Objective: To investigate the effect of surgical reconstruction of congenital aural atresia via tympanic antrum approach and the prevention for reatresia of the aural canal. Methods: From 1993 to 1998, 89 patients (94 ears) with congenital aural atresia were operated via tympanic antrum approach. All of them got aural canals reconstruction and tympanoplasty, including 80 ears of type Ⅱ, 11 ears of type Ⅲ and 3 ears for fenestration of inner ear. Kenacort\|A and dilator were used to prevent reastresia of the aural canals. Results: The tympanic antrums of 94 ears were encountered smoothly, and their hearings were reconstructed. The hearing improvement were found over 20dB in 80 ears (85.1%), over 25dB in 49 ears (52.1%). Kenacort\|A and dilator should be applied when the reastresia began to appear, and then the good effect could be made. Conclusion: It′s easy to master for surgical reconstruction of congenital aural atresia via tympanic antrum approach, and it also owns the characteristics of safety, save time and reliable effect. It should be managed as soon as the reastresia appears.

Objective To investigate the mechanism of contrast-induced nephropathy (CIN) caused by Iopromide.Methods Two-four female SD rats were randomly divided into two groups which were control group and CIN group .The rats in CIN group were injected Io-promide via caudal vein ,the rats in control group were injected the equal amount of solvent .After 24 hours,all the rats were euthanized and tested.The excretion of 24 h urinary protein was detected using biochemistry assay .The expression of related cell cycle regulatory protein such as P21,P27 and TGF-β1 in glomerular visceral epithelium cells were measured using immunohistochemical technique .A semiquantitative score was used to evaluate the injure degree of glomerular and tubulointerstitium .Renal glomerular cell apoptosis was evaluated by TUNEL . Results Compared with control group ,CIN group rat glomerular epithelial cells of P 21,P27 and TGF beta 1 positive expression rate signifi-cantly increased,[(12.86 ±0.98) %vs (0.46 ±0.21)%,P=0.004 5],[(21.76 ±2.75)% vs (9.57 ±1.86)%,P =0.0071], [(12.85 ±5.54) vs (7.63 ±0.84),P=0.003 7)] respectively,24 h urine protein significantly increase [(23.44 ±5.22) mg/d vs (2.13 ±0.52) mg/d,P=0.007 0,P=0.005 0],CIN pathological damage of rat glomerular epithelial cells and apoptotic rate significantly more serious [(52.5 ±6.4)%vs (4.2 ±0.3) %,P =0.007 5].In addition,the renal pathologic scores were positively correlated with the excretion of 24hr urinary protein and the expression of P 21,P27,and TGF-β1(r=0.765,0.701,0.842,0.651,P<0.01).Conclusion Io-dine amine via increased glomerular epithelial cells P 27 and TGF-beta 1expression and urinary protein excretion , aggravating pathological damage and apoptosis .

OBJECTIVE To study the prognosis factors of sudden hearing loss.METHODS The clinical data of 249 out-patients of sudden hearing loss in Department of Otolaryngology Head and Neck Surgery of Beijing Tongren Hospital during 2003 to 2006 were retrospectively studied.The clinical data included age, initial diagnosis time,average hearing level of the first pure tone audiometry,type of audiogram,with or without vertigo and distort-product otoacoustic emissions (DPOAE).RESULTS The initial diagnosis time was 1 to 23 days after the onset of the diseases.The degree of hearing loss was evaluated according to the average hearing loss on frequency 250-4000Hz of the affected ear during the first diagnosis.There were 31(90 dB)cases with profound deafness(26.70 %). There were 72 cases with rising audiogram,81 cases with falling audiogram and 96 cases with flat audiogram. There were 96 cases with vertigo and 174 cases with tinnitus.Medicines used included vasodilators,steroid, neural nutritional agents,antiviral agents,energy mixture.Treatment period was 2 to 4 weeks.DPOAE was examined on 81 patients and was presented in 45 patients whose hearing level achieved normal after treatment.CONCLUSION The old and children patients and patients with vertigo have poor prognosis. The earlier the diagnosis,the better the hearing recovered.The rising audiogram and presentation of DPOAE indicate good prognosis.

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

Objective The aim of this study was to evaluate the optimal time for decompression in a 24-hour lasting porcine model.Methods After baseline data were recorded,24 pigs were randomly allocated into three groups as follows:one SAP-alone group,and two SAP + ACS groups (decompression at 6 and 12 hours,respectively).We used a N2 pneumoperitoneum to increase the intra-abdominal pressure to 25 mmHg and retrograde intra-ductal infusion of sodium taurocholate to induce severe acute pancreatitis (SAP).Systemic hemodynamic profiles,urine output,systemic oxygenation,and serum biochemical parameters of the animals were obtained.Results After induction of ACS,the hemodynamics and oxygenation of the study animals deteriorated significantly.The survival time of the 12-hour group was significantly shortened (P =0.008 vs.6 hours).Early decompression (6 h) restored systemic hemodynamics,oxygenation,organ function,and inflammatory intensity to a level comparable to that of the SAP-alone group.In contrast,animals in 12-hour group developed more severe hemodynamic suppression,oxygenation and organ dysfunction and inflammatory process.For instance,the cardiac output levels in the three groups were 2.70 ±0.50 for the SAP group,2.75 ±0.48 for the 6 hour-group and 2.19 ±0.43 for the 12 hour-group.Conclusion Early decompression could significantly reduce the mortality in a porcine model of SAP incorporating ACS,and also improve systemic hemodynamics,organ function and inflammatory intensity.

