Objective:To explore the characteristics of cognitive impairment in elderly adults with deafness and assess its influencing factors.Methods:This was a cross-sectional study.From July 2015 to July 2017, 117 elderly patients with age-related hearing loss(presbyacusis group)admitted to Otolaryngology Clinic of the Yangzhou University Affiliated Hospital and 97 healthy elderly adults(control group)undergoing healthy physical examination in the same period were included.We evaluated the cognitive function was with Montreal cognitive assessment(MoCA)scale Chinese version, and calculated their MoCA total score, and recorded the clinical data and the hearing loss level.The correlation between hearing loss level and MoCA was analyzed.Results:The total scores of MoCA was significantly lower in the presbyacusis group(21.6±5.8)than that in the control group(26.8±1.5)( t=8.49, P<0.05). Patients in the presbyacusis group were associated with significantly lower levels of visuospatial and executive function(4.1 ± 0.9 vs.4.8 ± 0.5), naming(2.2 ± 1.0 vs.3.0 ± 0.0), attention(5.2 ± 1.7 vs.5.9 ± 0.5), language(2.0 ± 0.9 vs.3.0 ± 0.2), abstraction(1.6 ± 0.5 vs.1.9 ± 0.3), delayed recall(1.8 ± 0.7 vs.2.2 ± 0.4), orientation(4.4 ± 1.2 vs.5.8 ± 0.4)than the control group( all P <0.05). The level of hearing loss was negatively correlated with the total scores of MoCA and all the subscale of MoCA(all P<0.01). Univariate analysis showed that age, educational level, marital status, hearing loss level, course of hearing loss, and hearing aid were correlated with MoCA total score in elderly patients with presbcyusis(all P<0.05). Multiple linear regression analysis showed that marital status( t=6.596, P<0.05), and hearing aid( t=2.182, P<0.05)were positively correlated with MoCA total score, and age( t=-2.691), the educational level( t=-2.691), hearing loss level( t=-7.626), and course of hearing loss( t=-6.11)was negatively associated with MoCA total score(all P<0.05). Conclusions:Cognitive function is generally decline in elderly patients with presbycusis, and age, educational level, marital status, the course of hearing loss, hearing loss level and whether or not hearing aid are important factor affecting cognitive function in elderly patients with presbycusis.

Sixty-three elderly patients with allergic rhinitis and symptoms of anxiety and depression attending in the Affiliated Hospital of Yangzhou University from August 2016 to August 2018 were randomly divided into two groups: 30 patients received deanxit combined with anti-allergic drugs for treatment (study group) and another 30 patients received anti-allergic drugs treatment alone (control group). Subjective nasal obstruction was evaluated by Visual Analogue Scale (VAS), and the quality of life of patients was assessed by Rhinoconjunetivitis Quality of Life Questionnaire (RQLQ).The anxiety and depression mood changes were assessed by Self-rating Anxiety Scale (SAS) sand Self-rating Depression Scale (SDS).The scores of symptoms and mood were compared after 4 weeks and 8 weeks of treatment. The clinical nasal symptoms VAS score, the total RQLQ scores and its 7 domains scores, SDS and SAS scores of patients in two groups were significantly reduced compared to those before treatment ( P<0.05). The VAS score, the total of RQLQ scores and its 7 domains scores, SDS and SAS scores were significantly lower in the study group than those in the control group after 4 weeks and 8 weeks of treatment.The total effective rate of study group was significantly higher than those of the control group (χ 2=6.922, P=0.031; χ 2=11.544, P=0.003). Deanxit combined with anti-allergic drugs shows significant clinical efficacy, it also can improve the symptoms of anxiety and depression, and the quality of life for elderly patients with allergic rhinitis.

