Objective T o investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (H C N 4) and connexin43 (C x43) in the sinoatrial node of electric shock death. Meth-ods As experim ental group, 34 cases of electric shock death who had definite current m ark evidence were selected from pathology departm ent of X uzhou M edical C ollege from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. T he expressions of H C N 4 and C x43 in the sinoatrial node were observed by im m unohistochem ical technology. Results H C N 4 positive cells expressed in the cell m em brane and cytoplasm of the sinoatrial node. C x43 positive cells expressed in the cell m em brane and cytoplasm of T cells and m yocardial cells. T he expression of H C N 4 was significantly higher than that of the control group (P<0.05) and the expression of C x43 was signifi-cantly lower than that of the control group (P<0.05). Conclusion T he changes of H C N 4 and C x43 ex-pressions in the sinoatrial node illustrate electric shock death m ight be related to the abnorm alities of cardiac electrophysiology and conduction.

[ABSTRACT]OBJECTIVETo evaluate the short-term efficacy of Eustachian tube balloon dilation (ETBD) in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis.METHODS Forty patients who underwent ETBD were included. Subjects’ inclusion criteria were as followed: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) and Eustachian Tube Score (ETS) were assessed 1 week and 6 months postoperatively.RESULTSAll cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM and ETS 1 week and 6 month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%.CONCLUSIONETBD can provide short-term benefits to those who are diagnosed with SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.

OBJECTIVE: To investigate the effect of Eustachian tube balloon dilation (ETBD) in treatment of eustachian tube related diseases. METHOD: Fifteen cases (20 ears) of otitis media with effusion and 22 cases (30 ears) of symptomatic Eustachian tube dysfunction were recruited. Technique of tubomanometry (TMM) showed obstructive Eustachian tube dysfunction in all patients. All the patients were received ETBD and followed up with VAS evaluation of ear fullness, muffled hearing, poping sound in the ear and tinnitus. And also the TMM change and middle ear effusion. RESULT: Ear fullness, muffled hearing released with 1 week (ear fullness: 8.2 ± 1.4 vs. 2.0 ± 1.2, P < 0.05, muffled hearing: 6.2 ± 1.2 vs. 3.1 ± 0.8, P < 0.05). No recurrence was seemed within 6 months. The eustachian function test turned better. Symptomatic Eustachian tube dysfunction had an effective rate of 96.6% while otitis media with effusion was 95.0%. CONCLUSION ETBD have good short-term effect in obstructive eustachian tube dysfunction related middle ear dysfunction, which might provide a good way to solve the eustachian tube related diseases.
Catheterization ; Ear Diseases ; Ear, Middle ; Eustachian Tube ; physiopathology ; Humans ; Otitis Media ; Otitis Media with Effusion ; Recurrence

OBJECTIVE Aim to explore the value and the selection of observation target of P1 component in children with cochlear implant(CI). METHODS 13 children(4.37±0.73 years old) with right side CI and one year of regular post-CI rehabilitation were recruited as CI group. 15 gender and age (4.25±0.84)years matched children with left side external and middle ear malformation were selected as control group. We collected their AEP which showed their reaction to 1000 Hz pure tone and analyzed the P1 component. RESULTS The cut off value between CI group and control groupwas 10.4mV for P1 Amplitude(P1A) and 110.5 mV for P1 Latency(P1L). More precisely, the values of CI group were above the cut off value while the values of control group were below it. Whether choosing P1A or P1L as dividing standard, the AUC were between 0.5 and 0.9(AUC: P1A0.733, P1L0.800), which showed medium distinguishing significance. P1L component showed greater You-den index(0.590>0.471) and sensitivity(0.923> 0.538) while P1A showed greater specificity(0.933>0.667). CONCLUSION P1L shows greater ability in distinguishing the difference between CI group and control group while P1A has advantage in determining their common feature. Generally, P1L shows higher value in studying CI children. We need to make choice between P1A and P1L in different situation and use P1A and P1L standard in series or parallel.

Objective To study the relationship between tubomanometry(TMM) and tympanograms before and after the treatment of otitis media with effusion(OME) in children,and to evaluate the function of tubomanometry in forecasting the prognosis of OME.Methods Data from 66 patients(98 ears) were collected before and after one to four weeks treatment,all the patients received tympanometry and tubomanometry ETS,recorded eustachian tube scores(ETS) and tympanogram types.Results Before treatment,there were significant differences between the ETS of normal ears and sick ears,also between ETS of type B tympanograms and type C.There was significant difference between ETS before and after treatment,but not between the ETS of type B tympanograms and type C after treatment.The increased ETS value of type B tympanograms was higher than type C with a significant difference.There was a significant difference between the ETS of the effective group and the invalid group before and after treatment,whether type B tympanograms or type C.Conclusion Eustachian tube scores increased after treatment,and the functions of eustachian tube were improved in children of otitis media with effusion.Before treatment,the ETS of type B tympanograrns was lower than type C,indicating a poorer function of eustachian tube.After treatment,the increased ETS value of type B tympanograms was more than type C.Tubomanometry could forecast the prognosis of otitis media with effusion in children.

Objective: To discuss the characteristics of symptoms improvement based on the follow-up evaluation of Eustachian tube balloon dilation medium to long-term efficacy in patients with symptomatic Eustachian tube dysfunction (SETD). Methods: Patients from 2015 to 2017 were followed up after Eustachian tube balloon dilation (with the sense of aural fullness, or tinnitus and hearing ambiguity). All participants had been done ETDQ-7 before surgery and were re-evaluated with ETDQ-7 in follow-up. The improvement of overall and individual symptoms scores in ETDQ-7, the effects of gender and the difference of scores at different stages (12-18 months, 18-24 months and 24-30 months) after the operation were analyzed. Results: There were 29 patients, including 16 males and 13 females, whose age ranged from 20 to 62 years old. The medium to long-term score of ETDQ-7 significantly declined after surgery (27.0±7.9 vs. 14.1±7.5, P<0.05). Among all symptoms, symptoms like "blockage feeling in ear or being like under the water, constriction feeling" , "sound of blisters or explosions in the ear" decreased obviously (P<0.05). Comparing different stages after surgery, the scores of ETDQ-7 existed no difference (P>0.05). And the difference of gender showed no significant influence on surgery effects. Conclusion The subjective symptoms of patients with Eustachian tube dysfunction diagnosed with SETD can be significantly improved in the medium to long-term follow-up after Eustachian tube balloon dilation, and the degree of improvement is not linearly related to the postoperative time.