Objective:Retrospective analysis of clinical data of 123 patients with atticotomy, exploring the clinical characteristics of patients undergoing atticotomy and the efficacy of hearing reconstruction methods. Methods:123 patients with atticotomy were divided into three groups according to the ossicular chain treatment method: preservation of the ossicular chain group（37 cases）, cartilage elevation of stapes group（49 cases）, and PORP group（37 cases）. The clinical characteristics of patients with atticotomy, preoperative and postoperative hearing levels of the three groups of patients, and postoperative complications were analyzed. Results:①89.43%（110/123） of patients who underwent atticotomy were pars flaccida cholesteatomas, while 10.57%（13/123） of patients were secondary cholesteatoma, adhesive otitis media, pars tensa cholesteatomas, congenital cholesteatoma, and external auditory canal cholesteatoma; ②The group with preserved ossicular chain had a shorter medical history compared to the other two groups, and the difference was statistically significant（P<0.001）. The group with preserved ossicular chain had smaller inter group ABG values and average ABG values at frequencies of 500 Hz, 1 000 Hz, 2 000 Hz and 4 000 Hz before surgery compared to the other two groups, and the difference was statistically significant（P<0.001）; The differences in ABG frequencies and average ABG between the three groups of patients before and after surgery were statistically significant（P<0.05）; Postoperative ABG: The group preserving the ossicular chain had a smaller difference compared to the other two groups, with a statistically significant difference（P<0.05）. There was no statistically significant difference between the cartilage plus high stapes group and the PORP group（P>0.05）; ③At 3 months post surgery, all patients achieved ear dryness. Two patients experienced delayed facial paralysis after conservative treatment, and all recovered. One patient had a slight decrease in bone conductivity due to the influence of grinding during hammer anvil fixation surgery, and one patient experienced a recurrence after 4 years due to residual surgery. 81 patients（65.85%） experienced non cartilage repair area invagination during postoperative follow-up, of which 5 patients（4.07%, 5/123） underwent a second surgery. Although the rest of the patients had local invagination, they could still self clean and did not form a cholesteatoma. The total recurrence rate was 4.88%（6/123）, with an average recurrence time of 4 years. Conclusion:Atticotomy surgery is most commonly used for pars flaccida cholesteatomas with limited scope. The incidence of postoperative retraction is high, and regular follow-up is necessary; When conditions permit during surgery, priority can be given to preserving the ossicular chain for better postoperative hearing. Both cartilage elevation of stapes and PORP implantation can effectively improve hearing, and there is no difference in postoperative hearing between the two methods. However, there is a risk of detachment and high cost after PORP surgery, and cartilage elevation of stapes is limited by insufficient height and stapes head erosion. Therefore, it is necessary to choose a comprehensive hearing reconstruction method based on the patient's condition.
Humans ; Retrospective Studies ; Female ; Male ; Adult ; Middle Aged ; Plastic Surgery Procedures/methods* ; Hearing ; Middle Ear Ventilation/methods* ; Treatment Outcome ; Adolescent ; Child ; Ossicular Replacement/methods* ; Ear Ossicles/surgery* ; Young Adult ; Tympanoplasty/methods*

Reduced sulfur compounds ( RSCs) are one of the main pollutant species in the atmosphere, so it is of great significance to develop a rapid and on-line approaches for their detection. In this study, a portable time-of-flight mass spectrometer ( TOF-MS) with magnetic field enhanced photoelectron ionization source was designed to detect RSCs. The photoelectron ionization source was induced from vacuum ultraviolet photons which generated from vacuum ultraviolet (VUV) lamp with energy of 10. 6 eV. The energy of photoelectrons was controlled by adjusting the extraction voltage to produce the photoelectron ionization, and an annular magnet was used in the ionization region to improve the ionization efficiency of photoelectrons. From the simulation result by SIMION software, it was found that the introduction of magnet field made the motion trajectroies of electrons in the helical motion increase and the convergence of electron at the ionization source was achieved. Experimental results showed that after introducing the magnet filed, the sensitivity of H2 S, SO2 and CS2 was improved by a factor of 5. 3, 9. 4 and 6. 9, respectively. With a detection time of 50 s, the limits of detection for H2S, SO2 and CS2 were 0. 14, 0. 52 and 0. 31 mg/m3(S/N=3), respectively. It could be concluded that the portable TOF-MS with magnetic field enhanced photoelectron ionization source has great potential to be applied for on-line monitoring of volatile sulfides at the emission source.

