Objective To evaluate the efficacy of intratympanic steroid therapy compared with systemic ster‐oid therapy on the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with damaged glu‐cose tolerance .Methods Fifty first -diagnosed unilateral ISSNHL patients with damaged glucose tolerance were randomized devided equally to the intervention group (intratympanic steroid therapy) or the control group (systemic steroid therapy) ,all patients received conventional drug therapy simultaneously .Pure-tone hearing threshold tests were performed in all patients every 3 days after the first time ,and repeated measures anova was used to assess effects of hearing recovery accompanied with time .Results The mean hearing threshold in the control group de‐creased from 85 .4 ± 5 .6 dB to 48 .2 ± 4 .9 dB ,while in the intervention group it decreased from 84 .8 ± 5 .6 dB to 31 .7 ± 4 .6 dB .Total effective rate in the intervention group (84 .00% ,21/95) was higher than that in the control group (68 .00% ,17/25)(P<0 .05) .Conclusion The intratympanic steroid therapy is more effective than systemic steroid therapy in the treatment of ISSNHL patients with damaged glucose tolerance .

Objective: To investigate the causes and management of enteral feeding intolerance in patients with severe acute pancreatitis (SAP). Methods: The clinical data were retrospectively analyzed of 128 SAP patients who underwent enteral feeding treatment during the period from January 2006 to January 2008. Results: The rate of enteral feeding intolerance was significantly higher in the group of patients who didn' t use Flocare 800 pump, single-use enteral feeding tube and heater (10/50 or 20.0%) than that in the group of patients who used Flocare 800 pump, single-use enteral feeding tube and heater (5/78 or 6.4%). Conclusion: The possible risk factors of enteral feeding intolerance may be transfusional speed, temperature and concentration of nutritional fluid. Severity of acute pancreatitis is another important factor. Intestinal dysfunction should be noticed during the enteral nutritional support.

Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.

Objective To investigate the variation of procalcitonin(PCT) in blood and tissue level of acute pancreatitis rats and probe its significant. Methods One hundred and two male Wistar rats were randomly divided into control group ( n = 6 ), lipopolysaccharide group ( LPS, n = 24 ), acute edematous pancreatitis (AEP) group ( n = 24), acute necrotizing pancreatitis (ANP) group ( n = 24), AN P + LPS group ( n = 24). Subcutaneous injection of cerulein was used for AEP induction, while ANP model was induced by retrograde injection of sodium taurocholate into the biliary and pancreatic duct. The rats were sacrificed at 3,6, 18 and 24 hours after model induction. Pancreatic tissue was harvested and the pathological scores were assessed. Levels of PCT in serum, liver, lung, spleen, pancreas, small intestine, large intestine tissue was harvested and tissue levels of PCT were determined. Results AEP and ANP models were established successfully. At 6 h, the serum levels of PCT in control group, LPS group, AEP group, ANP group and ANP +LPS group were (0.0144 ±0.0082) ng/ml, (0. 1722 ±0.0449) ng/ml,(0.4751 ±0.0572) ng/ml, (0.7070 ±0. 1040) ng/ml and ( 1. 1960 ±0.8644) ng/ml, respectively; and the difference was statistically significant (P < 0.05 ). PCT could be detected in liver, lung, spleen, pancreas, small intestine and large intestine tissue of normal rats. PCT levels in liver and pancreas of ANP group were not statistically different, but the PCT levels in lung, spleen, and large intestine tissue significantly decreased, and the corresponding values were (5.63 ±0.62) ng/ml vs. (6.85 ±0.46) mg/ml, (4.73 ±1.27) mg/ml vs. (6.88 ±0.37) ng/ml, (1.08 ±0.52) ng/ml vs. (4.12 ± 1.02) ng/ml (P <0.01 ). However, the PCT levels in small intestine significantly increased, which were (2.51 ±0.90) ng/ml vs (0.98 ±0. 12) ng/ml (P<0. 01). Conclusions Serum PCT level was associated with the severity of AP and infection; the changes of PCT levels in different tissues may be related with the changes of organ's function.

