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Objective: To explore the help seeking efficacy and social assistance willingness of medical staff during major public health events, so as to provide basis for improving the psychological resources and service quality of medical staff and further optimizing the prevention and treatment policies. Methods: In February 2020, a convenient sampling method was used to conduct an online questionnaire survey on medical staff in Henan Province, and a total of 2136 questionnaires were collected. Among them, there were 1940 valid questionnaires, and the effective recovery rate was 90.82%. The questionnaire of help seeking efficacy and willingness to social assistance under epidemic situation was used to investigate the help seeking efficacy and willingness of medical staff. The frequency and rate (%) were used to analyze the overall situation of medical staff's help seeking efficacy and social assistance willingness. The differences among different demographic variables were tested by χ(2) test. Results: Among the 1940 medical and nursing staff, 18.81% (365/1940) did not know how to obtain appropriate psychological assistance. Compared with the low age group, the medical staff in the high age group had the ability of information query, the ability to occupy knowledge resources, the ability to distinguish rumors and facts and the sense of efficacy of obtaining appropriate medical help, and the difference was statistically significant (P<0.05) . The willingness of medical and nursing staff to actively cooperate with the government, maintain social stability and volunteer work were 99.43% (1929/1940) , 98.81% (1917/1940) and 97.11% (1884/1940) . Conclusion: The medical staff had a higher sense of help seeking efficacy and willingness to social assistance. It is necessary to further strengthen the resource support of psychological, social and humanistic care for medical staff.
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Humanos , Intenção , Corpo Clínico , Organizações , Saúde Pública , Inquéritos e QuestionáriosRESUMO
ObjectiveTo explore the mechanism of Fuzi Lizhongwan alleviating the damage of chemotherapy-induced peripheral neuropathy (CIPN) mice caused by cisplatin based on mitogen-activated protein kinase (MAPK) signaling pathway. MethodA total of 40 female KM mice were randomized into blank group (distilled water, ig), model group (distilled water, ig), Fuzi Lizhongwan group (3.5 g·kg-1, ig), and aspirin group (0.026 g·kg-1, ig). Cisplatin (3 mg·kg-1, ip, 5 days) was used to induce CIPN in mice. Administration began while modeling and lasted 12 days. The general conditions and behaviors of mice were observed. After the last administration, samples were collected. Pathological changes of the soles were observed based on hematoxylin-eosin (HE) staining. Biochemical assay was employed to determine the levels of serum superoxide dismutase (SOD), hydrogen peroxide (H2O2), malondialdehyde (MDA), and nitric oxide (NO), enzyme-linked immunosorbent assay (ELISA) the content of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and glutathione peroxidase-3 (GPX-3) in kidney tissue, and Western blotting the expression of extracellular signal-regulated kinase1/2 (ERK1/2), phosphorylated-ERK1/2 (p-ERK1/2), p38 MAPK, and phosphorylated-p38 MAPK (p-p38 MAPK) in kidney tissue. ResultCompared with the blank group, model group demonstrated obvious pathological damage on the soles, hyperkeratosis of the epidermis with a basketweave pattern, atrophy of stratum spinosum, reduction of cells, and intracellular edema. Compared with the model group, Fuzi Lizhongwan significantly alleviated the pathological damage of the skin tissue of the soles. The model group showed lower body weight, mechanical pain threshold, thermal pain threshold (P<0.01), and SOD activity (P<0.05), higher content of H2O2, MDA, and NO (P<0.01), and higher expression of IL-6, IL-1β, and TNF-α (P<0.01) than the blank group. Fuzi Lizhongwan group demonstrated higher body weight, mechanical pain threshold, thermal pain threshold (P<0.01), and SOD activity (P<0.05), lower content of H2O2, MDA, and NO (P<0.05), and lower expression of IL-6, IL-1β, and TNF-α (P<0.01) than the model group. The expression of ERK1/2, p-ERK1/2, p38 MAPK, and p-p38 MAPK increased significantly (P<0.01) in the model group compared with that in the blank group, while the expression decreased significantly (P<0.01) in the Fuzi Lizhongwan group compared with that in the model group. ConclusionFuzi Lizhongwan can relieve the neurological injury of cisplatin-induced CIPN mice and increase the pain threshold of mice, possibly by regulating the MAPK signaling pathway and inhibiting inflammatory response and oxidative stress.
