Objective To observe the abnormal brain activity in patients with migraine without aura(MwoA)with MRI.Methods Fifty MwoA patients(MwoA group)and 46 healthy volunteers(control group)were prospectively enrolled.Functional MRI(fMRI)was performed to observe the dynamic regional homogeneity(dReHo)of brain regions,then brain regions with differences of dReHo value between groups were extracted,and correlations with clinical scales were analyzed.Results Compared with control group,dReHo values of surrounding cortex of bilateral calcarine fissure and right middle occipital gyrus increased,of right middle temporal gyrus,right middle frontal gyrus and left cuneus decreased in MwoA group(GRF correction,voxel level all P＜0.005,cluster level all P＜0.05).The weight analysis showed that brain regions with top 3 absolute weight values were surrounding cortex of right calcarine fissure,left cuneus and right middle occipital gyrus.dReHo value of surrounding cortex of left calcarine fissure in MwoA patients was negative correlated with self-rating depression scale(SDS)(r=-0.28,P=0.04).Conclusion Abnormalities in the upward transmission pathway of visual information existed in MwoA patient,especially in surrounding cortex of right calcarine fissure,left cuneus and right middle occipital gyrus.

Objective:To study on the effect of ultrasound-guided thoracic paravertebral nerve (TPVB) block on quality of recovery from general anesthesia in tuberculosis patients with fiberboard exfoliation in post anesthesia recovery unit (PACU).Methods:From May 2018 to December 2019, 40 tuberculosis patients in Changsha Central Hospital with pulmonary fibreboard exfoliation and focal abscess lesions cleaning were randomly divided into two groups, with 20 patients in each group. The patients in group A received endobronchial general anesthesia and in group B received ultrasound-guided TPVB combined with endobronchial general anesthesia. Patients in the two groups were maintained under anesthesia by propofol, and the bispectral index (BIS) was maintained within the range of 40-50. The dosage of propofol and sufentanil was adjusted according to changes in BIS and hemodynamics. The mean arterial pressure (MAP), heart rate (HR) in two groups of patients were recorded at before anesthesia induction (T 0), before cutting leather (T 1), cut skin after (T 2), the end of operation (T 3), extubation time (T 4), and T 5 (time of leaving PACU). The visual analogue scale (VAS) of all patients in resting and cough state was recorded at 5, 30 min after extubation and the time of leaving PACU. The dosage of propofol and sufentanil in the operation and the additional dosage of sufentanil in PACU were recorded in both two groups. And the respiratory recovery time, consciousness recovery time, extubation time and sedation agitation scale(SAS) were observed. The adverse reactions such as nausea, vomiting, drowsiness and hypotension were observed in PACU. Results:Compared with group A, MAP and HR of patients at T 2, T 3, T 4, T 5 in group B were more stable during anesthesia, and VAS of patients in group B were lower than that in group A at each time point after extubation ( P<0.05). The dosage of sufentanil and propofol in group B were (35.92±8.12)μg and (749.56±95.30)mg respectively, which were significantly lower than those in group A [(45.74±4.42)μg and (862.83±105.34)mg, P<0.05]; the dosage of sufentanil in postoperative anesthesia recovery room of group B was (5.26±2.10)μg, significantly less than that of group A (10.35±5.86)μg ( P<0.05). The respiratory recovery time, consciousness recovery time and extubation time in group B were (12.92±5.12) min, (20.56±5.10) min and (26.87 ± 6.16) min, which were shorter than those in group A [(15.74±4.72)min, (25.83±5.34)min and (35.35±5.80)min, P<0.05]. The incidence of postoperative nausea, vomiting, lethargy and hypotension in group B were 10%, 10%, 35% and 20%, which were significantly lower than those in group A (30%, 20%, 75% and 45%, P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block may significantly reduce the dosage of opioid analgesics for general anesthesia in tuberculosis patients with fiberboard exfoliation, accelerate the speed of anesthesia recovery, reduce the agitation during recovery, and improve the quality of anesthesia recovery.

