Clinical Study on Dingxuan Decoction Combined with Vestibular Function Rehabilitation Training in the Treatment of Meniere's Disease / 广州中医药大学学报

Objective To investigate the efficacy of Dingxuan Decoction combined with vestibular function rehabilitation training in the treatment of Meniere's disease and to observe its effect on clinical symptoms and blood flow of vertebral artery.Methods A total of 100 patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type were randomly divided into an observation group and a control group,with 50 patients in each group.The control group was given conventional treatment and vestibular function rehabilitation training,and the observation group was treated with Dingxuan Decoction on the basis of treatment for the control group.The two groups were treated for 4 weeks and then were followed up for 6 months.The changes of traditional Chinese medicine(TCM)syndrome score,Dizziness Handicap Inventory(DHI)score,Tinnitus Handicap Inventory(THI)score,hearing visual analogue scale(VAS)score and vertebral artery blood flow in the two groups were observed before and after the treatment.After treatment,the TCM syndrome efficacy,hearing improvement and follow-up results were compared between the two groups.Results(1)After 4 weeks of treatment,the total effective rate for TCM syndrome efficacy of the observation group was 86.00%(43/50),and that of the control group was 62.00%(31/50),and the intergroup comparison showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group(P＜0.01).(2)After 4 weeks of treatment,the hearing of patients in both groups was improved,and the total effective rate for the efficacy of hearing improvement in the observation group was 76.00%(38/50),while that in the control group was 46.00%(23/50).The intergroup comparison showed that the efficacy of hearing improvement in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the TCM syndrome scores,DHI score,THI score and hearing VAS scores in the two groups were all decreased compared with those before treatment(P＜0.05 or P＜0.01),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the average blood flow velocity of the left vertebral artery(LVA)and the right vertebral artery(RVA)in the two groups were both increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)The results of 6-month follow-up after treatment showed that the incidence of Meniere's disease and the frequency of attack in the observation group were significantly reduced compared with those in the control group,and the episode duration in the observation group was significantly shorter than that in the control group,the differences being all statistically significant(P＜0.05 or P＜0.01).Conclusion Dingxuan Decoction combined with vestibular function rehabilitation training exert certain effect in treating patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type,and the therapy is effective on improving patients'clinical symptoms and vertebral artery blood flow,reducing the risk of recurrence and improving the quality of life of the patients.

A model of partial ligation of common carotid artery and neointima / 解剖学报

Objective To discuss a method to induce vascular remodeling (intimal regeneration) after partial ligation of the left common carotid artery. Methods Forty 8-week-old male C57BL / 6 J mice were randomly divided into 6 groups: normal group (WT), sham group (sham), 4 weeks, 8 weeks, 10 weeks and 12 weeks postoperative groups. Only the internal carotid, external carotid and occipital arteries in the four distal branches of the left common carotid artery (LCA) were ligated, and the superior thyroid artery was retained, resultsing in intimal neovascularization and vascular remodeling of the left common carotid artery. The changes of body weight and forage were observed after operation. Morphological changes of blood vessels were observed by HE staining. The aggregation of collagen fibers in blood vessels was observed by sirius red staining. Results In addition to the WT group, the weight and dietary quantity of other groups were reduced 1-2 days after the operation, and began to rise from the third day, while the sham group began to rise from the second day. HE staining showed that no new intima was formed in the left common carotid artery of sham group and WT group, and thickening of intima and media layer and stenosis of the nasal cavity were observed in the 4, 8, 10 and 12 weeks groups after partial ligation. There was no intima thickening in the unligated carotid artery on the right side, but there was an enlargement of the lumen. This sirius red stain demonstrated collagen accumulation in the intima and tunica media. Conclution Partial ligation of the left common carotid artery can establish a mouse model of arterial endothelial injury with obvious intima regeneration.

Clinical analysis of 118 patients with tympanosclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the incidence of tympanosclerosis (TS) and the major risk factors of hearing loss.</p><p><b>METHODS</b>A total of 118 TS patients (137 ears) were compared with 265 patients with chronic otitis media (COM) (311 ears) for gender, age and course of disease. The disease regions and hearing loss of the TS patients were analyzed.</p><p><b>RESULTS</b>TS showed higher prevalence in women of older ages. Sclerosis was seen most frequently in the tympanic membrane, followed by the malleus, incus, incudomalleolar joint, other regions, ariticulus incudostapedius and stapes. The patients with sclerosis or deterioration in the ossicular chain had worse hearing loss than the other patients. Carhart notch occurred in 45 ears (32.85%), an incidence similar to that of inverted "V"-shaped curve of air-conduction audiometry near 2 kHz (47 ears, 34.31%). The factors contributing to the hearing loss, listed in the order of their importance, included pathologies in the incus, malleus, incudomalleolar joint, ariticulus incudostapedius, stapes, other regions, tympanic membrane, and gender.</p><p><b>CONCLUSIONS</b>Female patients may had increased risk of TS. The presence of Carhart notch and inverted "V"-shaped curve in air-conduction audiograph may indicate myringosclerosis or ossicular chain sclerosis. Abnormal ossicular chain is the leading factor contributing to hearing loss.</p>

