Retrospective analysis of two cases of advanced carcinoma of the middle ear. Two patients underwent operation and radiotherapy. A case developed extensive necrosis in ear and neck, which finally led to lethal hemorrhage. Multiple relapse with cranial fossa invasion and extensive necrosis was found in the other case.
Aged ; Ear Neoplasms ; pathology ; radiotherapy ; surgery ; Ear, Middle ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local ; Retrospective Studies

Objective Clinical studies show that the level of C-reactive protein ( CRP ) markedly increases in the acute phase of cerebral hemorrhage .However , the correlation of the CRP level with early neurological deterioration ( END) in patients with basal ganglia hemorrhage remains unclear .This study investigated the correlation between CRP and END in basal ganglia hemorrhage . Methods This study included 142 cases of basal ganglia hemorrhage diagnosed by cranial CT between Jan 2010 and Dec 2012 .END was defined as any decrease in Canadian Stroke Scale ( CSS) score≥1 point in the first 48 hours after stroke onset .We compared the baseline data between the END and non-END patients and evaluated the correlation between CRP and END by logistic regression analy -sis. Results END was found in 31 (21.8%) of the 142 patients.Univariate analysis of the END versus non-END cases showed that hyperglycemia (29.03 vs 11.71%, P=0.018), neutrophil count ([11.8 ±1.2] vs [7.8 ±7.7] ×109/L, P=0.019), CRP (P=0.001), hematoma expansion (54.83 vs 19.81%, P=0.001), hematoma volume ([23.6 ±21.9] vs [14.8 ±12.7] mL, P=0.005), and intraventricular hemorrhage (68.75 vs 28.83%, P<0.001) were significantly associated with END .Logistic regression a-nalysis indicated that the CRP level (OR=1.072, 95%CI:1.034-1.112, P=0.001), intraventricular hemorrhage (OR=4.162, 95%CI: 1.498 -11.564, P =0.006), and hematoma expansion (OR=5.297, 95%CI:1.906-14.723, P=0.001) were correlated with END in the patients during their hospital stay .ROC analysis man-ifested the predictive value of the CRP level for END in basal ganglia hemorrhage (OR=0.812, 95%CI: 0.732 -0.891, P <0.001). Conclusion The elevated level of CRP is significantly correlated with END in patients with basal ganglia hemorrhage and therefore can be re-garded as a predictive factor for this condition .

OBJECTIVE: Through the use of the categories of auditory performance (CAP-II), the speech, spatial and qualities of hearing scale-parents' version (SSQ-P), children using hearing implants quality of life (CuHI-QoL) in patients with prelingual hearing impairment to compare the rehabilitation effect between preoperative and postoperative auditory performance, speech behavior and quality of life and at the same time to figure out dose rehabilitation effect connected to age. METHOD: Mainly used classification method to compare the audotory performance, speech behavior and quality of life of 50 patients before and after 2.5 years after the implantation. At the same time these 50 patients are divided on the basis of the age received the surgery, A group received the surgery before 6(1.0-5.9) years old and group B received the therapy after this age (6.0-10.9). Their auditory performance, speech behavior and quality of life were all evaluated. RESULT: There were statistical difference between two kinds of classification method of CAP-II. In the study of SSQ-P and CuHI-QoL, there was no statistical difference in well-being and happiness before and 3 years after the implant, also there was no statistical difference in parental stress between two age groups. In addition to the above two, the rest all have statistical significance. CONCLUSION After the implant, postoperative auditory performance, speech behavior and quality of life all had improved and the smaller the age, the better the performance.
Age Factors ; Child ; Cochlear Implantation ; Cochlear Implants ; Deafness ; therapy ; Hearing ; Hearing Tests ; Humans ; Quality of Life ; Speech

