Effectiveness of auricular orthosis in the treatment of children with congenital auricular deformity / 中华整形外科杂志

Objective@#To explore the treatment effects of domestic auricular orthosis on children born with congenital auricular deformity.@*Methods@#Children born with congenital auricle deformity were treated by "Yi Er" auricle orthosis, included 42 ears of 29 cases.These children were divided into three groups according to the birth age. The age less than 7 days was divided into group 1, 7-42 days for group 2, and more than 42 days for group 3. Compare the therapeutic effect of children in different ages.@*Results@#The therapeutic effect was divided into three grades: markedly effective and cured (basically return to normal appearance); effective (improved, but not reached the normal appearance); invalid (no improvement after treatment). The markedly effective and cured rate in group 1, group 2 and group 3 were 100%, 85.7% and 45.0%, the difference was statistically significant(P<0.05), and the average correction time was(20.75±6.50)d, (32.64±15.40)d, (48.23±17.32) d, the difference was statistically significant(P<0.05).@*Conclusions@#The domestic auricle orthosis has a significant effect on the correction of children born with congenital auricular deformity. The better treatment effect and the shorter wearing time can be acquired in the early correction.

Conversion from mycophenolic acid to mizoribine in renal transplant recipients with gastrointestinal tract symptoms: a prospective observational multi-center study / 中华器官移植杂志

Objective To evaluate the effect of conversion from mycophenolic acid (MPA) to mizoribine (MZR) in renal transplant recipients with gastrointestinal tract (GI) symptoms.Methods A total of 355 renal transplant recipients with GI symptoms caused by MPA administration were enrolled from April 2015 to March 2017 in 25 different renal transplant centers in China.The symptomatic improvement of GI before (baseline) and after conversion to MZR (1,2,4 weeks) was assessed by each item of GI symptoms indication.In addition,the efficacy and safety of the conversion therapy during 12 months were determined.Results Patients showed improvement in GI symptoms including diarrhea,abdominal pain,abdominal distention and stomachache after conversion to MZR 1,2,4 weeks (P＜0.05).In patients with different severity of diarrhea,conversion to MZR therapy significantly improved diarrhea (P＜0.05).During 12 months,no patient experienced clinical immune rejection.We did not observe any infections,leucopenia and other serious side effects.Conclusion MZR could markedly improve GI symptoms caused by MPA administration in renal transplant recipients.

The Evaluation of the Quality of Life of Prelingually Deaf Adolescents with Cochlear Implants / 听力学及言语疾病杂志

Objective To evaluate the family and individual quality of life for the prelingually deaf adolescents with cochlear implants and compare the influence of preoperative communication mode.Methods A retrospective study was conducted in 21 prelingually profoundly deaf adolescents divided into the nonverbal group and oral group according to preoperative communication modes.The scores of the children using hearing implants quality of life (CuHI Qol) and nijmegen cochlear implant questionnaire (NCIQ) were collected and compared statistically between the two groups.Results The postoperative scores of CuHI Qol (51.71±8.9) in 21 patients were significantly higher than those before operation (42.14±6.04,P<0.001), and no significant differences were observed in the family influence between the two groups while the scores of oral group were significantly higher than the nonverbal group in parents' expectation and quality of life(P<0.05).The NCIQ scores of the oral group were significantly higher than nonverbal group(P<0.05) in the following subdomains : advanced sound perception, speech production, social interactions and there was no statistical difference in basic sound perception, self-esteem and activities.Conclusion The quality of life of prelingually deafened adolescents with cochlear implants can be improved obviously and patients with oral communication mode before operation have better quality of life.