Objective: To investigate the quality of life(QoL) and emotion symptoms(anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis(PPFP). Methods: A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients(PPFP group, disease course >12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University, and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short-form 36 items health survey(SF-36), Chinese version of facial clinimetric evaluation(FaCE) scale, self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were evaluated.The correlation among SF-36, SDS, SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data. Results: By the assessment of SF-36, the score of vitality[(73.23±15.04)points], social function[(72.41±15.46)points], role-emotion[(72.53±15.27)points] and mental health[(73.35±14.54)points] in four dimensions of the PPFP group were lower than those of the control group [(97.56±3.76)points, (96.51±3.32)points, (97.09±2.49)points and (96.63±2.37)points](t=-10.506, -10.144, -10.505, -10.403, all P<0.001), but the scores of physical function, role-physica, bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P>0.05). By the assessment of FaCE, the total score of the PPFP group was lower than those of the control group [(48.63±17.44)points vs.(100.00±0.00)points, t=-19.281, P<0.05]. The score of SDS in the PPFP group was higher than those of the control group[(48.43±11.57)points vs.(40.63±5.39)points](t=4.174, P<0.001), but the score of SAS had no statistically significant difference between the two groups (P>0.05). According to the assessment of the correlation among SF-36, SDS, SAS and FaCE, the total scores of FaCE in the PPFP group was related only to SF-36 related mental health dimensions and SDS(r=-0.848~0.908, all P<0.001). Multiple linear regression analysis showed that marital status(t=-2.442, P=0.017), occupation(t=-2.377, P=0.020), and age(t=-5.501, P=0.000) were negatively correlated with the SDS scores; with/without synkinesis(t=3.604, P= 0.042), disease course(t=4.152, P=0.000), and the level of House-Brackmann grading system(HBGS)(t=2.116, P=0.038) were positively associated with the SDS of the PPFP group.However, disease course (t=-2.616, P=0.011), HBGS(t=-6.523, P=0.000) were negatively correlated with the total scores of FaCE, and with/without synkinesis(t= 2.767, P=0.000) was positively associated with the total scores of FaCE. Conclusion The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals.The present study suggested that age, gender, occupation, marital status, disease course, with/without synkinesis, the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Objective: To explore the reliability, validity and best cut-off value of Chinese version Addenbrooke's cognitive examination-Ⅲ(ACE-Ⅲ) in presbycusis patients with mild cognitive impairment(MCI). Methods: A total of 43 presbycusis patients with mild cognitive impairment, 61 presbycusis patients with normal cognitive impairment and 60 healthy controls treated in outpatient clinic of department of otolaryngology in the Affiliated Hospital of Yangzhou University from January 2016 to October 2017 were enrolled.The Chinese version of mini mental state examination(MMSE), Montreal cognitive assessment(MoCA) and ACE-Ⅲ were used to evaluate cognitive function of subjects.The reliability and validity of the ACE-Ⅲ were analyzed with the SPSS 21.0, and the cut-off point was confirmed with the receiver operating characteristic(ROC) curve analysis, and the value of the scale questionnaire in the diagnosis of presbycusis patients with MCI was assessed. Results: Chinese version of ACE-Ⅲ had betler feasiblity, and the receiving rate, recovery rate and effivience were 100.0%, 100.0% and 94.9%, respetively.The Cronbach's alpha, split-half reliability and intraclass correlation coefficient were 0.870(P<0.05), 0.874(P<0.05) and 0.880(P<0.05), respectively.The patients in MCI group got a lower score in the sub-scale of attention/orientation, memory, verbal fluency, language and visual space of ACE-Ⅲ compared with those in NCI group and healthy control group, and the differences were statistically significant (F=48.042, 46.594, 35.442, 19.374, 256.19, 140.319, all P<0.001). The criteria validity calculated between the Chinese version of ACE-Ⅲ and MMSE was 0.802 (P<0.001). Factor analysis of the construct validity showed that the 26 items were classed into five domains.Every domain was sensitive and effective to discriminate between patients and healthy individuals(P<0.05). The Chinese version of ACE-Ⅲ showed significantly correlation with the total scores of MoCA(r=0.802, P<0, 001). When the cut-off value for diagnosis was 86.5, the largest area under the ROC curve for the Chinese version of ACE-Ⅲ was 0.98(95% CI: 0.897-0.996). The relative sensitivity and specificity were 100.0% and 95.0%, respectively. Conclusion The Chinese version of ACE-Ⅲ had better internal consistency, reliability and validity, and is applicable for MCI assessment in elderly patients with presbycusis.Patients with presbycusis can be considered to have cognitive dysfunction with score of 86.5 by using this questionnaire.