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BACKGROUND@#The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with pre-lingual deafness present before 3 years of age.@*METHODS@#Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI.@*RESULTS@#The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P 0.05). The optimal cutoff age for CI was 15 months.@*CONCLUSIONS@#Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.
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Background@#The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with prelingual deafness present before 3 years of age.@*Methods@#Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI.@*Results@#The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P < 0.05). The optimal cutoff age for CI was 15 months.@*Conclusions@#Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.
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Mouret abscess is a rare extracranial complication of suppurative otitis media. It is generally believed to be a deep neck abscess caused by inflammation leading to the rupture of the bony tip of the mastoid tip. The location of Mouret abscess is deep. The symptoms are insidious at the onset, but may eventually spread to the surrounding tissue, and even lead to mediastinal abscess, cavernous sinus thrombosis, meningitis, dyspnea and other serious complications. At present, with the popularization of antibiotics, the occurrence rate of Mouret abscess is very low, and only sporadic cases have been reported.In this paper, a case of Mouret abscess caused by cholesteatoma was analyzed to explore Mouret abscess in terms of the route of infection, clinical manifestations, imaging features, diagnosis and treatment.
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Humanos , Abscesso , Diagnóstico , Tratamento Farmacológico , Terapêutica , Colesteatoma , Processo Mastoide , Patologia , Meningite , Pescoço , Patologia , Otite Média , Otite Média SupurativaRESUMO
To investigate the long-term efficacy of endolymphatic sac mastoid drainage for Ménière disease.Data from 26 patients diagnosed with MD strictly meeting the criteria issued by " Guideline of diagnosis and treatment of Meniere disease(2017)" from 2006 to 2015 were analyzed in this study.Endolymphatic sac mastoid shunt surgery was performed for each patient.The therapeutic effect was evaluated against the " Guideline of diagnosis and treatment of Meniere disease(2017)".Vertigo control and auditory function were measured after at least two years follow up.In 26 cases,16 cases were male and 10 cases were femaleThe age ranged from 24 to 71 years old,with an average of 52.04 years.The disease duration ranged from 1 to 32 years.22 cases were diagnosed as unilateral Ménière disease,and bilateral involvement was identified in 4 cases,thus a total of 30 ears were included.According to the preoperative staging of hearing,there were 0 cases in stage one,5 cases in stage two,16 in stage three and 9 cases in stage four.15 cases(57.7%)achieved class A vertigo conrol(complete control),9 cases(34.6%)class B(substantial control)and 2 cases(7.7%)class D(no control).The severity of vertigo and its impact on daily life were improved in 24 cases(92.3%)with a score of 0 point,and 2 cases(7.7%)scored 2 points.Post-operative hearing was improved in 3 cases(11.5%),unchanged in 16 cases(61.6%)and worsened in 7 cases(26.9%).After operation,tinnitus disappeared in 5 cases(19.2%),reduced in 13 case(50%)and unchanged in 8 cases(30.8%).Endolymphatic sac mastoid drainage was an effective and safe management for intractable Ménière disease patients with pre-operative residual hearing.The occurrence of complication was unsual.The patients who are in stage four could gain benifits from the surgery.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Drenagem , Saco Endolinfático , Seguimentos , Processo Mastoide , Doença de Meniere , Terapêutica , VertigemRESUMO
Objective To observe the clinical efficacy of modified Yiqi Shengjiang Decoction for chronic heart failure (CHF) and its effects on BNP and LP-PLA2. Methods Totally 100 cases of patients with CHF were randomly divided into treatment group and control group, with 50 cases in each group. The control group received basic treatment, and the treatment group was treated with modified Yiqi Shengjiang Decoction on the basis of control group, one dosage per day, twice a day, orally, for 4 weeks. The curative effect of heart function grading and curative effect of TCM symptoms of the two groups, the changes of plasma BNP and LP-PLA2 levels were observed. Safety indicators were monitored. Results The total effective rate of cardiac function classification was 88% (44/50) in the treatment group and 68% (34/50) in the control group, with the treatment group much better than the control group (P<0.05); the total effective rate of TCM symptom efficacy was 90% (45/50) in the treatment group and 74% (37/50) in the control group, with the treatment group much better than the control group (P<0.05). The BNP and LP-PLA2 levels in the treatment group were lower than the control group after treatment, with statistical significance (P<0.05). No adverse reactions were observed in both groups, with no abnormalities in blood, urine, liver and kidney function. Conclusion Modified Yiqi Shengjiang Decoction combined with Western medicine has obvious advantages in the treatment of CHF in improving patients' heart function, and reducing plasma BNP and LP-PLA2 levels.
