Objective To study the outcomes of two intervention strategies on the language development of young children with hearing loss greater than moderate degree by universal newborn hearing screening (UNHS) system.Methods Infants and young children,born from Jan 2002 to Dec 2007 in Shanghai and failed UNHS,were included in this study.They received audiometric evaluations at the Shanghai Children's Hearing and Speech Center.Among those diagnosed with hearing loss greater than moderate degrees,65 were intervened at 6 months and followed up subsequently.According to hearing loss degree and intervention strategies,20 of 65 were included in the hearing aid group(M_(HA)),19 was in the severe hearing aid group(S_(HA)),9 in the profound hearing aid group(P_(HA)),and 17 in the profound cochlear implamation group(P_(CI)).Other 36 were not intervened at 6 months old but followed up also.The control group was 36 normal hearing young children.The hearing losse and speech development were analyzed for statistical study.Results Between the group without intervention and the control group,between the group intervened and without intervention,statistically significant differences were noted (P＜0.05) in the average hearing threshold and the developmental scores.Between the control group and anyone group among M_(HA),S_(HA) and P_(CI),no statistically significant differences (P＞0.05) were noted in the developmental scores.For the same hearing level between the group P_(HA) and P_(CI),statistically significant differences (P＜0.05) were noted in the developmental scores.The developmental scores of P_(HA) was lower than that of P_(CI).Conclusion Early intervention is effective for infants and young children with hearing loss greater than moderate degree.Their speech development is noticeably faster than that of those without any intervention.According to hearing loss degree,it was very important for acquiring the best speech development that selected the most proper intervention mode.

OBJECTIVE: To observe the efficacy of intratympanic steroid injection as supplementary or initial treatment for sudden sensorineural hearing loss (SSNHL). METHOD: A total of 68 patients diagnosed with SSNHL were randomized into group A (45 cases including systemic steroid for 33 cases and systemic steroid + intratympanic steroid as supplementary treatment for 12 cases) and group B (23 cases, initial intratympanic steroid). Then observe the therapeutic effect in two groups. RESULT: The total effective rate was 55.6% in group A and 56.5% in group B. No statistical difference was detected between these two groups (P > 0.05). There was statistical difference after therapy of intratympanic steroid as supplementary treatment for 12 patients due to poor hearing improvement after systemic steroid in group A (P < 0.05). CONCLUSION Both systemic and intratympanic steroid injection for SSNHL are effective. The efficiency of intratympanic steroid injection as supplementary or initial treatment for SSNHL is similar to that of systemic steroid. The intratympanic steroid injection for SSNHL as initial protocol or as supplementary treatment when poor hearing improvement after systemic steroid is recommended.
Hearing Loss, Sensorineural ; drug therapy ; Hearing Loss, Sudden ; drug therapy ; Humans ; Injection, Intratympanic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome ; Tympanic Membrane

BACKGROUND: Although some studies have been done on the functional change of cochlea in chickens during prolonged administration of kanamycin,few studies on ultrastructural changes in chicken cochlea have been reported.OBJECTIVE: To observe ultrastructural changes of the chicken basilar papilla following poisoning with prolonged administration of kanamycin.DESIGN: A completely randomized design and controlled observation.SETTING: Affiliated Xinhua Hospital, Shanghai Second Medical University.MATERIALS:The experiment was conducted in Xinhua Hospital Affiliated to Medical College, Shanghai Jiao Tong University from June 2001 to August 2003. Newly born Roman chickens (n=78), of either sex, provided by Shanghai Guixing Breeding Chick Farm, were used as subjects.METHODS: 200 mg/kg kanamycin was injected into muscles daily at day 3 after birth for 10 days. Then they were divided into 3 groups randomly:①typical application group: The chickens were applied with drugs no longer, and then killed at days 1, 3,7, 10 and 15, 6 chickens in each time phase. ②prolonged application group: 200 mg/kg kanamycin per day were injected into muscles continuously, and then killed at days 13, 17, 20, 25and 30, 6 chickens in each time phase. ③control group: The chickens were not treated with any drug. They were assigned into 3, 13 and 33 days groups with 6 chickens in each time phase. When the chickens were killed they were at the same age with the experime ntal animals at days 0, 10 and 30 of kanamycin treatment. All the experimental animals were studied with auditory brain-stem response (ABR) and scanning electron microscopy in chicken basilar papilla to observe ultrastructural change of cochlea, threshold, latency and amplitude of ABR wave I.MAIN OUTCOME MEASURES: ①Ultrastructural change of the chicken basilar papilla, and ② ABR result of chicken.RESULTS: A total of 78 Roman chickens were involved in the result analysis, without dropout. ①Outcome of ABR: Loss and recovery of chicken ABR threshold value was similar between within continuous administration for 20 days and administration for 10 days plus 10 days of recovery (drug withdrawal group). Twenty days after administration, ABR threshold significantly increased again. ②Outcome of scanning electron microscopy: At the end of 10-day kanamycin administration, hair cells in 40％ proximal chicken basilar papilla were destroyedand disappeared completely. Although continuous administration was performed, the hair cells began to regenerate and repair after damage. Within the 20-day continuous administration, the regenerated hair cells of basilar papilla developed maturity, which was mostly coincident with the administration for 10 days group. At day 25, regenerated hair cells of proximal basilar papilla were injured once again. At day 30, most of the regenerated hair cells were destroyed and disappeared.CONCLUSION: Prolonged administration of kanamycin obviously prevents the full repair of chicken basilar papilla damaged by kanamycin poisoning.

