OBJECTIVETo discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children.

METHODSA total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group Al, group B1, and group Cl matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and Al accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and Cl accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared.

RESULTSThe control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times.

CONCLUSIONSOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate.

Child ; Cleft Palate ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; therapy ; Prognosis ; Recurrence

Objective To estimate time of gauze swabs left in abdomen with comparison of the number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers in different times.Methods F344 rat models dependent 2,8,30,120 days were established by gauze swab fixed in the abdomen,and were studied on gauze swab wrapped by greater omentum,the number of foreign body giant cells and theirs nuclei by HE staining,and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers by sirius red and silver staining respectively.The results were analyzed by image analysis system.Results The results showed that number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers increased gradually(P<0.01)followed the time delayed.The Proportion of type Ⅰ collagenous fibers to argentaffin fibersis Power Function of Days of guaze swab left in rat abdomen(r=0.972).Conclusion The number of foreign body giant cells,theirs nuclei and the proportion of type Ⅰ collagenous fibers to type Ⅲ and argentaffin fibers contribute to the estimation of foreign body(eg.gauze swab)left in abdomen.

Objective:To understand the epidemiological characteristics of imported COVID-19 cases in Guangzhou and provide scientific basis for the prevention and control of the disease.Methods:The data of imported COVID-19 in Guangzhou reported as of April 1, 2020 were collected from National Notifiable Disease Report System of China. The software Excel 2010 and SPSS 19.0 were applied for data cleaning and statistical analysis.Results:As of April 1, 2020, a total of 103 imported COVID-19 cases had been reported in Guangzhou, in which 92 were confirmed cases and 11 were asymptomatic infection cases. The number of the confirmed imported cases accounted for 11.4 % (92/806) in of the total in China at the same time. The male to female ratio of the cases was 1.58∶1 (63∶40). The median age of the cases was 31 years ( P 25- P 75:22-40 years), range of age was 11-63 years. The main occupational distributions of the cases were business services (41/103, 39.8 %) and students (36/103, 35.0 %). The imported cases whose destinations were 19 provinces and municipalities rather than Guangdong after entering the country accounted for 43.7 %. The main source countries of infections were the United Kingdom (27/103, 26.2 %), the Philippines (13/103, 12.6 %), the United States (13/103, 12.6 %) and Nigeria (7/103, 6.8 %). There were 34 inbound flights from which the imported COVID-19 cases were detected, in which 10 flights (10/34, 29.4 %) were found to carry more than 3 cases, with an average voyage time of (11.14±0.53) hours. A total of 29 imported cases(28.2 %) showed symptoms before entering the country, and 65 cases (63.1 %) had been isolated before the onset of the disease. The mean free activity time of the isolated cases after the onset was (6.76±0.79) days. The average number of the imported cases’ close contacts was 53. There were 13 clusters of COVID-19 caused by the imported cases, involving 36 cases (including 1 imported associated case). Conclusions:The sources of the imported COVID-19 cases in Guangzhou were widely distributed, and no cases had been found to be infected on the flights. In the early stage of the imported epidemic, there was high risk for the spread of the epidemic. Strengthened prevention and control of imported COVID-19 effectively reduced the of transmission risk of COVID-19 in communities.

Objective??To?discuss?the?treatment?characteristics?of?secretory?otitis?media?(SOM)?in?cleft?palate?children. Methods??A?total?of?319?patients?(524?ears)?with?SOM?and?cleft?palate?(3-14?years?old)?who?accepted?treatment?were?divided?into?experiment?group?A,?group?B,?and?group?C?according?to?effusion?characteristics?in?the?middle?ear?and?tympanic?pressure.?Group?A?included?112?patients?with?serous?effusion?(198?ears).?Group?B?included?162?patients?with?mucinous?effusion?(248?ears).?Group?C?included?45?patients?(78?ears)?with?negative?pressure?in?the?middle?ear?without?effusion?and?an?acoustic?immit-tance.?A?total?of?208?patients?(246?ears)?with?SOM?and?tonsil?and?adenoid?hypertrophy?were?divided?into?control?group?A1,?group?B1,?and?group?C1?matched?with?the?same?effusion?characteristics?in?the?middle?ear?and?tympanic?pressure.?Group?A?and?A1?accepted?puncture?in?the?tympanic?cavity,?group?B?and?B1?accepted?tympanostomy?tubes,?and?group?C?and?C1?accepted?puncture?in?the?tympanic?cavity?after?palatoplasty,?adenoidectomy,?and?tonsillectomy.?All?groups?were?treated?with?antibiotics?and?ear?drops.?Cure?rate?and?recurrence?rate?between?the?experiment?group?and?the?control?group?were?compared.?Results??The?control?group?had?a?better?cure?rate?[93.09%?(229/246)]?than?the?experiment?group?[77.29%?(405/524)]?12?months?after?treatment.?The?experiment?group?had?a?higher?recurrence?rate?[14.57%?(59/405)]?than?the?control?group?[3.93%?(9/229)].?Statistical?diffe-rences?were?observed?between?the?two?groups?(P<0.05).?SOM?with?cleft?palate?initially?had?a?low?cure?rate,?and?thus?it?was?treated?repeatedly?for?many?times.?Conclusion??SOM?with?cleft?palate?is?different?from?normal?otitis?media?in?terms?of?clinical?manifestation,?treatment,?outcome,?and?prognosis.?This?case?should?be?considered?a?special?otitis?media?to?be?treated?with?special?examination?and?therapy?to?obtain?better?results.?Repeated?puncture?in?the?tympanic?cavity?and?tympanostomy?tubes?for?six?months?according?to?effusion?characteristics?are?better?treatment?options?for?patients?with?SOM?and?cleft?palate.