Pure tone audiology for Meniere disease: a clinical analysis of 75 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze clinical pure tone test data in patients with Meniere disease and study the changes in the audiometic curve configuration.</p><p><b>METHODS</b>A retrospective analysis was conducted of the pure tone test data in 75 cases (82 ears) from 1984 to 2008. The audiometic curve configuration was divided into 6 categories to analyze the relationship between the main curve types and the clinical stages. RESULTS The most common audiogram was the peak type (46.34%), followed by the falling type (19.51%) and the mountain type (12.19%), and the dip type was relatively rare (2.43%). No significant differences were found in the rate of peak audiograms between the clinical stages. The common audiogram peak frequency occurred at 2 kHz (47.39%). The top curve of 1-2 kHz had the largest proportion in mountain type audiograms (70%, 7/10 ears).</p><p><b>CONCLUSION</b>The peak type and mountain type configuration are one of the audiological characteristics of Meniere disease, especially for 2 kHz peak, which may serve as the diagnostic features of Meniere disease in the vertigo patients on their first visit.</p>

Tragus cartilage tympanoplasty for treatment of adhesive otitis media / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of cartilage tympanoplasty in the treatment of adhesive otitis media.</p><p><b>METHODS</b>From June to October, 2008, 18 patients with adhesive otitis media (18 ears) were treated with tragus cartilage tympanoplasty. The air-bone gap changes and the self-perceived symptomatic improvement were evaluated at 1 month and 1 year after the operation.</p><p><b>RESULTS</b>All the patients showed dry ear within 6 weeks after the operation. Tympanic membrane healing was achieved in 17 cases, and 1 case presented with a inferior-anterior fissure in the tympanic membrane. With the average preoperative air-bone gap (at 0.25, 0.5, 1.0, and 2.0 kHz) of 44.65 dB, the patients showed an obvious decrease of the air-bone gap by over 10 dB at 1 month after the operation and by over 25 dB at one year. Symptomatic improvements were achieved in these cases, including alleviated ear discomforts (3/15 cases), total tinnitus relief (1/11 cases), and alleviated tinnitus (10/11 cases). High-frequency tinnitus was noted in 1 case (1/7 cases), and the tympanic membrane appeared normal in 17 cases.</p><p><b>CONCLUSION</b>Tympanic membrane reconstruction using the tragus cartilage can be feasible for treatment of secretory otitis media, but the surgical indications should be carefully controlled.</p>

Therapeutic effect of ossicular reconstruction with bioceramic or porous macromolecular polyethylene partial ossicular replacement prosthesis in patients with tympanosclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of ossicular reconstruction with partial ossicular replacement prosthesis (PORP) in patients with tympanosclerosis.</p><p><b>METHODS</b>The data of 31 cases of tympanosclerosis treated between 1992 and 2009 were reviewed. Of the 31 patients, 17 (17 ears) underwent ossicular reconstruction with porous macromolecular polyethylene PORP, and 14 (14 ears) with bioceramic PORP. All the patients were followed up for 3-24 months.</p><p><b>RESULTS</b>Significant improvement was found in postoperative speech frequency (500, 1000, 2000 Hz) pure tone average (PTA) and air-bone gap (ABG) (P < 0.05) after the treatments without statistically significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Porous macromolecular polyethylene and bioceramic are valuable ossicular prosthesis for tympanosclerosis.</p>

Application of two auricular cartilage-perichondrium complexes in tympanoplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effects of cartilage-perichondrium palisade complex and cartilage-perichondrium horseshoe complex in tympanoplasty for large tympanic membrane perforation.</p><p><b>METHODS</b>Nineteen patients (19 ears) undergoing tympanoplasty with cartilage-perichondrium palisade complex and 20 patients (20 ears) with cartilage-perichondrium horseshoe complex were compared for postoperative hearing and closure rate of tympanic membrane perforation.</p><p><b>RESULTS</b>The closure rates of the tympanic membrane were all 100% in both groups 3 months after the operation, while tympanoplasty with cartilage- perichondrium horseshoe complex resulted in significantly greater improvement of the postoperative air-bone gap in speech frequency.</p><p><b>CONCLUSION</b>Both of the two auricular cartilage-perichondrium complexes produced good effects for repair large tympanic membrane perforation, but cartilage-perichondrium horseshoe complex can achieve better results in speech frequency.</p>