OBJECTIVE: To explore the factors related to the occurrence of otitis media with effusion (OME) in patients with long-term tracheal intubation. METHOD: This retrospective study included 47 cases with endotracheal intubation more than 7 days (endotracheal intubation group) and 20 cases without mechanically ventilated in the same period(control group). The relationships between secretory otitis media with age, gender, intubation method,duration of intubation, breathing patterns, consciousness, gastric tube position were analysed. RESULT: The study showed 27 out of 47 patients in endotracheal intubation group had OME, 9 cases had negative pressure in the middle ear and 11 patients were normal. No OME was found in control group, and 2 cases with negative pressure in bilateral middle ear were detected. The incidence of OME was significantly increased in patients with the application of ventilator in PEEP mode or nasotracheal tube, and with conscious disturbance or tracheal intubation using for more than 10 days. The presence of OME had a significantly higher rate in patients with nasal intake subjects than the oral intake subjects. The incidence of OME decreased significantly in patients using glucocorticoid. CONCLUSION The incidence of OME increased in patients applied with tracheal intubation for more than 7 days. Ventilator in PEEP mode, nasotracheal tube, and conscious disturbance were closely related with OME. Application of glucocorticoids reduced the incidence of OME.
Ear, Middle ; Glucocorticoids ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Otitis Media with Effusion ; Pressure ; Retrospective Studies

OBJECTIVE: To detect the influence of heat coagulation of middle meningeal artery (MMA) on plasma CGRP and SP levels in migraine rat triggered by nitroglycerin (NTG). METHOD: Twenty-four female Wistar rats were randomly divided into four groups, with six rats in each group. In group A, rats were treated with isotonic saline; in group B, rats were injected subcutaneously with 10 mg/kg nitroglycerin to set up the animal model of migraine; in group C, rats were subjected to sham surgery by merely exposing MMA and then injected with nitroglycerin (10 mg/kg); and in group D, rats were firstly subjected to heat coagulation of MMA and, subsequently, injected with nitroglycerin (10 mg/kg). Following the injection, the animal's behavior was continuously recorded by an observer. Radioimmunoassay was employed to measure the amounts of CGRP and SP in venous plasma. RESULT: Injection of 10 mg/kg nitroglycerin was able to trigger the animal model of migraine as evidenced by the appearances of a series of symptoms, such as, scratching head frequently, climbing cage and red ear. Rats in group A occasionally showed off scratching head, whereas, rats from group B and group C presented with much severe symptoms. Of note, rats in group D appeared slightly scratching head and climbing cage, without red ear compared with group B and C. At the same time, the amounts of plasma CGRP and SP in group B, group C, or group D were increased significantly compared with that of group A (P < 0.05). Furthermore, the plasma CGRP and SP levels in group D were much lower than that in group B and group C (P < 0.05), but there was no statistical difference between group B and group C (P > 0.05). CONCLUSION Heat coagulation of MMA may relieve symptoms of rats following nitroglycerin infusion, possibly by inhibiting the release of CGRP and SP.
Animals ; Calcitonin Gene-Related Peptide ; blood ; metabolism ; Electrocoagulation ; Female ; Meningeal Arteries ; Migraine Disorders ; chemically induced ; metabolism ; therapy ; Nitroglycerin ; adverse effects ; Rats ; Rats, Wistar ; Substance P ; blood ; metabolism

