Objective: To investigate the effect of surgical reconstruction of congenital aural atresia via tympanic antrum approach and the prevention for reatresia of the aural canal. Methods: From 1993 to 1998, 89 patients (94 ears) with congenital aural atresia were operated via tympanic antrum approach. All of them got aural canals reconstruction and tympanoplasty, including 80 ears of type Ⅱ, 11 ears of type Ⅲ and 3 ears for fenestration of inner ear. Kenacort\|A and dilator were used to prevent reastresia of the aural canals. Results: The tympanic antrums of 94 ears were encountered smoothly, and their hearings were reconstructed. The hearing improvement were found over 20dB in 80 ears (85.1%), over 25dB in 49 ears (52.1%). Kenacort\|A and dilator should be applied when the reastresia began to appear, and then the good effect could be made. Conclusion: It′s easy to master for surgical reconstruction of congenital aural atresia via tympanic antrum approach, and it also owns the characteristics of safety, save time and reliable effect. It should be managed as soon as the reastresia appears.

OBJECTIVE To study the effect of age on tympanoplasty. METHODS The preoperative pure tone hearing threshold was 55dB in the aged group and 39 dB in the medium aged group. All patients, includ-ing 24 with chronic suppurative otitis media, 29 with cholesteatoma otitis media and 27 with chronic silent otitis media and/or tympanosclerosis, underwent radi-cal mastoidectomy and tympanoplasty (typeⅠfor 25 ears, modified type Ⅱfor 23 ears and modified type Ⅲ for 32 ears) under general anesthesia. RESULTS The average air-conductive hearing threshold was 46dB in the aged group (healing rate was 67 %) and 33dB in the medium aged group (healing rate was 70 %). With aging, the average air-conductive hearing threshold in-creased (P

OBJECTIVE To establish secretory otitis media(SOM) model induced by endotoxin and evaluate its reliability. METHODS Healthy 50 Sprague-Dawley rats of either sex( 250-300g)were randomly divided into experimental group(ET group) and control group(NS group),with 30 and 20 rats respectively. 35ul volume of 1mg/ml endotoxin from Pseudomonas aeruginosa and same amount of saline(NS) were transbullaly injected into the right tympanic bullas of the two groups. Six rats of ET group and four rats of NS group were killed postoperative on 6h,1d,3d,7d,14d respectively. The temporal bones were harvested for histological study. The left tympanic bullas served as control. Another four rats(each group 2 rats) were used for SEM study with the same method. One rat was killed and harvested for SEM observation of mucocilliary transporting system on the tympanic ostium of Eustachian tube. RESULTS ①LM(light microscope):The epithelial layer and subepithelial space(SES) were thicked mildly in ET group at 6 hours,and more heavily at 1 day with inflammatory cells infiltration (mostly polymorphonuclear leukocytes,PMNs). At 3 days,the same changes were observed most severely. By 14 days,the mucosal lining returned to normal. No obvious changes were observed in the NS group. ②SEM(scan electrical microscope):In ET group,the impairment of mucociliary transport system such as lodging,shedding of cilias were observed at 3 days and returned to normal at 14 days. No abnormal changes were observed in NS group. CONCLUSION Endotoxin can induce SOM with inflammatory changes peak at day 3 and return to normal by day 14.

目的调查特勤疗养人员社会适应的特点。方法以症状自评量表（SCL-90）中与社会适应有关的3个因子（人际关系、敌对、偏执）对558名特勤疗养人员进行测评。结果特勤疗养人员3个因子有阳性症状的百分比为人际关系7.2%、敌对9.3%、偏执6.5%；特勤疗养员的得分明显低于军人常模和地方常模（P<0.01）；海勤疗养员在人际关系、敌对因子上明显高于空勤疗养员（P<0.01），偏执因子无显著性差异（P>0.05）。结论特勤疗养员的社会适应状况良好。

