The cochlear dead regions are common exist in the case of moderate to profound sensorineural hearing loss. Patients with dead regions have demonstrated poor understanding of speech in noise and report less satisfaction with hearing aids than patients with no dead regions. Dead regions are assumed to occur if a hearing-impaired listener can be shown to be using off-place listening. A correctly diagnosed dead regions facilitates accurate and informed aural rehabilitation.
Cochlea ; physiopathology ; Hearing Loss, Sensorineural ; diagnosis ; rehabilitation ; Humans

Objective To evaluate the role of fibroblast growth faetor-2 (FGF-2) in neuropathic pain (NP) in rats.Methods One hundred male Sprague-Dawley rats,aged 7 weeks,weighing 200-250 g,were randomly divided into 4 groups (n=25 each): sham operation group (group S),group NP,phosphate buffer solution (PBS) group and FGF-2 antibody group (group Ab).FGF-2 antibody 18 μg (40 μl) was injected intrathecally at 1,6,9,13,16 and 20 days after operation in group Ab,while the equal volume of PBS was injected intrathecally in group PBS.Spinal nerve injury was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve.Pain behavior was assessed at 1 day before operation and at 1,4,7,14 and 21 days after operation.The paw withdrawal mechanical threshold (PWMT) was measured.The animals were then sacrificed and the lumbar segment (L4-6) of the spinal cord was obtained for determination of the contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the spinal cord.Results Compared with group S,the PWMT was significantly decreased and the contents of TNF-α and IL-6 in the spinal cord was significantly increased in groups NP,PBS and Ab (P ＜ 0.05).The PWMT was significantly higher and the contents of TNF-α and IL-6 in the spinal cord were significantly lower in group Ab than in groups NP and PBS (P ＜ 0.05).Conclusion FGF-2 is involved in the occurrence and development of NP and induction of the inflammatory response in the rat spinal cord in involved in the mechanism.

Objective To investigate the effects of different modes of one-lung ventilation (OLV) on hemodynamies in the patients undergoing thoracic operation.Methods Forty-five adult patients undergoing thoracic surgery,were randomly allocated into 3 groups based on the modes of OLV used ( n =15 each):intermittent positive pressure ventilation ( IPPV,VT 6-8 ml/kg,RR 10-14 bpm,I:E 1:2) group,IPPV + positive end-expiratory pressure (PEEP) group and IPPV + continuous positive airway pressure (CPAP) group.Double-lumen tube was inserted.Conrrect positioning was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.In group IPPV + PEEP,OLV was performed for 30 min with PEEP of 5 cm H2O and then for another 30 min with PEEP of 10 cm H2O.In group IPPV + CPAP,OLV was performed with IPPV in the lung on the ventilated side and with CPAP of 5 cm H2O in the lung on the operated side (for 1 h).MAP,HR,cardiac output (CO),cardiac index ( CI),stroke volume (SV),and stnoke volume index (SVI) were recorded before induction of anesthesia,at 10 min after intubation,at 30 min of two-lung ventilation,at 30 min and 1 h of OLV,and at the end of operation ( T1-6 ).Arterial blood samples were taken at T1,2,4-6 for blood gas analysis.The levels of blood glucose and lactate were measured.Oxygen delivery ( DO2 ) and DO2 index ( DO2I) were calculated.Results Compared with IPPV group,SV,SVI,CO,CI,DO2 and DO2I were significantly decreased at T4,5 ( P ＜ 0.05),and no significant change was found in the levels of blood glucose and lactate in group IPPV + PEEP,and no significant change was found in the parameters mentioned above in group IPPV + CPAP ( P ＞ 0.05).Compared with IPPV + PEEP group,SV,SVI,CO,CI,DO2 and DO2I were significantly increased at T4,5 ( P ＜ 0.05),and no significant change was found in the levels of blood glucose and lactate in group IPPV + CPAP ( P ＞ 0.05).Conclusion It exerts no influence on hemodynamics using OLV with IPPV in the lung on the ventilated side and with CPAP of 5 cm H2O in the lung on the operated side,however,OLV with IPPV + PEEP can result in hemodynamic fluctuation,but the degree of fluctuation is lesser and DO2 can be maintained in the patients undergoing thoracic operation.

OBJECTIVETo observe the temporal changes of basic fibroblast growth factor (FGF-2) expression in the spinal cord of a rat model of spared nerve injury (SNI) of the sciatic nerve.

METHODSA total of 100 male SD rats were randomly divided into sham-operated group and SNI group. The paw withdrawal threshold to mechanical stimulation was recorded at 1 day before and at 1, 4, 7, 14 and 28 days after the operation. The expressions of FGF-2, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the L4-6 spinal cord segments of the rats were measured at the specified time points.

