ABSTRACT
ObjectiveTo explore the efficacy and predictive indicators of stellate ganglion block (SGB) as an adjunctive intervention for chronic subjective tinnitus and accumulate experience for the application of SGB in the clinical treatment of tinnitus. MethodsA retrospective review was conducted on the data of chronic subjective tinnitus patients who received SGB intervention, with unsatisfactory outcomes otherwise. Pure tone audiometry (PTA), tinnitus loudness evaluation and Pittsburgh sleep quality index (PSQI) were used. The tinnitus handicap inventory (THI) scores were compared before and after SGB intervention. Correlation analysis and linear regression equations were employed to identify the potential indicators predicting the effectiveness of SGB intervention. Statistical analysis was performed by SPSS 24.0 software. ResultsBy April 2023, a total of 107 patients with chronic subjective tinnitus had undergone SGB intervention, including 67 male and 40 female, with a mean age of (45.32±11.40) years old and an average tinnitus history of (20.32±24.64) months [16 (12~20)]. Only 7 patients (6.54%) quitted the intervention for personal reasons, which demonstrated good compliance with the intervention. No patients experienced adverse reactions such as infection at the injection site, hematoma, nerve injury, local anesthetic intoxication and so on, which revealed good safety. After SGB intervention, THI scores decreased to below 36 points in 77 patients and decrease by 10 points or more in 12 of the remaining patients, with a total effective rate of 89%. A paired sample t-test showed a significant difference in THI scores before and after SGB intervention (t=15.575, P<0.001), indicating good improvement. Pearson correlation analysis suggested that pre-intervention THI scores and subjective tinnitus loudness were significantly positively correlated with the improvement level of THI scores (P<0.05). Further stepwise linear regression analysis found that "pre-intervention THI scores" had statistical significance (P<0.001), with a regression coefficient of 0.308, predicting a 17.4% improvement level in THI scores. ConclusionsDue to its good and safe short-term effects, SGB intervention can be used as a supplementary option for chronic subjective tinnitus when other interventions are not ideal, especially for patients with higher THI scores. However, further research is needed to clarify the long-term efficacy and underlying mechanisms, in order to establish a more solid theoretical basis for SGB intervention in the treatment of subjective tinnitus.
ABSTRACT
Objective:To evaluate the relationship between lung injury induced by cardiopulmonary bypass (CPB) and acetyltransferase p300 (p300) in rats.Methods:Eighteen SPF healthy adult male Sprague-Dawley rats, aged 12-16 weeks, weighing 350-450 g, were divided into 3 groups ( n=6 each) using a random number table method: sham operation group (S group), CPB group, and CPB+ left lung ischemia-reperfusion (I/R) group (CPB+ IR group). CPB group was connected to CPB pipeline for cardiopulmonary bypass. The lung I/R injury model was prepared by clamping the left lung hilum for 45 min followed by opening during CPB, 30 min later CPB was terminated, and mechanical ventilation was continuously performed for 1.5 h before ending the experiment in CPB+ IR group. Arterial blood gas analysis was performed and oxygenation index (OI) and respiratory index (RI) were calculated before CPB, at 10 min after opening the lung hilum, and immediately after the end of experiment. The bronchoalveolar lavage fluid (BALF) and left lung tissues were collected immediately after the end of experiment for determination of the concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in BALF and total protein in BALF and concentrations of IL-17 in lung tissues (by enzyme-linked immunosorbent assay), expression of p300, phosphorylated p300 (p-p300), and acetylated histone H3 (AC-H3) in lung tissues (by Western blot) and expression of p-p300 (using immunohistochemical staining) and for microscopic examination of the pathological changes of lung tissues (under the light microscope) which were scored. Results:Compared with S group, OI was significantly decreased and RI was increased at 10 min after opening the lung hilum and immediately after the end of experiment, the lung injury score and levels of IL-6, TNF-α and total protein in BALF and IL-17 in lung tissues were increased, and the expression of p300, p-p300 and AC-H3 was up-regulated in CPB and CPB+ IR groups ( P<0.05). Compared with CPB group, OI was significantly decreased and RI was increased at 10 min after opening the lung hilum and immediately after the end of experiment, the lung injury score and levels of IL-6, TNF-α and total protein in BALF and IL-17 in lung tissues were increased, and the expression of p300, p-p300 and AC-H3 was up-regulated in CPB+ IR group ( P<0.05). Conclusions:The mechanism by which CPB induces lung injury may be related to up-regulation of the expression of p300 and enhancement of activity of p300 in lung tissues and increased release of inflammatory factors in rats.
