Objective To study the clinical manifestations,etiology,magnetic resonance imaging features,prognosis of patients with bilateral medial medullary infarction.Methods The clinical information of two case reports were summarized with review of the literature.Results The 2 patients with bilateral medial medullary infarction reported here were manifested with progressive quadriplegia,both complicated with respiratory disorders.On etiology,both were due to atherosclerosis,and one was combined with congenital vascular variation.The Y shaped hyperintense signals were seen in diffusion weighted imaging (DWI) cross-section in the medulla oblongata level.And both had poor outcomes that one was dead and the other was discharged with tracheotomy and severe sequela.Conclusions Bilateral medial medullary infarction is presented with complicated symptoms such as quadriplegia,dysarthria,hypoglossoplegia,even respiratory failure,in which quadriplegia is most often seen,and it is associated with a poor clinical prognosis.DWI appears the characteristic Y Shaped sign.

OBJECTIVE: Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion. METHOD: We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively. RESULT: In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P<0. 01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P < 0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P < 0.01). There were no both statistical significance in the variation of air-bone-gap and tympanogram of comparison with results between three months and six months, six months and one year postoperatively (P > 0.05). CONCLUSION This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.
Acoustic Impedance Tests ; Adult ; Audiometry, Pure-Tone ; Cryosurgery ; Eustachian Tube ; surgery ; Humans ; Lost to Follow-Up ; Otitis Media with Effusion ; drug therapy ; surgery ; Plasma Gases ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tympanoplasty

Objective To study methylation status of the Runx3 gene in occurrence and development of children malignant lymphoma.Methods The bone marrow specimens of 48 children diagnosed as malignant lymphoma were included into experimental group.20 children with non-malignancy were included into control group.Methylation-specific polymerase chain reaction (MS-PCR) was used to detect methylation status of Runx3 gene in bone marrow cells.The reverse transcription-polymerase chain reaction (RT-PCR) was used to detect mRNA expression of Runx3 gene.Results MS-PCR assay results showed that 31 cases expressed Runx3 gene methylation in experimental group,the positive rate was 64.6 ％ (31/48),but no one was detected in control group (20 cases),the difference between two groups was significant (x2 =15.7,P ＜0.05).Dynamic observation of 42 cases in experimental group showed the declining of Runx3 methylation positive rate.RT-PCR assay results showed that all 20 cases in the control group expressed Runx3 gene mRNA,all cases with methylation status of the Runx3 gene in the experimental group didn’ t expressed Runx3 gene mRNA.In experimental group,9 cases of clinical remission expressed Runx3 gene mRNA,and 1 case of relapsed didn’ t expressed Runx3 gene mRNA.Conclusion Runx3 gene shows a high methylation status in bone marrow cells of malignant lymphoma children,so that blocked the expression of Runx3 gene,which is closely related to the occurrence and development of children malignant lymphoma.