0.05). Conclusion The noise induced by otologic drill did not show the effect that could damage the inner ears and led to the deterioration of the inner ear function.

OBJECTIVE To describe the surgical experience in the repair of cerebrospinal fluid (CSF)rhinorrhea treated by endoscopic transnasal approaches. METHODS From Oct. 2003 to Dec. 2008, 38 patients with CSF rhinorrhea were treated. Endoscopic endonasal approaches and surgical techniques in repair of CSF leaks were reviewed in a series of 38 patients included 21 patients with traumatic CSF leakage, 10 patients with spontaneous CSF leakage, and 7 patients with other reasons. RESULTS Followup of 6 months to 3 years after operation, successful rate at first attempt was 92.1%. Two patients needed a second surgical repair and one patient a third surgical repair. The complications included meningitis and acute obstructive hydrocephalus in two patients respectively. CONCLUSION The endoscopic endonasal approaches is the first choice for repair of CSF leakage for its minimal invasive injury and high successful rate. Leakage site identification, site preparation, accurate graft placement and postoperative management are critical to the success of operation.

Adult ; Colloids ; therapeutic use ; Epistaxis ; etiology ; therapy ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Perioperative Period ; Tissue Adhesives ; therapeutic use ; Treatment Outcome

Objective:To evaluate the psychological pain of patients with head and neck cancer aged ≥60 years old before and after intensity-modulated radiotherapy (IMRT).Methods:Distress Thermometer (DT)(Chinese version) was used to investigate the degree and problems of psychological pain before and after IMRT for 85 elderly patients with head and neck cancer. The results before and after IMRT were compared by paired t-test. Relevant factors were identified by Logistic regression analysis. Results:The median age in the cohort was 66 years old (60-85 years old). The incidence rates of psychological pain were 73% and 87% before and after IMRT ( P<0.001). The corresponding incidence rates of severe distress were 6% and 34%( P<0.001). The main distress problems before IMRT were memory loss/attention deficit, worry, oral pain, economic problems, stress, sleep problems, and dry nose. The significantly-increased distress problems after IMRT were oral pain, constipation, eating, nausea, and dry nose. Logistic regression analysis showed gender ( OR=5.520, 95% CI 1.437-21.212, P=0.013), pre-treatment PG-SGA score ( OR=1.220, 95% CI 1.048-1.421, P=0.010) and medical insurance ( OR=0.230, 95% CI 0.053-0.995, P=0.049) were the relevant factors of the severe psychological distress before IMRT. Occupation ( OR=2.286, 95% CI 1.291-4.050, P=0.005) and medical insurance ( OR=0.089, 95% CI 0.029-0.276, P<0.001) were the relevant factors of severe psychological distress after IMRT. Conclusion:The incidence rate of distress is high in elderly patients with head and neck cancer before IMRT, which can be aggravated after IMRT, primarily the treatment-related physical pain problems.

Objective To investigate the characteristics of distortion products otoacoustic emission (DPOAE) in hepatitis B carriers and chronic hepatitis B patients with normal pure tone results .Methods DPOAE was detected in 29 hepatitis B carriers (58 ears) ,30 chronic hepatitis B patients (60 ears)and 30 normal controls .The three groups had normal pure tone results .The detection rate and amplitude difference of DPOAE at 553～6250 Hz were compared between the two groups .Results The incidence of the DPOAE in HBV carriers for all the frequencies was higher than that in the chronic hepatitis B group ,but there was no significant difference (P>0 .05) .The level of the DPOAE in HBV carriers for all the frequencies was higher than that in chronic hepatitis B group ,and there were significant differences at 1105 ,1560 ,2211 ,3125 ,4416 ,6250 Hz (P<0 .05) ,and at 1560 ,2211 ,6250 Hz(P<0 .01) ,except at 553 ,783 Hz (P>0 .05) .Conclusion There is a potential loss of cochlear functions in the chronic hepatitis B group compared with the HBV carrying group .We suspect that the progress of liver disease is related to the potential hearing loss .

ObjectiveA high-risk group of diabetes in a community in Shanghai was followed up for 2 years. The level of blood glucose control was monitored， the incidence and risk factors of the high-risk group were analyzed， and the incidence and risk factors distribution in the community were studied. The results will provide a basis for the community to formulate strategies for early prevention and treatment of diabetes in Shanghai. MethodsA total of 580 subjects were collected， according to the criteria of high-risk groups of diabetes. Among them， 77 people whose blood glucose had reached the diagnostic criteria for diabetes entered the patient group， and the rest 503 people entered the high-risk group. Corresponding intervention methods such as outpatient follow-up and health education were given， and blood glucose monitoring was repeated at the 12th month and 24th month after enrollment. Blood glucose control， new-onset diabetes and the effect of intervention were analyzed. ResultsThe patients’ venous fasting blood glucose level at the 12th and 24th month was significantly lower than that at the baseline survey， and there was no significant change in body mass index （BMI） and waist circumference. Subjects in patient group were older and had a higher proportion of a history of impaired glycemic regulation， family history of diabetes， hypertension， and hyperlipidemia than those in high-risk group. In the high-risk group of 503 cases， 74 （14.7%） were new-onset diabetics during the follow-up period， A higher proportion of new-onset diabetics were male， BMI， a combined history of impaired glucose regulation and gestational diabetes history of gestational diabetes mellitus （women only） was a contributing factor to the onset of diabetes. ConclusionHigh-risk groups are more susceptible to diabetes； patients in the diabetes group have better control of fasting blood glucose levels during the 2-year follow-up period， and outpatient follow-up combined with comprehensive interventions helps diabetic patients to control blood glucose.