AIM:To evaluate the efficacy and safety of the regimen based on platinum compound plus docetaxel in the treatment of advanced esophageal carcinoma as first-line drug,and to further explore prognostic factors of advanced esophageal carcinoma by survival analysis.METHODS:From August 2006 to October 2008,36 patients with advanced esophageal carcinoma were enrolled in the study,and non-randomly assigned to docetaxel 75 mg/m2 in the first day every 3 weeks,combined with cisplatin 25 mg/m2 in the first day to third day or in the first day to forth day(DT,n=27),or with carboplatin AUC=5 on day 1(CT,n=9).RESULTS:The curative and toxic side effects were evaluated to the 36 patients.There were 1 complete respone,17 partial respone,11 no changes and 7 progressive disease in 36 patients with total response rate of 50.00%.The response rates of DT,CT regimen were 59.26% and 22.22%(P=0.121).The major side effects were nausea-vomiting,all side effects were reversible by symptomatic treatment.After a median follow-up of 8.70 months,the overall median survival was 10.50 months(95% CI 7.36 to 13.64 months).The COX univariate regression analysis suggested there was no correlation with sex,age and the hemoglobin of before chemotherapy with existence.But there was statistical significance between the behavior state of chemotherapy and the existence(P=0.036).CONCLUSION:The regimen based on platinum compound plus docetaxel is tolerable and more effective as a first-line treatment for advanced esophageal carcinoma.Patients with good performance status before chemotherapy indicates good prognosis and it is an independent factor affecting survival for advanced esophageal carcinoma.

Objective:To compare the risk assessment capability of model for end-stage liver disease (MELD), glasgow-blatchford score (GBS), and the AIMS65 scoring system for liver cirrhosis patients with esophageal and gastric variceal bleeding (EGVB).Methods:A retrospective analysis was made on data of 182 cirrhosis patients with EGVB admitted to the Department of Gastroenterology, General Hospital of Tianjin Medical University from January 1, 2015 to March 1, 2018. According to the MELD, GBS and AIMS65 scoring system, the corresponding scores of each patient were calculated to evaluate the ability of the three scoring systems to correctly classify EGVB as a " high-risk patient" . The receiver operating characteristic curve was drawn to compare the predictive value of three scoring systems for different clinical outcomes (blood transfusion, rebleeding, and death). The area under curve (AUC)>0.7 was believed to have higher accuracy.Results:The clinical outcomes of 182 patients included blood transfusion in 113 (62.1%) cases, rebleeding in 31 (17.0%) cases, and death of 11 (6.0%) cases. The MELD score was 7-25, GBS was 3-16, and AIMS65 score was 0-3. There were 4 (2.2%) patients with MELD score < 9, 139 (76.4%) patients with AIMS65 score 0-1, including 68 patients with AIMS65 score of 0 and 71 patients with AIMS65 score of 1. The AUC of MELD, GBS and AIMS65 for predicting blood transfusion was 0.514 (95% CI: 0.439-0.589), 0.681 (95% CI: 0.608-0.748), and 0.669 (95% CI: 0.596-0.737), respectively. When predicting rebleeding, the AUC of MELD, GBS and AIMS65 was 0.525 (95% CI: 0.449-0.599), 0.528 (95% CI: 0.453-0.602) and 0.580 (95% CI: 0.505-0.652), respectively. When predicting in-hospital mortality, the AUC of MELD, GBS and AIMS65 was 0.642 (95% CI: 0.567-0.711), 0.581 (95% CI: 0.505-0.653) and 0.786 (95% CI: 0.719-0.843), respectively. AIMS65 was superior to MELD ( P=0.083 6) and GBS ( P=0.047 0). Conclusion:GBS can correctly classify cirrhosis patients with EGVB as " high-risk group" , and is better than AIMS65 and MELD scoring system. MELD, GBS and AIMS65 all have poor accuracy in predicting blood transfusion and rebleeding, AIMS65 has a higher predictive value for death.