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<p><b>BACKGROUND</b>Cochlear implants (CIs) can improve speech recognition for children with severe congenital hearing loss, and open-set word recognition is an important efficacy measure. This study examined Mandarin open-set word recognition development among Chinese children with CIs and normal hearing (NH).</p><p><b>METHODS</b>This study included 457 children with CIs and 131 children with NH, who completed the Mandarin lexical neighborhood test. The results for children at 1-8 years after receiving their CIs were compared to those from the children with NH using linear regression analysis and analysis of variance.</p><p><b>RESULTS</b>Recognition of disyllabic easy words, disyllabic hard words, monosyllabic easy words, and monosyllabic hard words increased with time after CI implantation. Scores for cases with implantation before 3 years old were significantly better than those for implantation after 3 years old. There were significant differences in open-set word recognition between the CI and NH groups. For implantation before 2 years, there was no significant difference in recognition at the ages of 6-7 years, compared to 3-year-old children with NH, or at the age of 10 years, compared to 6-year-old children with NH. For implantation before 3 years, there was no significant difference in recognition at the ages of 8-9 years, compared to 3-year-old children with NH, or at the age of 10 years, compared to 6-year-old children with NH. For implantation after 3 years, there was a significant difference in recognition at the age of 13 years, compared to 3-year-old children with NH.</p><p><b>CONCLUSIONS</b>Mandarin open-set word recognition increased with time after CI implantation, and the age at implantation had a significant effect on long-term speech recognition. Chinese children with CIs had delayed but similar development of recognition, compared to normal children. Early CI implantation can shorten the gap between children with CIs and normal children.</p>
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OBJECTIVE@#To observe the effect of miR-467b on the atherosclerosis (AS) of rats with apolipoprotein E (ApoE) gene knockout (ApoE(-/-)).@*METHODS@#ApoE(-/-) rats were fed with high fat and high cholesterol diet and were randomly divided into group A, group B and group C, with 10 rats in each group. Group A: rats were injected with ApoE agonist through the caudal vein; group B: rats were injected with ApoE antagonist through the caudal vein; group C: as negative control group. Enzyme oxidation method was used to detect the blood lipid levels of rats. Western blotting method was used to detect the aortic lipoprotein lipase (LPL) expression levels of rats. HE staining and oil red O staining were performed to observe the AS lesions and lipid accumulation state.@*RESULTS@#Compared with group C, blood lipid level, aortic intima and aortic sinus lipid accumulation area ratio, aortic sinus lesion area and LPL expression level in group A significantly reduced; while blood lipid level, aortic intima and aortic sinus lipid accumulation area ratio, aortic sinus lesion area, and LPL expression level in group B significantly increased, with the statistical difference (P < 0.05).@*CONCLUSIONS@#miR-467b can alleviate the AS lesions of ApoE(-/-) rats, and its inhibiting effect on AS may be related to LPL expression.
