The suprachoroidal space (SCS) is the potential space between the sclera and choroid.Drugs delivered through SCS can bypass the sclera,avoiding clearance by conjunctival and scleral blood vessels and lymphatic circulation,so that more drugs can reach the disease tissues such as choroid and retina.SCS drug delivery does not disrupt the ocular integrity,is safer than the intravitreal drug injection and more effective than trans-scleral drug delivery.In addition,SCS delivery only needs a very small volume of drug,which makes it possible to be carried out in multiple parts of the sclera,and the specific disease area can be more precisely targeted.SCS drug delivery is suitable for the treatment of choroidal and retinal diseases.However,currently SCS drug delivery is still a novel field and many aspects need to be more in-depth studied,including its safety,delivery methods,drug formulation and effectiveness.

Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR,ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children.Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test,and group BA of the children unable to perform on behavioral evaluations.Results The analysis of the audiometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds(P＜0.01) at various frequencies.The correlation coefficients were 0.75,0.76,0.76,and 0.83 at different frequencies.The ASSR-PTA linear regression was utilized.The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR.Those without ASSR responses also had no ABR There were 116 tests in total four frequencies for the 29 ears.83 responses were obtained from ASSR,89 responses from behavior audiometry and 96 from the use of the both tests.Conclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe heating loss children as compared to the pure tone audiometry alone.More detailed data can be obtained thus from children to assist in rehabilitation in a more effective mariner.

Objective To investigate the clinical efficacy of Ilizarov bone transport combined with dressing change in the treatment of acute tibial osteomyditis accompanied with massive soft tissue defection.Methods From July 2009 to september 2012, 14 patients with acute tibial osteomyelitis associsted with large-area soft tissue necrosis and defection were treated in Traumatic Orthopaedics Department of the Central Hospital of Binzhou.All cases were Gustillu Ⅲ type open fracture, and Ⅲ C type injury in 11 casas accompanied with vascular injure.Associated with contralateral lower limb in 4 casas.They were 10 male and 4 female,aged from 21 to 45 years old(average age of 35 years old).The duration from injury to surgery ranged from 12-24 days,averaging of 19 days.All cases were treated first with excision of the infected or necrosis bone segment and soft tissue.The wound keep opening, followed by llizarov bone transport combined with dressing change to repair the bone and soft tissue defection.The clinical efficacy was assessed using the Paley's evaluation system at the last follow-up.Results All the patients were followed up for 24 to 36 months (average of 27 months).The bone defection rapaired was from 5 to 1 3 cm(average of 7 cm).The mean duration of distraction was 4 months, range from 2 to 6 months.All cases' gain s.ufficient soft tissue coverage the later period of Ilizarov bone transport.All the fracture and bone defection were cured.Infection were cured in 13 cases, and 1 case converted to chronicle osteomyelitis, and the cure rate was 93％.According to the Paley' s system, the bone union was excellent in 11 cases, good in 2 cases, and fair in 1 Cases, with a good-to-excellent rate was 93％.The functional outcome was excellent in 10 cases,good in 2 cases,and fair in 2 cases,with a good-to-excellent rate of 86％.Conclusion Ilizarov bone transport and dressing change is one reliable and effective treatment of tibial acute infected and soft tissue defection.

Objective To evaluate the measurement uncertainty for the determination of ethanol in human blood by auto-headspace GC/MS.Methods Each source of uncertainty,arising from the procedure of testing,was analyzed and confirmed according to the guidelines of the uncertainty in measurement.After each uncertainty component was evaluated,the combined standard uncertainty and the expanded uncertainty of the result were calculated.Results The expanded uncertainty was 0.084mg/mL when the concentration of ethanol in blood sample was 0.738 mg/mL.Conclusion The measurement uncertainty of the concentration of ethanol was came primarily from the sample determination,standard solution of the ethanol and the calibration curve.

Objective To investigate audiological characteristics of patients with intact tympanic membranes and conductive or mixed hearing loss .Methods A retrospective study was carried out among 30 patients (42 ears) with intact tympanic membranes and conductive or mixed hearing loss who underwent exploratory tympanotomy . The preoperative outcomes of pure tone audiometry ,tympanometry ,resonant frequency of middle ear and temporal bone CT scan were analyzed .Results Among 42 ears ,30 ears with otosclerosis and 12 ears with ossicular chain dis-ruption were confirmed in exploratory tympanotomy ,but only 5 ears showed positive findings in CT scan .The mean thresholds of bone conduction ,air conduction and air -bone gap at frequencies of 0 .5 ,1 and 2 kHz were 27 .5 ± 1 .3 dB HL ,67 .0 ± 1 .8 dB HL ,39 .5 ± 1 .1 dB HL ,respectively .An analysis of tympanometric data of all patients re-vealed that 50% of all ears (21/42) were type A tympanograms ,42 .9% (18/42) were type As tympanograms ,and 7 .1% (3/42) were type Ad tympanograms .The mean of the resonant frequency of the middle ear in otosclerositic patients (1 079 .0 ± 67 .4 Hz) was significantly higher than ossicular chain disruption patients (633 .3 ± 43 .6 Hz) . Conclusion Otosclerosis is the most common in the patients with intact tympanic membranes and conductive or mixed hearing loss .The middle ear resonant frequency of otosclerositic patients is significantly higher than that of ossicular chain disruption patients .

