Objective To explore the contrast perilymphatic MRI characteristics of inner ears with sudden hearing loss with vertigo.Methods Forty three patients with sudden hearing loss with vertigo and 35 patients with unilateral tinnitus diagnosed by the department of Otolaryngology-Head and Neck Surgery were retrospectively included.Forty eight ears (38 ears with unilateral sudden hearing loss and 10 ears in 5 cases with bilateral sudden hearing loss) were regarded as sudden hearing loss group,35 asymptomatic ears (the opposite ears of the unilateral tinnitus ears) as control group.Thirty eight opposite ears of the 38 unilateral sudden hearing loss ears and 35 ears of the control group showed normal in the pure tone audiometry exam.One hundred and twenty one ears (48 hearing loss ears,38 opposite ears of the 38 unilateral sudden hearing loss ears and the 35 control group's ears) underwent contrast perilymphatic MR exams,0.4 to 0.5 ml gadolinium hydrate diluted with saline was injected through the tympanic membrane,twenty four hours later,three-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence was performed using a 3.0 T MRI scanner.After the contrast perilymphatic MR exam,success in the exam was judged through the raw image.The signal intensity ratio (SIR) of cochlea basal turn and homolateral brain stem was quantitatively calculated.The SIR difference of 48 ears with sudden hearing loss and 35 asymptomatic ears in control group was analyzed by t test.The SIR difference of the 38 unilateral sudden hearing loss ears and the contralateral asymptomatic ears was also analyzed.The presence of endolymphatic hydrops was judged.Results The contrast perilymphatic MRI of 121 inner ears with intratympanic gadolinium injection were all successful.Endolymphatic hydrops were observed in 12 sudden hearing loss ears with the occurrence rate of 25％(12/48).The SIR of basal turn and homolateral brain stem of the sudden hearing loss ears (2.062±0.907) were lower than the SIR of the control groups' asymptomatic ears (2.703± 0.640) with significant difference between them (t=3.619,P=0.001),the SIR of basal turn and homolateral brain stem of the unilateral sudden hearing loss ears (1.941 ±0.860) were also lower than the SIR of the contralateral asymptomatic ears (2.411±0.670) with statistical difference between them (t =3.270,P=0.002).Conclusions Endolymphatic hydrops were observed in sudden hearing loss with vertigo.The SIR of the cochlea in sudden hearing loss ears were lower than that of the asymptomatic ears,indicating the abnormal permeability of the round window membrane.

After discussing the reasons and pathogenesis of headache due to fluid retention,it is believed that such situations as coagulation of water in the taiyang meridian,upward reversion of yangming,internal accumulation in shaoyin and cold stagnation in jueyin all can lead to headache.Hence,the methods of opening taiyang to dispel water retention,warming yangming to resolve water retention,warm shaoyin to disperse water retention and warm jueyin to purge cold water accumulation are applied to treat headache.

OBJECTIVETo study gene expression of collagen types IX and X in human lumbar intervertebral discs during aging and degeneration and to explore the role of collagen types IX and X in disc degeneration.

METHODSFetal, adult and pathologic specimens were subjected to in situ hybridization with cDNA probes to investigate mRNA-expressions of types IX and X collagen gene.

RESULTSIn fetal intervertebral discs, positive mRNA hybridization signals of type IX collagen were concentrated in the nucleus pulposus and the inner layer of anulus fibrosus. Interstitial matrix of the nucleus pulposus also showed positive type X collagen staining. Positive mRNA hybridization signals of types IX and X were not detected in the middle and outer layers of anulus fibrosus. In adult specimens, expression of type IX collagen mRNA was markedly decreased. No hybridization signals of type X collagen was observed. As for pathological specimens, there was no gene expression of type IX collagen. In severe degenerated discs from adults, there were focal positive expressions of type X collagen.

CONCLUSIONSObvious changes of collagen gene expression occur with aging. Expression of type IX collagen decreases in adult and pathological discs. Results of type X collagen expression suggest that type X collagen is expressed only in older adult and senile discs (i.e., when disc degeneration has already reached a terminal stage), indicating the terminal stage of degeneration.

Adolescent ; Adult ; Collagen Type IX ; metabolism ; Collagen Type X ; metabolism ; Female ; Gene Expression ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Intervertebral Disc ; embryology ; metabolism ; Lumbar Vertebrae ; Male

OBJECTIVETo study the impact of gonadotropin-releasing hormone analogs (GnRHa) on body mass index (BMI) in girls with idiopathic central precocious puberty (ICPP).

