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 compare the number of DARPP-32 positive cells yield in the grafts based on the application of single cell suspension by neural micro-transplantation technique and by traditional cell delivery technique and to explore effects and mechanisms of different approaches.Methods Cells derived from the whole ganglionic eminence of E15 rat embryos,ubiquitously expressing Green Fluorescent Protein(GFP) were implanted into unilaterally QA-lesioned rat striatum in a single-tract with an ultra-thin glass capillary with an outer diameter of 50 μm or using traditional cannula tip with a diameter of 500 μm.Results Histological assessment at 4 months after transplantation showed that there was about two-fold DARRP-32 positive striatal-like neurons in the micro-transplantation group(TT group) than that in the traditional group(MT group).Total graft volume was similar in both groups[(2.8±0.2) mm3 vs(2.5±0.4)mm3,F =0.25,P ＞ 0.05].And DARRP-32positive plaque volume[(0.6±0.1) mm3 vs(0.6±0.2) mm3,F =0.90,P ＞ 0.05]and TH staining plaque volume[(1.0±0.1) mm3 vs(0.7±0.1)mm3,F =1.44,P ＞ 0.05]also had the same performance in both groups.Number of DARRP-32 positive cells was calculated by Abercrombie correction formula,and the result showed that the number of DARRP-32 positive cells in MT group was two-fold of that in TT group[(20.1 ×103±1.2 × 103) vs(9.8 × 103±3.2 × 103),F =8.62,P ＜ 0.05].Higher DARRP-32 positive cells in MT group indicated that grafts had a better condition of growth and development.Conclusion Micro-transplantation approach can increase the number of new born striatal-like neurons,potentially due to the enlargement of the graft-host border area intensifying the graft's exposure to host derived factors and the minimized mechanical injury.

BACKGROUND:Clinical effects and the recovery of hip function after total hip arthroplasty via different approaches are quite different.
OBJECTIVE:To observe total hip arthroplasty through lateral approach and posterolateral approach, and to evaluate the difference in hip function during 2-year fol ow-up.
METHODS:Total y 93 patients who treated with total hip arthroplasty from March 2009 to March 2012 in the Department of Orthopedics, Yangjiang Municipal Traditional Chinese Medicine Hospital were enrol ed in this study. They were randomly divided into lateral approach group (45 cases, 60 hips) and posterolateral approach group (48 cases, 60 hips).
RESULTS AND CONCLUSION:Al patients were fol owed up for averagely 2 years. No significant difference in operation time, postoperative complications, and the recovery of hip function in the middle and late phases of replacement was visible (P>0.05). However, perioperative blood loss, operative length, blood transfusion rate, postoperative hemoglobin levels, and early postoperative hip joint functional recovery were better in the posterolateral approach group than in the lateral approach group (P<0.05). In the 2 years after replacement, no significant difference in therapeutic effects was detectable between the two groups (P>0.05). Moreover, no significant difference in the incidence of adverse reactions was visible such as postoperative infection, dislocation, loosening, bone cement reaction, intraoperative fractures of proximal end of the femur and venous thromboembolism between lateral approach and posterolateral approach groups (P>0.05). Results indicated that posterolateral approach in total hip arthroplasty is helpful to early recovery, but long-term effects are similar to lateral approach.

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.

Biomedical Research ; trends ; Carcinoma, Squamous Cell ; secondary ; Head and Neck Neoplasms ; pathology ; Humans ; Neck

Objective To investigate the effect of scan table on size-specific dose estimate ( size-specific dose estimate, SSDE) in children's CT scan. Methods CT imaging data and CTDIvol of 44 children ( 15 heads, 13 chests, 16 abdomen-pelvis) who underwent Siemens SOMATOM Definition AS+ 64 row 128-slice CT scan were retrospectively collected. CTDIvol of each patient was recored, WED ( water equivalent diameter) was calculated by two different methods ( with or without table) , donated as WED-T and WED-NT, then the corresponding SSDEWED ( SSDEWED-T and SSDEWED-NT ) was calculated. And the SSDEWED-NT was used as reference to evaluate the difference between WED and SSDEWED obtained by two different methods. Results Including part of table will lead to the overestimate for WED, with mean differences of 0. 10％, 2. 82％ and 2. 54％ for head, chest and abdomen-pelvis, respectively, while SSDEWED will be underestimated by 0. 06％ ( head ) , 2. 70％ ( chest ) and 1. 59％ ( abdomen-pelvis ) . Conclusions Including par of the patient table has a certain effect on SSDEWED for children, more attention should be paid for the application of SSDEWED.