OBJECTIVE: To summarize and analyze the clinical characteristics of Mondini dysplasia with cerebrospinal fluid leakage, as well as preliminarily investigate the genetic mechanism of the disease. METHOD: The clinical data of 2 patients diagnosed as Mondini dysplasia with cerebrospinal fluid leakage treated in our hospital were analyzed. Blood samples of these two patients were obtained to extract DNA. We screened DNA samples for gene SLC26A4 mutations by using polymerase chain reaction and direct sequencing. The sequencing results were analyzed in DNASTAR software. RESULT: Both patients came to our hospital because of recurrent meningitis, and the fistula were both located in vestibular window. Patients were cured one-time after surgical closure of the leakages with temporalis + temporalis fascia + temporalis through the mastoid approach. No pathogenic mutations of gene SLC26A4 with exome sequencing were found. CONCLUSION Mondini dysplasia with cerebrospinal fluid leakage should be considered in patients with recurrent meningitis and hearing disorder. Temporal bone HRCT is helpful to the diagnosis. Surgical closure is an effective therapeutic method and may prevent recurrent meningitis. The molecular mechanism of simple Mondini dysplasia needs further study.
Cerebrospinal Fluid Leak ; physiopathology ; Cochlea ; pathology ; Fistula ; pathology ; Humans ; Hyperplasia ; genetics ; physiopathology ; Membrane Transport Proteins ; genetics ; Meningitis ; physiopathology ; Mutation ; Sulfate Transporters

OBJECTIVE: To explore the effect of masking therapy for the early stage of the patients with noise-induced tinnitus,and imply the treatment for patients with noise-induced tinnitus. METHOD: Sixty-eight cases with tinnitus were studied. All the patients took the audiological examinations and tinnitus tests firstly, and accepted the masking therapy for 6 months. The therapeutic effiency was evaluated according to tinnitus handicap inventory (THI) and subjective visual-analogue scale (VAS). The minimum masking intensity was also evaluated. RESULT: The majority of the patients with noise-induced tinnitus (59 cases, 86. 8%) had tinnitus frequency of 4 kHz,and most of them (44 cases, 64. 7%) had positive residual inhibition tests. Tinnitus completely disappeared in 3 cases after masking therapy, and the efficiency of this treatment is 83. 8%. There was significant difference in the scores of THI and VAS before and after therapy(P<0. 01), and there was also significant difference in the minimum masking intensity (P<0. 01). CONCLUSION Masking therapy is the most important treatment for the patients in the early stage of noise-induced tinnitus. The therapeutic effiency is significant and should be promoted.
Humans ; Noise ; adverse effects ; Tinnitus ; etiology ; therapy

