OBJECTIVETo explore the temporal pattern of postmortem color changes in the pupil region of the cornea for noninvasive estimation of the postmortem interval (PMI).

METHODSTwo rabbit models of air embolism and drowning were established in a dark room at a temperature of 20 ℃ with a relative humidity of 30%. The corneal images of the rabbits were acquired using a digital camera at two-hour intervals within 72 h after death. The pupil region on the corneal images was segmented using computer image processing technique (MATLAB), and the parameters of 6 image color features (RGBHSV) were extracted. Regression analysis was used to analyze the relationship between these parameters and the PMI, and the effects of different death causes on the changes of the corneal color features were also assessed.

RESULTSWithin 72 h after death from different causes, the R, G and B values of the pupil region on the corneal images all tended to increase with the PMI, showing a good fitting with the PMI ( < 0.01). No significant correlation was found between the values of H, S and V and the PMI (>0.05). The R, G and B values in the pupil region on the corneal images showed consistent variation trends after death from the two causes, and their correlations with PMI were also similar. The measured values of R, G and B in air embolism group were greater than those in the drowning group.

CONCLUSIONSThe postmortem color changes of the pupil region on corneal images follow an identifiable temporal pattern and can vary across different causes of death. The regression equations established in this study provide references for non-invasive and objective estimation of the PMI.

A new concept and solution of architecture of the intelligent POCT network, based on Internet of Things and intelligent POCT devices, is proposed. This network's topology structure and components with basic requirements are introduced. Through the experience of clinical application scenario, the main characteristics of the network and superiority over traditional POCT device have been analyzed.
Internet ; Point-of-Care Systems

Objective: To evaluate the auditory efficacy of Bonebridge implantation in patients with bilateral congenital malformation of external and middle ear. Methods: Eleven cases (6 males and 5 females) had unilateral Bonebridge implantation. The age ranged from 8 to 26 and the average age was 16.9. Seven to ten days after operation, the first fitting was undergone. In acoustic sound field, the average auditory thresholds were respectively measured for unaided ears and Bonebridge implanted ears by pure tone auditory (PTA, 0.25, 0.5, 1, 2 and 4 kHz). For the group over 12-year-old, MSTM was applied to evaluate speech discrimination score (SDS). For the other cases, MLNT was used as the test material. The auditory efficacy post Bonebridge implantation would be analyzed and evaluated by comparing the differences between unaided ears and Bonebridge implanted ears. Results: The bone conduction audibility threshold after Bonebridge implantation was as well as the preoperative. The auditory threshold with Bonebridge aided was improved to 25-35 dB HL, when compared to that of the unaided ears in the sound field. The SDS in the group over 12-year-old was improved about 50%; the efficacy was slightly limited for the other two cases (both less than 12 years old). Statistical analysis showed that there were significant differences between unaided ears and Bonebridge implanted ears in the sound field and SDS(P<0.05). Conclusions The auditory efficacy of Bonebridge is significant and noticeable in patients with bilateral congenital malformation of external and middle ear. Bonebridge provides a new and effective way for patient with congenital malformation of external and middle ear to reconstruct hearing.

BACKGROUNDAnterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time, and multiple-stage surgery. This study aimed to explore better treatment to repair anterior glottis web.

METHODSWe performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs. All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.

RESULTSAll 32 patients completed surgery in one stage, without postoperative laryngeal edema, difficulty in breathing, or other complications. After the surgery, the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however, in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords, accompanied by scar appearance of bilateral vocal cords. The GRB score, voice handicap index scores, and maximum phonation time score significantly improved in all patients after the surgery. There was no evidence of recurrent laryngeal webbing in the 6-month follow-up.

CONCLUSIONVocal cords mucosal flap repair surgery has the advantages of less trauma, quick recovery, and significant improvement of the voice in the treatment of laryngeal webs.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Surgical Flaps ; Suture Techniques ; Vocal Cords ; surgery ; Young Adult

OBJECTIVE: To investigate the effect of vibrant sound bridge implantation in microtia whose reconstructive external auditory canal occurred atresia. METHOD: Three cases (2 males and 1 female) of microtia had underwent hearing reconstruction operation (Include the external ear canal reconstructive surgery and tympanoplasty). The age ranged from 15 to 18 years and the average age was 17 years. All the 3 cases suffered from conductive hearing loss with the air-bone gap ranging from 51.6 to 65.0 dB HL and the average value being 56. 3 dB HL. All the 3 cases underwent vibrant sound bridge implantation, including the floating mass transducer implanted in the head of stapes in 2 cases and in the niche of round window in 1 case. RESULT: The postoperative hearing level improved from 21.6 to 52.5 dB HL with an average of 32.2 dB HL. There were no complications such as vertigo, tinnitus and facial paralysis. CONCLUSION Through vibrant sound bridge implantation, the hearing level of microtia whose reconstructive external auditory canal occurred atresia was improved effectively.
Adolescent ; Congenital Microtia ; surgery ; Ear Canal ; surgery ; Female ; Hearing Loss, Conductive ; surgery ; Hearing Tests ; Humans ; Male ; Ossicular Prosthesis ; Reconstructive Surgical Procedures ; methods ; Tympanoplasty