Evaluation on the hearing, speech and quality of life for cases received cochlear implant / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the use of the categories of auditory performance (CAP-II), the speech, spatial and qualities of hearing scale-parents' version (SSQ-P), children using hearing implants quality of life (CuHI-QoL) in patients with prelingual hearing impairment to compare the rehabilitation effect between preoperative and postoperative auditory performance, speech behavior and quality of life and at the same time to figure out dose rehabilitation effect connected to age.@*METHOD@#Mainly used classification method to compare the audotory performance, speech behavior and quality of life of 50 patients before and after 2.5 years after the implantation. At the same time these 50 patients are divided on the basis of the age received the surgery, A group received the surgery before 6(1.0-5.9) years old and group B received the therapy after this age (6.0-10.9). Their auditory performance, speech behavior and quality of life were all evaluated.@*RESULT@#There were statistical difference between two kinds of classification method of CAP-II. In the study of SSQ-P and CuHI-QoL, there was no statistical difference in well-being and happiness before and 3 years after the implant, also there was no statistical difference in parental stress between two age groups. In addition to the above two, the rest all have statistical significance.@*CONCLUSION@#After the implant, postoperative auditory performance, speech behavior and quality of life all had improved and the smaller the age, the better the performance.

Angiotensin Ⅱ type 1 receptor agonistic antibodies enhance acute ischemic tubular injury in patients subject to kidney transplantation / 中华器官移植杂志

Objective To evaluate the impact of autoantibodies to angiotensin Ⅱ type 1 receptor AT1-AA on clinic outcomes of delayed graft function (DGF) grafts.Method We reviewed the records of all 139 consecutive adult recipients who received single kidney transplantation and clinical management between Jan.2010 and Dec.2012 in our centre.The serum levels of AT1-AA were measured by a streptavidin-enzyme-linked immunosorbent assay.All patients with DGF were enrolled in this study and divided into two groups:(1) AT+ DGF group (serum AT1-AA positive,11 cases) ;(2) AT-DGF group (serum AT1-AA negative,23 cases).All clinical and laboratory data were recorded in our transplant database system at each visit.Result 139 recipients were enrolled.The overall presence of DGF was 24.5％ (34/139).The incidence of DGF in patients with high binding AT1-AA was significantly higher than that in those with low binding of AT1-AA (11/24 vs.23/115,45.8％ vs.20.0％,P＜0.05).In addition,longer duration of renal replacement therapy (59 ± 32 vs.47 ± 26 months,P＜0.05),higher resistance index (0.80 ± 0.10 vs.0.72 ± 0.10,P＜0.05) of allografts and more severe acute tubular injury (2.7 ± 0.5 vs.1.8 ± 1.1,P＜0.05)/acute tubular necrosis (0.9 ± 0.5 vs.0.5 ± 0.3,P＜0.05) were observed in AT + DGF group than in AT-DGF group.One-year graft survival and death censored graft survival were similar between two groups (90.9％ vs.95.7％,P＞0.05).Conclusion Presence of high binding anti-AT1 receptor had detrimental impacts on initiation and development of DGF.

Middle ear cancer recurrence after operation+radiotherapy with adjacent tissue necrosis: two cases report / 临床耳鼻咽喉头颈外科杂志

Retrospective analysis of two cases of advanced carcinoma of the middle ear. Two patients underwent operation and radiotherapy. A case developed extensive necrosis in ear and neck, which finally led to lethal hemorrhage. Multiple relapse with cranial fossa invasion and extensive necrosis was found in the other case.

A questionnaires study on cochlear implantation in patients with white matter changes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This article evaluates the auditory and speech perception outcomes of sensorneural hearing loss with cerebral white matter abnormalities after cochlear implantation.@*METHOD@#A retrospective analysis was performed on the cochlear implantatees with cerebral white matter abnormalities by using the categories of auditory performance and speech intelligibility rating, and compared with the non-syndrome patients with sensorineural hearing loss. Paired t-test was used for statistical analysis.@*RESULT@#There was statistical difference between normal group and white matter changes group with sensorineural hearing loss after 6 month. No statistical difference was found after 12 month and 24 month.@*CONCLUSION@#In the short term, the cochlear implant can be performed safely in patients with white matter changes. After a formal rehabilitation training,no significant difference in auditory or language ability was found between normal group and white matter changes group with sensorineural hearing loss.