ABSTRACT
Objective To analyze etiology,clinical manifestation and diagnosis process of vertigo and dizziness in children.Method The clinical data of 82 children with vertigo and dizziness treated in our hospital from January 2006 to December 2016 were retrospectively analyzed.Results There were 46 girls and 36 boys with a female:male ration of 1.28:1.The median age of patients was 9.0 years (14 months-18.0 years) and 21 cases were less than 6 years old.The chief complaints were repeatedly falling,crying,walking unsteadily and scratching the ear for unknown reasons.For children aged > 5 years may express " roof or tent rotation";for those aged > 6-< 15 years (n =34),the main complaint was more ambiguous "dizziness";for those aged ≥ 15-≤ 18 years (n =27) with the main complaint of " dizziness" may clearly express the " sense of rotation" or " the feeling of feeling drowsy,the top-heavy sense," and the accompanying deafness,earfullness,tinnitus and so on.Among 82 cases,there were 15 cases of benign paroxysmal vertigo (BPV,18.3%),12 cases of secretory otitis media (SOM,14.6%),11 cases of vestibular migraine (VM,13.4%),9 cases of benign paroxysmal positional vertigo (BPPV,11.0%),8 cases of inner ear malformation (9.8%),8 cases of Meniere's disease (9.8%),7 cases of vestibular neuritis (8.5%),6 cases of sudden deafness with vertigo (7.3%),4 cases of central vertigo (4.9%),1 case of rare genetic disease (1.2%) and 1 case of vertigo due to mental psychological (1.2%).The incidence of BPV,VM and Meniere's disease in girls was higher than that in boys.There was a tendency to self heal in BPV with the age increasing,in 15 BPV cases,8 after 12 years of age,3 after 14 years old had no vertigo attacks,and 4 cases were still in follow-up.The attack frequency of VM was decreased,and the extent was reduced with the age.Children older than 6 years were able to cooperate to vestibular function tests,and the majority completed the tests.Conclusion The analysis shows that the etiology of vertigo and dizziness in children is different from that of adults.Central vertigo and rare genetic disorders with dizziness as the first symptom are of great harmfulness,so intensive observation and multidisciplinary consultations are recommended.
ABSTRACT
OBJECTIVE@#To explore the methods to detect and intervene children's late-onset hearing loss early which are suitable for basic-level hospitals.@*METHOD@#Udiology and imaging diagnosis had been given to the children who passed the newborn hearing screening but showed auditory behavior disorders in the growth process, and individualized interventions were given according to the results of diagnosis. Seven children with high risk for hereditary deafness were sent to superior hospital and had molecular screening of common mutations of inherited deafness carried out, then corresponding prevention guidance and intervention were given to them.@*RESULT@#Fifty-two cases with late-onset hearing loss or verbal disorders were detected by auditory behavior observations,including 4 cases of auditory neuropathy, 4 cases of unilateral sensorineural deafness, 27 cases of secretory otitis media. 13 cases of bilateral sensorineural deafness and 4 cases of autism. Seven newborns with high risk of hereditary deafness were sent to the Third Affiliated Hospital of Sun Yat-Sen University and received molecular screening of common mutations of inherited deafness. One case with GJB2 compound heterozygous mutations was detected and followed up to 4 years old, he was found bilateral moderate hearing loss and accepted the hearing aids at 2 years old. Mitochondrial DNA 1555 a > G heterogeneity mutation in 2 cases and GJB2 235 delC single heterozygous mutations in 3 cases, no mutation in 1 case, all these 6 cases have been followed-up until now, their hearing are normal.@*CONCLUSION@#Children's auditory behavior observations and the superior hospitals referral performing high risk individual screening for newborns with high risk for hereditary deafness can detect children's late-onset hearing loss in time, this model is suitable for basic-level hospitals.