OBJECTIVE: To explore the difference of mitochondrial DNA 4,834 bp deletion mutation in tissues of inner ear, kidney and skeletal muscle and to discuss the possible mechanism of this kind of mutation in doxorubicin induced mtDNA 4,834 bp deletion mutation rat model. METHOD: Twenty-eight Wistar rats were randomly divided into two groups, one was experimental group (18 rats), the other was the blank control group (10 rats). The rats of experimental group were treated with intraperitoneal injection doxorubicin (1 mg/kg) twice a week for 3 months. The blank controls received an equivalent volume of saline instead. The tissues of inner ear, kidney and skeletal muscle were harvested and the mitochondrial DNA 4,834 bp deletion mutation was detected by nested-PCR (nested polymers chain reaction) technique. The product of PCR was sequenced directly. RESULT: Two rats of the experimental group and the blank group died during the experiment. The frequency of the mitochondrial DNA 4,834 bp deletion mutation of inner ear, kidney and skeletal muscle were 68.75% (11/16), 75.00% (12/16) and 100.00% (16/16) respectively. The difference of this kind of mutation between tissues of the inner ear and the skeletal muscle was statistic significance (P < 0.05). There were no significant difference between the inner ear tissue and the kidney tissue (P > 0.05). None of the rats of the blank control group carry this kind of mitochondrial DNA mutation. CONCLUSION The mitochondrial DNA 4,834 bp deletion mutation could be induce by doxorubicin in rats, and a notable difference were found of the frequencies of this kind of mutation between tissues of the inner ear and the skeletal muscle. So it suggested that this kind of mitochondrial DNA common deletion mutation was tissue specific.
Animals ; DNA, Mitochondrial ; genetics ; Doxorubicin ; toxicity ; Ear, Inner ; Gene Deletion ; Kidney ; metabolism ; Muscle, Skeletal ; metabolism ; Rats ; Rats, Wistar ; Sequence Deletion ; drug effects

OBJECTIVE: To study the changes in facial nerve function, morphology and neurotrophic factor III (NT-3) expression following three types of facial nerve injury. METHOD: Changes in facial nerve function (in terms of blink reflex (BF), vibrissae movement (VM) and position of nasal tip) were assessed in 45 rats in response to three types of facial nerve injury: partial section of the extratemporal segment (group one), partial section of the facial canal segment (group two) and complete transection of the facial canal segment lesion (group three). All facial nerves specimen were then cut into two parts at the site of the lesion after being taken from the lesion site on 1st, 7th, 21st post-surgery-days (PSD). Changes of morphology and NT-3 expression were evaluated using the improved trichrome stain and immunohistochemistry techniques ,respectively. RESULT: Changes in facial nerve function: In group 1, all animals had no blink reflex (BF) and weak vibrissae movement (VM) at the 1st PSD; The blink reflex in 80% of the rats recovered partly and the vibrissae movement in 40% of the rats returned to normal at the 7th PSD; The facial nerve function in 600 of the rats was almost normal at the 21st PSD. In group 2, all left facial nerve paralyzed at the 1st PSD; The blink reflex partly recovered in 40% of the rats and the vibrissae movement was weak in 80% of the rats at the 7th PSD; 8000 of the rats'BF were almost normal and 40% of the rats' VM completely recovered at the 21st PSD. In group 3, The recovery couldn't happen at anytime. Changes in morphology: In group 1, the size of nerve fiber differed in facial canal segment and some of myelin sheath and axons degenerated at the 7th PSD; The fibres' degeneration turned into regeneration at the 21st PSD; In group 2, the morphologic changes in this group were familiar with the group 1 while the degenerated fibers were more and dispersed in transection at the 7th PSD; Regeneration of nerve fibers happened at the 21st PSD. In group 3, most of the fibers crumbled at the 7th PSD and no regeneration was seen at the 21st PSD. Changes in NT-3: Positive staining of NT-3 was largely observed in axons at the 7th PSD, although little NT-3 was seen in the normal fibers. CONCLUSION Facial palsy of the rats in group 2 was more extensive than that in group 1 and their function partly recovers at the 21st PSD. The fibres' degeneration occurs not only dispersed throughout the injury site but also occurred throught the length of the nerve. NT-3 immunoreactivity increased in activated fibers after partial transection.
Animals ; Facial Nerve ; metabolism ; pathology ; physiopathology ; Facial Nerve Injuries ; classification ; metabolism ; pathology ; physiopathology ; Neurotrophin 3 ; metabolism ; Rats ; Rats, Wistar

