Objective To explore the value of plasma brain natriuretic peptide test in the diagnosis and treatment of elderly heart failure patients with normal ejection fraction,and to provide reference for clinical diagnosis and treatment of the disease.Methods 104 patients with heart failure were selected,at the same time,30 elderly patients with normal heart function in our hospital were selected as the control group.The plasma brain natriuretic peptide and cardiac color Doppler ultrasound were examined.The plasma brain natriuretic peptide and left ventricular ejection fraction,left ventricular posterior wall thickness,left ventricular mass index,left ventricular diastolic diameter and ventricular septal thickness were compared between two groups ; at the same time,peptide and left ventricular plasma brain natriuretic ejection fraction were compared in heart failure patients with different levels of NYHA.Results The plasma level of brain natriuretic peptide,left ventricular posterior wall thickness,left ventricular mass index in the heart failure group were (401.37 ± 368.63) ng/L,(13.42 ± 1.33) mm,(130.62 ± 9.18) g/m2,which were significantly higher than those of the control group (all P ＜ 0.05).The left ventricular ejection fraction of the heart failure group was (51.36 ±4.41) ％,which was significantly lower than the control group(P ＜0.05).The left ventricular ejection fraction of patients with different NYHA grading in the heart failure group was significantly lower than that of the control group(all P ＜0.05),plasma brain natriuretic peptide levels in patients with different NYHA grading were significantly higher than those in the control group,and with the elevated levels of NYHA classification,the plasma brain natriuretic peptide level increased significantly(P ＜ 0.05).Conclusion The level of plasma brain natriuretic peptide in elderly heart failure patients with normal ejection fraction was significantly increased,and with the increase of NYHA grade,plasma brain natriuretic peptide level rised,it is important to assess diagnosis and severity of this disease.

OBJECTIVE: To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV). METHOD: One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test. RESULT: The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT. CONCLUSION The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.
Benign Paroxysmal Positional Vertigo ; diagnosis ; Head Movements ; Humans ; Posture ; Rotation ; Semicircular Canals ; Vertigo

OBJECTIVE: To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression. METHOD: Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS). RESULT: THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38. CONCLUSION Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.
Anxiety ; complications ; Depression ; Depressive Disorder ; Humans ; Personality Inventory ; Stress, Psychological ; Surveys and Questionnaires ; Tinnitus ; complications ; psychology

Objective To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age.Methods Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017.909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively.According to the age,of the 909 TOLAC cases,237 were the advanced age group,and 672 cases were the low age group.The maternal and neonatal outcomes between the two groups were compared.Results The percentage of TOLAC in women with advanced age was 32.4％ (237/731),and VBAC rate was 88.2％ (209/237).The percentage of TOLAC in younger women was 36.2％ (672/1 856),and VBAC rate was 82.4％ (554/672).The difference of the TOLAC rate between the two groups was not significant (P＞0.05),and the VBAC rate of the advanced age group was higher than the low age group (P＜0.05).In the comparison of the two groups,the proportion of bachelor degree or above(55.7％,132/ 237),the prepregnancy BMI (22.4±3.0) kg/m2,pregnant interval time (68.5±38.3) months,the proportion of gestational hypertension (8.4％,20/237),the proportion of gestational diabetes(34.6％,82/237) and the rate of the neonatal ICU admission (18.1％,43/237) in the advanced age group were higher than those of the low age group (P＜0.05),respectively.And there were no significant differences in the rate of postpartum hemorrhage,the rate of postpartum hemorrhage≥1 500 ml,the rate of postpartum transfusion,puerperal morbidity,neonatal birth weight,neonatal 5 min Apgar score＜7 score,umbilical artery blood pH＜7.0,neonatal tracheal intubation and respiratory distress syndrome (all P＞0.05).In all TOLAC cases,the rate of uterine rupture was 0.11％(1/909) and there was no maternal and neonatal death.Conclusion VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

OBJECTIVE: To study the management of basic parameters related to individual piston shaping on malleostapedotomy by MDST 3D reconstruction and microanatomy and to assess the accuracy of MDST method. METHOD: Ten Chinese temporal bones without ear diseases were numbered randomly and scanned by GE Light Speed Ultra 64 rows of spiral CT. 3D structure of ossicular chain were reconstructed by MPR and VR methods in AW4. 1 workstation. Then measurements of distances between stapes head to stapes footplate (A line), and manubrium to stapes head (B line), and manubrium to stapes footplate (C line), angle between line A and line B (angle AB) are completed. After that, all samples of temporal bone were undergone canal wall down mastoidectomy under microscope and the relevant measurements were completed. RESULT: The MPR and VR technique of MDCT reconstructed ossicular chain clearly, and revealed the spatial relationship between every structure stereoscopically. Respectively, lengths of A, B, C line by MDST and microanatomy are (3.42 +/- 0.86) mm and (3.60 +/- 0.94) mm, (3.42 +/- 0.80) mm and (2.96 +/- 0.42) mm, (5.86 +/- 0.60) mm and (6.22 +/- 1.10) mm, while angle AB (141.05 +/- 30.07) degrees and (144.57 +/- 41.86) degrees. There are no statistically significant differences between two groups (P>0.05). CONCLUSION The MPR and VR technique of MDCT can clearly reconstructed the 3D shapes of the temporal bone and finish the exactly managements on A, B, C lines and AB angel which is crucial for shaping a individual piston on malleus-to-oval window surgery.
Adult ; Ear, Middle ; anatomy & histology ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Malleus ; anatomy & histology ; surgery ; Stapes ; anatomy & histology ; diagnostic imaging ; Temporal Bone ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed

OBJECTIVE: To evaluate the clinical manifestation of Mondini dysplasia with cerebrospinal fluid leakage and investigate the effect of the surgical repair through trans-horizontal semicircular canal and vestibule approach. METHOD: Four cases which were operated by the approach of trans-horizontal semicircular canal and vestibule in our hospital were analyzed retrospectively. RESULT: The leakages were all stopped by the primary surgical closure after six-month follow up. CONCLUSION Mondini dysplasia should be considered in children or teenagers with recurrent bacterial meningitis whether or not with otorhinorrhea. Pure tone audiometry and a temporal bone CT or MRI will confirm the diagnosis. A trans-horizontal semicircular canal and vestibule approach is an effective and simple way for the treatment.
Adolescent ; Cerebrospinal Fluid Rhinorrhea ; complications ; surgery ; Child ; Child, Preschool ; Ear, Inner ; abnormalities ; Female ; Humans ; Male ; Retrospective Studies ; Semicircular Canals ; surgery ; Vestibule, Labyrinth ; surgery

OBJECTIVE: To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder. METHOD: Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed. RESULT: All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months. CONCLUSION Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.
Adult ; Female ; Humans ; Incus ; surgery ; Male ; Malleus ; surgery ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome