Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.
Humans ; Male ; Female ; Retrospective Studies ; Prognosis ; Adult ; Middle Aged ; Vertigo/diagnosis* ; Hearing Loss, Sensorineural/diagnosis* ; Young Adult ; Hearing Loss, Sudden/diagnosis* ; Adolescent ; Aged ; Vestibular Evoked Myogenic Potentials

Objective To study the expression of Nuclear factor E2 related factor 2 (Nrf2) ,Superoxide Dis‐mutas 1 (SOD1) ,and Heme Oxygenase- 1( HO -1) factors related to Nrf2 signaling pathway in noise-induced cochlear injury of rats .Methods A total of 30 SD rats were randomly and equally assigned into the following 2 groups :noise group and normal control group .The rats in noise group were exposed to an 115 dB SPL continuous steady white noise for 12 hours ,then 1 day ,3 days ,and 7 days later ,the rats receveid the ABR and DPOAE testing after noise exposure .Both RT -PCR and Peggy Sue trace protein detection techniques were used to detect gene ex‐pression in Nrf2 /Keapl-ARE signaling pathway and the protein levels by cochlear tissue sampling after noise ex‐posure 7 days later .Results The ABR thresholds in the noise group was higher than those of in normal control group after noise exposure 1 ,3 ,and 7 days later (P<0 .05) .The DPOAE values of noise group were significantly lower than those of normal control group (P<0 .05) .The up -regulation of expression of Nrf2 ,SOD1 ,HO -1 mRNA(1 .11 ± 0 .05 ,1 .45 ± 0 .12 ,1 .15 ± 0 .03) in noise group were higher than those of in the normal control group after noise exposure 7 days later (1 .00 ± 0 .02 ,1 .10 ± 0 .12 ,0 .92 ± 0 .08) ,and the differences were statistically sig‐nificant (P<0 .05) .And in Peggy Sue trace detection system ,we also found SOD1 ,HO -1 protein levels in noise group were higher than those of in normal control group .Conclusion After the noise -induced cochlear injury in rat ,Nrf2 expression in the cochlea increased and up-regulatd expression of downstream gene and protein content such as antioxidant enzymes SOD1 and HO-1gene by regulating Nrf2 /Keapl-ARE signaling pathway ,which may be involved in protection against oxidative stress injury in noise-induced cochlear injury of rat .

Objective To investigate the correlation of serum interleukin-6 (IL-6) and C-reactive protien (CRP) lev?els with left atrial thrombus and severe spontaneous echocontrast (SEC) in patients with atrial fibrillation (AF). Methods A case-control study of patients with atrial fibrillation (n=76) was carried out. All patients were divided into control group (n=45) and study group (n=31) according to their conventional echocardiography performance. Serum IL-6 and CRP were exam?ined in both groups. Results The levels of serum IL-6 in patients with thrombus and severe SEC were (324.13±42.86) ng/L and (332.29±53.17) ng/L, respectivly which is higher than that in patient without thrombus or without severe SEC (108.75± 25.43) ng/L and (93.59 ± 27.82) ng/L respectively. In parallel, CRP levels in patients of thrombus and severe SEC were (66.97 ± 17.65) mg/L and (71.81 ± 20.19) mg/L respectively which is higher than that in patients without thrombus or without severe SEC (17.28±6.52) mg/L and (16.76±8.73) mg/L respectively. All differences were of statistically significant(P<0.05). Conclusion Increase of serum IL-6 and CRP as well as high systemic inflammatory state correlate with left atrial thombus and severe SEC in patients with AF.

Objective To investigate the features of hearing loss induced by ship noise among sailors.Methods One thousand sailors,among whom 563 of them were from the deck department and 437 were from the engine department,received hearing tests.Results Of pure tone audiometry detection were evaluated,analyzed and compared.Results For hearing damage at various frequencies,hearing loss at 4 kHz was the most common.The rate of hearing loss at high frequency was greater than that at audio frequency,which conformed to the features of noise-induced hearing loss (NIHL).The longer the sea service of sailors was and the longer they exposed to ship noise,the greater hearing damage they would sustain.For instance,the rate of hearing loss for sailors with 31 years of sea service or longer would reach as high as 35.2％.Statistical differences could be seen in the severeness of hearing damage among different groups of sailor with different length of sea service (P ＜ 0.01).There was statistical significance in the rate of hearing loss,when comparisons were made between the engine department sailors (21.1％) and the deck department sailors (11.4％) (P ＜ 0.01).The rate of hearing loss for the sailors wearing ear plugs frequently was much lower than those not wearing them,also with statistical significance (P ＜ 0.01).Conclusions Due to the high rate of hearing loss among sailors,the application of ear plugs could alleviate noise-induced hearing loss to some extent.It is of practical importance to develop and adopt highly effective,convenient and nontoxic intervention measures or devices against noiseinduced hearing loss.

Objective To investigate the features of hearing loss induced by ship noise among sailors.Methods One thousand sailors,among whom 563 of them were from the deck department and 437 were from the engine department,received hearing tests.Results Of pure tone audiometry detection were evaluated,analyzed and compared.Results For hearing damage at various frequencies,hearing loss at 4 kHz was the most common.The rate of hearing loss at high frequency was greater than that at audio frequency,which conformed to the features of noise-induced hearing loss (NIHL).The longer the sea service of sailors was and the longer they exposed to ship noise,the greater hearing damage they would sustain.For instance,the rate of hearing loss for sailors with 31 years of sea service or longer would reach as high as 35.2％.Statistical differences could be seen in the severeness of hearing damage among different groups of sailor with different length of sea service (P ＜ 0.01).There was statistical significance in the rate of hearing loss,when comparisons were made between the engine department sailors (21.1％) and the deck department sailors (11.4％) (P ＜ 0.01).The rate of hearing loss for the sailors wearing ear plugs frequently was much lower than those not wearing them,also with statistical significance (P ＜ 0.01).Conclusions Due to the high rate of hearing loss among sailors,the application of ear plugs could alleviate noise-induced hearing loss to some extent.It is of practical importance to develop and adopt highly effective,convenient and nontoxic intervention measures or devices against noiseinduced hearing loss.

Objective To observe the effects of the re-therapeutic on later stage of sudden deafness.Methods Patients who met the criteria for sudden deafness and showed poor response tO conventional therapy over two months were recruited and assigned randomly for re-therapy.The pure tone audiometry was conducted before and after re-treatment in 103 patients(112 ears).Sodium bicarbonate and dexamethasone were iniected by intravenous drip for two days and batroxobin 5 BU for 6 days.Statistics were made in the effecency of the re-treatment.Results The effective rate of re-treatment group was 46.43% and the difference was significant before and after retreatment(P<0.01).Conclusion Combined use of sodium bicarbonate dexamethasone and batroxobin is effective in re-treating later sudden deafness.