Objective:To compare the chemical composition of decoction and granules of Sangju Decoction; To provide a method for quality evaluation of Sangju Decoction.Methods:HPLC was used to establish fingerprints, and a comprehensive comparative study was conducted on the traditional decoction and formula granules of Sangju Decoction from four aspects: chemical composition type, fingerprint similarity, chemical pattern recognition analysis, and representative index component content.Results:The fingerprint similarity of the 10 batches of traditional decoction was >0.988. 35 peaks were identified and 12 peaks were identified as common peaks (neochlorogenic acid for peak 7, chlorogenic acid for peak 10, cryptochlorogenic acid for peak 11, 1,3-dicaffeoylquinic acid for peak 13, rutin for peak 17, lenoside A for peak 19, lignan for peak 20, isochlorogenic acid B for peak 24, ammonium glycyrrhizate for peak 25). The fingerprint similarity of the formulation pellets was >0.983, and 29 characteristic peaks were identified. Compared with the traditional decoction, some batches of the granules lacked peaks 14, 26, 27, 30, 32 and 34, and clustering analysis (CA), principal component analysis (PCA), and orthogonal partial least squares discriminant analysis (OPLS-DA) could distinguish between the two. The contents of the 10 index components neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, 1,3-dicaffeoylquinic acid, forsythia ester glycoside A, grass glycosides, isochlorogenic acid B, 3,5-O-dicaffeoylquinic acid, forsythia glycosides, monkshood glycosides in the traditional soup were higher than that in the granules, and the contents of rutin and ammonium glycyrrhizate in the granules were higher than that in traditional decoction.Conclusions:The content and composition of traditional decoction and formula granules of Sangju Decoction are significantly different. The combination of fingerprinting and chemical pattern identification effectively can effectively evaluate the difference between traditional decoction and formula granules of Sangju Decoction, which can lay a foundation for the quality control and rational clinical application of formula granules of Sangju Decoction.

OBJECTIVETo investigate the effect and mechanism of endolymphatic sac-mastoid shunt surgery for intractable Meniere's disease of different stages according to hearing level.

METHODSData from 240 patients diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from January 1983 to January 2012 were analyzed in this study. Endolymphatic sac-mastoid shunt surgery was performed in affected ear for each patient. The evaluation of therapy followed the guidelines issued by Chinese Academy of Otolaryngology Head and Neck Surgery Committe. Vertigo control and auditory function were measured in two-year's follow-up.

RESULTSAccording to the preoperative staging of hearing, among these 240 patients, there were 12 cases in stage I (with an average hearing threshold < 25 dB), 130 cases in stage II (with an average hearing threshold of 25-40 dB), 85 in stage III (41-70 dB) and 13 cases in stage IV(with an average hearing threshold > 70 dB). Overall control rate of vertigo was 77.9% (187/240) in two-year's follow-up, with total control 49.2% (118/240) and substantial control 28.7% (69/240). The hearing was improved in 25.0% (60/240) of cases, no change in 59.2% (142/240) of cases, and worse in 15.8% (38/240) of cases. According to different stages, vertigo control rate was 83.3% (10/12) in stage I, 82.3% (107/130) in stage II, 75.3% (64/85) in stage III and 46.2% (6/13) in stage IV. Vertigo control rate of stage IV patients was significantly lower than that of stage II and III patients (χ(2) = 9.318 and 4.692, P < 0.05), while vertigo control rate of stage I, II, III patients had no significant difference with each other (P > 0.05).

CONCLUSIONEndolymphatic sac-mastoid shunt operation is an effective method in the treatment of intractable Meniere's disease, but the effect was poor in stage IV patients.

Endolymphatic Sac ; surgery ; Hearing ; Humans ; Mastoid ; surgery ; Meniere Disease ; surgery ; Otologic Surgical Procedures ; Vertigo ; therapy

