Objective:Aural fullness（AF） is one of the common symptoms in ENT outpatient department, the incidence is about 1.4%. Some patients have an unknown etiology and are diagnosed as idiopathic ear congestion. In this paper, the therapeutic effect of gabapentin on some patients with idiopathic ear congestion was studied. Methods:Forty-eight cases of patients with ear distress as the main complaint between January 2024 and September 2024 were examined by questionnaire, specialist physical examination, pure tone audiometry and acoustic impedance. Among them, 19 cases were diagnosed with definite etiology, 29 cases were diagnosed with idiopathic ear congestion, and 7 cases were lost to follow-up in the idiopathic ear congestion group. Twenty-two patients were divided into the administration group（12 cases receiving regular gabapentin treatment for 3-6 weeks） and the control group（10 cases receiving no medication） based on whether they received gabapentin to explore the effect of ear congestion and possible related factors. Results:Among the 12 patients in the medication group, 2 cases of aural fullness disappeared completely, 9 cases had different degrees of relief, and 1 case had no relief Among the 10 patients in the control group, 2 patients' aural fullness disappeared, 1 patient consciously relieved, and the remaining 7 patients had no significant change in ear boredom. According to the Wong-baker Facial expression Scale, the score of ear tightness decreased from 2.83 before medication to 1.51 after medication in the medication group. The remission rate of ear congestion in the medication group was significantly higher than that in the control group（P=0.004）. Conclusion:Gabapentin can be used to treat idiopathic aural fullness, which can reduce the symptoms effectively. This suggests that the occurrence of idiopathic aural fullness may be related to neuralgia and central sensitization.
Humans ; Gabapentin/therapeutic use* ; Amines/therapeutic use* ; gamma-Aminobutyric Acid/therapeutic use* ; Female ; Male ; Cyclohexanecarboxylic Acids/therapeutic use* ; Ear Diseases/drug therapy* ; Middle Aged ; Adult ; Aged

Objective:To analyze the clinical characteristics and prognostic factors of patients with acute low-frequency hearing loss（ALHL） and explore the potential role of migraine in its pathogenesis. Methods:A total of 56 ALHL patients treated at our outpatient clinic from June 2024 to January 2025 were randomly divided into two groups: a standardized treatment group and an anti-migraine treatment group. The standardized group received oral/intravenous steroids + oral/intravenous Ginkgo biloba extract, while the anti-migraine group received postauricular steroid injection/oral steroids + oral flunarizine for 2 weeks. Audiological, clinical, and psychological characteristics were collected, and statistical analysis was performed to assess clinical features and treatment outcomes, exploring the potential mechanism of migraine in ALHL. Results:The anti-migraine treatment group showed a significantly higher recovery rate than the standardized treatment group（92.86% vs 71.43%, P=0.036）. Among the anti-migraine group, 6 patients（21.43%） had a history of ALHL, 13（46.43%） had a confirmed migraine history, 26（92.86%） had anxiety, 26（92.86%） had depression, 5（17.86%） had irritable bowel syndrome, 21（75.00%） had sleep disorders, and 1（3.57%） experienced recurrence within 6 months. Conclusion:Anti-migraine therapy significantly improves the recovery rate in ALHL patients, suggesting that migraine may have a certain correlation with the pathogenesis of acute low-frequency hearing loss.
Humans ; Migraine Disorders/complications* ; Ginkgo biloba ; Male ; Female ; Flunarizine/therapeutic use* ; Plant Extracts/therapeutic use* ; Adult ; Treatment Outcome ; Middle Aged ; Ginkgo Extract

Objective:To investigate the peripheral blood inflammatory markers including white blood cell count (WBC), monocytes, neutrophils, lymphocytes, platelets, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), high-density lipoprotein(HDL-C), low-density lipoprotein and fibrinogen (FIB) in Ménière′s disease (MD) patients with and without migraine, and to explore the relationship between the inflammatory response with MD and migraine.Methods:The general physical condition, clinical manifestations, pure-tone audiometry, and peripheral blood inflammatory markers of 92 unilateral MD patients who were hospitalized in Peking University People′s Hospital for surgical treatment from January 2017 to January 2021 were continuously collected. Meanwhile, 50 healthy controls matched with age and sex were included, and their general physical conditions and peripheral blood inflammatory markers were also collected. This study consisted of two parts. First, the differences in epidemical characteristics and peripheral blood inflammatory markers between MD patients and healthy controls were compared by univariate analysis. Second, all 92 MD patients were divided into two subgroups according to whether they were accompanied by migraine. The clinical characteristics and peripheral blood inflammatory markers of MD patients with and without migraine were compared by univariate analysis. Thereafter, binary Logistic regression was used to analyze the related factors of whether MD patients were accompanied with migraine.Results:Compared with the healthy control group, the peripheral blood WBC, neutrophils and FIB of MD patients were significantly increased (all P<0.05). Compared with MD patients without migraine, MD patients with migraine had higher female prevalence, longer disease history, lower low-frequency hearing threshold, higher frequency of vertigo attacks and higher HDL-C levels (all P<0.05), meanwhile, female, frequency of vestibular attacks and HDL-C were independent related factors of whether MD patients were accompanied with migraine. Conclusion:The occurrence of MD and migraine may be related to the inflammatory response. The level of anti-inflammatory factors in the blood of MD patients with migraine are higher, suggesting that the inflammatory response status of MD patients with and without migraine is different.