Objective:To valuate the relationships between operation modus,pathological characteristics and the prognosis on hilar cholangiocinoma(HCC). Methods:The clinical features,diagnostic methods,operation modus and histopathology results of the 223 cases with HCC were analyzed retrospectively. Results:1) Radical excision had been performed in 85 cases with the excision rate of 38.1%,1,3,5 years survival rates were 58.8%,30.9%,8.8% respectively. Palliative therapy had been performed in 110 cases; the median life span was 8 months. The average life span of those who had given up treatment was about 5 months. 2) In 132 cases of HCC,121 cases were adenocarcinoma,accounting for 91.7%. Well-differentiated was 29 cases (24.0%),medium-differentiated was 43 cases (35.5%),and poor-differentiated was 49 cases(40.5%). The others accounted for 8.3%,in total. The 1,3,5 years survival rate after radical excision of the well-differentiated and the medium-differentiated groups were 55.0%,40.0% and 15.0% respectively,those of the poor-differentiated group were 45.8%,16.7% and 0% respectively. 3) According to the Bismuth Corlette grouping type I was 20.1%,type II was 23.2%,type IIIa was 10.3%,type IIIb was 23.2%,type IV was 7.2%,and the others were 16.0%. Conclusions:1)Radical excision is the key to raise the long-term survival rate. The average life span of those who had given up treatment was about 5 months,which can reflect the natural life span. 2) Poor-differentiated adenocarcinoma accounted for considerable proportion in histopathology types of the hilar cholangiocarcinoma. 3)Bismuth Corlette grouping has some certain limit and disadvantages in the application.

Objective To investigate the expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma and its relation to clinical features and prognosis of the tumor.Methods The expression of hMLH1 and hMSH2 was determined with immunohistochemistry in 54 specimens of hilar cholangiocarcinoma and 25 of normal bile duct tissue.Lahoratory data were then analyzed statistically together with the related clinicopathological data.Results 1)hMLH1 and hMSH2 were expressed in 24 and 21 out of the 54 cases of hilar cholangiocarcinoma(44.4%,38.9%)and 23 and 21 of the 25 normal cases(92%,84%),respectively(P＜0.05).2)The expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma had no association with the age,gender,tumor size and Bismuth type(P＞0.05)but close relation to lymph node metastasis and pathological changes(P＜0.05).3)The 2-year survival rate was markedly lower in hMLH1-negative patients than in hMLH1-and hMSH2-positive ones (15%vs.45.4%,23.5%vs.44%,P＜0.05).Conclusions Joint action of hMLH1 and hMSH2plays an important role in the oncogenesis and metastasis of hilar cholangiocarcinoma.These two may be valuble factors to indicate prognosis of the tumor.

OBJECTIVE: To discuss the multiple-frequency probe tones tympanograms and the normal ranges of admittance, susceptance and conductance in normal newborns. METHOD: Tympanometries with 226 Hz, 678 Hz and 1000 Hz probe tones were obtained from newborn infants with normal TEOAE and DPOAE(55 infants, 110 ears), analysed multiple-frequency prone tones tympanograms and values of admittance, susceptance and conductance by using GSI-33 middle ear analyzer. RESULT: 226 Hz tympanograms for admittance, susceptance and conductance main were W-shaped, the percentages were 90.0%, 99.1% and 85.5%. 678 Hz tympanograms for admittance, susceptance and conductance main were single-peaked, the percentages of single-peaked type were 62.7%, 77.3% and 62.7%, and the percentages of W-shaped type were 34.6%, 20.9% and 31.8%, had a little three-peaked type. 1000 Hz tympanograms for admittance, susceptance and conductance main were single-peaked, and percentages were 96.4%, 99.1% and 97.3%, and had a little W-shape type but no three-peaked type. There were significant differences between admittance and susceptance, susceptance and conductance in 226 Hz and 678 Hz probe tones tympanogram. There were significant differences between admittance and susceptance, susceptance and conductance, admittance and conductance in 1000 Hz probe tones tympanogram. CONCLUSION Multiple-frequency probe tones tympanograms and the normal ranges of admittance, susceptance and conductance of normal newborn infants is obtained, and 1000 Hz probe tone tympanometry is a sensitive test for function of middle ear in newborn infants.
Acoustic Impedance Tests ; methods ; statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Male ; Reference Values

OBJECTIVE To investigate the clinical effect of excising the laryngeal contact granuloma with CO2 laser. METHODS Twenty three patients with laryngeal contact granuloma were excised by CO2 laser under general anesthesia. The wound was sewed under microscope. All patients were followed up for 6 months. RESULTS The wound of 18 patients scarred over well when counterchecked 1 month after operation. The cure rate was 87.3 %. Five cases recurred. Three cases of them were cured by conservative therapy for 2 months. And the other two were healed after reoperation. CONCLUSION The curative effect of excising the laryngeal contact granuloma by CO2 laser and sewing up the breakage under microscope is aff irmative. This method has a low rate of relapse.

OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.