RESULTSThe paw withdrawal threshold began to decline at 1 day after SNI, reached the lowest level at 7 days, and maintained a low level till 28 days (P<0.05). The expression of FGF-2 began to increase significantly on postoperative day 4, reached the peak level on day 14 and maintained the high level till day 28 (P<0.05). The rats with SNI showed significantly higher expressions of TNF-α and IL-6A in the spinal cord than those in the sham-operated group at each time point of measurement (P<0.05).

CONCLUSIONSSNI of the sciatic nerve can induce neuropathic tactile allodynia and causes up-regulation of FGF-2 and inflammatory cytokines in the spinal cord.

Animals ; Disease Models, Animal ; Fibroblast Growth Factor 2 ; metabolism ; Hyperalgesia ; Interleukin-6 ; metabolism ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; metabolism ; Sciatica ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo review the influencing factors of the early complication after carotid endarterectomy (CEA).

METHODSRetrospective analysis of clinical data of 509 cases received CEA in Xuan Wu Hospital of Capital Medical University, Liaocheng People's Hospital and Dalian Central Hospital from January 2001 to December 2011. There are 422 male patients and 72 female patients among the 494 patients, 15 patients underwent CEA by stages. The patients were between 35-84 years old,and the mean age was (64 ± 9) years. The complications within 30 days after CEA were analyzed, and find the risk factors for the major adverse events. Chi-square analysis was performed to analyze the correlation between the each variable of the basic characteristics of population, clinical features and intraoperative data and early adverse events after CEA. Logistic regression analysis was used to assess the relationship between a variety of factors and the postoperative complications within 30 days.

RESULTSTechnical complete rate of 98.6%, 7 cases of near-total occlusion patients could not been recanalized. Major complications in 30 days after CEA occurred in 20 cases (3.9%), including 6 cases of deaths (1.2%), 9 cases of cerebral infarction (1.8%) and 5 cases of cerebral hemorrhage (1.0%). Secondary complications occurred in 120 cases (23.6%). Univariate analysis showed modified Rankin scale (mRS) ≥ 3 on the incidence of early postoperative complication had significantly difference (χ² =20.517, P < 0.01), multivariate logistic regression analysis revealed that smoking (OR=2.667, 95% CI: 1.048-6.791, P=0.040) and mRS ≥ 3 (OR=8.690, 95% CI: 3.279-23.031, P=0.000) were the significant predictors of 30 days of the end event.

CONCLUSIONThe complications after CEA are uncommon, the security is proved. Smoking and mRS ≥ 3 can increase the risk of CEA.

Adult ; Aged ; Aged, 80 and over ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; complications ; Endarterectomy, Carotid ; adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Smoking ; Time Factors ; Treatment Outcome

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.
Child ; Humans ; Maxillofacial Development ; Malocclusion, Angle Class III/complications* ; Nasopharynx ; Adenoids ; Palatine Tonsil ; Mouth Breathing/etiology* ; Hypertrophy/complications* ; Mouth

OBJECTIVE: To explore the biomarkers of tinnitus in vestibular schwannoma patients using electroencephalographic (EEG) microstate technology. METHODS: The EEG and clinical data of 41 patients with vestibular schwannoma were collected. All the patients were evaluated by SAS, SDS, THI and VAS scales. The EEG acquisition time was 10-15 min, and the EEG data were preprocessed and analyzed using MATLAB and EEGLAB software package. RESULTS: Of the 41 patients with vestibular schwannoma, 29 patients had tinnitus and 12 did not have tinnitus, and their clinical parameters were comparable. The average global explanation variances of the non-tinnitus and tinnitus groups were 78.8% and 80.1%, respectively. The results of EEG microstate analysis showed that compared with those without tinnitus, the patients with tinnitus had an increased frequency (P=0.033) and contribution (P=0.028) of microstate C. Correlation analysis showed that THI scale scores of the patients were negatively correlated with the duration of microstate A (R=-0.435, P=0.018) and positively with the frequencies of microstate B (R=0.456, P=0.013) and microstate C (R=0.412, P=0.026). Syntax analysis showed that the probability of transition from microstate C to microstate B increased significantly in vestibular schwannoma patients with tinnitus (P=0.031). CONCLUSION EEG microstate features differ significantly between vestibular schwannoma patients with and without tinnitus. This abnormality in patients with tinnitus may reflect the potential abnormality in the allocation of neural resources and the transition of brain functional activity.
Humans ; Neuroma, Acoustic/complications* ; Electroencephalography ; Patients ; Probability