Objective:To evaluate the effect of hydrogen on lung injury induced by extremity ischemia-reperfusion (I/R) in elderly patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-75 yr, with height 155-180 cm, weighing 50-75 kg, undergoing lower limb surgery under spinal anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: hydrogen inhalation group (H group) and control group (C group). In H group, 67% hydrogen-33% oxygen was inhaled through the nasal catheter until the end of surgery starting from the completion of anesthesia.In group C, 33% oxygen was inhaled through the nasal catheter until the end of surgery after the completion of anesthesia.Blood samples from the radial artery were collected before anesthesia and at 60 min after tourniquet deflation.Blood gas analysis was performed to determine and record arterial oxygen partial pressure (PaO 2) and arterial carbon dioxide partial pressure (PaCO 2), and alveolar-arterial partial pressure of oxygen difference (A-aDO 2), oxygenation index (OI) and respiratory index (RI) were calculated.Pulmonary surfactant protein D (SP-D) and interleukin-6 (IL-6) concentrations in serum were measured by enzyme-linked immuno sorbent assay.ICU stay time and incidence of pulmonary complications within 7 days after operation were recorded. Results:Compared with group C, PaO 2 and OI were significantly increased, RI and A-aDO 2 were decreased, SP-D and IL-6 concentrations in serum were decreased at 60 min after tourniquet deflation, and ICU stay time was shortened ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group H ( P>0.05). Conclusion:Hydrogen can reduce the lung injury induced by extremity I/R, and the mechanism may be related to the reduction of inflammatory response in elderly patients.

Objective:To evaluate the effect of hydrogen on the occurrence of pulmonary complications after thoracoscopic radical resection of lung cancer.Methods:One hundred and ten patients of both sexes, aged 45-75 yr, with body mass index of 18-23 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=55 each) using the random number table method: hydrogen group (group H) and control group (group C). Patients inhaled 66.7% hydrogen for 60 min before anesthesia in group H, while 33% oxygen was inhaled for 60 min in group C. Blood samples were collected from the radial artery at 5 min before one-lung ventilation (T 0) and 1 h of one-lung ventilation (T 1) for blood gas analysis and for determination of peak airway pressure, airway plateau pressure, driving pressure and dynamic lung compliance.Oxygenation index was calculated.Bronchoalveolar lavage fluid on the ventilated side was collected at T 0 and T 1 for measurment of interleukin-6 concentrations by enzyme-linked immunosorbent assay.The incidence of pulmonary complications within 7 days after surgery was recorded. Results:Compared with group C, the oxygenation index and dynamic lung compliance were significantly increased, and the peak airway pressure, airway plateau pressure, driving pressure, interleukin-6 concentrations in bronchoalveolar lavage fluid, and incidence of pulmonary complications within 7 days after surgery were decreased in group H ( P<0.05). Conclusion:Hydrogen can decrease the occurrence of pulmonary complications, and the mechanism is related to reducing lung inflammatory responses and improving lung compliance in the patients undergoing thoracoscopic radical resection of lung cancer.

Lymphomas are traditionally divided into Hodgkin's lymphoma and non-Hodgkin's lymphoma(NHL), the NHL is a common hematological cancer, which represents a wide spectrum of illnesses from the most indolent to the most aggressive malignancies, and the detection of related molecular targets will be needed for diagosing each subtype of NHL. Advances in understanding the pathogenesis of NHL have improved the precision of diagnosis and the prognosis evaluation of patients with this disorder, such as chromosomal translocation leading to the up-regulation of oncogene expression. Besides, the deletion of several tumor suppressor genes may cause excessive proliferation in tumor cells, and the single nucleotide polymorphism (SNP) determines the differences of susceptibility, drug-resistance and prognosis of NHL. In addition, DNA methylation, histone modification, non-coding RNA and other epigenetic phenomena play an increasingly important role in the diagnosis, selection of clinical drugs and evaluation of prognosis of NHL. In this review, the recent progress of researches on chromosome translocation, deletion of tumor suppression genes, gene poly-morphism and epigenetics are summarized.
DNA Methylation ; Epigenesis, Genetic ; Humans ; Lymphoma, Non-Hodgkin ; Prognosis