Objective To investigate the psychopathological characteristics in families of presbycusis patients and its influencing factors.Methods The psychopathological characteristics were evaluated with the Symptom Checklist-90(SCL-90) Chinese version in 157 families of presbycusis patients(FPP) in the Affiliated Hospital of Yangzhou University from July 2015 to July 2017. Somatization, obsessive - compulsive disorder, interpersonal sensitivity,depression,anxiety,hostility,phobic anxiety,paranoid ideation,psychoticism and other were assessed and compared with the Chinese standard norm.The correlation between SCL-90 and related data had also been analyzed. The general information and clinical data of patients were analyzed.Results The SCL-90 score in the FPP group was (146.3 ± 42.8)points.The total score and total average score of SCL-90 had statistically significant difference between the FPP group and the Chinese standard group(t=14.557,14.765,all P<0.05).The scores of somatiza-tion,interpersonal sensitivity,depression and anxiety factors in the FPP group were higher than those in the Chinese standard group(t=5.417,13.588,20.857,22.475,all P<0.05).Age,sleeping condition,educational level,hearing aids and the level of patients＇hearing loss were correlated with the total score of SCL-90( TSCL-90) in FPP( all P<0.05).Multiple linear regression analysis showed that age(t=2.550,P<0.000),the educational level( t =4.087,P<0.000),and the level of patients＇hearing loss ( t =2.188, P <0.05 ) were positively correlated with TSCL-90,and sleeping condition(t= -2.004,P<0.05) and hearing aids(t= -4.643,P<0.05) were negatively associated with TSCL-90.Conclusion The psychopathological characteristics are generally poor in families with presbycusis patients,accompanied by obvious depression and anxiety;and age,sleeping condition,educational level, hearing aids and the level of patients＇hearing loss are important influencing factors.It is important to pay attention to overall health in families with presbycusis patients.

Objective To evaluate the quality of life,emotional symptoms (anxiety and depressive symptoms)and their influencing factors in elderly patients with presbycusis.Methods From May 2015 to May 2017,288 patients with presbycusis and 123 healthy controls were consecutively included into this study.Quality of life and emotional symptoms were evaluated by a series of questionnaires including the generic questionnaire medical outcomes study short-form 36 items health survey(SF-36),self-rating depression scale (SDS) and self-rating anxiety scale (SAS).Results The prevalences of anxiety(SAS score≥50)and depression(SDS scores≥53)were 23.3％ (67/288)and 20.1％(58/288),respectively;and the prevalence of the two in combination was 13.2％ (38/288).When assessed with SF-36,the scores of physical functioning,physical role,bodily pain,general health,social functioning,emotional role,and mental health were 71.0 ± 9.0,77.3 ± 9.1,73.3 -±9.6,69.6±8.6,71.9±9.9,72.1±12.7,and 73.1±10.5,respectively,which were lower than those in the control group(82.1±10.2,82.4±4.3,86.4±11.3,2.1±7.9,82.8±9.9,83.1±7.7,and 82.2 ±3.6,respectively;all P＜0.05).The scores of SDS and SAS in the presbyacsis group were 53.2± 13.3 and 51.9 ± 11.2,respectively,which were higher than those in the control group(42.5± 10.3 and 43.9± 6.2,respectively;t =10.09 and 7.52,respectively;all P＜0.05).SDS was negatively correlated with general physical and mental health (r =-0.787,P ＜ 0.05;r =-0.743,P ＜ 0.05);SAS was negatively associated with general physical and mental health(r =-0.801,P ＜0.05;r =0.750,P＜0.05,respectively);and SDS was positively correlated with SAS(r =0.958,P ＜0.05).Multiple linear regression analysis showed that concomitant hearing impairment,educational level,marital status,living condition,and sleep condition were positively correlated with SF-36 general health scores;severity of hearing loss and number of comorbidities were negatively associated with general health.However,severity of hearing loss,concomitant hearing impairment,educational level,marital status,and number of comorbidities were positively correlated with SAS and SDS scores;educational level and sleeping were negatively associated with SAS and SDS scores.Conclusions Poor quality of life and high prevalences of depression and anxiety are found in elderly patients with presbycusis,and their influencing factors include severity of hearing loss,concomitant hearing impairment,education level,marital status,sleeping and number of comorbidities.

Twenty-three patients with uniloculated deep neck abscesses (UDNA),in whom the antibiotic therapy failed and CT-guided percutaneous catheter drainage (PCD) was performed from January 2005 to June 2015,were included in the study.Catheter placement was carried out using Trocar technique in all cases.Open surgical drainage was performed when PCD procedures failed.The abscess was completely drained and open surgical drainage was avoided in 19 cases (83％);the surgical drainage was performed because of muhiple internal septation in 3 (13％) case,and 1 (4％) case died from uremia.In this series the technical success rate and clinical success rate of PCD were 96％ (22/23) and 83％ (19/23),respectively.All patients were followed-up by CT scan.No other complications and no mortality occurred during the procedure,while postoperative pneumatosis developed in 1 case.CT-guided PDC is a safe and highly effective low-cost procedure for the treatment of patients with UDNA who failed medical therapy,it may be considered as an alternative to open surgery.