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Objective: To observe the effect of miR-467b on the atherosclerosis (AS) of rats with apolipoprotein E (ApoE) gene knockout (ApoE
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<p><b>OBJECTIVE</b>The aim of this study is to assess of cochlear implantation in children with auditory neuropathy and cochlear nerve aplasia by using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR).</p><p><b>METHODS</b>Twenty one children with cochlear implants participated in this study. They all received cochlear implant surgery at our hospital from January 2004 to October 2010. All children had hearing aid trial and hearing and speech rehabilitation before surgery at least three months.Nine children (7 male, 2 female) were diagnosed with auditory neuropathy, twelve (7 male, 5 female) with cochlear nerve aplasia. Twenty children (10 male, 10 female) with sensorineural hearing loss served as a control group. All the children received cochlear implant for more than six months. Forty two children with normal hearing served as another control group which were divided into three subgroups according to their age.Group A included 18 children aged under two yrs, group B consisted of 16 children aged from two to four yrs and group C comprised eight children aged above four yrs. CAP and SIR were used to evaluate among all the children and the scores were compared.</p><p><b>RESULTS</b>The CAP scores of children with auditory neuropathy, cochlear nerve aplasia, sensorial neural hearing loss and the three subgroups children with normal hearing were 4.44 ± 1.50, 4.83 ± 1.69, 4.55 ± 1.66, 5.22 ± 1.11, 6.75 ± 0.45 and 7.00 ± 0.00 respectively, and SIR scores were 2.66 ± 1.11, 2.33 ± 1.15, 2.40 ± 0.75, 2.56 ± 1.04, 4.12 ± 0.81 and 5.00 ± 0.00 respectively. There were significant differences among the six groups for CAP scores(χ(2) = 35.481, P < 0.001) and SIR scores(χ(2) = 40.549, P < 0.001).No significant differences for CAP and SIR scores were observed between children with auditory neuropathy/cochlear nerve aplasia and sensorial neural hearing loss as well as group A (P > 0.05 for each), and there were significant differences were shown between children with auditory neuropathy/cochlear nerve aplasia and group B as well as group C (P < 0.01 for each aplasia).</p><p><b>CONCLUSIONS</b>The auditory and speech capabilities of children with auditory neuropathy and cochlear nerve deficiency can can get benefits from cochlear implants as children with sensorineural hearing loss, however not achieve the level of those with normal hearing after cochlear implantation. The long term effects still need follow-up and evaluation.</p>
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Criança , Feminino , Humanos , Masculino , Implante Coclear , Implantes Cocleares , Nervo Coclear , Fisiologia , Audição , Auxiliares de Audição , Perda Auditiva Central , Cirurgia Geral , Perda Auditiva Neurossensorial , Testes Auditivos , Fala , Inteligibilidade da Fala , Percepção da Fala , Doenças do Nervo VestibulococlearRESUMO
<p><b>OBJECTIVE</b>To analyze the clinical features and the surgical treatment outcomes of patients with tuberculous otitis media and mastoiditis.</p><p><b>METHODS</b>The medical records of 16 patients (18 ears) with tuberculous otitis media and mastoiditis, who received surgery in Beijing Tongren hospital, were reviewed.</p><p><b>RESULTS</b>The common symptoms were otorrhea and hearing loss, and 3 patients demonstrated severe sensorineural hearing loss. Three patients demonstrated a peripheral-type facial palsy. Temporal bone high resolution CT scans demonstrated the entire tympanum and mastoid air cells were occupied by soft tissue. Eleven patients demonstrated bone destruction and sequestra was found in 7 temporal bones. Contemporary pulmonary tuberculosis were diagnosed in 7 of the 16 patients. Surgical removal of disease lesions in combination with anti-tuberculosis treatment were given to 15 patients. Other than 2 cases of tuberculous otitis media and mastoiditis diagnosed by pre-operational biopsy through the perforated tympanic membrane, the remaining 14 cases were diagnosed intra-operatively or post-operatively. No relapse of tuberculosis in the middle ear and mastoid were found after follow-up for more than 1 year, except for the one case that was lost to follow-up. The 3 cases of facial nerve palsy almost recovered to normal.