Objective To evaluate right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) patients by echocardiography and cardiac magnetic resonance (CMR),and to evaluate the value of clinical application of those right heart function indexes.Methods 32 patients with CTEPH who underwent CMR and echocardiography were involved in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (FAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.Right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV) were measured by cardiac magnetic resonance and right ventricular ejection fraction (RVEF) was calculated.Results A positive correlation was found between FAC and RVEF (r =0.423,P =0.022),there was a negative correlation between RIMP and RVEF (r =-0.387,P =0.048),there was no correlation between TAPSE and RVEF (r =0.451,P =0.22),a positive correlation was found between S' and RVEF (r =0.689,P =0.000).Conclusions The echocardiographic parameters FAC,RIMP and S' can reflect right ventricular function in patients with CTEPH and can be used as a routine clinical parameters.

Objective To evaluate right ventricular systolic function in patients with pulmonary hypertension (PH) by real-time three-dimensional echocardiography (RT-3DE),and compared with cardiac magnetic resonance.Methods A total of 23 patients with PH who underwent MRI and echocardiography in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (RVFAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.RV end-diastolic volume (RVEDV) and endsystolic volume (RVESV) were measured by RT-3DE and cardiac magnetic resonance and RV ejection fraction (RVEF) was calculated.Results A positive correlation was found between RVFAC and RVEF (r =0.595,P =0.003),there was a negative correlation between RIMP and RVEF (r =-0.745,P =0.000),has no correlation between TAPSE and RVEF (r =-0.029,P =0.896),a positive correlation was found between S' and RVEF (r =0.489,P =0.018).There were close correlation between RVEDV,RVESV and RVEF measured by RT-3DE and MRI (P ＜0.001,respectively);Bland-Altman analyses showed good agreement between them.Conclusions RT-3DE can noninvasive,accurate assessment right ventricular systolic function in patients with PH,and provide prognosis and treatment choice for clinical demands.

Objective To discuss the correlation between right ventricular function and systolic pulmonary artery pressure (PASP ) in patients with chronic thromboembolic pulmonary hypertension (CTEPH)and explore the change of right ventricular function under different degree of PASP.Methods One hundred and thirty-seven CTEPH patients were divided into four groups by PASP:Group Ⅰ (50 mmHg≤PASP<70 mmHg),20 cases;Group Ⅱ (70 mmHg≤PASP<90 mmHg),35 cases;Group Ⅲ,55 cases (90 mmHg ≤ PASP < 1 10 mmHg);Group Ⅳ (PASP ≥ 1 10 mmHg),27 cases.Echocardiographic parameters include:PASP,tricuspid regurgitation area (ATR ),left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD),inner diameter of main pulmonary artery (DMPA ),inner diameter of left arterial branch (DLPA ),inner diameter of right pulmonary arterial branch (DRPA ).Right ventricular function parameters include:tissue Doppler-derived tricuspid lateral annular systolic velocity (s'),tricuspid annular plane systolic excursion (TAPSE),RV index of myocardial performance (RIMP)and right ventricular fractional area change (FAC).Results There were significant differences in RVTD, TAPSE,FAC and RIMP in CTEPH patients under different PASP(P <0.05).RV structure and function was significantly correlated with PASP in CTEPH patients.With the elevation of PASP,RV was significantly enlarged and RV function becomes worse.Conclusions Echocardiography may contribute to evaluate RV function in CTEPH patients and provide basis for clinical treatment and prognosis evaluation.

OBJECTIVEWe aimed to determine whether blood lipid parameters were related to the severity and the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) patients.

METHODSA retrospective cohort study of 258 patients with ISSNHL from December 2013 to February 2015. The distribution characteristics of lipids [total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Non-high-density lipoprotein cholesterol (Non-HDL-C), et al] in different degree of deafness (mild, moderate, severe, and profound), hearing curve types (low frequency, high frequency, full range frequency, and completely deafness type) and prognosis of recovery (complete, partial, slight, and no recovery) were analyzed by IBM SPSS 22.0 ANOVA analysis, chi square test and multiple regression analysis.

