OBJECTIVE: To investigate the characteristics of air-conducted ocular vestibular-evoked myogenic potential(oVEMP) in patients with sudden sensorineural hearing loss (SSHL). So as to understanding the range and the degree of the vestibular system damage in patients with SSHL. METHOD: Thirty-five cases of unilateral SSHL were enrolled as the observing group from December in 2013 to December in 2014. 500 Hz air-conducted tone burst was employed as stimulation. Fifity-five healthy young subjects were recruited as the control group. The results were compared between the affected ears, the contralateral ears and the normal controls. RESULT: Thirty-five patients with SSHL, 31 of them in both ears lead to oVEMP Waveform, 4 sick ears did not elicit oVEMP waveform, extraction rate of 88%. 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in healthy ear were (11.92 ± 0.85)ms; (17.07 ± 1.04)ms, (5.15 ± 0.69)ms, (5.44 ± 2.53) µv. 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in sick ear were (12.16 ± 0.76) ms; (16.94 ± 2.57)ms, (5.16 ± 0.73)ms, (2.89 ± 1.66) v. The 55 cases (110 ears) were elicited P1-N1 complex typical, extraction rate was 100%. The threshold of oVEMP examination was (82.23 ± 2.92) dBHL, 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval, peak-to-peak P1-N1 amplitude in these healthy young people were (11.53 ± 0.80)ms, (16.61 ± 0.87) ms, (5.18 ± 1.04) ms, (5.96 ± 2.59) µv, there were no significant differences between the affected ears, the contralateral ears and the normal controls in the latencies P1 and N1, P1-N1 interval. The wave amplitude in SSHL were lower than the healthy ear and the healthy control group. CONCLUSION Through the detection of oVEMP in patients with SSHL,we observed that P1-N1 wave amplitude decreased, and it may be related to the damage of the utricle and vestibular nerve.
Case-Control Studies ; Hearing Loss, Sensorineural ; physiopathology ; Humans ; Saccule and Utricle ; pathology ; Vestibular Evoked Myogenic Potentials ; Vestibular Nerve ; pathology ; Vestibule, Labyrinth ; physiopathology

OBJECTIVE: To investigate the characteristics of air-conducted ocular vestibular-evoked myogenic potential (oVEMP) in healthy young people , so as to establish the normative data of young people. METHOD: Fifty-five healthy young subjects were recruited as study participants, 500 Hz air-conducted tone burst was used as stimulation. The threshold of oVEMP in each ear was examined. The latencies of P1 and N1, P1-N1 interval, peak-to-peak of P1-N1 amplitude and asymmetry ratio were measured. Effects of gender on oVEMPs were also exam- ined. RESULT: The typical complex wave of N1 and P1 was observed in all subjects. The threshold of oVEMP examination was(82.23 ± 12.92) dBHL, 95 dBHL air-conducted get the latencies of P1 and N1, P1-N1 interval,peak-to-peak P1-N1 amplitude in these healthy young people were(11.53 ± 0.80)ms, (16.61 ± 0.87)ms, (5.18 ± 11.04)ms, (5.96 ± 2.59)μv, respectively. The peak-to-peak P1-N1 amplitude of male was (6.49 ± 2.67) μv ,the female was (5.21 ± 2.34) μv, there were significant differences between male and female subjects in the wave amplitude (P < 0.05). CONCLUSION Air-conduction induced oVEMP is a new method for vestibular function test. The amplitude of the oVEMP wave was different between male and female. Therefore it is necessary to establish the normal value according to genders.
Acoustic Stimulation ; Eye ; Female ; Head ; Humans ; Male ; Reference Values ; Vestibular Evoked Myogenic Potentials ; Vestibular Function Tests ; Vestibule, Labyrinth ; Young Adult

OBJECTIVE: To investigate the value of spectral CT imaging in the diagnosis and classification of liver cirrhosis during the arterial phase (AP) and portal venous phase (PVP). MATERIALS AND METHODS: Thirty-eight patients with liver cirrhosis (Child-Pugh class A/B/C: n = 10/14/14), and 43 patients with healthy livers, participated in this study. The researchers used abdominal spectral CT imaging during AP and PVP. Iodine concentration, derived from the iodine-based material-decomposition image and the iodine concentration ratio (ICratio) between AP and PVP, were obtained. Statistical analyses {two-sample t test, One-factor analysis of variance, and area under the receiver operating characteristic curve (A [z])} were performed. RESULTS: The mean normalized iodine concentration (NIC) (0.5 +/- 0.12) during PVP in the control group was significantly higher than that in the study group (0.4 +/- 0.10 on average, 0.4 +/- 0.08 for Class A, 0.4 +/- 0.15 for Class B, and 0.4 +/- 0.06 for Class C) (All p < 0.05). Within the cirrhotic liver group, the mean NIC for Class C during the AP (0.1 +/- 0.05) was significantly higher than NICs for Classes A (0.1 +/- 0.06) and B (0.1 +/- 0.03) (Both p < 0.05). The ICratio in the study group (0.4 +/- 0.15), especially for Class C (0.5 +/- 0.14), was higher than that in the control group (0.3 +/- 0.15) (p < 0.05).The combination of NIC and ICratio showed high sensitivity and specificity for differentiating healthy liver from cirrhotic liver, especially in Class C cirrhotic liver. CONCLUSION: Spectral CT Provides a quantitative method with which to analyze the cirrhotic liver, and shows the potential value in the classification of liver cirrhosis.
Analysis of Variance ; Case-Control Studies ; Contrast Media/diagnostic use ; Female ; Humans ; Liver/pathology ; Liver Cirrhosis/pathology/*radiography ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Triiodobenzoic Acids/diagnostic use

