Objective To investigate the clinical effect of myringoplasty with double flaps in treatment of large tympanic membrane perforaton.Methods Ninety-five patients (112 ears) with large tympanic membrane perforation were enrolled in this study,48 patients (54 ears) were performed myringoplasty with double flaps (double flaps method group) and 50 patients (58 ears) were performed myringoplasty with underlay method (underlay method group).The air conduction (AC) and air bone gap (ABG) were measured before operation and 6 months after operation.The clinical efficacy of two groups was compared.Results The successful rate in double flaps method group was 96.3％ (52/54) and 91.4％ (53/58) in underlay method group,there was no significant difference (P ＞0.05).The effective rate in double flaps method group was 92.6％ (50/54) and 77.6％ (45/58) in underlay method group,there was significant difference (P ＜ 0.01).Conclusions Myringoplasty with double flaps in treatment of large tympanic membrane perforation can effectively mould tympanic membrane and improve hearing.The operation is worthy of spreading.

[ABSTRACT]OBJECTIVETo investigate the treatment choice and curative effect of stage III external auditory canal cholesteatoma (EACC) with different degrees of damage to the posterior wall of external auditory canal and mastoid.METHODS44 patients (45 ears) diagnosed with III type external auditory canal cholesteatoma and treated with different surgeries were collected: 27 ears with damages of mastoid which did not involve tympanic antrum (group A) underwent simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). 18 ears with damages of mastoid which involve the tympanic antrum (group B) underwent mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty. RESULTSAll patients were followed up for 1 to 2 years postoperatively. There was no recurrence of cholesteatoma, no external auditory canal collapse, stricture or atresia,and hearing improved to different degrees. The postoperative dry ear rate of group A and group B was 100% and 94.4% respectively. The mean duration of dry ear in group A and B was (12.1±2.3) and (28.1±3.5) days respectively. The cases with smooth external auditory canal and good self-purification in group Aand B accounted for 100% and 88.9%respectively.CONCLUSIONType III external auditory canal cholesteatoma can be treated with different surgical methods according to different damages of mastoid. The cases in which damages of mastoid did not involve tympanic antrum can be treated with simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). The cases in which damages of mastoid involved tympanic antrum can be treated with mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty.

OBJECTIVE: To explore the clinical manifestations and treatments of retro-esophageal space abscess. METHOD: The clinical data of 27 cases with retro-esophageal space abscess were analyzed retrospectively. Twenty-one cases (77. 78%) were secondary to acute injury of esophageal meatus caused by foreign bodies. 2 cases (7. 41%)were secondary to old foreign body infection in retro-esophageal space, 3 cases (11. 11%) after secondary to pharyngeal abscess, and 1 case (3. 70%) was unknown to etiology. All patients were confirmed by sectional medicalimageology. Six cases(Conservation group, C group) were treated conservatively and 6 cases (Oropharyngeal incision group, OI group) were performed with oropharyngeal incision drainage. 15 cases(Extra-neck incision group, ENI group)were performed with extra-neck incision and vacuum sealing drainage. RESULT: In C group, 6 cases were cured with conservative therapy and the average hospital stay was 15. 6 days. In OI group, 5 cases were healed with oropharyngeal drainage but aspiration pneumonia complicated with septic shock occurred in 2 cases, and 1 case dead from septic shock secondary to mediastinum and lung abscess. The average hospital stay was 18. 8 days. In ENI group, 15 patients were cured with extra-neck drainage without complication and the average hospital stay was 9. 5 days. CONCLUSION The main causes of retro-esophageal space abscess are foreign body injury of upper esophagus and remnant of retro-esophageal space. Sectional medicalimageology can be of important value of diagnosis and treatment for displaying the retro-esophageal space abscess and other deep cervical fascia space sufficiently. Incision and vacuum sealing drainage via extra-neck is an effective therapy while oropharyngeal drainage is less effective and is not advocated as a primary treatment because of aspiration pneumonia complication . Conservative cure is a choice for patients without dyspnoea and background diseases, and it is necessary to recognize and treat severe complications early.
Abscess ; etiology ; therapy ; Drainage ; Esophagus ; Foreign Bodies ; complications ; Humans ; Neck ; Pharyngeal Diseases ; Retrospective Studies