Objective To analyze the causes of misdiagnosis of esophageal leiomyoma.Methods The clinical data of 20 patients who were preoperatively misdiagnosed as esophageal leiomyoma at our hospital in 16 years were retrospectively analyzed.There were 11 males(55%) and 9 females(45%) with a mean age of(45.9 ± 16.4) years(range, 13-71 years).The initial presentations were obstructive symptoms in 12 patients(60%).CT imaging were performed in 9 patients(45%), of which 4 cases were enhanced CT(20%).Results The misdiagnosed patients included 5 cases of extraesophageal lesions(4 cases of paraesophageal lymph node tuberculosis and 1 case of lymph node hyperplasia), 8 cases of begin interstitial diseases(3 cases of neurinoma, 3 cases of inclusion cyst, 2 cases of angioma), 5 cases of malignant interstitial diseases(4 cases of GIST, 1 case of PNET), and 2 cases of esophageal cancer.The 4 cases of esophageal tuberculosis were misdiagnosed due to the absence of CT examination.The patients with esophageal cancer were treated with esophageal resection and reconstruction without clear staging of the tumor.This might be associated with the neglection of the rapid symptom development and the characteristic lumen stenosis under the gastroscope.The characteristic mucosal ulcer in patients with highly malignant GIST was overlooked.The disease relapsed postoperatively because only tumor enucleation was performed.Conclusion Preoperative diagnosis of esophageal leiomyoma is not uncommon.This disease is most often misdiagnosed as paraesophageal lymph node tuberculosis or esophageal GIST.CT examination is useful in distinguishing esophageal leiomyoma and paraesophageal lymph node tuberculosis.The roles of reoperation and adjuvant therapy in the surgical treatment of esophageal leiomyoma need further investigation.

Objective To investigate the role of Ephrin A2 in the regeneration and reinnervation of hair cells in the chick cochlea following kanamycin ototoxicity.Methods 66 newly hatched Roman chickens (3 days old) were randomly divided into experimental group and control groups. Experimental chickens (n=48) received intramuscular kanamycin (200 mg/kg:Sigma,St Louis,MO) for 10 consecutive days and were subsequently sacrificed 2 days before the last injection,and 1,3,7,10,15,21,30,and 60 days after the last injection (n=6 per subgroup). Control chickens (n=18) were untreated and sacrificed 3,13 and 43 days after hatching (n=6 per subgroup). Ephrin A2 protein expression in acoustic ganglia was determined by western blot analysis in all chickens after sacrifice. Results Ephrin A2 protein expression was found and the protein level was almost same in acoustical ganglia of all normal chickens. After kanamycin exposure,the Ephrin A2 protein expression level in the cochlea of the experiment chickens from 2 to 7 days after last kanamycin injection was lower than that in control chickens,respectively. Ephrin A2 expression increased obviously at 15 days after kanamycin last injection. By 30 days after the cessation of kanamycin treatment,the level of Ephrin A2 protein approximated to that in normal control group.Conclusion The expression of Ephrin A2 protein in the acoustical ganglia basically synchronizes with the regeneration and the reinnervation of the hair cells in the chicken cochlea following kanamycin damage,indicating that Ephrin A2 may play an important role in this process.

Objective To evaluate hepatectomy for liver metastasis in breast cancer patients. Methods From May 1997 to May 2000, 18 primary breast cancer patients with metachronous liver metastases underwent hepatectomy. The clinicopathologic features and surgical results were analyzed. Results The actuarial 1,3-year survival rates after hepatic resection were 100% and 83. 3% for patients with solitary metastasis, and 90.9% and 54.5% for those with multiple foci. Conclusions Posthepatectomy long term survival was correlated with the number of foci in postmastectomy breast cancer patients suffering from heterochronous liver metastasis. Tumor size and TNM stage of breast cancer were not correlated with the survival. Aggressive surgery helps to prolong the survival.