</p><p><b>CONCLUSIONS</b>Clinicians should suspect tuberculous otitis media and mastoiditis if clinical findings include refractory otorrhea, total occupation of the tympanic cavity and mastoid ari cells by soft tissue, and erosion of the bone or sequestra as shown by CT. A history of tuberculosis should be asked carefully in order to differentiate tuberculous otitis media and mastoiditis. The patients who received surgery and anti-tuberculosis chemotherapy achieved more rapid healing of the ear.</p>
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Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Perda de Seguimento , Mastoidite , Diagnóstico , Terapêutica , Otite Média , Diagnóstico , Metabolismo , Terapêutica , Prognóstico , Estudos Retrospectivos , Tuberculose , Diagnóstico , TerapêuticaRESUMO
<p><b>OBJECTIVE</b>To investigate the efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in the treatment for obesity and type 2 diabetes mellitus (DM).</p><p><b>METHODS</b>Twenty-one cases of obesity and 9 cases of type 2 DM received the LRYGB. Weigh changes, excess body weight lose rate (EWL%) and blood glucose level were measured after surgery and occurrence of complications was observed postoperatively.</p><p><b>RESULTS</b>LRYGB procedures in all the 30 cases were successfully performed with no conversion to open surgery. Average operation time was 168 minutes (110-270 mins), volume of blood loss during the surgery was 24.0 ml (10-75 ml). Twenty-one cases of simple obesity received follow-up from 2 months to 5 years. Body weight and BMI decreased significantly in one month [(85.1+/-10.1) kg vs (97.2+/-15.0) kg, 31.2+/-2.2 vs 35.3+/-3.5, both P<0.01] and to a minimal level in 2 to 3 years [(66.8+/-9.2) kg, 24.3+/-1.1], and then maintained at this level. EWL% was correspondingly higher (all P<0.05). Nine type 2 DM patients were followed up for 3 to 8 months, fasting blood glucose and blood glucose OGTT2 hours decreased significantly [(5.9+/-1.4) mmol/L vs (12.6+/-2.6) mmol/L, (7.8+/-1.4) mmol/L vs (17.8+/-4.1) mmol/L, both P<0.05], of whom 4 patients with obesity decreased in BMI significantly (P<0.05), and 5 patients without obesity had no significant changes in BMI (P>0.05). Five cases (16.7%) had postoperative complications, including 1 case of death due to acute fulminant pancreatitis, 1 case of mesenteric hiatal hernia with obstruction in line for reoperation, and the other 3 cases of healing by conservative therapy.</p><p><b>CONCLUSIONS</b>Treatment of obesity and type 2 DM by LRYGB surgery is feasible with significant short term result. Long term outcome needs further observation.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Diabetes Mellitus Tipo 2 , Cirurgia Geral , Derivação Gástrica , Métodos , Laparoscopia , Obesidade Mórbida , Cirurgia GeralRESUMO
<p><b>OBJECTIVE</b>To research the effects of chronic suppurative otitis media on bone conduction threshold in old patients.</p><p><b>METHODS</b>The files of patients with unilateral chronic otitis media were retrospective analyzed, who were all oder than 60 years, who were inpatient in our department since January 2005 to March 2009. Conventional puretone audiometry test was carried out. Bone conduction thresholds were calculated for frequencies of 0.5, 1, 2, and 4 kHz, with comparison between the ear with chronic otitis media and contralateral ear. Thresholds were examined separately for each frequency.</p><p><b>RESULTS</b>The bone conduction threshold for the normal side was lower than those for the ear with chronic otitis media. The threshold shift was statistically significant for each frequency (P < 0.01). There were no differences between the groups when analyzed for the presence of cholesteatoma except at 2 kHz frequencies (Z = -1.975, P = 0.048). There were differences between the groups when analyzed for an interruption of the ossicular chain only at 2 kHz frequencies (Z = -2.721, P = 0.007). There were differences between the groups when the duration of middle ear disease was not same at 1 kHz and 2 kHz frequencies (Z value were -2.877, -2.624, P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>This study shows that chronic otitis media can enhance bone conduction threshold for old patients. All measures for early cure should be considered as early as possible in oder patients with chronic otitis media to prevent advance of sensorineural hearing loss.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Audiometria de Tons Puros , Limiar Auditivo , Condução Óssea , Doença Crônica , Otite Média Supurativa , Estudos RetrospectivosRESUMO