Subject(s)
Child , Humans , Infant, Newborn , Male , Behavior Observation Techniques , Connexin 26 , Connexins , Genetics , DNA Mutational Analysis , DNA, Mitochondrial , Genetics , Deafness , Diagnosis , Genetics , Early Diagnosis , Genetic Testing , Hearing Tests , Heterozygote , MutationABSTRACT
OBJECTIVE@#To analyze social-psychological causes of acute exacerbation or re-decompensation of chronic tinnitus and provide theoretical basis for controlling and preventing tinnitus exacerbation and re-decompensation.@*METHOD@#Systemic audiological tests and tinnitus handicap inventory were performed on 136 chronic tinnitus patients with acuteexacerbation or re-decompensation. For the patients with new hearing loss, a further investigation of living conditions and assessment of social support rating scale were utilized. The patients with relatively definite causes were treated accordingly.@*RESULT@#(1) There were 89 patients complained of new changes of hearing, all of whom could tell the definite time point of tinnitus exacerbation, and 5 of them felt the exacerbation of hearing loss meanwhile. (2) Forty-two patients encountered adverse events on life or working, and tinnitus exacerbation occurred within several weeks to 3 months afterwards. Most of these patients could not tell the definite time point of tinnitus exacerbation or re-decompensation. Five cases of tinnitus exacerbation didn't tell any adverse events on life or working, but showed mood disorders, and the anti-anxiety treatment was effective to them. (3) Forty-seven cases without new hearing loss scored significantly lower in SSRS than healthy adults.@*CONCLUSION@#Emerging hearing loss is the main cause of acute exacerbation of chronic tinnitus. To find it in time and give effective treatment can save newly presented hearing loss, cure or relieve tinnitus. Adverse events in life(or working) and short of social support is another important cause of acute exacerbation of chronic tinnitus or decompensation recurrence, which suggests that social-psychological factors besides of hearing loss should be concerned in diagnosis and treatment of tinnitus.
Subject(s)
Adult , Humans , Disease Progression , Hearing Loss , Social Support , Tinnitus , PsychologyABSTRACT
OBJECTIVE@#To investigate whether there is gender difference in the incidence and severity of tinnitus in medical staff (including doctors, nurses, and technicians).@*METHOD@#A total of 354 people (all are medial stuff from hospitals in Guangzhou) were invited to be involved in the investigation and granted a self-reported questionnaire of tinnitus (designed by the authors; based on the scoring method of severity of tinnitus (Liu et al.). Statistical analysis on the data was performed using SPSS Statistics 17.0.@*RESULT@#(1) The incidence of tinnitus of the sample was 43.22%, with that in female higher than in male (P 0.05). (4) There was statistically significant difference among the four sub-items of the questionnaire (P < 0.01), with the mean score of "occurred environment" higher than "the impact on sleeping", "the impact on everyday life", and "the impact on emotion".@*CONCLUSION@#(1) The effort-reward imbalance might be the key factor of the gender difference in the incidence of tinnitus. (2) For patients of tinnitus, improving the knowledge about their symptoms as well as levels of psychological resilience would be helpful to relieve the mental impairment of tinnitus.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Emotions , Incidence , Medical Staff , Sex Factors , Surveys and Questionnaires , Tinnitus , Epidemiology , PsychologyABSTRACT
OBJECTIVE@#To probe the factors that affect the pure-tone threshold glycerol test and the distribution of frequencies in positive glycerol test.@*METHOD@#We tested the pure-tone threshold before and after glycerol intake in patients with Meniere's disease, and then analyzed the positive rates,distribution of positive frequencies and the time when the maximum threshold changes appeared.@*RESULT@#The positive rate of pure-tone glycerol test was 72.09%, of which the threshold descending rate was 47.67%, and the threshold rebounding rate was 24.42%; the pure-tone threshold changes of descending group and rebounding group were (17.41 +/- 9.92) dB, (13.53 +/- 4.64) dB respectively, and the differences were significant. The distribution of positive frequencies were 250 Hz, 125 Hz, 500 Hz, 1 kHz, 4 kHz, 2 kHz, 8 kHz in descending order. The maximum pure-tone threshold changes mostly appeared within 2 or 3 hours after glycerol intake.@*CONCLUSIONS@#Patient selection, test occasion and the judgement criteria may affect the positive rate of glycerol test; the positive frequencies distribute in the low-frequency region mainly; the maximum pure-tone threshold changes mostly appeared within 2 or 3 hours after glycerol intake.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Audiometry, Pure-Tone , Auditory Threshold , Meniere Disease , DiagnosisABSTRACT
OBJECTIVE@#To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy.@*METHOD@#The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents.@*RESULT@#There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo.@*CONCLUSION@#Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.