Objective:To evaluate postoperative pain control and functional recovery of standardized pain management after total hip arthroplasty.Methods:A retrospective analysis between December 2018 and August 2019 included 100 patients who underwent unilateral total hip arthroplasty in department of arthroplasty at the First Affiliated Hospital of Xinjiang Medical University. After informed consent were obtained, the 100 subjects were randomly divided into the control group and the study group according to the inclusion and exclusion criteria, which totaled 50 patients in each group. Traditional postoperative pain management was used in control group and a self-made standardized pain management strategy was chosen in the study group. The prognosis of postoperative pain and the Harris Hip Score (HHS) were compared between the two groups.Results:Before intervention, there was no statistically significant difference in pain outcomes and HHS ( P>0.05). After standardized management of pain, the pain outcome scores of the intervention group were all higher than those of the control group, and the total pain outcome score of the intervention group (12.23±2.39) points was lower than that of the control group (14.50±2.18) points, with statistically significant difference ( t value was 4.962, P<0.001). All the Harris scale scores of the intervention group were higher than those of the control group, and the total score of the intervention group (73.61±5.06) was higher than that of the control group (64.98±7.35), with statistically significant differences ( t value was -6.652, P<0.001). Conclusion:Standardized pain management protocol can be fairly effective in the prognosis of postoperative pain and functional recovery and therefore improve patients′ satisfaction after total hip arthroplasty.

OBJECTIVETo explore the long-term efficacy and safety of triple semicircular canal occlusion (TSCO) in the treatment of intractable Meniere's disease (MD) so as to provide an alternative surgical procedure for treating this disorder.

METHODSData from Forty-nine patients, who were referred to our hospital and diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from Dec. 2010 to Jul. 2012, were retrospectively analyzed in this work. Forty-nine patients, in whom the standardized conservative treatment was given at least one year and frequent vertigo still occurred, received TSCO. Vertigo control and auditory function were measured. Pure tone audiometry, caloric test, and cervical vestibular evoked myogenic potential (cVEMP) were performed for evaluation of audiological and vestibular function. Magnetic resonance hydrograph of inner ear was performed in patients received TSCO after 2 years for the observation of morphology of membranous labyrinth. Postoperative follow-up period was more than 2 years.

RESULTSAccording to the preoperative staging of hearing, among these 49 patients, there were 2 cases in stage II (with an average hearing threshold of 25-40 dBHL), 40 in stage III (41-70 dBHL) and 7 in stage IV (over 70 dBHL). Vertigo was controlled effectively in all 49 cases in two-year follow-up, of which 40 cases (81.6%) were completely controlled and 9 cases (18.4%) were substantially controlled after surgery. The rate of hearing preservation was 69.4% and the rate of hearing loss was 30.6%. Post-operatively, all patients suffered from temporary vertigo and balance disorders. Vertigo was disappeared in all patients within 3-5 days, while averagely recovered after 13.5 days. Two years afer treatment, loss of semicircular canal function by caloric test was found in the operation side of all patients and no change in cVEMP test was noted. All patients had no facial paralysis, cerebrospinal fluid leakage, and other complications. Magnetic resonance hydrograph of inner ear showed that endolymph fluid in the position of plugging had no water after 2-years of TSCO.

CONCLUSIONSTSCO, which can reduce vertiginous symptoms effectively in patients with intractable MD in long-term follow-up, represents an effective and safe therapy for this disorder. TSCO is expected to be used as an alternative procedure for the treatment of MD in selected patients suffering from severe hearing loss or recurrence after endolymphatic sac surgery.

Audiometry, Pure-Tone ; Caloric Tests ; Endolymph ; Follow-Up Studies ; Hearing ; Hearing Loss ; therapy ; Humans ; Meniere Disease ; surgery ; Otologic Surgical Procedures ; methods ; Recurrence ; Retrospective Studies ; Semicircular Canals ; surgery ; Vertigo ; therapy ; Vestibular Evoked Myogenic Potentials

OBJECTIVETo analyze factors relevant to revisional tympanomastoid surgery for chronic otitis media(COM).

METHODSThe clinical data of 159 patients (159 ears), who exhibited either wet ear or relapsed after the initial operation, and were subjected to revisional tympanomastoid surgery, were retrospectively analyzed in this study. Of those 159 consecutive patients, 85 were males and 74 were females, aged 11-64 years, with a median age of 36 years old. The situations in terms of intra-operative findings, surgical procedures, change dressing post-operation, dry ear time, and the improvement of aural ability during the second operation, were recorded and analyzed.