Brucella organisms are facultative intracellular bacteria capable of surviving inside professional and non-professional phagocytes.Upon cell contact the bacteria is internalized via receptor molecules.Once inside cells,Brucella localizes in early phagosomes,where it avoids fusion with late endosomes and lysosomes.Then,the bacterium redirects its trafficking to autophagosomes and finally reaches the endoplasmic reticulum,the replicating niche.Once inside the endoplasmic reticulum,Brucella extensively replicates without restricting basic cellular functions or inducing damage to cells.Invasion,intracellular trafficking and replication of Brucella organisms in professional and non-professional phagocytes and the molecular determinants involving Brucella intracellular life are reviewed in this article.

Objective:To investigate the impact of aging on the correlation between the intestinal microorganism Akkermansia and obesity, and to analyze the features of the correlation in the elderly population. Methods:This was a cross-sectional study.A total of 6896 cases were collected from the Guangdong intestinal microbiome in 2018, aged 18-94 years old, including 3806 females, 1641 cases with abdominal obesity(23.7%)and 707 cases with systemic obesity(10.3%). The 16S rRNA sequencing data were from individuals of Cantonese descent.The abundance of Akkermansia was calculated after data cleaning, clustering and annotation.The type of abdominal obesity or systemic obesity was diagnosed based on the standards of the Working Group on Obesity in China(2002). According to the five quintiles of the abundance of Akkermansia, subjects were divided into Q1~Q5(Q1-Q4: n=1379, Q5: n=1380). Logistic regression was used to study the relationship between Akkermansia and obesity after adjusting for common confoundors such as gender.Subjects were subgrouped into two types of age groups: the <65 group(n=5467)and the ≥65 group(n=1519); the <70 group(n=6136)and the ≥70 group(n=850). Age windows were used to analyze changes in characteristics of this relationship with increasing age. Results:There were significant differences in age and gender among different Akkermansia groups( t/ χ2=3.51, -5.03, P<0.01). Logistic regression analysis showed that after adjusting for two main confounding factors, age and gender, the risk of systemic obesity and abdominal obesity gradually decreased from Q2 to Q5 group, compared with Q1 group( P<0.001). The correlation between Akkermansia and obesity decreased with age.The protective effect of Akkermansia on obesity was weaker in the ≥65 and ≥70 groups, respectively, than in the <65 and <70 groups. Conclusions:Akkermansia is a protective factor for obesity, but the protective effect is affected by aging and weakened in the elderly.

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis

OBJECTIVETo assess the association between SIRT1 gene polymorphisms and the longevity phenomena in Yongfu region of Guangxi. In this case-control study, 500 individuals from Yongfu region of Guangxi were recruited. The subjects were divided into a longevity group (n=223, average age=93.17 U+00B1 3.08 yr) and a healthy control group (n=277, average age=46.92 U+00B1 17.12 yr). Polymerase chain reaction-high resolution melting curve (PCR-HRM) and DNA sequencing were used to determine the allelic and genotypic frequencies of rs3758391, rs3740051, rs2273773, rs4746720 and rs10997870 polymorphisms of SIRT1 gene in the two groups. The association between above polymorphisms and longevity was assessed.

RESULTSIn the longevity group, CT genotype of the rs4746720 locus was significantly more common than CC and TT genotypes (P=0.000, OR=2.098, 95%CI:1.412-4.117). However, no significant difference was found in the allelic and genotypic frequencies of rs3758391, rs3740051 and rs2273773 between the two groups.