Subject(s)
Adult , Female , Humans , Middle Aged , Decompression, Surgical , Microsurgery , Nerve Compression Syndromes , Diagnosis , General Surgery , Retrospective Studies , Vertigo , Vestibular Nerve , Pathology , Vestibular Neuronitis , Diagnosis , Pathology , General Surgery , Vestibulocochlear Nerve , PathologyABSTRACT
OBJECTIVE@#To investigate the risk factors of tinnitus and provide evidence for tinnitus prevention.@*METHOD@#Retrospectively analyzed the audiograms and the risk factors of 462 tinnitus victims who never perceived hearing loss, find the relationship between every risk factor and tinnitus.@*RESULT@#The rate of tinnitus victims with high frequency hearing loss was the 46.1%, with low frequency hearing loss was 15.8%, with single middle frequency notch was 11.04%, with an audiogram like upset-basin was 7.58%, with normal audiogram was 14.07%, with other type of audiograms was 5.41%. The age distribution in the high frequency hearing loss group was mainly between 30 and 40 years, in the upset-basin hearing loss group was mainly older than 50 years, and in the other groups, mainly between 20 and 30 years. In the high frequency hearing loss group, male to female ratio was 158/55, in the low frequency hearing loss group and single middle frequency notch group ,male to female ratio was 14/59 and 12/39 respectively. In another three groups, the male to female ratio was nearly 1. Risk factors for high frequency hearing loss group, low frequency hearing loss, single middle frequency notch group and in the upset-basin hearing loss group were noise, fatigue, long-time musical instrument contact and ageing respectively.@*CONCLUSION@#Among the tinnitus victims who never perceived hearing loss, 86% of them have hearing impairment in high frequency area, low frequency area or single middle frequency. The rate of high frequency hearing loss was 46.01%, the major risk factor was noise, most of victims were men. The rate of low frequency hearing loss was 15.8%, the major risk factor was fatigue and nervous, most of the victims were women. The rate of single middle frequency notch was 11.04%, the major risk factor was long-time musical instrument contact. The rate of upset-basin hearing loss was 7.58%, ageing was the major risk factor.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Audiometry, Pure-Tone , Auditory Threshold , Hearing Loss , Hearing Tests , Retrospective Studies , Risk Factors , TinnitusABSTRACT
Objective To compare the tannin contents of Platycladus orientalis(L.) Franco and its carbonisatus.Method A tungsten molybdophosphate-casein colorimetric method was used with gallic acid as reference substance.Results The standard curve in the range of 0.026~0.26 mg(r =0.999 4),and the average recovery rate was 97.85%,RSD=1.07%(n =9).Conclusion The method is reliable and can be used to determine the tannic of and its different processed products.
ABSTRACT
Objective To investigate the appropri ate changes of the central masking effect(CME) when there were pathologies in d ifferent segment of auditory pathway,so as to give some instructions in cli nical masking test. Methods We tested the subjects with one ear normal and th e other ear diseased. The diseased ears included conductive deafness in 30 ca ses?sensory deafness in 27 cases and retrocochlear deafness in 7 cases. Results The pure conductive deafness had very little effect on CME; secretory otistis media and chronic suppurative otistis medi a made CME lower than normal due to the secondary cochlear impairment .When su dden deafness companied with vertigo,CME appeared much higher than the normal and appeared great difference individually;but CME appeared lower than normal at other kinds of cochlear deafness ears.CME appeared differently at retrocochlear deafness ears. Conclusion Audiometry results should be corrected when th e masker higher than 40 dB EM,because the masker can make the CME higher than 5 dB in the conductive impairment ears.In the sudden de afness companied with vertigo ears,CMEs were too high and too individually to fi nd a suitable correction for PTT.Insert earphone should be used in measuring the air-conduction PTT,and bone-conduction PTT test might be given up.
ABSTRACT
0.05).② The VMCD group had a higher speech recognition threshold than the healthy aged group and the ARCD group(P