<p><b>OBJECTIVE</b>To explore the experience and value of overlay tympanoplasty.</p><p><b>METHODS</b>Sixty-three ears with overlay tympanoplasty were reviewed and followed up for the external auditory canal, tympanic membrane and hearing.</p><p><b>RESULTS</b>The diseases of the patients included middle ear cholesteatoma in 25 ears and chronic suppurative otitis media in 38 ears. The surgical techniques involved three kinds: overlay tympanoplasty, overlay tympanoplasty with canal wall up mastoidectomy and overlay tympanoplasty with canal wall down mastoidectomy. In middle ear cholesteatoma and suppurative otitis media patients, the case received the three techniques are 4, 17, 4 ears and 19, 18, 1 ears respectively. All patients gained stage I incision cure. Followed up for 0.5 to 3.5 years respectively, the external auditory canal was wide and tympanic membrane gained a good shape. The hearing in all case kept intact or increased while hearing decrease did not occur. Complications were free in patients with punctual visit.</p><p><b>CONCLUSIONS</b>Overlay tympanoplasty has positive significance in treating the chronic otitis media with the merits of standard procedure, sufficient operative field and thorough erosion elimination.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Colesteatoma da Orelha Média , Cirurgia Geral , Otite Média Supurativa , Cirurgia Geral , Resultado do Tratamento , Timpanoplastia , MétodosRESUMO
<p><b>OBJECTIVE</b>To explore the problems and describe clinical experiences associated with multichannel cochlear implantation in patients with cochlear ossification.</p><p><b>METHODS</b>Seven cochlear implant cases with bilateral cochlear ossification from 1996 to 2006 in Beijing Tongren Hospital were retrospectively reviewed, 4 of which were the consequence of meningitis. Three patients' cochlear were completely ossified, 1 patient's tympanic scala was completely ossified, 1 patient's cochlear was partially ossified, and 2 patients' cochlear were partially fibrotic. This article addressed the components of the preoperative evaluation, surgical decision-making, and specific techniques for cochlear implant array insertion in all kinds of ossified cochlea.</p><p><b>RESULTS</b>Gusher was found in 1 case but less serious than that with inner ear malformations. The electrodes were inserted in the cochleostomy in full length in 4 cases, 1 case gave up, and the cochlear implant array were partially inserted in the remains. No serious complications occurred after implantation. All patients had auditory sensations. The impedance of the electrodes, the T level, C level and the hearing threshold were slightly higher than that of the normal cochlear implantation.</p><p><b>CONCLUSIONS</b>The key influencing factor of ossified cochlear patients were the degree of the disease and whether the electrode implanted completely or not. So, the profound sensorineural hearing loss patients after meningitis should be paid more attention. Patients with ossified cochlear could be benefit from cochlear implantation.</p>