Objective To investigate the effects of different doses of remifentanil on learning and memory ability,the expression of hippocampal tissue phosphorylation of cAMP response element binding protein (p-CREB)in developing rats.Methods A total of 72 Sprague-Dawley rats (1 9-23 g) were randomly divided into 4 groups (n =18 each):Group C:normal saline control group;R1,R2, R3 group received continuous intraperitoneal remifentanil 1,5,10 μg·kg-1 ·min-1 for 2 hours re-spectively.Both total volume of remifentanil and saline were 2 ml.The SpO 2 and pulse rates were mo-nitored during the experiment.Step-down test was used to evaluate the learning and memory ability, while Western blot analysis was performed to measure the expression of hippocampal p-CREB protein in 4 h,24 h,1 week when the rats were awake.Results Compared with group C,group R1 and R2, pulse rates of group R3 decreased significantly (P <0.05 ),but the changes of SpO 2 in each group were not statistically significant.At 4 h point:compared with group C and group R1,the error times in step-down test were increased in both group R2 and R3,the latencies were shortened (P <0.05);Compared with group R2,the error times were increased in group R3,latency was shortened (P <0.05).At 24 h point,compared with group C and group R1,the error times were increased in group R2,R3,latencies were shortened (P < 0.05 );Compared with group R2,the error times were in-creased in group R3,latency was shortened (P <0.05 ).The error times and latency of each group had not statistical significance in one week.At 4 h point,the expression of p-CREB protein in hippo-campus of group R3 downregulated compared with group C and group R1,R2,respectively (P <0.05).At 24 h point,the expression of p-CREB protein in hippocampus of group R2,R3 decreased compared with group C and group R1 respectively(P <0.05);The expression of p-CREB protein in each group had no statistical significance in one week.Conclusion 5-10 μg · kg-1 · min-1 dose of remifentanil can result in a decline of learning and memory ability in the developing rats in short-term,and the mechanism may relate to the inhibition of p-CREB protein expression in hippocampus.

Adolescent ; Adult ; Ear, Middle ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Mastoid ; diagnostic imaging ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Objective .To prove aristolochic (AA) caused vascular endothelial cells (VEC) injury via intracellular calcium overloa-ding and investigate the mechanism of calcium dobesilate antagonism. Methods Human umbilical vein endothelial cells (HUVEC) were cultured in vitro, and randomly divided into three groups: Control group, AA group, intervention group. Microscope and transmission elec-tron microscopy were used to observe changes of cell morphology and ultrastructure. ELISA method were applied to determine thrombomedu-lin (TM) in cell culture supernatant, fluorescent indicator FLuo-3/AM and intracellular calcium concentration ([Ca2+]. Results TM val-ue and average [Ca2+] i of AA group were significantly higher than that of control group (P < 0.05). Compared with the AA group, when the concentration of calcium dobesilate was 25 μM or 50 μM, TM value and average [Caz +] significantly decreased in intervention group (P < 0.05). Compared with control group, endoplasmic reticulum was pool expansion shaped, and mitochondrial cristae was absent in AA group cells. Endoplasmic reticulum and mitochondria patterns in the intervention group cells showed some improvement, compared with AA group. Conclusion AA induced VEC calcium overloading, 'I'M secretion and injury of endothelial ceils, endoplasmic reticulum and mito-chondria destruction. Dabesilate calcium could protect endoplasmic reticulum and mitochondria and reduce AA induced VEC calcium over-loading, and these could protect VEC.

OBJECTIVE: To describe the HRCT appearances of congenital inner ear malformations with cerebrospinal fluid leakage. METHOD: Conducted a retrospective case review. The subjects comprised 11 patients who were decisively confirmed by HRCT and exploratory tympanotomy. The result of temporal bone computed tomography scans (HRCT) were analyzed. RESULT: Inner ear malformations were classified into 4 types according to HRCT findings. There were 4 patients with cochlear aplasia, 2 patients with common cavity anomaly, 2 patients with IP-I anomaly, and 3 patients with IP- II anomaly. Eight patients had defects in the lamina cribrosa of the internal auditory canal. The development and aeration in the mastoid of involved ears was normal. Soft tissues were seen near the oval window in all involved ears. CONCLUSION HRCT image has an important value in the diagnosis and treatment of inner ear malformations with cerebrospinal fluid leakage.
Adolescent ; Adult ; Cerebrospinal Fluid Otorrhea ; diagnostic imaging ; Child ; Child, Preschool ; Ear, Inner ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; methods ; Young Adult

Objective:To establish a quality evaluation method for the simultaneous determination of Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin in Danqi Xinmaikang boiled powders and pieces.Methods:Quantitative analysis of multi-components was performed to determine contents of Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin with Calycosin-7-O-β-D-Glucopyranoside as the reference substance by single-maker (QAMS). The chromatogram conditions were established, with C18 column as solid phase, acetonitrile-water as flowing phase, 268 nm as detecting wavelength, 1.0 ml/min as flowing rate, 30 ℃ as column temperature, and 10 μl as injection volume.Results:The relative correction factor between Calycosin-7-O-β-D-Glucopyranoside and Lobetyolin was 1.14. There was no significant difference of measured values between the external standard method and QAMS ( P>0.05). With Calycosin-7-O-β-D-Glucopyranoside retention time of 1.00, the relative retention time of Lobetyolin was 1.51 and RSD was less than 5%. Conclusion:It is feasible and accurate to evaluate the quality of Danqi Xinmaikang boiled powders and pieces by QAMS.