METHODSOne hundred and thirty-four girls with ICPP were enrolled. Fifty-seven out of the 134 girls were treated with GnRHa for 1.69±0.43 years. The height, weight, bone age and BMI were measured before treatment, at the end of the treatment and after reaching near adult height and compared with those in the untreated 77 girls.

RESULTSThe adult predicted height standard deviation score (SDS) at the end of treatment was significantly higher than that before treatment (P<0.01) and was similar to the target height SDS in the GnRHa treatment group (P>0.05). With GnRHa treatment, the near-adult height SDS was higher than the target height SDS (P<0.01). At the end of treatment, the BMI SDS slightly increased compared with pretreatment level (P>0.05). A significant reduction in the BMI was observed when reaching the near-adult height in the GnRHa treatment group compared to the level of pretreatment and the untreated group (P<0.01). However, the BMI in the GnRHa treatment group before treatment, at the end of the treatment and after reaching near adult height remained in the normal range (±1 SD).

CONCLUSIONSGnRHa may improve the final height in girls with ICPP. The alterations of BMI after GnRHa therapy fluctuate in a normal range.

Body Height ; drug effects ; Body Mass Index ; Child ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; analogs & derivatives ; therapeutic use ; Humans ; Puberty, Precocious ; drug therapy ; physiopathology

Objective To explore the effect of opposite and complementa-ry method on mitochondrial encephalomyopathy . Methods Thirty -seven patients with mitochondrial encephalomyopathy diagnosed based on the imaging , genetics , and muscle biopsy were included in the study and the data of clinical manifestations , treatment and outcomes were retro-spectively analyzed.Results Thirty-seven patients were treated by the opposite and complementary method , based on ocktail therapy .Patients were given Xin Nao-xin capsule and Shu Xue -ning or Xing Nao-jing based on syndrome differentiation , and the treatment of oral Xin Nao -xin capsule continued after discharge . The clinival effective rate was 89.2%. Conclusion With various manifestations , mitochondrial encephalomyopathy is easily misdiagnosed.Genetics and muscle biopsy can help.The opposite and complementary method is of certain effect on patients with mitochondrial encephalomyopathy .

OBJECTIVETo explore a method for the treatment of the skin defects at the distal phalanges of 2-5th fingers.

METHODSThe island flap at the dorsum of the middle phalange was designed with the pedicle of dorsal branches from the digital proper artery. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. From Feb. 2005 to May. 2010, 54 cases with skin defects at the distal phalanges of 61 fingers were treated with the flap, including 35 defects at finger pulp and 26 defects at finger tip.

RESULTSThe maximum size of defects and flaps was 2.2 cm x 2.5 cm and 2.4 cm x 2.7 cm, respectively. 61 flaps survived completely. Blister was happened in 3 flaps 2 days after operation, which healed spontaneously without necrosis. 54 cases were followed up for 5 to 22 months (average, 11 months). The flaps had good texture and color match with normal sensation (grade S4). The 2-point discrimination distance was 6-9 mm. The interphalangeal joint had normal movement.

CONCLUSIONSThe island flap at the dorsum of the middle phalange is an ideal method for the skin defect at the distal phalange of finger.

Adolescent ; Adult ; Aged ; Arteries ; Female ; Fingers ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

AIM:To analyze the association of intrauterine growth retardation (IUGR) and retinopathy of prematurity (ROP).METHODS:A retrospective analysis of a case series included in ROP screening from January 2011to December 2015 was performed in Suzhou Municipal Hospital.Totally 2527 children (5054 eyes) underwent screening.According to the gestational age,the data was divided into 4 groups (≤32wk,＞32 and ≤34wk,＞34 and ≤37wk,＞37wk).Every group was divided into two groups (IUGR group and no IUGR group) respectively.We compared the incidence of ROP in IUGR and non IUGR group.RESULTS:Of all the 2527 children,IUGR group were 702 including 78 ROP children,and non IUGR group were 1825 including 329 ROP children.There were 991 children were divided into ≤ 32wk group,including 63 IUGR in which 27 children were screened out ROP(42.9％) and 928 non IUGR in which 274 children were screened out ROP (29.5％),the difference on the incidence of ROP was statistically significant (X2 =4.958,P=0.026).There were 1025 children were divided into ＞ 32 and ≤ 34wk group,including 232 IUGR in which 33 children were screened out ROP(14.2％) and 793 non IUGR in which 51 children were screened out ROP (6.4％) and the difference was statistically significant (x2 =14.488,P＜0.001).There were 464 children were divided into ＞ 34 and ≤ 37wk group,including 374 IUGR in which 18 children were screened out ROP(4.8％) and 90 non IUGR in which 4 children were screened out ROP (4.4％) and the difference was not statistically significant (Fischer exact test,P=1).There were 47 children were divided into ＞37wk group,including 33 IUGR and 14 non IUGR,none were screened out in the two groups.CONCLUSION:Intrauterine growth retardation was closely related to the incidence of ROP.In the preterm infants with gestational age less than 34wk,the incidence of ROP in children with intrauterine growth retardation is significantly higher than that in children without intrauterine growth retardation.