RESULTSTG level in mild hearing loss group was significantly lower than that in severe and profound hearing loss group (P = 0.017 and P = 0.007). There were no correlation between curve types and lipid indexes (P > 0.05). Non-HDL-C level was elevated in no recovery and slight recovery groups (P = 0.026 and 0.021). TC levels in partial recovery group and no recovery group were significantly higher than that in the complete recovery group (P = 0.049 and 0.042), TG was higher in slight recovery group (P = 0.014).

CONCLUSIONSTG has significant correlation with the severity of hearing loss. There are negative correlations between hearing recovery and Non-HDL-C, TC and TG levels. Non-HDL-C, TC and TG might be a prognostic factor for treatment outcome in ISSNHL patients.

Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Deafness ; Hearing Loss, Sensorineural ; blood ; diagnosis ; physiopathology ; Hearing Loss, Sudden ; blood ; diagnosis ; physiopathology ; Humans ; Lipids ; blood ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Triglycerides ; blood

OBJECTIVETo investigate the effect and mechanism of endolymphatic sac-mastoid shunt surgery for intractable Meniere's disease of different stages according to hearing level.

METHODSData from 240 patients diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from January 1983 to January 2012 were analyzed in this study. Endolymphatic sac-mastoid shunt surgery was performed in affected ear for each patient. The evaluation of therapy followed the guidelines issued by Chinese Academy of Otolaryngology Head and Neck Surgery Committe. Vertigo control and auditory function were measured in two-year's follow-up.

RESULTSAccording to the preoperative staging of hearing, among these 240 patients, there were 12 cases in stage I (with an average hearing threshold < 25 dB), 130 cases in stage II (with an average hearing threshold of 25-40 dB), 85 in stage III (41-70 dB) and 13 cases in stage IV(with an average hearing threshold > 70 dB). Overall control rate of vertigo was 77.9% (187/240) in two-year's follow-up, with total control 49.2% (118/240) and substantial control 28.7% (69/240). The hearing was improved in 25.0% (60/240) of cases, no change in 59.2% (142/240) of cases, and worse in 15.8% (38/240) of cases. According to different stages, vertigo control rate was 83.3% (10/12) in stage I, 82.3% (107/130) in stage II, 75.3% (64/85) in stage III and 46.2% (6/13) in stage IV. Vertigo control rate of stage IV patients was significantly lower than that of stage II and III patients (χ(2) = 9.318 and 4.692, P < 0.05), while vertigo control rate of stage I, II, III patients had no significant difference with each other (P > 0.05).

CONCLUSIONEndolymphatic sac-mastoid shunt operation is an effective method in the treatment of intractable Meniere's disease, but the effect was poor in stage IV patients.

Endolymphatic Sac ; surgery ; Hearing ; Humans ; Mastoid ; surgery ; Meniere Disease ; surgery ; Otologic Surgical Procedures ; Vertigo ; therapy

Objective To investigate the application value of transesophageal echocardiography(TEE) in allogeneic lung transplantation. Methods The study enrolled 37 patients receiving allogeneic lung transplantation because of end stage lung disease,including sequential bilateral lung transplantation 20 cases and unilateral lung transplantation 17 cases,the latter included 4 cases with extracorporeal membrane oxygenation (ECM O).Echocardiographic parameters before surgery,including right ventricular transverse diameter (RVTD),left ventricular transverse diameter (LVTD),right atrial transverse diameter (RATD), left atrial transverse diameter (LATD),main pulmonary artery (DMPA),left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure (SPAP),and TEE parameters during surgery,including pulmonary artery anastomosis diameters (DRPAand/or DLPA) and blood flow velocity (VRPAand/or VLPA), pulmonary vein anastomosis blood flow velocity (V RPVand/or VLPV),were measured. Results ①Preoperative transthoracic echocardiographic showed a slight increase of right heart in patients with allogeneic lung transplantation,different degrees of increase in SPAP,a normal or slightly increase of D MPA and a normal LVEF,according to the ASE guidelines. ②Compared with pre-operation,the diameters of left and right pulmonary artery decreased ( P < 0.001) and the blood flow velocity of arteries and veins increased ( P <0.001). ③Patients with ECMO support had a higher SPAP before operation ( P <0.05) and a lower LVEF ( P <0.05),but within a normal range.The blood flow velocity of pulmonary artery and vein had no difference between two groups ( P > 0.05). Conclusions During allogeneic lung transplantation,TEE plays an important role in the monitor of pulmonary arteriovenous anastomosis. It could remind the surgeon whether anastomosis is narrow timely,and determine the patient′s hemodynamic status and cardiac load to guide the surgical process.