Objective To assess the influence of allergic rhinitis(AR)on the quality of life and anxiety and depression symptoms in the elderly.Methods Retrospective analysis of elderly patients with AR treated at our hospital from January 2015 to October 2016 was conducted on quality of life and anxiety and depression symptoms.The participants were investigated using the rhino-conjunctivitis quality of life questionnaire(RQLQ),self-rating depression scale(SDS)and self rating anxiety scale (SAS).The correlation between SDS,SAS and RQLQ was also analyzed.Results RQLQ scores of AR patients in 7 demensions were higher than those of healthy individuals (P＜ 0.05 for all).The scores of SAS(44.8±10.1 vs.40.7±4.9)and SDS(46.7 ±12.2 vs.41.3±4.8)in AR patients were also higher than in healthy individuals (F =21.59 and 26.63,respectively,each P＜ 0.01).Furthermore,anxiety and depression symptoms were significantly associated with seven RQLQ dimensions.Conclusions Compared with healthy individuals,elderly patients with AR has poor quality of life,which is further negatively impacted by increased anxiety and depressive symptoms.Appropriate intervention measures should be taken to alleviate anxiety and depressive symptoms and enhance quality of life for elderly patients with AR.

Objective To research the pathogen characteristics and influencing factors for peritonsillar peripheral space infections in acute tonsillitis patients,so as to take measure to reduce the peritonsillar peripheral space infections.Methods 898 acute tonsillitis patients who received treatment were chosen as study subjects.Bacteria analyzer was adopted to identify pathogens.Chi-square test was used to analyze the univariate factor,and logistic regression analysis was conducted to different factors.Results 228 patients were involved the complications of peritonsillar peripheral space infections(cellulitis in 52 cases or abscesses in 176 cases),and the infection rate was 25.4％.Bacterial cultivation performed in 177 patients and positive results were detected in 107.The top three infections bacteria were Staphylococcus aureus (21.5％),Streptococcus viridians (19.6％) and Klebsiella pneumoniae (15.9％).Univariate factor analysis found that the history diabetes and peritonsillar peripheral space infections,age,acute phase of smoking and drinking,fatigue,nutritional status,class of antibiotic use,tonsillitis type,educational level and the long first diagnosis time were risk factors for peritonsillar peripheral space infections,and the differences were significant (x2 =39.851,8.818,89.041,87.266,30.417,21.499,13.472,64.548,12.223,62.871,70.749,all P ＜ 0.05).Logistic regression analysis found that acute phase of smoking and drinking,age,fatigue,tonsillitis type and the long first diagnosis time were independent risk factors for peritonsillar peripheral space infections patients with acute tonsillitis (OR =2.873,5.311,5.876,0.290,2.244,2.369,all P ＜ 0.05).Nutritional status and educational level had beneficial effect to peritonsillar infections event (OR =0.290,0.461,all P ＜ 0.05).Conclusion Acute tonsillitis is easy to cause peritonsillar peripheral space infection,it should be paid much attention and strengthened prevention.The pathogens causing peritonsillar peripheral space infections in acute tonsillitis is still mainly Staphylococcus aureus.After the analysis of related factors,the certain measures should be taken to reduce the complications rate of peritonsillar peripheral space infections in acute tonsillitis.

Chronic osteomyelitis (COM) is an infectious disease caused by methicillin-resistant Staphylococcus aureus (MRSA),the main characteristics of COM including local dead bone formation,soft tissue infection,and repeatedly attacks.As a sensitive antibiotic,vancomycin plays an important role in the therapy of COM caused by MRSA.Currently,drug treatment is divided into systemic and topical,systemic medication is given priority to intravenous drug delivery;local drug application including local delivery device and local antibiotics lavage and regional arterial perfusion.In practice,its validity depends on whether free drug concentration of vancomycin has riched the effective concentration in the organization.Nevertheless,low concentration lead to treatment failure and even induce drug-resistance bacteria,meanwhile high concentration may cause acute renal failure.So when using vancomycin for the treatment of chronic osteomyelitis,both drug resistance and renal toxicity is as the same important as the effectiveness.Systemic administration is a targeting weak way and has many complications;topical medicate effect on the lesion can be targeted,it would be an effective way in the future treatment of COM.Different methods of delivering vancomycin have great influence on local drug concentration,which makes it become the most important factor on local drug concentration of COM.