Objective To compare the effects of two different surgical methods in the treatment of female unilateral cT1N0-1a thyroid cancer and the satisfaction of incision cosmetics.Methods A retrospective analysis of the data of female patients with unilateral cT1N0-1a stage thyroid cancer in our hospital from October 2020 to September 2022 was conducted.They were divided into open group(65 cases)and oral group(55 cases)according to different surgical methods.Patients in open group were underwent traditional open thyroid surgery,and patients in oral group were underwent transoral vestibular approach laparoscopic thyroid surgery.Intraoperative conditions,postoperative complications and satisfaction degree of postoperative incision beauty between the two groups were comparded.Results The operation time was(124.40±11.59)minutes and the dissection time of the central lymph node was(26.44±5.33)minutes in the transoral group,which were longer than those in the open group[(65.91 ±11.44)minutes and(17.38±4.32)minutes,(P＜0.05)].Vancouver scar evaluation[(3.29± 0.96)points],patient scar evaluation[(8.62±1.57)points],observer scar evaluation[(6.67±1.17)points]and scar self-awareness score[(1.65±0.70)points]in the oral group were significantly lower than those in the open group[(5.29±1.20)points,(15.02±2.85)points,(19.57±2.94)points and(3.12±0.98)points,(P＜0.05)].There were no significant difference in the amount of blood loss,the amount of drainage,the number of days in hospital and the number of central lymph nodes dissection between the two groups(P＞0.05).There was no significant difference in total incidence of postoperative complications(hoarseness,cough after drinking water,postoperative bleeding,subcutaneous effusion)between oral group and open group(7.2％vs7.6％,P＞0.05).Conclusion The two surgical methods have their own advantages,the incidence of postoperative complications is low,safe and reliable,and the patients in the oral group are more satisfied with the cosmetology of the postoperative incision.In actual clinical work,the appropriate operation can be chosen according to the specific conditions of the patients.

Objective To retrospectively analyze the therapeutic effect of endoscopic ablation combined with metal stent implantationon biliary obstruction caused by unrespectable cholangiocarcinoma. Methods Fourty-seven patients with unrespectable cholangiocarcinoma were enrolled in this study ,who were treated in our department from June 2013 to June 2016. Patients in the experimental group(n = 24)underwent ERCP combined with metal stent implantation for biliary tract ablation. Patients inthe control group(n=23)underwent ERCP with simple metal stent implantation. Liver function indicators,complications,patency rate and survival rate were analyzed between the two groups. Results A total of 51 patients were satisfactorily performed the operation of metal stent implantation. One week after operation,the levels of total bilirubin(TBIL),alkaline phosphatase(ALP),gamma-glu-tamyltransferase(GGT)and alanine aminotransferase(AST)in the experimental group were much lower than those in the control group(P<0.05,respectively). After 3-month follow-up,the patency rate in the experimental group was significantly greater than that in the control group(P<0.05). The patency and survival time of patients in the experimental group were significantly higher than thosein the control group ,with 8.56 ± 1.12 vs 5.73 ± 0.81 months and 13.88±1.45 vs 9.48±1.38 months,respectively(P<0.05). No postoperative bleeding,perforation and other se-rious complications were found in all cases,8 patients with postoperative biliary tract infection and the increased blood amylase received anti-infective treatments,such as inhibition of symptomatic improvement after treatment. Conclusion The results of endoscopic radiofrequency ablation combined with metal stent implantation for the treatment of unrespectable cholangiocarcinoma were significantly better than those of simple metal stent implantation.