Objective: To investigate the influence of inhibiting expression of polyamine-modulated factor (PMF-1) on the antitumor effect of glucocorticoid dexamethasone (DEX) in human cervical cancer Caski cells. Methods: siRNAs which target human PMF-1 gene were designed and synthesized, and their effect on the expression of PMF-1 in Caski cells was evaluated by Western blotting. The PMF-1 down-regulated and control Caski cells were treated with DEX, and then the affect of PMF-1 down regulation on the sensitivity of the tumor cells to DEX was analyzed. MTT method was used to detect cell proliferation, flow cytometry was used to analyze cell cycle, Western blotting method was used to evaluate expression level of glucocorticoids receptor (GR), and HPLC was used to analyze intracellular polyamine content. Results: The transient transfection of Caski cells with siRNAwhich targets PMF-1 gene can significantly reduce the expression level of PMF-1 protein. Compared with the control cells, treating PMF-1 down-regulated Caski cells with DEX can more effectively inhibit cell proliferation（P<0.01), up regulate GR expression, arrest cell cycle at G2 stage（P<0.01), and also significantly reduce intracellular polyamine level（P<0.01). Conclusion：Inhibiting PMF-1 expression can enhance antitumor pharmacological activity of DEX against human cervical cancer cells, and the underlying mechanism may be related with enhanced cell cycle inhibition and decreased intracellular polyamine level.

Objective: To evaluate the feasibility of combining simultaneous triple semicircular canal plugging (TSCP) and cochlear implantation (CI) to treat vertigo and hearing loss in advanced Meniere's disease(MD) patients, so as to provide an alternative surgical procedure for treating this disorder. Methods: Data from seven patients, who were referred to our hospital and diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006), from Jan. 2015 to Jan. 2016, were retrospectively analyzed in this work. Seven patients, in whom the standardized conservative treatment had been given for at least one year and frequent vertigo still occurred, underwent simultaneous TSCP and CI under general anesthesia via mastoid approach. Postoperative follow-up time was more than six months. Vertigo control and auditory function were measured. Pure tone audiometry, speech perception scores, caloric test, head impulse test (HIT), and vestibular evoked myogenic potential (VEMP) were performed for evaluation of audiological and vestibular functions. Results: All patients had bilateral severe sensorineural hearing loss preoperatively. One side hearing loss was due to MD and another side was due to reasons including sudden sensorineural hearing loss, mumps and other unknown reason. The total control rate of vertigo in seven MD patients was 100.0% in the six-month follow-up, with complete control rate of 85.7% (6/7) and substantial control rate of 14.3% (1/7). Improved hearing threshold and speech perception scores were observed in all study participants. Postoperative average aided hearing threshold was 32.5 dBHL, the average monosyllabic word score was 42.6% and speech perception scores of sentences tested in quiet was 52.3%. Tinnitus improved in five cases, and no significant change in two patients. Post-operatively, all patients suffered from temporary vertigo and balance disorders. Vertigo was disappeared in all patients within 3-5 days, while, an average recovery time of balance disorders was 19.7 days. Six months after treatment, loss of semicircular canal function by caloric test was found in the operation side of all patients and no change in cVEMP or oVEMP test was noted. All patients had no facial paralysis, cerebrospinal fluid leakage, and other complications. Conclusions A combined approach of TSCP and CI which could control vertigo effectively and improve hearing loss and tinnitus represents an effective and safe therapy for some advanced MD patients.