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Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Implante Coclear , Implantes Cocleares , Correção de Deficiência Auditiva , Métodos , Eletrodos , Ossificação Heterotópica , Reabilitação , Cirurgia Geral , Estudos Retrospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To evaluate the effect of the prognostic factors on long-term surgical outcome in myringoplasty.</p><p><b>METHODS</b>Retrospective cohort 205 patients (223 ears) with sandwich temporal fascia myringoplasty were analyzed using the multiple logistic regression analysis. The charts of inpatients had undergone myringoplasty before at least 2 years between January 1999 and November 2003 at Beijing Tongren Hospital. Postoperative follow-up rate was 78.2%. Their ages ranged from 12 to 65 years (mean = 34. 3 years). Their durations of disease ranged from 1 month to 25 years (mean = 16.07 months). The effect of prognostic factors on myringoplasty were investigated by variables noted from patients' files such as age, sex, causes of disease, duration of disease, period of dry ear of disease, operation types, places of tympanic membrane perforation, size of tympanic membrane perforation, status of middle ear and status of eardrum.</p><p><b>RESULTS</b>There were 11 ears with re-perforation of eardrum at the last follow-up. Successful closure of the tympanic membrane perforation was obtained in 95.1% of the ears (212 ears) with 2 to 5 years follow-up. There were 26 ears with other complications at the last follow-up. Operations were successful in 186 patients. The overall take rate of the myringoplasty was 83.4%. Multiple logistic regression analysis (ward) was subsequently carried out on these prognostic factors on overall take rate of the myringoplasty and yielded the following classification. Relative importance of the predictive variables was as follows: size of tympanic membrane perforation (OR = 1.900), duration of disease (OR = 1.003) and period of dry ear of disease (OR = 0.908). Hearing outcomes: the average air-bone gap improvement was 7.0 dB and the average air conduction improvement was 6.8 dB for all 175 myringoplasty procedures.</p><p><b>CONCLUSIONS</b>A long term follow-up was important. Late atelectatic pocket was a late complication and a cause of failure. A relatively smaller tympanic membrane perforation, a relatively shorter duration of disease and a relatively longer period of dry ear of disease were found to be significant prognostic factors positively influencing the success rate of myringoplasty.</p>
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Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Miringoplastia , Métodos , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Perfuração da Membrana Timpânica , Cirurgia GeralRESUMO
<p><b>OBJECTIVE</b>To explore the electrophysiological results and rehabilitation outcome of two prelingually deafened pediatric cochlear implant patients with auditory neuropathy.</p><p><b>METHODS</b>Preoperative audiological evaluation, intra-postoperative electrically evoked auditory brainstem response (EABR) and neural response telemetry (NRT) record for the two cases were conducted in Beijing Tongren Hospital. A one year follow-up was performed. Data collected before and at 6,12-month intervals after implantation were compared with that from control pediatric cochlear implant patients matched for the same duration of implant use as this two cases.</p><p><b>RESULTS</b>The two children implanted had not had any postoperative medical or cochlear implant device complications. Intraoperative EABR and NRT were elicited in case 1 with unrepeatable waveforms. After 12 months of training, Case 1 had shown significant improvements in sound detection, speech perception abilities and communication skills, which was better than the control group, and the electrophysiological results became normal. Case 2 had also benefited from cochlear implantation, even though no recognizable NRT was found until he returned 12 month after the operation. CONTUSIONS: The desynchronization of auditory path had been changed after the electrical stimulation ongoing 12 months for children with auditory neuropathy. The two children had not had any complications postoperatively, and each child had shown improved listening and communication skills. Cochlear implantation could help patients with auditory neuropathy to improve their communication skill and go back to the main stream.</p>
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Criança , Humanos , Lactente , Masculino , Implante Coclear , Implantes Cocleares , Perda Auditiva Neurossensorial , Cirurgia Geral , Doenças Retrococleares , Cirurgia Geral , Resultado do TratamentoRESUMO
