OBJECTIVE: To evaluate the function of tubomanometry (TMM) in forcasting the progonosis of acute otitis media with effusion (OME). METHOD: We used the technique of TMM to quantify the degree of eustachian tube (ET) dysfunction in 65 patients with OME. The opening of the ET and the transportation of gas into the middle ear were registered by a pressure sensor in the occluded outer ear after applying the stimulus of a controlled gas bolus into the nasopharynx during swallowing. Three excess pressure values were tested subsequently (30, 40, and 50 mbar). If tube opening was registered, the time of opening in relation to pressure applied was measured. The TMM calculated the opening latency index or index R. An R value of < 1 indicated early opening of the tube at the start of application of the stimulus, which was considered optimal. A value > 1 indicated late opening of the tube occurring after the initial stimulus and was interpreted as suboptimal. Inability to calculate the index R value indicated that the tube was unable to actively open at all. The TMM results, were weighted as follows: no R with 0 points, R > 1 with 1 point and R < 1 with 2 points for the measurements at 30, 40, and 50 mbar, respectively. The points of these three tests were added so the ET score (ETS) ranges from 0 (worst value) to 6 (best value). According to the medical history, the patients were divided into two groups, chronic OME group (defined as positive control group), 30 cases with 38 ears; and acute OME group, 35 cases with 46 ears. The healthy ears of all patients were defined as normal control group, 46 cases with 46 ears. The same regular treatments, including classic medical treatments and intratympanic dexamethasone injections, were used to acute OME group in the following 1-2 months. On the basis of therapeutic effect, acute OME group was subdivided into valid group (26 cases with 33 ears) and invalid group (9 cases with 13 ears). RESULT: The ETS of normal control group was 5.11 ± 1.32 while it was 1.08 ± 1.32 in positive control group. It was found marked differences between the two groups (P < 0.01). The ETS of both valid and invalid subgroup of actue OME group were significantly lower than normal control group (P < 0.01), but in valid subgroup it was significantly higher than positive control group (P < 0.01), and no marked difference was found between the invalid subgroup and positive control group. After treatments, a significant improvement of the ETS was found in both valid and invalid subgroup (P < 0.05) there was no marked difference between valid subgroup and normal control group. But in invalid subgroup it was still significantly lower than normal cohtrol group (P < 0. 01). CONCLUSION TMM could forecast the prognosis of acute OME. Patients with acute OME suffered from ET dysfunction of varied degrees. Those with high ETS could be cured by classic medical treatments and intratympanic dexamethasone injections. But those with poor ETS could not be cured in short period, tube insertion should be considered. If ETS could not be improved by ventilation tube placement, more active treatment, for example, balloon Eustachian tuboplasty (BET), should be used to prevent transforming into chronic OME.
Acute Disease ; Ear, Middle ; Eustachian Tube ; physiopathology ; Humans ; Injection, Intratympanic ; Manometry ; Middle Ear Ventilation ; Otitis Media with Effusion ; diagnosis ; Pressure ; Prognosis

Objective To study the correlation between prognosis and vertigo and status of the vestibule functions with the patients of the sudden deafness (SD).Methods For 161 patients of the SD, the parameters of the hearing before treatment, vertigo and vestibule functions, were analyzed to establish a statistic model by means of Logistic regression with single factor analysis of variance, Logistic regression analysis and Chi square test.Results The single factor analysis of variance and Chi square revealed statistical differences between prognosis of the SD and hearing before treatment(P0.05).Conclusion If the patients with SD had more severe hearing loss, the prognosis would be less successful. The normal or abnormal caloric tests had influence for the prognosis of the SD, but vertigo showed influence on prognosis only when caloric test was abnormal. The degree of hearing loss was not related to that of vertigo or vestibule functions while the sudden deafness accompanied with vertigo was not due to the damage of vestibular functions.

Objective To investigate the clinical characters of posturographic test in patients with sudden hearing loss.Methods The postural map and correlative parameters value were examined by dynamic posturography in 100 cases of normal subjects and 120 cases of sudden hearing loss.According to state of the vestibule function,120 patients were divided into normal(67 cases) and abnormal(53cases) groups.The parameters of the length,velocity and Romberg of postural sway were compared between two groups.Results The postural map was most prominent centre patten(51%) in normal subjects,the patient's map was most prominent diffuse patten(60.83%).Length,velocity and Romberg of postural sway of the patients were significantly increased in comparison with normal subjects(P0.05).Conclusion The results of posturographic test indicate that the vestibular system in patients with sudden deafness is damaged.

OBJECTIVETo explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children.

METHODSFrom February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects.

RESULTSSixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair.

CONCLUSIONTreatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Male ; Mechanical Phenomena ; Radiography ; Treatment Outcome

Acute Kidney Injury ; Humans ; Terminology as Topic

Objective To investigate the type of gene mutation and its distribution in patients with thalassemia in Dongguan . Methods 7 845 specimens collected from the patients and individuals with physical examination in our hospital from June 2014 to May 2015 were performed according to the results of routine blood and electrophoresis screening with suspected cases .The speci‐mens with phenotype positive were definitely verified the thalassemia type by using Gap‐PCR and reverse dotblot(RDB) .Results Among 7 845 specimens ,suspected cases of 1 132 cases ,662 specimens were finally diagnosed as α‐thalassemia andβ‐thalassemia , with the thalassemia carrying rate of 8 .44% (662/7 845) ,including 412 cases(5 .25% ) of a‐thalassemia .The most common type ofαα/‐‐SEA ,‐α3 .7/ααaccounted for 61 .17% and 17 .48% inα‐thalassemia ,also detected HKαα/‐‐SEA mixed type in 1 case and 250 cases(3 .19% ) ofβ‐thalassemia cases .The most common type ofβCD41‐42/βN ,βIVS‐Ⅱ‐654/βN ,βCD17/βN accounted for 37 .6% , 23 .2% ,16 .0% inβ‐thalassemia .The α‐thalassemia composite β‐thalassemia for 12 cases(0 .18% ) .Conclusion Dongguan city of Guangdong province is a high incidence area of thalassemia .Premarital examination ,genetic counseling should be strengthened ,and reduce the birth rate of the thalassemia children to improve the quality of the population .

Objective To investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in each ear,and to explore the effect of sleep position in lateral-predominance of ear by PC-BPPV during sleep onset in elderly patients. Methods Totally 114 patients aged (67.4±7.5) years with unilateral PC BPPV confirmed by a positive Dix Hallpike test,were retrospectively reviewed.All patients included in the study were able to define a leteral predominant,favorate head-lying side (right,left or supine position) during sleep onset. Results The Dix Hallpike test was found to be positive on the right side in 72 patients and positive on the left side in 42 cases.During sleep onset,61 patients habitually laid their head on the right side,34 laid their head on the left,and the remaining 19 cases on the supine position.Among 114 cases with positive Dix Hallpike test,there were 78 cases with the same side between affected ear and sleep position (52 cases right,26 cases left),36 cases with different side (9 cases with right position and left positive Dix Hallpike test,8 cases left position and right positive Dix Hallpike test,19 cases slept in a supine position including 12 cases with right positive Dix Hallpike test and 7 cases with left positive).The association between affected ear and head-lying side during sleep onset was statistically significant (x2 =35.737,P＜0.01) and Pearson coefficient of continency was 0.4885. Conclusions Among the elderly,right-sided PC-BPPV is popular,and these patients favorite right head-lying position during sleep.There is association between the affected side by PC-BPPV and the head-lying side during sleep.

Objective To study the expression of intercellular adhesion molecule-1 (ICAM-1 ) in the rat cardiac heterotopic allo- grafts and the effect of cyclosporin A on prevention of allograft rejection. Methods Heart transplantated animals were divided into three groups: Group Ⅰ(control), Group Ⅱ(CsA 7. 5mg/kg B W, daily) and Group Ⅲ(CsA l5mg/kg B W, daily). Acute cardiac rejection grade was valued by the standrd of ISHLT(1990 ). Immunohistochemistry was performed to analyze the expression of ICAM-1 in heart grafts and donor aorta segments. Results After heart transplantation, it was found that from day 1 to 3, there was sligtly inflammatory infiltratiation, the rejection was graded 1A of 1B, But from day 11 to 12, there were disseminated inflammation and cardiac necrosis with serous hyperemia, exutation, edema, acute vasculitis and myocarditis. The rejection grade was 3B or 4, and could be reduced 1to 2. 5 grades by administration of CsA. It was also found that both in heart graft and donor aorta segments the expression of ICAM-1 on the endothelium cells, infiltrated lymphocytes was clearly increased. It was time-dependent and could be down-regulated by administra- tion of CsA. On Day 1 and Day 3 the suppressing function of CsA on expressing of ICAM-1 showed singificant dosage-dependent. But from Day 7 to Day 11, it appeared dosage- independent. Conclusiou Trea tment with CsA is an effect ive methed to down- regulate I - CAM-1 expression and could reduce the lympphocyte migration and filtration. These results may explain, in part, the mechanism of CsA reducing acute rejection in a rat cardiac transplantation medel.

OBJECTIVE To explore and control the related factors of nosocomial pulmonary infection in patients with extensive burn. METHODS To study retrospectively 193 hospitalized patients with extensive burn in our hospital from Jan 1997 to Oct 2004. RESULTS In 193 cases of extensive burn,there were 37 cases complicated by infection,the rate of nosocomial pulmonary infection was 19.17%.A total of 248 pathogen strains were isolated by bacterial culturing.Nosocomial pulmonary infection was closely related with such factors as aging,course of disease,burn area,burn shock with fluid resuscitation,inhalation injury,tracheotomy,antibiotic use for a long time,and so on.The mortality of 193 patients with extensive burn was 11.40%,in the infective group it was 27.03% and in the non-infective group it was 7.69%(P

Archives ; Information Management ; Occupational Health