Objective To investigated the effects of IL -18 on middle ear allergic inflammation in rat model of OME .Methods Eighteen SD rats were randomly divided into three group :group A(control group ,n=12 ears) , group B (OME model group ,n=12 ears) ,group C (IL -18 injectiion group ,n=12 ears) .The rat model of OME was established by sensitizing with ovalbumin (OVA) and later challenging in tympanic bullae .Recombinant rat IL-18 (1 μg ,+0 .2 ml saline ,) were injected in group C at 1 ,2 ,7 ,8 ,15 ,16 day .At the same time sacle ,0 .2 ml sa-line ,instead of IL -18 ,were intraperitoneal injection in group A and B .The morphologic changes of the middle ear epithelial cells and inflammatory cells infiltration were observed under light microscope .The level of IFN -γand IL-4 in tympanic lavage fluid(TLF) were determined by ELISA .Results Pathological examination showed that middle ear mucosa inflammation and eosinophil infiltration in group C were no less severe than group B .The numbers of neutrophils in group C increased significantly compraring with group B (P<0 .05) .Numbers of eosinophils in group C were slightly increased comparing with group B (P>0 .05) ,while significantly greater than that in group A (P<0 .05) .ELISA showed that the level of IFN -γ in group C was stronger than that in group B and A (both P<0 .05) .As compared to the group A ,the expression of IL -4 in group B and group C were remarkably stronger (both P<0 .05) ,no significant difference was found between group B and group C (P>0 .05) .Addtionally ,there was no significant difference in the ratio of Th1 /Th2(IFN -γ/IL -4)between group B and group C (P>0 .05) . Conclusion IL -18 acts as an immune regulatory factors ,significantly increases Th1 cytokine IFN -γ.Although to some extent alleviate the OME rat middle ear Th1 /Th2 imbalance ,there is still excessive activation of Th cells . Th1 and Th2 cells factor are excessive for the secretion disorder of the immune response status .The OME rat mid-dle ear allergic inflammation has not been fundamentally alleviated ,the underlying mechamism should be further studied .

OBJECTIVETo study the role of interleukin 17 (IL-17) in the pathogenesis of chronic otitis media with effusion (COME).METHODSThe expression of IL-17 in middle ear effusion (MEE) and blood plasma were measured in 30 patients (48 ears) by means of Cytometric Bead Array (CBA), as well as in 20 normal volunteers.RESULTSCompared with the control group, the level of IL-17 significantly increased in the peripheral blood of COME patients (P<0.05). What was more, the level of IL-17 in the MEE was higher than that in peripheral blood of COME patients (P<0.05).CONCLUSIONIL-17, as an important immunoregulatory mediator, may play an important role in chronic course of COME.

Objective To develop a scale of social adaptation degrees of special service personnel (referred to as scale) applying Traditional Chinese Medicine and psychological theory and to assess its reliability and validity. Methods By literature review, job analysis, inventory survey, topics interview, this scale was determined in dimensions, items and items pool based on theoretical model. Results After specialist important analysis and combining the different results of statistical analysis, including Cronbach's α coefficient, resolution factor, correlation analysis and confirmatory factor analysis, 6 dimensions, 14 factors and 40 items were finally kept in the scale. The dimensions were psychological characteristics, physical condition, intelligence level, interpersonal relationships, environmental factors and moral character. The factors were self-control, self-esteem character bias, self-confidence, physiological function, learning intelligence, creating intelligence, leadership intelligence, gregariousness, cooperative, confidence feeling, natural environment, social environment and moral character. Conclusion This scale was made on the basis of general international principle, it had good reliability and validity meeting measurement standard of traditional Chinese medicine and psychological theory, and it is an effective and practical evaluation tool of social adaptation degrees of special service personnel.