Clinical effect of conversion to Rapamycin on chronic allograft nephropathy / 中华器官移植杂志

Objective To study the effect and safety of conversion from calcineurin inhibitors to rapamycin in kidney transplantation recipients with chronic allograft nephropathy.Methods In 82 kidney transplant recipients enrolled in this study,72 cases were diagnosed as having chronic allograft nephropathy by biopsy.Recipients (SRL group) were administered with rapamycin after withdrawal of calcineurin inhibitors.The doses of CNI in other recipients (non-SRL group) were not changed.Renal function,proteinuria,blood pressure,blood fat,hepatic function and hemogram were observed for 24 months in each group.Results During the follow-up period,serum creatinine level was dropped significantly in SRL group (P＜0.05),but it was increased in non-SRL group (P＜0.05).SRL group showed increased proteinuria,serum cholesterol and triglycerides (P＜0.05),and reduced Plt (P＜0.05).According to the renal function before conversion,the recipients who were administered rapamycin divided into four groups.In group A (Scr ＜ 120 μmol/L),there was no significant difference in diverse variables before and after conversion.In group B (Scr 120-200 μmol/L and Banff Ⅰ-Ⅱ),renal function was improved,and proteinuria alleviated.In group C (Scr 120-200 μmol/L and Banff ＞ Ⅱ),and group D (Scr ＞200 μmol/L),renal function was damaged to varying degrees and proteinuria was deteriorated.Conclusion It is safe and effective for patients with chronic allograft nephropathy to convert from calcineurin inhibitors to rapamycin.

Diagnostic diagnosis of thyroid microcarcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate how to improve the rate of clinically diagnosis of thyroid microcarcinoma.@*METHOD@#Clinically diagnostic data of 73 cases with TMC, operated and confirmed by pathology from Jan. 2000 to Dec. 2009 were retrospective analyzed, the data were divided into A, B groups, A group (21 cases) can touch the regional lymph nodes and/or thyroid nodule with hard quality; B group(52 cases) can't touch the regional lymph nodes and/or thyroid nodule with hard quality, and the data was analyzed by statistical software.@*RESULT@#Fifty-three cases diagnosed preoperatively and intraoperatively, the diagnosis rate was 73% (53/73). A group including 18 ca ses, diagnostic rate was 86% (18/21); B group including 35 cases, diagnostic rate was 67% (35/52); A variety of auxiliary examination and intraoperative exploration, etc, was statistically significant for improving the diagnostic rate of TMC.@*CONCLUSION@#The clinically missed diagnostic rate of TMC was high, but the physicians adequate attention, careful palpation before surgery, the corresponding auxiliary inspection measures will help improve the clinically diagnostic rate of TMC.

A clikical study on kidney transplantation patients with a survival time over 10 years and long-term administration of cyclosporine / 中华器官移植杂志

Objective To investigate the effect of cyclosporine blood level at first year after kidney transplantation on patients with a survival time over 10 years. Methods 380 patients with functional allograft, a survival time over 10 years and long-term administration of cyclosporine A (CsA) were studied, and received CsA-based treatments. According to the blood CsA level at the first year after kidney transplantation, patients were divided into five groups: group 1, blood CsA level was above 0. 208 μmol/L (1 μmol/L = 1201.9 μg/L), group 2, blood CsA level between 0. 166-0. 208μmol/L; group 3, blood CsA blood level between 0. 125-0. 166 μmol/L; group 4, blood CsA blood level between 0. 083-0. 125 μmol/L; group 5, blood CsA level less than 0. 083 μmol/L. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine(SCr), uric acid (UA), cholesterol (CH), triglyceride (TG), alanine aminotransferase (ALT), direct bilirubin (DBil) and total bilibubin (TBil), albumin (Alb), hemoglobin (Hb), count of white blood cells and positive rate of proteinuria in 5 groups at the 1st, 5th and 10th year after kidney transplantation were analyzed. Results At the 5th year SBP in groups 1 and 2 was higher than in groups 3, 4 and 5. UA level in group 5 was lower than other groups, and Alb level in group 5 was higher than other 4 groups. Proteinuria positive rate in groups 4 and group was lower than other groups. At the 10th year after kidney transplantation,indexes among 5 groups had no statistically significant difference, except for SBP, DBP, DBil and CH in some groups. There was also no significant difference in SCr level among 5 groups at the 5th or 10th year after transplantation. Conclusion Blood CsA levels at the first year after kidney transplantation has no significant effect on long-term allograft function. But higher level of CsA (＞0. 166μmol/L) at the first year maybe predict high rate of hypertension, high blood UA and proteinuria at the 5th and 10th year after transplantation.