Theof(for short) was officially published as a standard of China Association of Acupuncture and Moxibustion in 2015. From the purpose, methodology, scope, indication, recommended protocol, etc., this was explained to provide convenience for clinical use of acupuncturists. Thiswas developed based oncomprehensive search of literature regarding acupuncture for periarthritis of shoulder, the adoption of best evidence, expert experience, patient value across the world, methods of evidence quality and GRADE, references of clinical experience of famous acupuncturists in the ancient and modern time and expert consensus in the national level, which was hoped to provide solid evidence of acupuncture clinical treatment for periarthritis of shoulder to ensure the safety and effectiveness. In this, the stage-by-stage treatment principle of acupuncture for periarthritis of shoulder was recommended. In the acute stage, the treatment aim was to relieve the pain, and distal acupoints along the meridians were selected with strong stimulation; the local acupoints were combined. In the chronic stage and rehabilitation stage, the treatment aim was to improve the dysfunction of shoulder joint, and acupuncture treatment was based on syndrome differentiation of etiology and meridian; the local acupoints were mainly selected, combined with acupoints based on etiology and acupoints along meridians.

Objective:To investigate vision-related quality of life, anxiety and depression in patients with primary angle-closure glaucoma (PACG) and the influencing factors in Baotou, Inner Mongolia.Methods:A cross-sectional study was conducted.One hundred and eighty-two consecutive PACG patients (364 eyes) with intraocular pressure ≤20 mmHg (1 mmHg=0.133 kPa) at 3 random times after treatment were enrolled in Baotou Chaoju Ophthalmic Hospital from September 2018 to January 2020.Gender, age, marital status, education level, monthly income, total treatment cost, glaucoma treatment time, surgery and drug treatment history, best corrected visual acuity (BCVA), Humphrey visual field index (VFI) and scores of the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and Hospital Anxiety and Depression Scale (HADS) of patients were recorded.Pearson correlation analysis was used to analyze the correlation between age and composite VFQ-25 score.Spearman rank correlation analysis was used to analyze the correlation between other statistical data.Stepwise multivariate linear regression was used to analyze the correlation between composite VFQ-25 score, HADS score and statistically significant influencing factors above.This study protocol adhered to the Declaration of Helsinki, and was approved by an Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2015-30). Written informed consent was obtained from each subject.Results:The mean age of subjects was (59.75±8.43) years.The mean composite VFQ-25 score was (68.59±14.43) points.The mean HADS, HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were 16.00 (12.00, 20.00), 8.00 (6.00, 10.00), 8.00 (6.00, 10.00) points, respectively.The proportion of anxious (HADS-A score>10 points) and depressd (HADS-D score >10 points) patients was 18.1% (33/182) and 13.7% (25/182), respectively.Age was positively correlated with BCVA in eyes with better and worse vision ( rs=0.36, 0.29; both at P<0.01), and it was negatively correlated with mean deviation (MD) of Humphrey visual field in the better-MD and worse-MD eyes, VFI of Humphrey visual field in the better-VFI and worse-VFI eyes ( rs=-0.21, -0.23, -0.30, -0.23; all at P<0.01). The composite VFQ-25 score was negatively correlated with age, BCVA in the eyes with better and worse vision ( rs=-0.32, -0.34, -0.48; all at P<0.01), and it was positively correlated with MD in the better-MD and worse-MD eyes, VFI in the better-VFI and worse-VFI eyes ( rs=0.37, 0.45, 0.38, 0.46; all at P<0.01). The HADS-A score was negatively correlated with MD in the better-MD eye ( rs=-0.20, P<0.01). The HADS-D score was positively correlated with BCVA in the eyes with worse vision ( rs=0.26, P<0.01) and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes ( rs=-0.21, -0.22, -0.22; all at P<0.01). The HADS score was positively correlated with BCVA in the eyes with worse vision ( rs=0.22, P<0.01), and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes ( rs=-0.20, -0.20, -0.21; all at P<0.01). The composite VFQ-25 score was negatively correlated with mean HADS-A, HADS-D and HADS scores ( rs=-0.41, -0.41, -0.45; all at P<0.01). According to the multivariate analysis, the composite VFQ-25 score was related to age ( P<0.01), education level ( P<0.01), total treatment cost ( P<0.05), BCVA in the eyes with better vision ( P<0.05) and MD in the worse-MD eyes ( P<0.01). The HADS score was related to gender ( P<0.05) and the composite VFQ-25 score ( P<0.01). Conclusions:The vision-related quality of life and incidence of anxiety and depression are low in patients with PACG in Baotou region, Inner Mongolia.With age increasing, PACG patients suffer from declined visual function, increased visual field damage, reduced vision-related quality of life and raised anxiety and depression.The vision-related quality of life is poorer in patients with lower education level and higher total treatment cost.Female glaucoma patients are more likely to suffer from anxiety and depression.