OBJECTIVE: To evaluate the hearing results and the effects of the prognostic factors following myringoplasty. METHOD: Retrospective cohort 165 inpatients (175 ears) with preoperative conductive hearing loss were analyzed using multiple linear regression statistical analysis. They have undergone sandwich temporalis fascia myringoplasty between January 1999 and November 2003. Patients have been followed-up for more than 2 years. RESULT: The average air-bone gap improvement for all 175 myringoplasty procedures was 7.1 dBHL. Multiple linear regression statistical analysis was subsequently carried out on these prognostic factors on hearing outcomes and yielded the following relative importance of the predictive is as follows: mean preoperative air conduction threshold, duration of dry ear, duration of disease, age. There is a strong correlation between subjective audition and pure tone threshold audiometry. CONCLUSION A relatively better preoperative hearing, a relatively longer duration of dry ear, a relatively shorter duration of disease and a relatively younger age were found to be significant prognostic factors influencing the postoperative air-bone gap improvement of myringoplasty. Subjective audition improvement coupled with objective pure tone threshold audiometric improvement.
Adolescent ; Adult ; Audiometry, Pure-Tone ; Child ; Female ; Hearing ; Hearing Loss, Conductive ; surgery ; Humans ; Male ; Middle Aged ; Myringoplasty ; Regression Analysis ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE Congenital aural atresia repair is difficult owing to unpredictable anatomy. Benefits may be gained from image-guided surgery(IGS) . its exact role and surgery indication were def ined. METHODS From 2001 to 2004,36 ears with bony type C(Schuknecht classification) congenital atresia were performed. In the IGS group(n=18) ,repair surgery was performed with IGS,while in the control group(Non-IGS,n=18) ,similar intervention was applied without IGS. IGS group:aged from 12-29 years,follow-up from 6 months to 1 year. Non-IGS group:aged from 10-27 years,follow-up from 6 months to 3 years. Intra-and post-operative clinical and audiometric findings were compared. RESULTS All of the patients had congenital bony aural atresia,ossicles malformation,tympanic cavity hypoplasia and facial nerve malformation. IGS revealed a malformed horizontal semicircular canal hidden in the bony atresia plate during the operation while computed tomography(CT) did not show preoperatively. IGS computed tomography images correlated well with intra-operative findings,gave the surgeon more securityand reduced operative time(2 hours and 24 minutes) by 25 minutes. The prepare time increased 20 minutes(15-30 minutes) ,but total time decreased 5 minutes in IGS group. The registration accuracy was 0.6-1.3 mm,average 0.84 mm,which was suitable for the otologic surgery. There were 1 case in IGS group and 3 cases in Non-IGS group happened local aural restenosis after operation. But there were no facial nerve paralysis and hearing injury happened in both groups,and all of the patients got the satisfactory hearing after the hearing reconstruction(the air-bone gap with an average of IGS is 31.8dB,Non-IGS is 30.5dB) . CONCLUSION In our estimation,IGS is valuable for type C congenital aural atresia repair. It serves as an educational tool and a guide both for the experienced and inexperienced surgeons in critical situations where anatomical landmarks are distorted and approach is limited. There is no statistically significant between two groups on hearing improvement after operation.

OBJECTIVE: To describe the HRCT appearances of congenital inner ear malformations with cerebrospinal fluid leakage. METHOD: Conducted a retrospective case review. The subjects comprised 11 patients who were decisively confirmed by HRCT and exploratory tympanotomy. The result of temporal bone computed tomography scans (HRCT) were analyzed. RESULT: Inner ear malformations were classified into 4 types according to HRCT findings. There were 4 patients with cochlear aplasia, 2 patients with common cavity anomaly, 2 patients with IP-I anomaly, and 3 patients with IP- II anomaly. Eight patients had defects in the lamina cribrosa of the internal auditory canal. The development and aeration in the mastoid of involved ears was normal. Soft tissues were seen near the oval window in all involved ears. CONCLUSION HRCT image has an important value in the diagnosis and treatment of inner ear malformations with cerebrospinal fluid leakage.
Adolescent ; Adult ; Cerebrospinal Fluid Otorrhea ; diagnostic imaging ; Child ; Child, Preschool ; Ear, Inner ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; methods ; Young Adult