossicular chain discontinuity were (27.2±9.7)dBHL and (17.8±8.8)dBHL(P=0.000)respectively. Through the tympanic exploration with endaural incision under the microscope, different hearing reconstruction were applied according to different lesions. After the operation, the hearing level of 52 patients with return visit were improved, the mean air-conductive threshold were decreased from (60.0±11.4)dBHL to (32.2±12.1)dBHL(P=0.000); and the mean ABG were decreased from (43.2±12.0)dB to (16.3±9.4)dB(P=0.000).</p><p><b>CONCLUSIONS</b>Congenital middle ear malformations, otosclerosis, congenital cholesteatoma are the most common causes in unilateral conductive hearing loss with an intact tympanic membrane. The diagnosis rate can be improved by analyzing the clinical features. Through exploratory tympanotomy and hearing reconstruction, we can clarify the diagnosis and achieve a satisfying hearing recover.</p>
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Audiometry , Cholesteatoma , Pathology , Diagnosis, Differential , Ear Ossicles , Pathology , Ear, Middle , Congenital Abnormalities , Hearing Loss, Conductive , Pathology , General Surgery , Middle Ear Ventilation , Otosclerosis , Pathology , Tympanic Membraneالملخص
With the expansion of human practical activities, more and more areas have suffered from big data problems. The emergence of big data requires people to update the research paradigm and develop new technical methods. This review discussed that big data might bring opportunities and challenges in the area of auditory implantation, the deafness genome, and auditory pathophysiology, and pointed out that we needed to find appropriate theories and methods to make this kind of expectation into reality.
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Humans , Cochlear Implantation , Deafness , Genetics , Otolaryngology , Research Designالملخص
OBJECTIVE@#To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal.@*METHOD@#Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed.@*RESULT@#There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later.@*CONCLUSION@#Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
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Humans , Carcinoma, Adenoid Cystic , Diagnosis , General Surgery , Carcinoma, Basal Cell , Diagnosis , General Surgery , Carcinoma, Squamous Cell , Diagnosis , General Surgery , Ear Canal , Pathology , Ear Neoplasms , Diagnosis , General Surgery , Neoplasm Recurrence, Local , Neoplasm Staging , Parotid Gland , Pathology , Prognosis , Retrospective Studies , Temporal Bone , General Surgeryالملخص
OBJECTIVE@#To investigate the clinical features of labyrinthine fistula and obtain the diagnosis, treatment and prognosis of different types of fistula.@*METHOD@#A retrospective analysis of 42 cases (43 ears) with labyrinthine fistula in our hospital from January 2007 to November 2014 was conducted. Data of preoperative clinical manifestation, auditory function, CT image, operative findings, treatment and postoperative recovery were collected and statistically analysed.@*RESULT@#Thirty-nine cases (40 ears) of the 42 cases (43 ears) which were diagnosed as labyrinthine fistula according to operative findings occurred in the lateral semicircular canal, 1 case occurred in the posterior semicircular canal, 1 case occurred in the superior semicircular canal, and 1 case occurred both in lateral and posterior semicircular canal. Before operation, 24 ears (55.8% ) experienced vertigo and 14 ears (32.6%) showed impaired bone conduction hearing threshold. According to Dornhoffer classification standard, 22 cases (23 ears) were diagnosed as type I fistula, 9 cases as type II fistula and 11 cases as type III fistula. There was no statistical difference among the 3 groups on type of hearing loss, vertigo, CT, facial nerve canal damage before operation and bone conduction hearing threshold, vertigo after operation.@*CONCLUSION@#An accurate diagnosis of labyrinthine fistula relies on the operative findings rather than preoperative clinical manifestation, auditory function or CT The surgical intervention should be individualized. There is no significant difference on postoperative recovery among different types of labyrinthine fistula.
الموضوعات
Humans , Bone Conduction , Cholesteatoma, Middle Ear , Deafness , Facial Nerve Injuries , Fistula , Labyrinth Diseases , Otitis Media , Postoperative Period , Prognosis , Retrospective Studies , Vertigoالملخص
ObjectiveTo investigate the clinical efficacy of warm needling moxibustion plus tricolor medicinal paste in treating knee osteoarthritis.MethodNinety-one patients meeting the diagnostic criteria were randomly allocated to a treatment group (45 cases) and a control group (46 cases). The treatment group was given warmneedling moxibustion plus tricolor medicinal paste and the control group, warm needling moxibustion alone. The clinical therapeutic effect and the WOMAC score were observed in thetwo groups. An improvement in the symptoms of knee osteoarthritis was assessed in the patients after treatment.ResultIn both groups, there were statistically significant pre-/post-treatment differences in the pain and daily activity scores and the WOMAC total score (P0.05). There were statistically significant differences in the daily activity score and the WOMAC total score (P0.05) between the two groups.Conclusion The study shows that warm needling moxibustion plus external application of tricolor medicinal paste has a marked improving effect on the pain, swelling and physiological functions in patients with knee osteoarthritis. Improving lower limb function further in daily activities can produce a satisfactory and stable therapeutic effect.