Objective: To investigate the correlation between age-related hearing loss and cognitive impairment. Methods: 201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. Results: Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). Conclusions Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

Objective: To study the relationship between the average hearing of different frequencies and the audiometry staging in patients with Meniere′s disease. Methods: A total of 259 patients from 1996 to 2016 were collected .All patients underwent pure tone audiometry, of which 93 patients underwent 3 000 Hz audiometry. The patients were divided into five groups according to the frequencies of hearing(Ⅰ: 500, 1 000, 2 000, 3 000 Hz; Ⅱ: 250, 500, 1 000, 2 000, 3 000 Hz; Ⅲ: 250, 500, 1 000, 2 000; Ⅳ: 500, 1 000, 2 000, 4 000 Hz; Ⅴ: 500, 1 000, 2 000 Hz), then calculated the average audiometry and made the hearing staging. The obtained data were analyzed by chi-square test and Bonferroni correction was performed among the groups, P<0.05 was defined as a statistically significant criterion. Result: There were no significant difference between the five groups(P=0.441>0.05). Conclusions The choice of different pure tone audiometry frequency has no significant effect on the hearing staging. It would be more likely upstaging when plus 250 Hz. There is no statistically significant difference in staging between the latest guidelines and the 1995 guidelines.500, 1 000 and 2 000 Hz are recommended when 3 000 Hz examine is not available.

Objective To investigate the possible pathway of FITC-dextran to the cochlea after post-aural injection.Methods The FITC-dextran(weight between 3 000~5 000) was chosen as a tracer in this study.A total of 200 suckling mice were randomly divided into four groups, with 50 in each group.Each animal was then administered with FITC-dextran or dextran via either post-auricular or intra-muscular injection, to a total dose of 20 μl (5 mg/ml).Samples were obtained at 0, 1/12, 1/4, 1/2, 1, 3, 5, 7, 12, and 24 hours after adminstmiceion, and the confocal technique was used to observe the distribution of the tracer.Taking into consideration the influence of spontaneous fluorescence, the fluorescence intensity ratio of the experimental and control groups was used as the final statistical data.Results FITC-dextran injected intramuscularly group: The fluorescence signal can be detected in the sigmoid sinus(SS) 3h after management, while in endolymphatic sac and cochlea at 12 h.FITC-dextran injected post-aurally group: After administration, an obvious fluorescence signal could be observed in the sigmoid sinus and endolymphatic sac immediately, cochlea at 30 min.The signal of the sigmoid sinus, endolymphatic sac and cochlea gradually increased successively, peaked at 5~15 min, 30 min and 60 min, and then decreased gradually.At 12 h, another small increases appeared, and the signal could not be detected at 24 h.Conclusion Compared with intramuscularly application, post-auricular injection can allow the drug to directly reach the endolymph.It is possible that the tracer first gathered in the SS via local blood circulation or infiltration, then entered the ES via micro-circulation around, and eventually arrived at the cochlea.

OBJECTIVEThe objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux.

METHODSThis was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group (36 patients) and positive group (40 patients) by the score of RSI (reflux symptom index) and RFI (reflux findings index) scale. The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed.

RESULTSThe smoking rate of 80.6% (25/31) in laryngeal carcinoma group was significantly higher than that of (36.1%, P < 0.0167) in the negative group while it did not vary in laryngeal carcinoma group and the positive group (65.0%, P > 0.0167). The drinking rate of 71.0% (22/31) in laryngeal carcinoma group was higher than that of (36.1%, P < 0.0167) in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group (50.0%, P > 0.0167). The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group, the positive group, the negative group were 74.2% (23/31), 16.7% (6/36) and 52.5% (21/40) respectively, which was significantly different (P < 0.05). The positive rate of gastroesophageal reflux in the three groups above were 71.0% (22/31), 52.8% (19/36) and 75.0% (30/40), which had no significant difference (P > 0.05). The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group (P < 0.0167) while did not differ in laryngeal carcinoma group and the positive group (P > 0.0167). In the results of 24-hour ambulatory double pH monitoring, there was significant difference in the total and upright reflux number, the total reflux time, the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and DeMeester Scores.

CONCLUSIONSThe positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high. Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma, it needs further research.

Adult ; Aged ; Case-Control Studies ; Esophageal pH Monitoring ; Female ; Humans ; Laryngeal Neoplasms ; complications ; epidemiology ; Laryngopharyngeal Reflux ; complications ; epidemiology ; Male ; Middle Aged ; Risk Factors