OBJECTIVE: This article evaluates the auditory and speech perception outcomes of sensorneural hearing loss with cerebral white matter abnormalities after cochlear implantation. METHOD: A retrospective analysis was performed on the cochlear implantatees with cerebral white matter abnormalities by using the categories of auditory performance and speech intelligibility rating, and compared with the non-syndrome patients with sensorineural hearing loss. Paired t-test was used for statistical analysis. RESULT: There was statistical difference between normal group and white matter changes group with sensorineural hearing loss after 6 month. No statistical difference was found after 12 month and 24 month. CONCLUSION In the short term, the cochlear implant can be performed safely in patients with white matter changes. After a formal rehabilitation training,no significant difference in auditory or language ability was found between normal group and white matter changes group with sensorineural hearing loss.
Child, Preschool ; Cochlear Implantation ; rehabilitation ; Female ; Follow-Up Studies ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Leukoencephalopathies ; complications ; Male

Objective To compare the effect of injection with botulinum toxin type A (BTX-A) before serial casting with BTX-A injection alone for the treatment of spastic equinus in children with cerebral palsy (CP).Methods Sixty patients were divided into an experimental group and a control group with 30 patients in each.Those io the experimental group received a BTX-A injection followed by serial casting,while the controls received BTX-A only.Before treatment and 1 month,3 months and 6 months after treatment,the dorsiflexion range of motion (ROM)of the ankle recorded while the knee in flexion and extension were measured,and gait was evaluated with an observational gait scale.Results Before treatment there was no significant inter-group difference in any of the 3 outcome measures.At 1 montb,3 months and 6 months after treatment,there were significant inter-group differences in all 3 measures,and also significant differences compared with before treatment in both groups.Conclusion Lower muscle tone,greater ankle mobility and better gait patterns can be promoted in CP children with spastic equinus using serial casting combined with BTX-A injection.The improvements may last longer than those after BTX-A injection alone.

BACKGROUND:Preoperative walking ability and activities are good predictors of functional recovery of patients after hip replacement. But these objective assessment tools are invalid to predict postoperative function of patients with no preoperative walking ability.
OBJECTIVE:To assess the effect of preoperative subjective physical activity questionnaire to predict the 6-month postoperative physical functioning outcomes in elder patients receiving hip arthroplasty, and to determine which aspects of patient’s characteristics influence 6-month postoperative physical activity.
METHODS:A two-center prospective audit was carried out in elder patients who underwent hip arthroplasty between November 2010 and February 2013. These patients were divided into three groups, including the group of total hip arthroplasty for fractures of the femoral neck, the group of total hip arthroplasty for osteoarthritis and the group of hemiarthroplasty for fractures of the femoral neck. Al patients had fulfil ed Longitudinal Aging Study Amsterdam-Physical Activity Questionnaire (LAPAQ) and Short Form 36 (SF-36) recal ing their physical activity at 2 weeks before the fal accident (for fractures of the femoral neck) or admission (for hip osteoarthritis). Preoperative demographic data were also col ected. Postoperative assessment regarding subjective physical activity assessment including LAPAQ and SF-36, and objective physical activity assessment including timed up and go test and six-minute walk test were evaluated at the time of 6-month postoperation.
RESULTS AND CONCLUSION:Total y 115 patients finished the study. Both preoperative LAPAQ and SF-36 can play a predictor to probe 6-month postoperative function of objective and subjective activity in patients with femoral neck fractures or hip osteoarthritis undergoing hip arthroplasty. Preoperative LAPAQ seems better than preoperative SF-36 to predict postoperative physical activity. For hip fracture patients, because preoperative objective function cannot be assessed, preoperative LAPAQ can play an effective and subjective index to predict postoperative function of objective activity, and physical functions can recover 70%-80%at 6 months postoperatively. For hip osteoarthritis patients, postoperative physical function can be increased by approximately 27%compared with before hip arthroplasty. Patient’s characteristics also affect the postoperative physical activity, and the occurrence of preoperative complications is a most important factor.

OBJECTIVE To study the diagnosis and management of epistaxis caused by traumatic pseudoaneurysm.METHODS The clinical data of 16 cases with epistaxis caused by traumatic pseudoaneurysm were retrospectively studied.There were 12 males and 4 females.Their ages ranged from 16 to 41 years with an average of 25.4 years.RESULTS All the patients were cured via digital subtraction angiogrophy(DSA) and embolization except one died.The time between the hospitalization and the DSA examinat ion was 3 to15 days.Interestingly,every patient had received anterior and posterior nasal packing one to 5 times.CONCLUSION If the anterior and posterior nasal packing were not effective to the patients with repeated and vast nasal bleeding,who had trauma history before nasal bleeding,the DSA examination should be carried out immediately to identify whether the pseudoaneurysm exists.

