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 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.

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.

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

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.

AlM:To compare the effect of different incision in corneal astigmatism after phacoemulsification.
METHODS: Totally 88 cases ( 122 eyes ) with pure cataract were randomly divided into two groups. Forty cases (60 eyes) were clarity corneal incision in group A, and 48 cases ( 62 eyes ) were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism ( SlA ) , uncorrected visual acuity ( UCVA ) and best correct vision acuity ( BCVA ) were observed in pre- and post-operation at 1d;1wk;1mo.
RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk;1mo after operation(P<0. 05). The SlA had statistically significant difference at 1d ( P<0. 05 ); The SlA had no statistically significant difference between two groups at 1mo after operation (P>0. 05). UCVA≥0. 5 and BCVA≥0. 8 had statistically significant difference at 1d; 1wk ( P<0. 05) . There had no statistically significant difference at 1mo after operation (P>0. 05).
CONCLUSlON: Phacoemulsification with scleral tunnel incision remove combined intraocular lens ( lOL ) implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

AlM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.
METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test ( Schirmer l ) , breakup time of tear film ( BUT ) test and fluorescein ( FL) staining test .
RESULTS: There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random (60. 6%), and 432 employees were diagnosed (43. 2%). The positive rate of dry eye was 71. 3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc.
CONCLUSlON: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.

Age-related macular degeneration(AMD), the most common cause of irreversible blindness over 50 years in developed countries, is a degenerative disease occurs with age. The prevalence rate in our country is also increasing by year and the pathogenesis is still undiscovered. In this review, we focus on the associated risk factors reported in recent years, aim to further understand the pathogenesis of AMD.

?Dry eye is a multi-factorial disease of tear film and ocular surface, and it can result in discomfort, visual disturbance and tear film instability and potential damage of ocular surface, accompanied by hyper osmolarity of tears and ocular surface inflammation. lnflammation is the key factor to dry eye. Many kinds of immune cells and inflammatory factors are involved in the occurrence and development of dry eye syndrome. Cell apoptosis, nerve dysregulation, disorders of sex hormones also play an important role in pathologic process of dry eye. Recently, while illustrating the pathophysiology and pathogenesis of dry eye has been made some progress, there is still no single standard. The possible mechanisms of ocular surface inflammation and tear dysfunction of dry eye were reviewed in this article.

ObjectiveTo explore the application value of two-dimensional ultrasonic measurement of fetal left and right lung area, left and right pulmonary longitudinal diameter, left and right lung volume and total lung volume in evaluation of fetal lung development.MethodsIn 489 cases of normal singleton pregnancy, two-dimensional ultrasound scanning were conducted at 12-40 weeks. The left and right lung area was traced in the four chamber view using Trace method. The distances of left diaphragmatic dome to left lung apex and the right diaphragmatic dome to right lung apex were measured respectively on the left and right fetal lung parasagittal planes. Then calculation of left and right lung volume and total lung volume was carried out.ResultsSpearman correlation coefficient of gestational age and left and right lung area, left and right pulmonary longitudinal diameter, left lung volume and total lung volume were 0.929, 0.923, 0.923, 0.917, 0.946, 0.943, 0.951, and a positive correlation, with statistical significance (P<0.05). At 12-40 weeks, fetal left and right lung area, left and right pulmonary longitudinal diameter, left and right lung volume and total lung volume increased with gestational age and fetal growth. Pulmonary area increased faster before 26 weeks than that after 26 weeks. Pulmonary longitudinal diameter and lung volume grew at a constant rate throughout pregnancy, but the growth rate of pulmonary longitudinal diameter was slightly faster than that of lung volume. The fifth, twenty-fifth, fiftieth, seventy-fifth, ninety-fifth percentile of fetal left and right lung volume and total lung volume at 12-40 weeks were obtained. ConclusionsFetal left and right lung area, left and right pulmonary longitudinal diameter, left and right lung volume and total lung volume were positively correlated with gestational age between 12 and 40 week. The normal values of lung volume and total lung volume provide a reference index for prenatal diagnosis of fetal pulmonary hypoplasia. The fetal four chamber view and fetal left parasagittal section was easy to obtain, and may serve as a new conventional method in evaluating fetal lung developments.