OBJECTIVE: To analyze and summarize nystagmus of patients with posterior canal benign paroxysmal positional vertigo (BPPV) in positioning test,and to improve the diagnosis and treatment of posterior canal BPPV (PSC-BPPV). METHOD: The present study was conducted on 175 patients who had unilateral BPPV of the posterior semicircular canal (PSC). Their positional nystagmus recorded by videnonystagmography in Dix-Hallpike test,roll test and roll over test were analyzed to summarize the characteristics of nystagmus on nystagmograph of PSC-BP-PV. RESULT: Of the 175 patients, lesion was located in the left PSC in 69 (39.4%) patients,the right PSC in 106 (60. 6%)patients. The nystagmus of patients with PSC-canalithiasis showed upward on the vertical phase of nystagmograph and orientated the different side on horizontal phase in the head hangging position. The horizontal phase pointed to the contralateral side in 47(26. 9%) patients, the ipsilateral contralateral side in 100(57. 1%) patients,no significant reverse ingredients in 28(16.0%) patients. When these patients returned to sit,139(79.4%) patients showed down beating positioning nystagmus, whereas 36 (20. 6%) patients with no nystagmus only had a short vertigo or dizziness. The horizontal phase of the 139 patients pointed to the contralateral side in 40(22. 9%) patients,the ipsilateral contralateral side in 68(38. 9%) patients,no significant reverse ingredients in 31(17. 7%) patients. In roll test,12 patients of the right PSC-BPPV presented an up-beating rotatory nystagmus when the head turned to right,and 5 patients of the left PSC-BPPV presented a down-beating rotatory nystagmus when the head turned to left. When the patients changed body from the left lateral position to the right lateral position in the roll over test, 74(42. 3%) patientsshowed vertical positioning nystagmus. In 30 patients who presented an up-beating nystagmus, there were 25(83. 3%) patientscame from the right PSC-BPPV. In 44 patients who presented a down-beating nystagmus, there were 36(81. 8%) patientscame from the left PSC-BPPV. The direction of the vertical nystagmus was highly correlated with the judgment about the side of the PSC-BPPV in roll over test (P<0. 01). CONCLUSION The patient with PSC-canalithiasis showed an uncertain direction in torsional nystagmus in Dix-Hallpike test,the diagnosis was mainly concern with the vertical nystagmus. When we found a rotatory nystagmus with much more up-beating nystagmus in roll test, it might be PSC-BPPV. We also can use the roll over test to diagnose the location of the otolith in which side of the PSC-BPPV.
Benign Paroxysmal Positional Vertigo ; complications ; Dizziness ; Electronystagmography ; Face ; Head ; Humans ; Nystagmus, Physiologic ; Otolithic Membrane ; Patient Positioning ; Semicircular Canals ; Vertigo ; Vestibular Function Tests

Background and purpose:The incidence of liver cancer is high in China. Primary liver cancers usually occur in patients with liver cirrhosis, which is a challenge for the early diagnosis of liver cancer. Our purpose is to investigate the efifcacy of contrast-enhanced ultrasonography (CEUS) in the early identiifcation and diagnosis of small hepatocellular carcinoma (HCC) by regularly tracking and supervising the high risk population. Methods:A total of 320 high risk patients of HCC admitted in our hospital from February 2011 to November 2013 were enrolled in this prospective study. All patients underwent conventional ultrasound and hepatic CEUS. The differential diagnosis of malignant HCCs from benign ones was based on the enhancement patterns of hepatic lesions in different phases on CEUS. Results:Twenty patients were diagnosed as small HCC among 320 HCC high risk patients who were under regular surveillance using CEUS and all were pathologically conifrmed. Seven of the 20 HCC cases were smaller than 1.0 cm and 13 measured 1.1-2.0 cm. There were 6 (30.0%) HCCs presented as“early wash-in and slow wash-out”atypical pattern of HCC. The small size of the lesion and iso-echogenicity were the main factors of atypical pattern of HCC on CEUS.Conclusion:Ultrasonography and CEUS surveillance is a useful strategy for the early detection of small HCCs in high risk patients, which can help them to receive proper therapeutic management in time.

OBJECTIVE: To determinate the occurring frequency and mutational hot spot in Hunan province. METHOD: Blood samples was obtained from 96 patients with nonsydromic hearing impairment in Hunan province. PCR and DHPLC techniques were used to screening for all the 21exon of SLC26A4. PCR samples which were abnormal for DHPLC screening were analyzed with direct sequencing. Sequencing results were analyzed in DNASTAR software. RESULT: Fifteen of 96 patients were found to have SLC26A4 gene mutations, detection rate was 15 6 , for 3 examples were homozygous mutations, ten samples were complex heterozygous mutations and 2 were heterozygous mutations. Totally, sixteen base variations were found, including 10 types of known gene mutation were identified (S90L, S252P, IVS7-2A>G, T410M, N392Y, IVS10-12T>A, S448X, G497S, S517fs, H723R. Four types of novel gene mutation (S8X, A227P,C565fs, Y728H), one type of same sense mutation (c. 2182 T>C)and 1 type of polypeptide IVS11+47 T>C). IVS7-2A>G was the most common gene mutation , which 9 samples were identified with, and it's detection rate was 9.38% and 5.73% for all the mutant alleles. IVS11+47 T>C was the most common polypeptide, which 20 samples were detected. CONCLUSION IVS7-2A>G was the most common gene mutation type for nonsyndromic hearing impairment in Hunan province; 4 novel mutations which were detected in the study enriched SLC26A4 gene mutation spectrum of Chinese.
Adolescent ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; Exons ; Female ; Genetic Testing ; Hearing Loss ; genetics ; Humans ; Male ; Membrane Transport Proteins ; genetics ; Mutation ; Sulfate Transporters ; Young Adult