RESULTSThe second surgery found that, of those 159 patients underwent the re-operation, 67 presented with cholesteatoma and 92 had no cholesteatoma. In addition, the inadequate skeletonization and insufficient opening for mastoid cavity accounted for 70.4% (112/159) of all previous operations, the external auditory canal stenosis for 98.7% (157/159), the high facial ridge leading to insufficient drainage for 61.0% (97/159), the lesion in tympanic ostium of Eustachian tube for 34.6% (55/159), the insufficient drainage due to inappropriate post-operating dressing for 5.0% (8/159), the postauricular incision for 30.8% (49/159), and the endaural incision for 69.2% (110/159). As for the re-operation of the canal wall down mastoidectomy, tympanoplasty plus plastic repairing of cavity of concha were performed in 94 cases, the modified Bondy plus plastic repairing of cavity of concha in four cases, the radical mastoidectomy plus plastic repairing of cavity of concha in 59 cases, and the simple cleaning for mastoid cavity in two cases. Since one to two weeks after the revisional operations, the post-operating dressing was performed with aid of microscopy once a week on average. The average dry ear time ranged from 2 to 6 weeks (median=3 weeks). During a period of 6-93 months for the follow-up, all patients presented with dry ears. The epithelialization of the operating cavity was well and the tympanic membranes were integrity. Neither granulation tissue nor cholesteatoma was found to reoccur. Both pure tone hearing thresholds and air-bone gap decreased in 87 cases after the revisional operation, with statistically significant different in comparison to those two parameters before the operation (P<0.05).

CONCLUSIONThe primary causes responsible for the wet ear or reoccurrent cholesteatoma after tympanomastoid surgery may be related to the improper operation procedures and selection of incision, the non-standard operation, inexhaustive removal of pathological tissues, as well as the irregular postoperation change dressing, and other factors.

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Ear Auricle ; surgery ; Eustachian Tube ; pathology ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Otitis Media ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; pathology ; surgery ; Tympanoplasty ; Young Adult

Objective: To evaluate the feasibility of combining simultaneous triple semicircular canal plugging (TSCP) and cochlear implantation (CI) to treat vertigo and hearing loss in advanced Meniere's disease(MD) patients, so as to provide an alternative surgical procedure for treating this disorder. Methods: Data from seven patients, who were referred to our hospital and diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006), from Jan. 2015 to Jan. 2016, were retrospectively analyzed in this work. Seven patients, in whom the standardized conservative treatment had been given for at least one year and frequent vertigo still occurred, underwent simultaneous TSCP and CI under general anesthesia via mastoid approach. Postoperative follow-up time was more than six months. Vertigo control and auditory function were measured. Pure tone audiometry, speech perception scores, caloric test, head impulse test (HIT), and vestibular evoked myogenic potential (VEMP) were performed for evaluation of audiological and vestibular functions. Results: All patients had bilateral severe sensorineural hearing loss preoperatively. One side hearing loss was due to MD and another side was due to reasons including sudden sensorineural hearing loss, mumps and other unknown reason. The total control rate of vertigo in seven MD patients was 100.0% in the six-month follow-up, with complete control rate of 85.7% (6/7) and substantial control rate of 14.3% (1/7). Improved hearing threshold and speech perception scores were observed in all study participants. Postoperative average aided hearing threshold was 32.5 dBHL, the average monosyllabic word score was 42.6% and speech perception scores of sentences tested in quiet was 52.3%. Tinnitus improved in five cases, and no significant change in two patients. Post-operatively, all patients suffered from temporary vertigo and balance disorders. Vertigo was disappeared in all patients within 3-5 days, while, an average recovery time of balance disorders was 19.7 days. Six months after treatment, loss of semicircular canal function by caloric test was found in the operation side of all patients and no change in cVEMP or oVEMP test was noted. All patients had no facial paralysis, cerebrospinal fluid leakage, and other complications. Conclusions A combined approach of TSCP and CI which could control vertigo effectively and improve hearing loss and tinnitus represents an effective and safe therapy for some advanced MD patients.