CONCLUSIONThere is an association between rs4746720 of SIRT1 gene and longevity in Yongfu region of Guangxi.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Case-Control Studies ; China ; Female ; Gene Frequency ; Gene Order ; Genetic Association Studies ; Genotype ; Humans ; Longevity ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Sirtuin 1 ; genetics ; Young Adult

OBJECTIVETo investigate the relation between sinus-straddling hematoma (SSH) and venous sinus injury and explore the approaches for surgical management.

METHODSThirty-six cases of stride sinus hematoma were reviewed to observe the incidence rate of sinus injury complicated with (SSH) and explore its surgical management.

RESULTSThe incidence rate of venous sinus injury following (SSH) was 80.56% (29/36), and appropriate surgical management yielded good therapeutic effect in these patients.

CONCLUSIONIntracranial stride sinus hematoma is often accompanied by venous sinus injury, and adequate preoperative risk evaluation may improve the success rate of the operation.

Adolescent ; Adult ; Brain Injuries ; complications ; China ; epidemiology ; Cranial Sinuses ; injuries ; Female ; Hematoma ; epidemiology ; etiology ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic ; epidemiology ; etiology ; Male ; Middle Aged

Objective To explore the association of peroxisome proliferators-activated receptor-γ coactivator-1 (PPARGC1) Gly482Ser with apolipoprotein E (ApoE) variations in longevity (aged above 90 yrs) Hans in Guangxi Yongfu and to explore the potential association between the variations and metabolic traits.Methods Based on our survey in Guangxi Yongfu in 2008-2011,212 elderly cases (aged 90～105 years) were included as longevity group and 207 cases without longevity history were included as control group.By household survey,we collected the longevity related parameters,blood glucose,blood lipid,blood pressure and other related metabolic traits.Peripheral blood was collected to extract DNA,the gene variations of Gly482Ser and ApoE were genotyped,and the database with genome and traits information were set up.By univariate analysis and multivariate genetic statistical analysis,the association between the variations and longevity and metabolic traits was assessed.Results Compared with the control group,the levels of fasting blood glucose,total cholesterol and low density lipoprotein were lower in the longevity group.Gly482Ser was genotyped in all samples and fully fulfilled the Hardy Weinberg equilibrium.After the Bonferroni correction,recessive model failed to find association between GG genotype and longevity.Stratified analyses by ApoEε4 allele revealed that,in the subgroup with no ApoEε4,PPARGC-1 GG genotype was positively associated with longevity in the recessive model,even after Bonferroni correction (OR =1.72,P＜0.05).In addition,longevity group with Gly482Ser GG genotype seemed to have relativelower fasting blood glucose (P ＜ 0.05) and higher high density lipoprotein levels (P ＜ 0.05).Conclusions Longevity Hans in Guangxi Yongfu preserve better metabolic state compared with the control group.GG genotype of Gly482Ser in PPARGC-1 is positively associated with longevity,which depends on not carrying the risk allele of ApoE ε4.

OBJECTIVE To discuss the clinical features of primary lateral recess cysts of the sphenoid sinus,and to study the therapeutic effect of the endoscopic surgery.METHODS Nine patients with primary lateral recess cysts of the sphenoid sinus received endoscopic surgery from 2007 to 2015.Clinical data of the disease was analyzed retrospectively.Seven cases complained of cheek numbness as the chief complaint and 2 cases with progressive vision loss as the chief complaint.There were no obvious positive signs in head and facial regions.All cases were underwent marsupialization of the cysts via sphenoid sinus with nasal endoscope under general anesthesia.RESULTS All the cases had no intraoperative and postoperative complications,and the symptoms were disappeared after operation.No recurrence was found during follow-up of 6 to 24 months.The cavity of the cysts had permanent drainage to sphenoid sinus after operation in all the patients.CONCLUSION 1.Primary lateral recess cysts of the sphenoid sinus had unique symptoms and imaging characteristics.2.The marsupialization of the cysts via sphenoid sinus with nasal endoscope under general anesthesia was a safe,effective and minimally invasive method to management of the primary lateral recess cysts of the sphenoid sinus.