OBJECTIVE:To compare therapeutic efficacy and safety of dexamethasone with different administration routes in the treatment of chronic secretory otitis media. METHODS:A total of 150 patients with chronic secretory otitis media were random-ly divided into control group(75 cases)and observation group(75 cases). Control group was given Dexamethasone sodium phos-phate injection 5 mg by auripuncture under endoscope. Observation group was given Dexamethasone sodium phosphate injection 5 mg via eustachian tube under endoscope. Both groups were given relevant medicine every 2 days,for 3 times in total. Clinical effi-cacies of 2 groups were observed as well as bone conduction threshold under 1,2,4,8 kHz,the levels of water channel protein 1 and water channel protein 4,recurrence,the occurrence of tympanic cavity effusion before and after treatment. The occurrence of ADR was recorded. RESULTS:The total response rate of observation group(93.33%)was significantly higher than that of control group(80.00%);recurrence rate and the incidence of tympanic cavity effusion of observation group were significantly lower than those of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in bone con-duction threshold,the levels of water channel protein 1 and water channel protein 4 between 2 groups(P>0.05). After treatment, the levels of bone conduction threshold in 2 groups were significantly lower than before;the observation group was significantly lower than the control group. The levels of water channel protein 1 and water channel protein 4 in 2 groups were significantly high-er than before;the observation group was significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:The administration of dexa-methasone via eustachian tube under endoscope is significantly better than auripuncture in terms of therapeutic efficacy for chronic secretory otitis media,relieving clinical symptom,improving bone conduction threshold,up-regulating water channel protein level, reducing the risk of recurrence and tympanic cavity effusion. The two routes of adimistration have similar safety.

OBJECTIVE:To investigate clinical efficacy and safety of Fluticasone furoate nasal spray in the treatment of aller-gic rhinitis(AR). METHODS:100 AR patients in our hospital during Jan. 2014-Dec. 2015 were divided into control group and ob-servation group according to random number table,with 50 cases in each group. Both groups received decongestant Oxymetazoline hydrochloride spray. Control group was additionally given Budesonide spray,once each nostril on the first day,twice each nostril on the second day,increasing suitably according to disease condition,less than 6 times a day for patients younger than 14 years old,less than 8 times a day for patients older than 14 years old;observation group was additionally given Fluticasone furoate nasal spray,once each nostril,qd for patients younger than 14 years old,once each nostril,while morning and night for patients older than 14 years old. Both groups received treatment for consecutive 30 d. The total nasal symptoms score(TNSS),total eye symp-toms score (TESS),total nasal resistance (TNR) under 75,150 Pa,nasal minimum cross-sectional area (MCA) and the occur-rence of ADR were compared between 2 groups before and after treatment. RESULTS:There was no statistical significance in above indexes between 2 groups before treatment (P>0.05). After treatment,TNSS of 2 groups and TESS of observation group were decreased significantly compared to before treatment,and TESS of observation group was significantly lower than that of con-trol group,with statistical significance (P<0.05). There was no statistical significance in TESS of control group before and after treatment(P>0.05). TNR of 2 groups under 75,150 Pa were significantly lower than before treatment,and the observation group was lower than the control group,with statistical significance (P<0.05). MCA of 2 groups were significantly lower than before treatment,without statistical significance between 2 groups(P>0.05). The incidence of ADR in observation group was significant-ly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:Fluticasone furoate is similar to budesonide in the treatment of nasal symptoms of AR patients,but it is better than budesonide in improving eye symptoms and nasal ventila-tion function with milder ADR.

OBJECTIVE: To evaluate the effect of aural/oral rehabilitation in the prelingual deaf children with cochlear implants, analyze the relationship between the age at the time of surgery and the rehabilitation effect, and explore the law of aural/oral rehabilitation in the prelingual deaf children after cochlear implantation. METHOD: Prelingual deaf children with cochlear implants were divided by age into 1.3-2.9 group (17 cases), 3.0-4.9 group(14 cases)and 5.0-7.9 group (26 cases). All the children were evaluated by CAP and SIR questionnaires 3 months, 6 months, 9 months and 12 months after the surgery. RESULT: The scores of CAP and SIR in different age groups were all increased with time after cochlear implantation. The score of CAP in 1.3-2.9 group rose the fastest, which was lowest at the end of the 3rd month and was highest at the end of the 12th month. There were no differences between the CAP scores of 1.3-2.9 group and 5.0-7.9 group in the later test. The score of SIR rose the fastest in 1.3-2.9 group, which was lowest at the end of the 3rd month and highest at the end of the 12th month and rose the slowest in 5.0-7.9 group, which was lower than the other groups at the end of the 12th month. CONCLUSION Within one year after cochlear implantation, the younger the age, the better the effect of aural/oral rehabilitation.
Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; rehabilitation ; Humans ; Infant ; Postoperative Period ; Surveys and Questionnaires

