A case of ear mold impression middle ear foreign body was reported. In the exploratory operation we found the ear mold impression surrounded the ossicular chains. During the process of removal the middle ear foreign body, the incudostapedial joint was protected from obvious external force and ossicular chains were kept integrity. Tympanoplasty was completed after management of foreign body. The patient recovered well postoperatively and was discharged as scheduled.
Ear Ossicles ; surgery ; Ear, Middle ; Female ; Foreign Bodies ; surgery ; Humans ; Middle Aged ; Tympanoplasty

AIM: To investigate the pathological changes of motoneuron's function and morphology after root avulsion in order to study the neurobiology mechanism of motoneuron death. METHODS: Twenty female adult Sprague-Dawley rats, 200-300 g were used. The C 5-C 8, T 1 roots of the right brachial plexus were avulsed. All rats were killed 3 d, 5 d or 1 week after avulsion. One group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the NADPH-d histochemistry with neural red counterstained. Another group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the c-Jun immunocytochemistry stain. The paraffin sections (5 ?m thick) were collected for HE stain. The amount of NOS-positive and survival motoneurons was counted. The percentage of NOS expression and motoneuron survive were quantitatively analyzed considering the amount of contra lateral motoneurons as one hundred percent. RESULTS: The NOS expression rate was 0.74%?0.59% (3 d), 24.84%?6.73%(5 d), or 51.16%?8.67% (1 week), respectively. The survive rate was 93.00%?4.32% (3 d), 93.67%?5.27% (5 d), or 89.83%?2.65% (1 week), respectively. The motoneuron expressed c-Jun as early as 3 days after avulsion. The expression declined afterward until one week after avulsion. There was no significant change on the size of motoneuron. The nuclear membrane was still clear but some nuclei were not located in the middle of the cell body. There were some nucleoli with the chromatin condensation. CONCLUSION: The motoneuron NOS expression and cell death were increased within one week after spinal root avulsion. meanwhile, the c-jun expression was decreased. The NO/NOS may induce the motoneuron death by inhibiting the regenerating reactions of motoneuron after root avulsion injury.

Objective: To investigate the changes of osteoprotegerin ( OPG) and receptor activator of nuclear factor kappa B ligand ( RANKL) level in perio-implant crevicular fluid ( PICF) and to monitor the development of the stability of Straumann ? tissue-level implants by resonance frequency analysis ( RFA) during the early phases of healing .Methods: A total of 35 implants ( length 10 mm ) were placed.PICF samples were collected with filter paper strips at baseline , 1, 2, 3, 4, 6, 8, and 12 weeks post-surgery, respectively.The OPG, RANKL levels were determined by ELISA method .At the same time points, the implant stability quotient (ISQ) values were determined with Osstell TM mentor.Results:During healing , PICF-OPG levels increased significantly 2 weeks after surgery when compared with the 4th-, 6th-, 8th-and 12th-week reevaluation (P<0.05).The OPG/RANKL ratio in PICF was significantly higher ( P<0 .05 ) than that in gingival crevicular fluid at 1 week post-surgery .ISQ slightly fluctuated within the first 4 weeks after installation .Following this, the ISQ values increased steadily for all the implants and up to 12 weeks.Significant differences were noted between the mean ISQ values at the 12th-week and other observation time points .Conclusion: The PICF-OPG levels may be effective in monito-ring the process of osseointegration .All the ISQ values indicated the stability of Straumann ? implants over a 12-week healing period .RFA is a reliable and effective assistant to monitor implant stability .

ObjectiveTo study the effect of facilitation techniques combined with acupuncture on movement function and activity of daily living(ADL) of the stroke patients.Methods200 patients with stroke were divided randomly into 4 groups,group A for facilitation techniques with acupuncture,group B for facilitation techniques only,group C for acupuncture therapy only,and group D for control.The recovery grades of the Brunnstrom and Functional Independent Measure(FIM) were applied to assess movement function and ADL before and after treatment.ResultsThe number of patients whose limbs recoveried up to Brunnstrom 4 in group A、B、C after treatment was higher than that in group D as while as the scores of FIM(P<0.05).The FIM scores and the number of patients whose whose limbs recoveried grades(>4 grades) of the Brunnstrom in group B and C were no difference(P>0.05),The FIM scores and the number of patients whose recovery grades(>4 grades) of the Brunnstrom in group A were significant higher than that in group B and C (P<0. 05).ConclusionsFacilitation techniques combined with acupuncture can improve the movement function and ADL of the stroke patients.

To improve students' experimental research skills,innovative consciousness,promote the construction of functional experimental center,we established series of “comprehensive,contrivable,innovative” experiments in medical students.

Objective To explore the radiation dose from body γ-knife treatment to the nontargeted region's sensitive organs before and after shielding.Methods 20 patients suffering tumors less than 5 cm were selected.Calibrated thermoluminescence dosimeters (TLD) were placed above the sensitive organs,such as lens,thyroid gland and sexual gland,to measure the radiation dose received before shielding.Different plans were prepared for the patients with lung and renicapsule tumors using calibrators of different size.Radiation dose was measured by the aid of water phantom.For selected lungtumor treatment plan,the radiation doses were measured at the same location on the water phantom shielded with and without 1,2 and 4 cm lead,respectively.Results The maximum doses were 1 023.3 mGy for lens,1 235.7 mGy for thyroid gland and 1 176.8 mGy for sexual glands after treatment,respectively,being higher on the left site than the right.The radiation doses to the sensitive organs were higher for the water phatom with more tartgted points,decreasing by 55％-91％ after being covered with 1,2 and 4 cm lead shieldings.There were significant differences in doses received before and after lead shielding (t =14.4,12.9,13.3,P ＜ 0.05).Conclusions In the course of body γ-knife treatment,the additional factors would increase the dose to the sensitive organs.Therefore,it is necessary to provide lead shielding protection to the teenagers and adults with fertility when they undergo body γ-knife treatment.Trial registration Chinese Clinical Trial Registry,ChiCTR-OOC-16008259.