AIM: To explore the significance of platelet activation, fibrinolytic activity and the changes of vasoactive mediators in acute myocardial infarction in rabbits and the intervention of amiodarone and metoprolol. METHODS: Fifty New Zealand white rabbits were randomly assigned to five groups, ten for each. Group Ⅰ: sham group, group Ⅱ: acute myocardial infarction(AMI) group, group Ⅲ: AMI and lidocaine group, group Ⅳ: AMI and amiodarone group, group Ⅴ: AMI and metoprolol group.The middle point of left ventricular coronary artery was ligated (groupⅡ,Ⅲ, Ⅳ and Ⅴ ) or a sham ligation(group Ⅰ). Four hours later, blood was collected for measuring plasma concentration of TXB 2, 6-Keto-PGF 1?, ET, NO, plasma activity of t-Pa and PAI.After that, the heart was taken out to evaluate the infarction size(IS). RESULTS: Plasma concentration of TXB 2, ET, NO and plasma activity of PAI were significantly higher in groupⅡ,Ⅲ, Ⅳ and Ⅴ than those in group Ⅰ(P0.05).Compared to group Ⅱ, plasma concentration of ET, NO and PAI activity were significantly decresed (P

OBJECTIVETo explore rest, cold compress and elevate (RICE) with rest, compress and elevate (RCE) without cold for the treatment of acute ankle sprain, in order to clear mid-term clinical effects.

METHODSEighty-nine patients with acute ankle sprains were collected from January 2013 to March 2014,including 30 males and 59 females aged from 18 to 60 years old with an average of 36 years old; the time from injury to hospital ranged from 3 to 24 h with an average of 9 h. All patients were divided into two groups according to visiting sequence. There were 45 patients in RICE group, and 45 patients in RCE groups. The main therapeutic effect index was evaluated by Karlsson scoring, and secondary therapeutic effect index was pain and satisfactory VAS scores. Safety index evaluated by adverse event.

RESULTSOn the 2nd weeks after injury, Karlsson score in RICE group was 44.66 ± 11.58, and 46.67 ± 8.52 in RCE group, while there was no statistical significance between two groups in Karlsson scores (P > 0.05). Karlsson score of two groups after treatment were higher than before treatment. There was no significantly meaning in pain and satisfactory VAS scores between two groups (P > 0.05). No adverse reaction were occurred between two groups.

CONCLUSIONCold compress did not receive much more final gains, and no evidence showed cold compress could affect recovery of joint function.

Acute Disease ; Adolescent ; Adult ; Ankle Injuries ; physiopathology ; therapy ; Case-Control Studies ; Cold Temperature ; Female ; Humans ; Male ; Middle Aged ; Sprains and Strains ; physiopathology ; therapy

Plants in Acaceae family are often considered as ornamental and medicines. However many of them have irritation properties. As medicinal plants some of them are recorded in Chinese Pharmacopoeia and they are figured as poisonous. Through investigating the domestic and overseas studied paper, the needle-like calcium oxalate crystal exits in the plants of Acaceae family could be thought as irritation components of them. This conclusion is same with the studied conclusion of our study group in the medicines plant of Pinellia ternate belonging to the Acaceae family and our studies showed that the needle-like calcium oxalate crystal was the main irritation component of raw P. ternate. The irritated mechanism of raphides is relevant to its special shape, the protein enzyme adhering to it and idioblasts in plants.
Araceae ; chemistry ; Calcium Oxalate ; analysis ; poisoning ; Conjunctival Diseases ; chemically induced ; Crystallization ; Dermatitis, Contact ; etiology ; Humans ; Mucous Membrane ; drug effects ; Pinellia ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVETo validate the irritation effects of calcium oxalate crystal in several herbal drugs which come from Araceae plants.

METHODCompared the irritation of pure calcium oxalate crystals isolated from the raw rhizome of Typhonium flagelliforme, T. giganteum and Arisaema erubescens and studied the quantity and irritating effect relationship of different concentration suspensions of needle-like calcium oxalate crystals by using the model of rabbits' eyes.

RESULTCalcium oxalate crystals isolated from above three rau rhizome typhonium rhizome showed strong irritation effects on rabbits' eyes. Under the condition of same content of calcium oxalate crystals, there were no difference in irritation effect between the suspensions of raw medicinal materials and pure calcium oxalate crystals. The degree of irritation on rabbits' eyes showed undoubted quantity and irritating effect relationship with the concentrations of Calcium oxalate crystel.

CONCLUSIONCalcium oxalate crystal is the irritant component in some herbal drugs which come from Araceae plants.

Animals ; Araceae ; chemistry ; Calcium Oxalate ; chemistry ; isolation & purification ; pharmacology ; Eye ; drug effects ; Female ; Male ; Rabbits ; Random Allocation