·AIM: To retrospectively analyze the prevalence of retinopathy of prematurity(ROP) in 3471 neonates in Suzhou Municipal Hospital. ·METHODS: A total of 3471 children (1947 males, 1524 females) were screened for ROP in Suzhou Municipal Hospital from January 2010 to September 2016 using binocular ophthalmoscope or ( and) RetCamⅡ. First examination was performed from 4-6wk after birth. The ocular findings were recorded according to the International Classification of ROP and The Early Treatment for ROP. Only the more aggressive eye of bilateral asymmetrical cases was counted for statistical purpose. Children with ROP in both binocular or single eye were counted in 1 case, and the cases required surgeries were defined as severe cases. The prevalence of ROP and severe ROP in recent 6a were analyzed retrospectively. ·RESULTS: The overall relevance ratio of ROP and severe ROP was 17.03% and 1.15%. The relevance ratio of ROP and severe ROP of the males were 16.38% and 1.08%,and of the females were 17.85% and 1.25%, the results were not statistically different (x2= 1. 296, P =0.255). The relevance ratio of ROP and severe ROP of the single birth infants were 17.61% and 1.13%, and of the multiple birth infants were 15.13% and 1.23%,the results were not statistically different (x2=2.706, P=0.100). The children were divided into 5 groups according to the birth weight. The relevance ratio of ROP with birth weight<1000g,1000-1499g,1500-1999g,2000-2499g and ≥2500g were 75. 00%, 36. 17%, 10. 75%, 6. 86% and 3. 77%respectively with significant differences (There were significant differences between the three groups which the birth weight <2000g, P<0.005). The relevance ratio of severe ROP were 36.54%, 1.68%, 0.31%, 0.19% and 0 respectively in these birth weight groups (There were significant differences between the three groups which the birth weight <2000g,P<0.005). The children were divided into 4 groups according to gestational weeks, the relevance ratio of severe ROP of gestational age<28wk,28-31wk, 32-36wk and ≥37wk were 69. 12%, 29. 91%, 8.28% and 3.33% respectively with significant differences (There were significant differences between the three groups which the gestational age <37wk, P<0.005). The relevance ratio of severe ROP were 25%, 1.52%, 0.24% and 0 in these gestational age groups respectively (There were significant differences between the three groups which the gestational age <37wk,P<0.005). · CONCLUSION: The detection rate of ROP in 3471 premature infants was 17. 03%, the severe ROP was 1.15%. There was no evidence that sex and birth were related to ROP, but lower birth weight and smaller gestational age increased the detection rate of ROP.

OBJECTIVETo investigate the management of complicated, severe or recurrent Budd-Chiari syndrome.

METHODSFrom February 2004 to August 2007, 28 patients with complicated, severe or recurrent Budd-Chiari syndrome were treated. In this series, 16 patients relapsed after treated with percutaneous transluminal angioplasty or stent deployment, 2 cases relapsed after surgery; and the other 10 were under severe conditions and hard to treat, including malignancy of the inferior vena cava and right atrium. Meso-cavo-atrial shunt was carried out in 10 cases, meso-cavo-jugular shunt in 6 (capitis medusa was used in one case), cavoatrial shunt in 2 and cavo-jugular shunt in 1, mesocaval shunt in 2, and radical or extended radical correction in 7.

RESULTSOne patient (3.6%) died in 24 hours after operation. Graft infection occurred in 1 case. Excellent, good, fair, poor and death rate were 22.2%, 55.5%, 14.8%, 3.7% and 3.7%, respectively, the overall effective rate was 92.5%.

CONCLUSIONTo select personalized treatment according to the disease status brings hopes to difficult, severe, recurrent Budd-Chiari syndrome.

Adolescent ; Adult ; Blood Vessel Prosthesis Implantation ; Budd-Chiari Syndrome ; surgery ; Child ; Child, Preschool ; Critical Illness ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Portacaval Shunt, Surgical ; Recurrence ; Retrospective Studies ; Treatment Outcome

Antigens, Bacterial ; immunology ; Antigens, Surface ; immunology ; China ; epidemiology ; Diarrhea ; microbiology ; Escherichia coli Infections ; epidemiology ; microbiology ; Escherichia coli O157 ; classification ; immunology ; isolation & purification ; Humans