Objective To study the auditory perception and speech ability outcomes after cochlear implantation in prelingually deaf children with extremely severe neurosensory hearing loss and comorbid leukoencephalopathy.Methods Our study included 14 prelingually deaf children with leukoencephalopathy (confirmed by preoperative MRI scanning) who were treated with cochlear implantation in the Department of Otorhinolaryngology Head and Neck Surgery of Hainan Provincial People''s Hospital, including 8 males and 6 females of 1~6 yr with a mean age of 3.8 yr.Sixteen synchronous prelingually deaf children without central nervous system (CNS) diseases were also included as the control group, including 11 males and 5 females of 1~6 yr with a mean age of 4.4 yr.All the patients underwent pre-surgical assessments of audiology, radiology, speech ability and intelligence before cochlear implantation via transmastoid facial nerve recess approach was done, after which rehabilitation was provided at the Hainan Rehabilitation Center for Deaf Children.Categories of auditory performance (CAP) and speech intelligibility rate (SIR) were employed as the assessment criteria for the outcome of surgery, the scores of which at different timepoints after surgery were statistically compared through paired t-test between the two groups.Results All the patients gained post-surgical hearing and speech abilities to different degrees, whereas CAP and SIR scores both chronologically improved in the both groups.No statistical difference was revealed either in CAP or in SIR scores between the two groups at 6, 12 and 24 months after surgery (P>0.05).Conclusion Children with extremely severe neurosensory hearing loss can be reated with cochlear implantation even if they have comorbid leukoencephalopathy.The effects of auditory and speech rehabilitation for the same age patients with leukoencephalopathy are similar to those without leukoencephalopathy in 2 years after surgery.

Objective:To develop and evaluate the improved Chinese hearing questionnaire for school children(CHQS)for mass epidemiology study on hearing impairment in China.Method:Using the probability proportion to size(PPS) method, 8 412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol.87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry.Result:The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with golden standard(pure tone audiometry), Sen=58.5%, Spe=96.7%, PV+=78.9%, PV-=91.7%, overall accuracy=90.0% . The sensitivity for women was higher than men.Conclusion:The questionnaire produced high efficiency and specificity values.It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.

OBJECTIVETo study the periodontal health status of Hui and Han adults in Ningxia Hui autonomous region, thus to provide scientific basis for the establishment of oral health care policies in this region.

METHODS2 628 adults in Ningxia Hui autonomous region were investigated in this study according to the criterion issued by World Health Organization on the basic methods of oral health investigation and China oral health third epidemiological survey protocol. The inspection item included gingival bleeding (bleeding on probing, BOP), dental calculus, probing depth (PD) and attachment loss (AL). SPSS 15.0 statistical software was applied to analyze the results.

RESULTS1) The positive rate of BOP sites, detection rate of calculus and PD were peaked in 36-45 and 46-59 years old, but in the > or = 60 age group rather lower. The prevalence of periodontitis and the percentage of AL > or = 4 mm sites were increased with the adults' age. 2) In addition to the percentage of AL > or = 4 mm sites, the differences of the other indicators between the genders were not statistically significant. 3) The positive rate of BOP sites, detection rate of calculus, PD, the prevalence of periodontitis and the percentage of AL > or = 4 mm sites were higher for the mountain areas than the plain areas. 4) Hui population's positive rate of BOP sites, detection rate of calculus, PD, the prevalence of periodontitis and the percentage of AL > or = 4 mm sites were significantly lower than the Han population in Ningxia.

CONCLUSIONThe periodontal health status of adults in Ningxia Hui autonomous region is associated with age, gender, nationality and region.

Objective:To explore the clinicopathologic characteristics of gastric mixed adenoneuroendocrine carcinoma (MANEC). Methods:From January 2011 to December 2016, the clinical and pathological data of 35 patients with gastric MANEC who were diagnosed and surgically treated in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. Results:The average age of the 32 men and 3 women in this study was 61.6±7.5 years. Tumor locations were as follows:17 related to gastric cardia, 9 related to gastric body, 8 related to gastric antrum, and 1 related to gastric stump. Clinical symptoms were non-specific and the diagnosis relies on post-operative pathological examination. Using the histological microscope, the affected structures were detected in neuroendocrine systems and tissue linings. Immunohistochemical staining showed that carcinoembryonic antigen (CEA) and cytokeratins 8 and 18 (CK8/18) were expressed in 32 and 33 adenocarcinoma-related cases, respectively, whereas synaptophysin (Syn) and chromogranin A (CgA) were revealed in 33 and 27 neuroendocrine-related cases, respectively. Al patients received surgical resection. A total of 17 incidents of death were reported at three years after the operation, and most of the patients were at clinical stageⅢorⅣ. Conclusion:Gastric MANEC is a rare neoplasm and is often diagnosed at its advanced stage and mainly occurs in the aged population. Neuroendocrine structures and glandular tissues are the most frequent location of such condition. Diagnosis relies on both immunohistochemical and histological examinations. Surgical resection is the most effective treatment, but the prognosis of this condition remains poor.