OBJECTIVE: To investigate how to improve the rate of clinically diagnosis of thyroid microcarcinoma. METHOD: Clinically diagnostic data of 73 cases with TMC, operated and confirmed by pathology from Jan. 2000 to Dec. 2009 were retrospective analyzed, the data were divided into A, B groups, A group (21 cases) can touch the regional lymph nodes and/or thyroid nodule with hard quality; B group(52 cases) can't touch the regional lymph nodes and/or thyroid nodule with hard quality, and the data was analyzed by statistical software. RESULT: Fifty-three cases diagnosed preoperatively and intraoperatively, the diagnosis rate was 73% (53/73). A group including 18 ca ses, diagnostic rate was 86% (18/21); B group including 35 cases, diagnostic rate was 67% (35/52); A variety of auxiliary examination and intraoperative exploration, etc, was statistically significant for improving the diagnostic rate of TMC. CONCLUSION The clinically missed diagnostic rate of TMC was high, but the physicians adequate attention, careful palpation before surgery, the corresponding auxiliary inspection measures will help improve the clinically diagnostic rate of TMC.
Adult ; Aged ; Carcinoma ; diagnosis ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; pathology ; Young Adult

OBJECTIVE: To investigate the influence of drying the ear canal by cleaning the focus of infection in the posterior tympanum in middle ear operations. METHOD: Retrospectively analyze 168 cases of middle ear operations, which were divided into two groups by whether the posterior tympanum was open or not in the operation process. Then comparing the drying ear rate. RESULT: The drying ear rate (DEC) were 81.7% (67/82) and 91.9% (79/86) in the posterior tympanum unopened and opened group, respectively. In the posterior tympanum unopened group, the DEC rate were 78.9% (30/38) and 84.1% (37/44) in 38 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum opened group, the DEC rate were 88.2% (37/42) and 94.7% (42/44) in 42 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum unopened group, the DEC rate were 81.7% (36/44) and 84.6% (34/38) in 44 cases of radical mastoidectomy and in 38 cases of tympanoplasty; compared with the posterior tympanum opened group, the DEC rate were 91.3% (42/46) and 92.5% (37/40) correspondingly. CONCLUSION In the middle ear operation, open the posterior tympanum in convention can not only have profits to clear the insidious focus of infection, but also have profits to skeletonized to lower facial ridge to the utmost limits and make the drainage of the ear canal easy and smooth. At last, the rate of DEC was raised.
Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; surgery ; Humans ; Otitis Media ; surgery ; Otitis Media, Suppurative ; surgery ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; methods

Objective To explore the role of NT-proBNP in the differentiation of acute pulmonary embolism (APE) from congestive heart failure (CHF) in patients with acute dyspnea.Methods Consecutive 260 patients aged ≥ 60 years complaining of acute dyspnea were collected between June 2010 and October 2015.The patients were divided into two groups of APE and CHF according to their diagnosis standards.The levels of NT-proBNP between the two groups were compared using t test,and receiver operating characteristic curve (ROC curve) was made to show the value of NT-proBNP in differentiation of APE from CHF.Results Patients in APE group had significantly lower median levels of NT-proBNP as compared with patients in CHF group [(2 478.8±1 473.9)ng/L vs.(5 955.4±3 180.1)ng/L,t =-12.020,P ＜ 0.01].The ROC curve of APE existence against serum levels of NT-proBNP showed an optimal cut-point of NT-proBNP of 1 518 ng/L,with specificity up to 98.8％,and the area under the ROC curve for NT-proBNP was 0.877.Conclusions NT-proBNP as a simple and bedside approach to identify APE versus CHF patients with acute dyspnea can help clinicians identify APE early and reduce the rates of misdiagnosis and missed diagnosis of APE.But the confirmative diagnosis of APE is still based on spiral CT angiography.