OBJECTIVE: Systematic reviews and Meta-analysis were conducted to assess the efficacy and security of adenoidectomy for the treatment of otitis media with effusion in children. METHOD: Based on the principles and methods of Cochrane systematic reviews, literature was searched in PubMed, Medline, Elisevier, Ovid, CBM, CNKI, VIP and Wanfang datebases. Randomized controlled trials about treatment of otitis media with effusion in children using adenoidectomy were included. Meta-analysis was performed for the result of homogeneous studies using RevMan 5.2 software. RESULT: Adenoidectomy (combined with myringotomy or puncture) was superior to non-surgical (combined with myringotomy or puncture) treatment in reducing the incidence of acute otitis media and removing the middle ear effusion. Adenoidectomy combined with tympanostomy tube was superior to tympanostomy tube alone in the removal of the middle ear effusion and improvement of hearing level. Three trials described some postoperative complications including haemorrhage, incipient malignant hyperthermia, postoperative pneumonia and velopharyngeal insufficiency. CONCLUSION Our research shows a benefit of adenoidectomy in the removal of middle ear effusion in children with OME. Adenoidectomy combined with tympanostomy tube was superior to tympanostomy tube alone in improving hearing level. At present, there is no evidence of serious postoperative complications after adenoidectomy.
Adenoidectomy ; Child ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; surgery ; Postoperative Complications

Background and purpose:Surgical operation is the main method in the treatment of laryngeal carcinoma, but different patients have different impacts on the survival time and the quality of life with different type of operation. This study was to analyze the methods of surgical treatment and its long-term effect of laryngeal carcinoma, to increase survival rates, laryngeal function reservation and reconstruction and improve life quality.Methods:A total mumber of 424 patients of laryngeal carcinoma treated with surgical treatment during between Jan. 2002 and Dec. 2012 were researched by clinical follow-up and data analysis. Surgical method: CO2 laser-assisted laryngeal microsurgery for laryngeal tumors for 50 cases, frontal partial laryngectomy or modiifed thyroid cartilage window partial laryngectomy without tracheostomy for 42 cases, vertical frontolateral partial laryngectomy for 119 cases, horizontal partial laryngectomy and extended subtotal laryngectomy for 22cases, anastomosis of pharynx and trachea for 4 cases, supra cricoid partial laryngectomy for 129 cases (CHEP of them for 103 cases, CHP for 26 cases), total laryngectomy for 58 cases, cervical lymph node dissection at the same term for 121 cases.Results:Partial laryngectomy without tracheostomy for 92 cases (21.7%), total laryngectomy for 58 cases (13.7%); decannulation rate was 86.5%, vertical frontolateral partial laryngectomy of them for 93.2%, horizontal partial laryngectomy of them for 90.9%,supra cricoid partial laryngeal of them for 82.2%; laryngeal function reservation rate for 86.3%; all patients did outpatient review and telephone follow-up, 9 cases loss to follow-up, a total of tumor recurrence, cervical lymph node metastasis and distant metastasis were 41 cases, mostly occurred in 1 year after surgery; death for 57 cases, relapse of them for 8 cases, cervical metastasis for 13 cases, pulmonary metastasis for 5 cases, hepatic metastases for 2 cases, brain metastases for 1 case, esophagus metastases for 1 case, pulmonary infection for 6 cases, acute renal failure for 2 cases, unknown reason for 19 cases, according to Kaplan-Meier to count survival rate, 3-year and 5-year survival rate were 90.7% and 84.1%, relapse and metastasis were the main causes of death.Conclusion:Surgical treatment is the main therapy mode of laryngeal carcinoma. We choose individualized surgical methods for patients according to tumor staging, invasion site, age, occupation and education background of patient, health condition and so on. On the premise that tumor is completely cut off, we always advocate function surgery and minimally invasive surgery, and adopt comprehensive treatment at the same time, in order to increase survival rates, lesson suffering and improve life quality as far as possible.

OBJECTIVE: To evaluate the efficacy and safety of vasodilators for sudden sensorineural hearing loss. METHOD: Based on the principles and methods of Cocharne Systematic Reviews, we searched the cochrane central register of controlled trials, PubMed, Embase, ISI, the China biological medicine datebase, VIP, CNKI and Wangfang database. Randomized controlled trials about using vasodilators to treat sudden sensorineural hearing loss were included. Meta-analysis was performed for the results of homogeneous studies using RevMan software. RESULT: Twenty eight randomized control trials met the inclusion criteria. Seven studies showed vasodilators was not more effective than placebo. From 14 studies comparing vasodilators with vasodilators and 9 studies comparing vasodilators with other drugs, no definite conclusion could be drawn. CONCLUSION The evidence currently available does not support the use of vasodilators in the treatment of sudden sensorineural hearing loss. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of vasodilators in the treatment of sudden sensorineural hearing loss.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Vasodilator Agents ; therapeutic use

Objective To investigate the effect of chaihu-shugan-san ( CSS) on the behaviors and Notch1 signal pathway in depression model rats. Methods Thirty-two SD rats with similar behavioral scores were divided into control group (CON),model group (CUMS),positive control group (FLU) and interven-tion group (CSS).The depression model was established by stimulating with chronic unpredictable mild stress (CUMS),and the behaviors evaluation was assessed by sugar water consumption and forced depression.Im-munofluorescence was used to detect the proliferation of hippocampus neurons in rats,at the same time,real- time PCR and Western blot were used to detect the mRNA and protein expression levels of each factor (Notch1,Hes1,Hes5 and Jagged1) of Notch1 signal pathway respectively. Results Compared with CON group,the percentage of sugar water preference and swimming length of rats decreased significantly in CUMS group (P＜0.05 and P＜0.01).Compared with CUMS group,the percentage of sugar water preference and swimming length of rats increased significantly in CSS group(P＜0.05).Compared with CON group,there was a significant increase in the inactivity length of rats between CUMS group,FLU group and CSS group,and the difference was statistically significant (P＜0.01).Compared with CUMS group,the swimming length of rats in CSS group was significantly reduced,and the difference was statistically significant (P＜0.01).Compared with CON group((750.00±27.51)/mm2),the number of BrdU positive cells in the substratum or granulocyte lay-er of the hippocampus dentate gyrus of rats in CUMS group ((338.75±29.61)/mm2),FLU group ((545.00 ±17.73)/mm2) and CSS group ((529.38±13.74)/mm2) was significantly reduced(P＜0.01).Compared with CUMS group ((338.75±29.61)/mm2),there was a significant increase in the number of BrdU positive cells in the substratum or granulocyte layer of the hippocampus dentate gyrus of rats in CSS group ((529.38 ±13.74)/mm2),and the difference was statistically significant (P＜0.01).Compared with CON group,the mRNA and protein expression levels of Notch1,Hes1,Hes5,and Jagged1 in the hippocampus of rats in CUMS group were significantly reduced(P＜0.05 or P＜0.01).Compared with CUMS group,the mRNA and protein ex-pression levels of Notch1,Hes1,Hes5 and Jagged1 in the hippocampus of rats in FLU group and CSS group were significantly increased,and the differences were statistically significant (P＜0.05 or P＜0.01). Conclu-sion Notch1 signal pathway may be related to the obstacle during the hippocampus nerve regenerating in the model rat under chronic unpredictable mild stress.CSS may play an anti-depressant role by regulating Notchl to improve hippocampus nerve regeneration.