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.

[Objective]To investigate the association between screen content and the frequency of screen exposure at the age of one and a half years and hyperactive behavior in preschool,and to explore how the association is affected by the interaction between outdoor activities and screen behaviors,which could provide theoretical basis and feasible solutions for the prevention and intervention of behavioral problems in childhoood.[Methods]The survey was conducted from June 2022 to June 2023 in Huicheng District,Huizhou (China) stratified by whole cluster sampling methods. Parents and teachers of 5648 children in 61 kindergartens were sampled for questionnaire surveys. The Conners Teacher Rating Scale (TRS) was used to investigate hyperactive behavior. A self-administered questionnaire was used to investigate basic demographic information of children,screen content,frequency of screen exposure and outdoor activities at the age of one and a half years. Multivariate logistic regression was used to explore the association between video screen behavior and hyperactive behavior and its interaction with outdoor activities by controlling for covariates such as children's age,gender,and parental education.[Results]Result showed the overall prevalence of 3.2％ for hyperactive behavior,2.1％ for conduct problems,2.1％ for hyperactivity problems,1.3％ for inattention-passivity problems,and 0.9％ for hyperactivity index. After adjusting for confounding factors,multiple logistic regression analysis showed that screen exposure of "two to four times a week" at one and a half years old was associated with an increased detection rate of hyperactive behaviors in preschool children,with an estimated ORs (95％ CI) of 1.682 (1.141,2.480). Daily screen exposure was associated with increased detection rates of hyperactive behavior,conduct problems,hyperactivity issues,inattention-passivity problems,and hyperactivity index in pre-school age. The estimated ORs (95％ CI) were 2.136 (1.218,3.746),2.321 (1.185,4.546),2.300 (1.208,4.380),2.776 (1.267,6.085) and 3.640 (1.525,8.687),respectively. But the above associations were not found in children who were engaged in daily outdoor activities at the age of one and a half years (P value for interaction<0.001). No association was found between screen content and hyperactive behavior (P>0.05).[Conclusions]Frequency of screen exposure in early childhood is significantly associated with hyperactive behavior problems in preschool,and outdoor activities could weaken the correlation between high-frequency screen exposure and hyperactive behavior,suggesting that parents and schools should prioritize scientifically guiding children's video viewing behavior and outdoor activities,ensuring a well-arranged daily life,to lay a good foundation for the healthy development of children's behavior.

Objective: To explore the relationship between different serum albumin and lymphocyte levels in patients with 2019-novel coronavirus (2019-nCoV) pneumonia (COVID-19). Methods: A retrospective study was performed to identify the characteristics of the clinical data of 205 COVID-19 patients who were hospitalized in the Happy Street of Hanchuan People's Hospital, Xiaogan, Hubei Province from January 24 to February 12, 2020, including their general information, serum albumin (ALB) levels, lymphocyte counts (LYM), percentage of lymphocytes (LYM%) and other laboratory parameter levels. Low ALB group and normal ALB group were demarcated by the concentration of 35g/L, further to identify the differences of LYM and LYM% levels and the incidence of LYM and LYM% decline at different ALB levels between groups,as well as the correlation between ALB and LYM, LYM% levels in hypoalbuminemia conditions . Results: 17.5% of COVID-19 patients were associated with hypoalbuminemia. The levels of LYM and LYM% in the low ALB group were significantly lower than those in the normal ALB group (P <0.001). The incidence of LYM and LYM% decline in the low ALB group was significantly higher than those in the normal ALB group (P <0.001). The levels of LYM and LYM% in the low ALB group were significantly positively correlated with serum ALB concentrations (P <0.05). Conclusions The decrease of lymphocyte levels in COVID-19 patients may be correlated to hypoalbuminemia. COVID-19 patients complicated by hypoalbuminemia should be actively intervened to maintain serum albumin in the normal range.