OBJECTIVE: To study the microanatomy by endoscope-assisted via retrolabyrinthine approach. METHOD: Nineteen cadaveric heads fixed with formalin were dissected in our study. The data that endoscope could be extent and the distance between the important point were measured. By simulated the retrolabyrinthine approach, endoscope was placed to observe the nerves and vessels, the distance between nerves and the central point of the anterior edge of sigmoid sinus were measured. RESULT: The distance from the inferior margin of petrous ridge to the upper bound of endolymphatic sac was (9.93+/-1.52)mm; and from superior margin of petrous ridge to the inferior margin common bony crus was (4.64+/-0.91)mm;and from the intersection of posterior semicircular canal to the anterior wall of sigmoid was (7.85+/-1.47)mm on the left, and (5.69+/-1.68)mm on the right. The distance from inferior margin common bony crus to the anterior wall of sigmoid was (13.9+/-1.71)mm on the left, and (11.31+/-2.03)mm on the right. The trochlear nerve and abducent nerve could be observed under endoscope. The relationship between the trigeminal nerve, acoustic nerve and the vessels could be identified clearly. The distance from the central point of the anterior edge of sigmoid to the roots of the trigeminal nerve, facial nerve, vestibulocochlear nerve and glossopharyngeal nerve were (29.88+/-2.77) mm, (32.04+/-2.04) mm, (29.17+/-1.65) mm, (35.49+/-1.53) mm respectively. CONCLUSION The visual field of the cerebellopontine angle appear wider by the endoscope assisted retrolabyrinthine approach. Nerves, vessel, internal acoustic pore, jugular foramen region can be clearly seen. Some minimal invasive surgery can be done by this approach.
Adult ; Cerebellopontine Angle ; anatomy & histology ; surgery ; Ear, Inner ; surgery ; Endoscopes ; Female ; Humans ; Male

Objective To investigate the relationships between tinnitus masking curve types and tinnitus re-sidual inhibition in the patients at different ages with normal hearing ,mild ,moderate severe hearing loss .Methods The minimum masking levels and residual inhibition of 335 patients with normal hearing ,mild to medium ,and mod-erate to severe hearing loss were tested and analyzed using the method of psychological acoustics .Results Ages and the duration of residual inhibition had a corresponding relationship :the 19～30 years old group had corresponding relations with 0～40 seconds of residual inhibition ,while the 31～50 years old group with 81～100 seconds of resid-ual inhibition ,and the 50～63 years old group with 101～200 seconds of residual inhibition ,respectively .The 31～50 years old group and 51％ ～80％ residual inhibition had a corresponding relationship ;0％ ～30％ residual inhibi-tion group and parallel type of tinnitus masking curves had a corresponding relationship ,31％ ～50％ residual inhibi-tion group and separation type of the tinnitus masking curves had a corresponding relationship ,the groups of 51％ ～80％ and 81％ ～100％ residual inhibition with the types of convergent and overlapping tinnitus masking curves had corresponding relationship ,respectively .Conclusion There were different characteristics of tinnitus masking patients at different ages with different levels of hearing loss .The older people are ,the better effects and longer time of residual inhibition are .Those tinnitus patients with the tinnitus masking curve of convergent type and overlapping type showed a better tinnitus masking effect than the others .

Objective This study addresses the characters of magnetic resonance imaging (MRI) and clinical features,and curative effects in the screening of SSNHL due to inner-ear hemorrhage.Methods MRI and relevant audiometric test were given to 160 patients with SSNHL,who were hospitalized in the First Affiliated Hospital of Sun Yat-sen University from January 2011 to April 2013.The clinical features and curative effects of patients with high signals in the labyrinth on MRI were analyzed.Results MRI abnormities were found in 22 (13.8％) of the patients.Specifically,eight cases were considered for innerear hemorrhage.For the eight inner-ear hemorrhage cases,clinical features included the sudden onset of complete hearing loss,which worsened within several hours.Pure tone audiometry indicated profound sensorineural deafness.The prevalence of inner-ear hemorrhage was 5％ in SSNHL cases and 18.6％ in cases of profound sensorineural.MRI showed high signal intensity in the cochlear,semicircular canals or vestibule on unenhanced T1-weighted and fluid-attenuated inversion recovery images.The high signal intensity in the inner ear gradually degraded in six months.There was no improvement in hearing for the patients with inner-ear hemorrhage following symptomatic therapy.Conclusion SSNHL due to inner-ear hemorrhage is characterized by profound sensorineural deafness in all frequencies,and high signal intensity for the hemorrhagic inner ear on T1-weighted MRI,with poor prognosis.