Background and Aims:The repair of giant incisional hernia is challenging,as closing the significant defect in the abdominal wall can lead to life-threatening complications like abdominal compartment syndrome(ACS).Botulinum toxin type A(BTA)can temporarily relax the abdominal wall muscles,facilitating defect repair,while preoperative progressive pneumoperitoneum(PPP)can increase intra-abdominal volume,reducing intra-abdominal pressure caused by hernia content reintegration.Combining BTA with PPP for the preoperative preparation of giant incisional hernia repair may have a complementary effect.This study was conducted to evaluate the clinical value of combining BTA and PPP in the repair of giant abdominal incisional hernia. Methods:The clinical data of 213 patients with giant abdominal incisional hernia treated at the Sixth Affiliated Hospital of Sun Yat-sen University from December 2015 to December 2019 were retrospectively analyzed.Two weeks after receiving combined BTA and PPP treatment,changes in bilateral abdominal wall muscle,intra-abdominal adhesions,abdominal circumference,abdominal cavity volume,and hernia sac volume ratio were assessed using CT.Intraoperative details,incidence of complications,and postoperative follow-up outcomes were recorded. Results:Following combined BTA and PPP treatment,CT scan showed a significant extension of bilateral lateral abdominal wall muscles towards the midline in all 213 patients,with an average increase of 2.45(1.53-3.29)cm on the left side and 2.54(1.68-3.40)cm on the right side;muscle thickness was reduced by an average of 0.84(0.64-1.00)cm on the left and 0.82(0.62-1.05)cm on the right,the average distance between viscera and the abdominal wall increased to(7.52±1.78)cm,with a mean increase of 6.1(4.2-6.9)cm;the mean increase in abdominal cavity volume was 1 802(1 494.98-2 316.26)mL,and the hernia sac volume ratio decreased by an average of 9％(6％-12％),all changes were statistically significant(P＜0.05).Post-PPP CT scan revealed no abdominal adhesions in 18 patients(8.45％),while 195 patients(91.55％)had varying degrees of adhesions,including 39 cases(18.31％)of sheet adhesions and 156 cases(73.24％)of mixed adhesions.Adhesions mainly consisted of omentum and intestinal tissues in 59.15％of cases.There were 43 cases(20.19％)of grade Ⅰ complications during the BTA-PPP process,including abdominal pain(28 cases),shoulder pain(9 cases),subcutaneous emphysema(6 cases),and dyspnea(3 cases).Dyspnea improved with oxygen therapy,while other complications required no special intervention.All 213 patients successfully underwent laparoscopic incisional hernia repair without conversion to open surgery or organ resection for volume reduction.Fascial closure was achieved in 209 cases(98.12％),with 4 cases(1.88％)having incomplete defect closure.The average time for adhesiolysis was 28(11.00-44.50)min,with a total operative time of 178.0(132.50-255.00)min and an average blood loss of 20(10-30)mL.The median intra-abdominal pressure(IAP)after operation was between 10 mmHg(9.00-12.00 mmHg),Among them,47 cases(22.07％)had IAP exceeding 12 mmHg,and after implementing proactive measures such as diuresis and diachoresis to reduce intra-abdominal contents,the IAP in these patients decreased to below 12 mmHg.No severe complications such as skin flap necrosis or ACS were observed.There were no deaths within postoperative 30 d,and during a follow-up period of 26(16.50-33.00)months,13 cases(6.10％)had surgical site events,including infections in 5 cases(2.35％),seromas in 7 cases(3.29％),and hematoma in 1 case(0.47％),with no hernia recurrence. Conclusion:The combination of BTA and PPP not only aids in identifying abdominal wall adhesion areas,improving preoperative surgical planning and enhancing surgical safety,but also significantly increases abdominal cavity volume and extends lateral abdominal wall muscles,facilitating the closure of giant incisional hernia defects and reducing the incidence of severe postoperative complications like ACS.This approach is worthy of clinical promotion.