Objective:To investigate the effect of serum cystatin C level on the occurrence and its long-term prognosis of contrast agent-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI)in elderly patients.Methods:A total of 848 elderly patients(≥60 years)undergoing PCI in our department between Mar 2015 and Dec 2017 were enrolled in a prospective cohort.The CI-AKI was defined as the increase of serum creatinine ≥44.2 μmol/L within 48-72 h after using iodine contrast agent or more than 25 % higher than base level within 48-72 h after PCI.A receiver operating characteristic curve was used to analyze the optimal cut-off value of Cystatin C for predicting CI-AKI after PCI.Patients were divided into 2 groups based on the optimal cut-off value of Cystatin C: the high Cystatin C group(Cystatin C ≥1.3 mg/L, n=178)and the control group(Cystatin C<1.3 mg/L, n=670). The differences in the incidence of CI-AKI after PCI and major adverse cardiac events(MACE)at 1 year follow-up were compared between the two groups.The Cox regression model was further used to analyze the predictors of the long-term prognosis after PCI.Results:Of 848 patients receiving PCI, the incidence of CI-AKI was 9.4%.The incidence of MACE at 1 year after PCI was higher in the high Cystatin C group than in the control group(15.7% vs.9.3%, χ2=6.524, P=0.011). Cox regression analysis confirmed that the high baseline level of Cystatin C was the most independent predictive factor for MACE at 1 year of follow-up( HR=16.244, P<0.001). Conclusions:The high baseline level of Cystatin C(≥1.3 mg/L)is an independent risk factor for CI-AKI and is also the most important predictor for the occurrence of long-term MACE in elderly patients undergoing PCI.

Objective To explore the impact of Enalapril-folic acid tablet on development of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elderly patients with coronary heart diseases(CHD) complicated with mild renal insufficiency. Methods A total of 935 old patients (≥60 years) undergoing selective PCI at our hospital from January 2013 to June 2016 were enrolled in this retrospective study.Based on treatments during the perioperative phase ,the 935 patients were divided into Enalapril-folic acid tablet intervention group (n= 296 ,31.7％ ) ,and other RAS blocker control group with Angiotensin eonverting-enzyme inhibitor (ACEI) or Angiotensin Ⅱreceptor blocker (ARB) (n=639 ,68.3％ ). The levels of serum creatinine for 72 hours after operation were monitored and evaluated.Baseline data and CIN incidence were compared between two groups.The clinical events within 1 month after contrast media application were recorded.Multivariate Logistic regression analysis was used to analyze independent risk factors for CIN after PCI. Results The incidence of CIN after PCI was lower in the intervention group than in the control group with no statistical significance[7.1％ (21/296) vs.11.1％ (71/639) ,χ2 = 3.679 ,P= 0.059].Multivariate regression analysis showed that age (OR=1.103 ,P=0.001) ,hypertension (OR=3.362 ,P=0.017) , and hyper-homocysteinemia (OR=3.528 ,P=0.003) were independent risk factors ,but the treatment with Enalapril-folic acid tablet might be a protective factor for development of CIN after PCI (OR=0.443 ,P=0.042).During the 1-month follow-up ,the rate of recurrent angina pectoris was lower in the intervention group than in the control group ( P < 0.05 ) ,while there were no statistically significant differences between two groups in the rates of rehospitalization due to worsening renal dysfunction ,dialysis/hemofiltration ,acute heart failure ,and new myocardial infarction (all P>0.05). Conclusions The treatment with enalapril-folic acid tablet may prevent the occurrence of CIN after PCI in elderly patients with coronary heart disease and mild renal insufficiency.