Objective:To construct a porcine model of ischemia with non-obstructive coronary artery (INOCA) and explore the diagnostic value of a one-stop noninvasive method including CT myocardial perfusion imaging (CT-MPI) and coronary CT angiography (CCTA).Methods:Twelve swines were divided into the experimental group (9) and the normal group (3). Coronary microvascular dysfunction (CMD) porcine model was constructed in the experimental group by inducing diabetes mellitus, chronic kidney disease, and hypercholesterolemia. Invasive coronary angiography (ICA) and functional examination were performed on all 7+3 trial swines to clarify the INOCA diagnosis after completion of the modeling. Then, CT-MPI and CCTA were performed on all individuals to explore the CT-MPI and CCTA characteristics of INOCA porcine models. CT-MPI parameters, including myocardial blood flow (MBF), and myocardial blood volume (MBV) in rest and stress conditions, and CCTA parameters, including severity of stenosis and CAD-RADS, were analyzed.Results:ICA and functional tests showed that all swines in the experimental group met the diagnostic criteria for INOCA, which meant that INOCA porcine model was constructed successfully. CCTA results confirmed that there was no obstructive coronary stenosis in all 10 swines which were examined, which was consistent with ICA findings. CT-MPI results demonstrated that the mean MBF values, as well as the mean MBV values, in the rest and stress condition of each swines in the experimental group were lower than those of the control group. In contrast to the control group, the mean MBF and MBV values of swines in the experimental group in stress condition were generally lower than those in resting condition.Conclusions:In this study, a porcine model of CMD is successfully constructed by inducing hypercholesterolemia+diabetes mellitus+chronic kidney disease. ICA and invasive functional tests show that this CMD model meet the diagnostic criteria for INOCA. It has been confirmed that one-stop CT multimodality examination including CT-MPI and CCTA can be used for the diagnosis of INOCA as a noninvasive diagnostic method.

Objective To investigate the appropriate age of primary and secondary school students for cardiopulmonary resuscitation (CPR) training.Methods A total of 437 students aged 9-15 years at 3 to 6 grade in the primary schools or 1 to 2 grade in the secondary schools were selected from 2 Yuyao primary and secondary schools by stratified random sampling between March 2017 and January 2018.The numbers of students with the age of 9,10,11,12,13,14 and 15 y were 61,62,66,64,63,63 and 58,respectively.All students received chest compression training provided by Yuyao emergency department People's Hospital according to the 2015 Cardiopulmonary Resuscitation Guidelines.The training included 30 min theoretic teaching and 6 min practice in the simulator.The quality of chest compression performed by students was assessed;the depth,rate,position and retention of chest compression were recorded.Results The mean depth of chest compression in the students aged 9-15 years was 3.8,4.1,4.6,5.1,5.2,5.6 and 5.6 cm,respectively;the accuracy rate was 24.6％(14/61),25.8％ (16/62),50.2％ (33/66),70.5％ (45/64),79.4％(50/63),88.9％(56/63) and 91.4(53/58),respectively.Compared with the students aged 9-11 years,the mean depth of chest compression was significantly increased and accuracy rate was significantly improved in the students aged 12-15 years (Compared with 9-y students,t=-8.936,-9.502,-10.640 and-11.370;x2=35.019,47.599,63.013 and 65.671;compared with 10-y students,t=-6.927,-8.179,-10.70 and-11.047;x2=24.977,35.967,50.916 and 52.727;compared with 1 1-y students,t=-3.095,-4.177,-6.785 and-6.995;x2=5.586,12.114,22.786 and 24.870;all P＜0.05).The mean rate of chest compression was 110-116/min and its accuracy rate was 86.4％-95.2％;the accuracy rate of chest compression position was 90.9％-96.8％ in all students,there were no significant differences among the 7 groups.The mean retention rate of chest compression in the 7 groups was 81.3％(122/150),67.3％(101/150),64.7％ (94/150),48.0％(72/150),48.7％(73/150),33.3％(50/150) and 27.3％(41/150),respectively.Compared with the students aged 9-11 years,the mean retention rate of chest compression was significantly decreased in the students aged 12-15 years (compared with the 9-y students,x2=36.472,35.179,70.64 and 119.92;compared with 10-y students,x2=11.483,10.728,34.682 and 72.150;compared with 11-y students,x2=6.528,5.927,25.855 and 59.11;all P＜0.05).Correlation analysis showed that the depth (r=0.96,0.89,0.91 and 0.86;P＜0.01) and retention rate (r=-0.99,-0.90,-0.93 and-0.86;all P＜0.01) of chest compression were significantly associated with the age,body weight,height and body mass index of students.Conclusion The students with an age of 12 years or more are able to effectively perform chest compression;thus,12 years and above might be the appropriate age for CPR training.