The Effects of Cochlear Implantation on Children with Large vestibular Aqueduct Syndrome / 听力学及言语疾病杂志

Objective The purpose of this study is to compare the most comfortable levels and neural re-sponse imaging threshold between children of cochlear implants with large vestibular aqueduct syndrome and normal inner ears. Methods Thirty-eight implanted children participated in this study and were divided into two groups. Group A consisted of 32 patients with normal inner ears and group B 6 patients with radiographically proven large vestibular aqueduct syndrome. All of the patients were the recipients of the cochlear implants by Advanced Bionics. The initial time for the first programming session was approximately one month after surgery. The psychophysical tests included M- level tests. Programming techniques used in the test were suitable for the age of patients. Sound-Wave 1.4 software was used to test tNRI. Results Using the rank sum test, M-level and tNRI of electrode 3,7,11 and 15 did not differ significantly between group A and B(P>0. 05). Conclusion The parameters of mapping are not significantly different between the implanted children with large vestibular aqueduct syndrome and normal inner ear. The management and procedures of mapping used to the subjects with normal inner ear can be applied to the children with large vestibular aqueduct syndrome.

Clinical features of pulmonary infection at different stages after renal transplantation / 中国感染与化疗杂志

Objective To investigate the clinical features and prognosis of pulmonary infection at different stages after renal transplantation.Methods Medical records of 61 patients with pulmonary infection after renal transplantation from January 2003 to July 2008 in our hospital were reviewed in this retrospective study. According to stages of infection onset, we divided all patients into two groups, early onset group (43/61, 70.5%, ≤12 months after transplantation) and late onset group (18/61, 29.5%, >12 months after transplantation). Clinical manifestations and prognosis were compared between the two groups.Results In the early onset group, the radiographic manifestation suggested diffuse interstitial changes of bilateral lungs. Combination of anti-infective therapy and early mechanical ventilation was preferred. While in the late onset group, unilateral pulmonary lesions were seen in most cases. More patients showed cardiac and gastrointestinal complications in this group, the mortality of which was much higher. Conclusions Pulmonary infection is a major complication of renal transplantation. The etiology, clinical characteristics and prognosis of infection varies with the stage after transplantation. Effective preventive and therapeutic measures should be applied more vigorously in patients with pulmonary infection, especially early onset ones.

Analysis of granzyme B mRNA and perforin mRNA levels in urine for renal transplantation patients with de-layed graft function / 中华泌尿外科杂志

Objective To explore the clinical value of the level of granzyme B and perforin mRNA in urine for the diagnosis of renal transplantation patients with delayed graft function (DGF). Methods Twenty-four cases of renal transplantation patients with DGF were included in this study. Seventy-three u-rine specimens were obtained from these patients who received graft biopsies. Among the 24 cases, ureteral obstruction occurred in 2 cases, vascular thrombosis in 1 case, acute CsA intoxication in 3 cases, acute tubu-lar necrosis (ATN) in 7 cases, ATN complicating borderline change in 2 cases, ATN complicating acute re-jection (AR) in 3 cases, AR in 6 cases. Total RNA was isolated from the urinary cells. Messenger RNA (mRNA) encoding the cytotoxic proteins perforin and granzyme B gene were measured with the quantitative polymerase-chain-reaction assay-(RT-PCR). SPSS13.0 software was used for data analysis. Levels of mRNA were log-transformed before analysis. Results The levels of perforin and granzyme B mRNA in u-rine among the ureteral obstruction group, vascular thrombosis group, acute CsA intoxication group and ATN group were very low. There was no significant difference among these groups (P>0.05). However,among the ATN complicating borderline change group 1.22, 0. 97 fg/μg, ATN complicating AR group (1.20±0.39), (1.07±0.30)fg/μg, and AR group(11.13±0. 33), (1.01±0.19)fg/μg, the levels were increased significantly(P<0.001). Conclusion Measurement of mRNA encoding the cytotoxic proteins perforin and granzyme B gene in urinary cells in renal transplantation patients with DGF could be helpful to etiological diagnosis of DGF, and might be used as an index for the appropriate management of the borderline change.