Objective To explore the effect of predictive nursing on monitoring data of a-cute myocardial infarction complicated with cardiac shock patients.Methods A total of 100 pa-tients with acute myocardial infarction complicated with cardiac shock were divided into observation group and control group according to random number table method.The observation group was conducted with predictive nursing while the control applied routine nursing.The blood pressure, heart rate,urine volume,left ventricular ejection fraction (LVEF),left ventricular end-diastolic volume (LVEDV),left ventricular systolic volume (LVESV)were monitored in the two groups. And LVEF line chart was drew in order to evaluate the change of the monitoring data of life. Meanwhile,the incidence of adverse events was analyzed in order to evaluate the efficacy of the treatment and nursing.Result The life monitoring data of two groups after treatment were signif-icantly improved,and the observation group indicators after treatment were significantly better than that in the control group.LVEF line chart can reflect that the data of 2 hours in observation group after CCU nursing was predominant.The adverse events rate in the observation group was significantly lower than that in the control group,the difference was statistically significant (P <0.05).Conclusion Predictive nursing intervention can significantly improve treatment effect of a-cute myocardial infarctions complicated with cardiogenic shock and it is of great significant in im-proving life monitoring data of patients with myocardial infarction complicated with cardiac shock.

Objective To explore the effect of predictive nursing on monitoring data of a-cute myocardial infarction complicated with cardiac shock patients.Methods A total of 100 pa-tients with acute myocardial infarction complicated with cardiac shock were divided into observation group and control group according to random number table method.The observation group was conducted with predictive nursing while the control applied routine nursing.The blood pressure, heart rate,urine volume,left ventricular ejection fraction (LVEF),left ventricular end-diastolic volume (LVEDV),left ventricular systolic volume (LVESV)were monitored in the two groups. And LVEF line chart was drew in order to evaluate the change of the monitoring data of life. Meanwhile,the incidence of adverse events was analyzed in order to evaluate the efficacy of the treatment and nursing.Result The life monitoring data of two groups after treatment were signif-icantly improved,and the observation group indicators after treatment were significantly better than that in the control group.LVEF line chart can reflect that the data of 2 hours in observation group after CCU nursing was predominant.The adverse events rate in the observation group was significantly lower than that in the control group,the difference was statistically significant (P <0.05).Conclusion Predictive nursing intervention can significantly improve treatment effect of a-cute myocardial infarctions complicated with cardiogenic shock and it is of great significant in im-proving life monitoring data of patients with myocardial infarction complicated with cardiac shock.

In this article, an acetone-enhanced negative photoionization (AENP) source based on a 10. 6 eV vacuum ultraviolet ( VUV) lamp was developed and coupled to a home-made time-of-flight mass spectrometer for rapid detection of trace explosives. In the AENP source, acetone molecules absorbed 10. 6 eV photons and were ionized by single photon ionization to emit photoelectrons. The photoelectrons reacted with O2 , CO2 , etc. in the atmosphere to produce mainly CO-3 negative reactant ions. With this ionization source, common explosives, N-nitrobiz ( 2-hyolorolroxy ethyl )-amine dinitrate ( DINA ) , Tetryl, trinitrotoluene ( TNT ) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX), could be detected sensitively, and the limit of detection of 2 pg ( TNT) with a linear range of 3 orders of magnitude was achieved. The simple structure, high sensitivity characteristics make the AENP source as a promising ionization source for mass spectrometry.