Objective To investigate the significance of "merge" model versus "traditional" model in rotation training for professional clinical postgraduate students in department of gastroenterology. Methods The professional clinical postgraduate students who underwent rotation training in Qingdao Municipal Hospital from July 2012 to July 2016 were enrolled as subjects and were trained with the"merge" model and the "traditional" model, respectively. The two groups of subjects were compared in terms of clinical knowledge , skills , and core competencies . Results The postgraduates trained by the"merge" model had a significantly higher total score of clinical examinations than those trained by the"traditional" model [(92.60±2.52) vs. (83.80±3.14), t=10.93, P<0.01], while there were no significant differences in professional quality and doctor-patient communication between the two groups. Compared with those trained with the"traditional"model, the postgraduates trained by the"merge"model had significantly better understanding of clinical knowledge and clinical thinking ability, diagnosis and treatment skills, and psychological quality (χ2=27.00, 10.23, and 12.21, all P<0.01);however, there was no significant difference in clinical research ability between the two groups (χ2=1.39, P=0.24). Conclusion The model of professional clinical postgraduate training combined with standardized training of residents is superior to the traditional training model, and compared with the "traditional" model, the "merge" model is more beneficial to the training of comprehensive clinical practice abilities and thus holds promise for further application.

Sixty general practitioners of in-service training undertaking rotation in gastroenterology department of Qingdao Municipal Hospital from July 2017 to July 2019 were randomized assigned in trial group ( n=30) and control group ( n=30). The problem-oriented mode was applied in trial group and conventional mode was applied in control group for teaching of two typical digestive diseases (upper gastrointestinal bleeding and acute pancreatitis). The formative evaluation and questionnaire survey were used to compare the teaching effects and the results of evaluation were compared with χ 2 test by SPSS 17.0 between two groups. The excellent and good rates of evaluation for the clinical psychological quality, clinical reasoning ability, doctor-patient communication ability and practice-based learning and improvement ability in trial group were significantly higher than those in the control group(χ2=7.38, P=0.03; χ2=12.96, P<0.01; χ2=23.33, P<0.01; χ2=16.14, P<0.01). Questionnaire survey showed more satisfaction towards teaching method in trial group was higher than that in control group(χ2=12.86, P<0.01); and the clinical reasoning ability, learning initiative and self-confidence in trial group were improved more markedly than those in control group(χ2=8.26, P=0.02; χ2=19.48, P<0.01; χ2=21.46, P<0.01). The problem-oriented clinical thinking teaching model demonstrates good effects on clinical comprehensive ability for general practitioners of in-service training during gastroenterology rotation, which is worth further promotion.

The study was initiated from a child with diabetes. After we collected his clinical data and traced back his family history of diabetes, a clinical diagnosis of maturity-onset diabetes of the young(MODY)was made. To amplify and sequence the target gene, the genomic DNA was extracted from the anticoagulant blood samples of the patient and his first-degree relatives, revealing a missense mutation(c.779C>T)in exon 4 of hepatocyte nuclear factor-1α in the proband and his father. The above sequencing result confirms the diagnosis of MODY3. During one year follow-up, the proband achieved the strict control of blood glucose with the use of repaglinide and his father got a notable improvement of blood glucose after his drug was shifted to the long-acting sulfonylurea.

OBJECTIVE: To determine whether or not detailed cystic feature analysis on CT scans can assist in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from serous cystadenoma (SCN), mucinous cystadenoma (MCN), and a pseudocyst. MATERIALS AND METHODS: This study received Institutional Review Board approval and informed patient consent was waived. Electronic radiology and pathology databases were searched to identify patients with PDAC (n = 19), SCN (n = 26), MCN (n = 20) and a pseudocyst (n = 23) who underwent pancreatic CT imaging. The number, size, location, and contents of cysts, and the contour of the lesions were reviewed, in addition to the wall thickness, enhancement patterns, and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 82) or on a combination of cytological findings, biochemical markers, and tumor markers (n = 6). Fisher's exact test was used to analyze the results. RESULTS: A combination of the CT findings including irregular contour, multiple cysts, mural nodes, and localized thickening, had a relatively high sensitivity (74%) and specificity (75%) for differentiating PDAC from SCN, MCN, and pseudocysts (p < 0.05). Other CT findings such as location, greatest dimension, or the presence of calcification were not significantly different. CONCLUSION: The CT findings for PDAC are non-specific, but perhaps helpful for differentiation. PDAC should be included in the general differential diagnosis of pancreatic cystic neoplasms.
Adenocarcinoma/pathology/*radiography ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous/pathology/*radiography ; Cystadenoma, Mucinous/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Neoplasms/pathology/*radiography ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

Neovascular glaucoma is classified as a type of refractory glaucoma. Its pathological manifestation is the formation of neovascularization of iris and chamber angle, and then the formation of neovascularization membrane. The contraction and traction of neovascularization membrane make the iris and chamber angle adhesion close, which leads to the obstruction of aqueous humor outflow and the sharp increase of intraocular pressure. Excessive intraocular pressure not only causes severe headache and eye pain, but also damages the optic nerve and affects the patient's vision, which can lead to blindness. At present, there are many methods for the treatment of neovascular glaucoma, such as panretinal photocoagulation, anti-vascular endothelial growth factor, local or systemic administration of intraocular pressure lowering drugs and anti-glaucoma surgery. The aim is to reduce neovascularization, preserve visual function and improve symptoms as much as feasible. However, due to the complex pathogenesis and pathological changes of neovascular glaucoma, the treatment of neovascular glaucoma is more difficult than primary glaucoma, and the prognosis is worse. Understanding its pathogenesis and treatment methods can aid in selecting the most appropriate treatment strategy based on individual circumstances. Therefore, this review will summarize the pathogenesis and treatment of neovascular glaucoma.