Clinical anatomical study of the adult lateral skull base / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the observation and the measurements of the significant anatomical landmark the lateral skull base, to provide anatomical data of clinical location and navigation for surgery at the lateral skull base.@*METHOD@#Significant anatomical landmarks of twenty adult cadaveric heads (40 sides) fixed in 10% formaldehyde and 20 operation cases (20 sides) had been observed and measured. Lateral skull bases of cadaveric heads were numbered from 1st to 40th, while the operation cases were numbered from 1st to 20th.@*RESULT@#The anatomical data was achieved by measuring related anatomical landmark as follows: the distances between the significant landmark of the lateral skull base and the pars neuraxis, vein of the jugular foramen; the areas of trautmann triangle; post labyrinths triangle and the superficial triangle of processus mastoideus; the maximal distance of initiative displacement of facial nerve in the lateral skull base operations.@*CONCLUSION@#The data measured at lateral skull base could effectively help operators not only to enlarge the field of vision in operations with security and to avoid the damagement of the important blood vessel and nerves, but also to retain the function of the facial nerve to the utmost.

A clinical study of the influence on the drying of the ear canal by cleaning the focus of infection in the posterior tympanum / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the influence of drying the ear canal by cleaning the focus of infection in the posterior tympanum in middle ear operations.@*METHOD@#Retrospectively analyze 168 cases of middle ear operations, which were divided into two groups by whether the posterior tympanum was open or not in the operation process. Then comparing the drying ear rate.@*RESULT@#The drying ear rate (DEC) were 81.7% (67/82) and 91.9% (79/86) in the posterior tympanum unopened and opened group, respectively. In the posterior tympanum unopened group, the DEC rate were 78.9% (30/38) and 84.1% (37/44) in 38 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum opened group, the DEC rate were 88.2% (37/42) and 94.7% (42/44) in 42 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum unopened group, the DEC rate were 81.7% (36/44) and 84.6% (34/38) in 44 cases of radical mastoidectomy and in 38 cases of tympanoplasty; compared with the posterior tympanum opened group, the DEC rate were 91.3% (42/46) and 92.5% (37/40) correspondingly.@*CONCLUSION@#In the middle ear operation, open the posterior tympanum in convention can not only have profits to clear the insidious focus of infection, but also have profits to skeletonized to lower facial ridge to the utmost limits and make the drainage of the ear canal easy and smooth. At last, the rate of DEC was raised.

Diagnosis and management of epistaxis caused by traumatic pseudoaneurysm / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the diagnosis and management of epistaxis caused by traumatic pseudoaneurysm.METHODS The clinical data of 16 cases with epistaxis caused by traumatic pseudoaneurysm were retrospectively studied.There were 12 males and 4 females.Their ages ranged from 16 to 41 years with an average of 25.4 years.RESULTS All the patients were cured via digital subtraction angiogrophy(DSA) and embolization except one died.The time between the hospitalization and the DSA examinat ion was 3 to15 days.Interestingly,every patient had received anterior and posterior nasal packing one to 5 times.CONCLUSION If the anterior and posterior nasal packing were not effective to the patients with repeated and vast nasal bleeding,who had trauma history before nasal bleeding,the DSA examination should be carried out immediately to identify whether the pseudoaneurysm exists.