<p><b>BACKGROUND</b>The development and maintenance of spiral ganglion cells (SGCs) appear to be supported by neurotrophins. Removal of this support leads to their gradual degeneration. Intracochlear infusion with neurotrophins can provide trophic support to SGCs in animal deafness models if given shortly after deafening. However, it is not known whether delayed intervention will provide similar protection, which might be clinically relevant. The present research was conducted to determine the effects of brain-derived neurotrophic factor (BDNF) administration on the capacity of the peripheral processes to resprout.</p><p><b>METHODS</b>The left cochlea of 20 profoundly deafened rats, which were divided into 2 groups equally, was implanted with an electrode and drug-delivery system 30 days after deafening. Either BDNF or artificial perilymph (AP) was delivered continuously for 28 days. Electrically evoked auditory brainstem responses (EABRs) were recorded during the period. SGC body and peripheral process density were measured.</p><p><b>RESULTS</b>The EABR thresholds of AP increase continually. Those of BDNF increase slowly at the beginning then decrease, and were significantly less than those of the AP group from day 14 to 28 (P < 0.01). In terms of SGC and peripheral process density, the difference between the treated and control ears of BDNF group was clearly significant (P < 0.01), but not in AP group (P > 0.05). Analysis of the left cochlea between the two groups demonstrated that SGC/peripheral process density of the BDNF group was significantly greater than that of the AP group. Finally, a functional formula was developed relating the last EABR threshold and SGC density and process density, which was as follows: T = 466.184 - 2.71 (F.B.L).</p><p><b>CONCLUSIONS</b>Under the conditions of delayed intervention following 30 days after deafening in rats, it can be concluded that BDNF enhances SGC bodies and peripheral processes survival after differentiation and so improves auditory sensitivity. SGC peripheral processes influence the auditory sensitivity.</p>
Assuntos
Animais , Masculino , Ratos , Fator Neurotrófico Derivado do Encéfalo , Sobrevivência Celular , Potenciais Evocados Auditivos do Tronco Encefálico , Ratos Sprague-Dawley , Gânglio Espiral da Cóclea , Biologia CelularRESUMO
<p><b>OBJECTIVES</b>To analyze the relationship between the fetus infection and HBV M, HBV DNA in amniotic fluid, umbilical cord blood, maternal blood and placenta, and to explore the mechanism of vertical transmission of HBV.</p><p><b>METHODS</b>Immunonetric assay and nucleic acid amplification hybri-comb were used. Both HBV M and HBV DNA were detected in amniotic fluid, vein blood, umbilical cord blood for each of 65 HBV-positive women in their different gestational periods, while immunohistochemical analysis was carried out on the tissue of placenta, liver, lung or heart from each abortive fetus/dead infant in the case.</p><p><b>RESULTS</b>For all of the 65 HBsAg-positive women in their different gestational periods, the detected positive rate of HBsAg was 21.50% in amniotic fluid, and 20.00% in umbilical blood. The positive rate of HBsAg, HBeAg, Anti-HBc and HBV DNA detected in blood, amniotic fluid and umbilical blood was 6.15%. The cases with positive HBsAg, Anti-HBe, Anti-HBc and negative HBV DNA were in a percentage of 13.85%. Immunohistochemical analysis on placentas after birth/abortion as well as the tissues of livers, lungs, hearts of the fetuses/dead infants in 4 cases of pregnant women with positive HBsAg, HBeAg, Anti-HBc or HBV DNA in blood, amniotic fluid or umbilical blood showed that HBsAg, HBcAg positive cells in the scope could be seen in every layer of the tissue of placenta, in the hepatic/pulmonary tissue, but not in the cardiac tissue.</p><p><b>CONCLUSION</b>The infection in amniotic fluid or placenta relates to HBV infection in fetus; intrauterine HBV may result in infection in organs such as blood, liver, or lung of a fetus; infection in the amniotic fluid may be another key route of the intrauterine infection of fetus, and the detection on HBV M or HBV DNA in amniotic may be used as one of diagnostic proofs of HBV infection of fetus in its early stage.</p>