The application value of imaging in the diagnosis and treatment of external auditory canal cholesteatoma in children / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the HRCT and MRI characteristic of external auditory canal cholesteatoma(EACC)in children.METHODS A total of 40 patients(45 lesions)with EACC confirmed by pathology were retrospectively analyzed with HRCT and MRI characteristics and clinical therapeutic value.Imaging findings of 40 patients(45 lesions)with EACC were retrospectively analyzed.RESULTS Soft tissues were found in all the external auditory canal(EAC).Of the forty-five soft tissues,7 manifested as inhomogeneous strip soft tissues and 38 as lesions solid soft tissues;30 located in medial part of the EAC and covered the tympanic membrane,while the other 15 presented as tympanic membrane perforation and involved the tympanic cavity.The MRI of the 3 ears showed high signal on T2/T1 iso-intensity,high signal on DWI,and low signal on ADC.Normal whole bony EAC was observed in 17 cases and enlarged medial EAC in 28 cases.Seven cases only involved in the superior wall,but 38 cases displayed as multiple bone wall involved,of which 6 involved in circumferential walls.Thirty-three cases displayed atactic ear bone margin,11 displayed blunted or disappeared drum shield plate.Destroy of long crus of incus and manubrium mallei occurred in 15 cases,of short crus of incus in 8 cases,of stapes in 2 cases,and mastoiditis in 5 cases.According to the pneumatization degree of mastoid air cell,37 cases were classified into pneumatic type,7 cases into mixed type,and the last one into diploic type.CONCLUSION The children EACC tends to be limited and rarely involved in middle ear and mastoid process.No patient with peri-ear infection was found.Application of HRCT and MRI help accurate location and determination of cholesteatoma.According to the extent of the lesion,selecting the appropriate surgical method is an effective method to remove cholesteatoma,improve hearing and reduce recurrence.

Study on the correlation between meteorological factors and acute otitis media in outpatients of children in Beijing / 中华耳鼻咽喉头颈外科杂志

Objective@#To explore the characteristics of acute otitis media(AOM) in children in Beijing and its correlation with meteorological factors.@*Methods@#Data were collected in 2011-2013 in the Otolaryngology Department of Capital Institute of Pediatrics. AOM in children with relevant information, such as age, sex and season, with the same period of the Beijing municipal meteorological data (the average temperature, average pressure, average wind speed, humidity and PM2.5) were compared to analysis the relationship of meteorological environmental parameters and the onset of AOM in children.@*Results@#Annual morbidity of AOM was 7 589, 8 245, 7 242 respectively, no obvious difference(P=0.761). It was noted that one peak could be seen in December, and a valley in February, followed by August. Summer was less than the other three seasons (P<0.05). The morbidity of AOM had a small peak within one year after birth, then reached peak at the age of about 4, and then reduced gradually. In different age groups, male patients were higher than those of female. The incidence of AOM was positively correlation tendency with air pressure and PM2.5 (r=0.333, 0.093, P=0.000, 0.002), which was negatively correlation tendency with daily temperature or humidity (r=-0.327, -0.195, P=0.000, 0.000).@*Conclusions@#The incidence of AOM of children in Beijing changes with age, and has obvious seasonal variation. There may be some correlation between the meteorological factors and the incidence of AOM in children.

Treatment of obstructive sleep apnea-hypopnea syndrome for children refractory asthma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study was to understand the effect of different treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) for refractory asthma in children.</p><p><b>METHODS</b>Fifty two children (32 in surgical group, 20 in conservative group) with refractory asthma and OSAHS were included in the study. All children received asthma condition assessment and polysomnography (PSG) examination before and after treatment, and were followed up for 6 months.</p><p><b>RESULTS</b>All children got improved in PSG values 3 months after treatment, more significant improvement was achieved in surgical group than in conservative group (P < 0.05). While compared of OSAHS treatment, there were 2 cure, 6 notable effective, 9 effective, 3 in vain cases in conservative group, 8 cure, 16 notable effective, 8 effective, 0 in vain cases in surgery group. There was significant difference between the two groups (χ² = 8.91, P = 0.031). All children got improved in asthma condition evaluation parameters and decreased the use number of short acting β2 agonists after 6 months treatment. More significant improvement was achieved in surgical group than in conservative group. The differences of all the items had statistical significance (P < 0.05). There was statistical correlation between days mutation rate of peak expiratory flow (PEF) and apnea hypopnea index (r = 0.712, P < 0.01), and between days mutation rate of PEF and lowest oxygen saturation (r = 0.726, P < 0.01).</p><p><b>CONCLUSIONS</b>Active treatment of OSAHS can improve asthma symptoms and reduce asthma medication effectively. The curative effect of surgical treatment is superior to conservative treatment.</p>

Changes and clinical relevance of plasma interleukin-6 and high sensitive C-reactive protein in patients with coronary heart disease and angina / 中国综合临床

Objective To explore the roles of interleukin-6 (IL-6) and high sensitive C-reactive protein (hsCRP) in coronary heart disease (CHD). Methods One hundred and fifty patients diagnosed as angina pectoris by coronary angiography were enrolled and randomly divided into unstable angina pectoris group ( UAP group n =78) and stable angina group (SAP group n =72). At the same time,50 cases with normal coronary angiography were selected as control. The plasma level of IL-6 was measured by ELISA, and hsCRP was measured by immunonephelometry. Results The mean plasma levels of IL-6 and hsCRP were significantly higher in UAP group compared with SAP group ( IL-6 ( 36. 98 ± 9. 35 ) pg/L vs. ( 23.19 ± 7. 35 ) pg/L; hsCRP ( 2. 25 ± 0. 73 ) μg/Lvs 1.88 ± 0. 68 ) μg/L; P ＜ 0. 01 respectively), both were significantly higher than those of control group ( IL-6 (16. 93 ± 6. 15 )pg/L and hsCRP (1.28 ± 0.40)μg/L,P ＜0.01 respectively). We also found significantly positive relationship between IL-6 and hsCRP plasma level ( r = 0. 875, P ＜ 0. 05 ). Conclusions Inflammatory response might play an important role in CHD. IL-6 and hsCRP were of high value in prediction of angina pectoris and development of CHD.