Objective To establish examination methods of electromyography (EMG) for tensor veli palatini (TVP) ,to obtain EMG values and EMG graphic patterns of TVP in normal healthy population .Methods A total of 20 healthy adults were selected for the study .Under the guidance of nasopharyngoscope ,especially designed elec-trode needles were inserted into different sites of TVP .All the 20 healthy adults were asked to perform series of swallowing and recorded the EMG values and EMG waveforms .Results At a scanning speed of 5 ms/div ,and with the TVP point as tie point ,the results of 20 healthy adults were obtained for 38 sides of TVP EMG .With the TVP contraction duration (0 .863 ± 0 .255 s) ,the peak voltage was produced by the contraction of 445 .100 ± 246 .808μV .The wave forms of EMG were considered as the interference .TVPs were observed bilaterally in synchroniza-tion with the contraction during swallowing .Action potential durations were 9 .142 ± 2 .178 ms ,and the amplitude of the action potential was 254 .260 ± 191 .544 μV .The action potential graphic configuration was multi -phasic with 2~3 waveforms .Conclusion This experimental study showed that when the TVP point was as tie point and the scanning speed was set at 5 ms/div record ,the results of action potentials were obtained more stable and clearer and the TVP normal values were also obtained for the normal population .

Objective To investigate the learning curve of cochlear implantation and its guiding significance for clinical surgery.Methods A retrospective analysis of the clinical data of two otologists in early cochlear implant surgeries,including 98 cases of Dr.A and 54 cases of Dr.B.Statistics of the two doctors incidence of complications and operating time.Operation time as index were drawing a,b two groups of cases of scatter plot,the oscillating sine curve model Y =sin(X)-P/2 and logarithmic curve model Y =b1 ln (X) + b0 curve fit were analyzed.Then,extract the early 90 cases of surgery by Dr.A which was divided into a,b,c three groups with 30 cases a group.The operating time and complications were further compared and analyzed (SPSS 16.0).Results From the operation sequence,A and B physicians,early operation cases cost more operating time,and more complications.Learning curve before and after about 30 cases appeared inflection point,showing a rapid decline in period (learning phase) and slow decline period (consolidation phase) in two stages.Group contrast to Dr.A's early 90 consecutive cases,the operating time of Phase b and Phase c decreased significantly than Phase a (Pa-b ＜0.01,Pa-c ＜0.01),while there was no significant difference between group Phase b and Phase c (Pb-c =0.68),the complication rate of Phase b and Phase c decreased significantly than Phase a (Pa-b ＜ 0.01,Pa-c ＜ 0.01),while there was no significant difference between group Phase b and Phase c (Pb-c =0.15).Conclusions Our department of cochlear implantation followed the learning curve rule.The minimum number of cases that should accumulate in the learning phase needs about 30 cases.

OBJECTIVE: To evaluate the position and shape of inserted electrode arrays by plain X-ray during cochlear implantation. METHOD: Cochlear view of implanted electrode arrays by plain X-ray were observed during operation in 54 patients received cochlear implant. RESULT: The image in cochlear view could provide the information about position and shape of inserted electrode arrays. The spiral-shape electrode arrays without distortion and folding were found in 52 cases. The complete insertion of intracochlear electrode in these patients were confirmed by surgery. Of 54 cases, the other 2 cases showed improper position and C-shape of intracochlear electrodes, one was partial insertion and the other was bending inside the cochlea. The bending electrode array was reinserted immediately during operation. CONCLUSION Routine plain X-ray after inserted electrode during operation was a best way of knowing the shape and depth of the electrode array, especial for the difficult cochlear implantation, and also could avoided anesthetization again.
Adolescent ; Child ; Child, Preschool ; Cochlea ; diagnostic imaging ; Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Female ; Humans ; Infant ; Male ; Radiography ; X-Rays ; Young Adult

Objective To observe the efficacy of monosialotetrahexosy lganglioside (GM1) in the treatment of vascular cognitive impairment (VCI). Methods Sixty patients with VCI were randomly divided into either a treatment group or a control group. The patients in the control group received conventional treatment and those in the treatment control group were treated with conventional treatment plus continuous intravenous infusion of GM1 (80 mg/d) for 2 weeks. The efficacy was evaluated by the Montreal Cognitive Assessment (MoCA) before and after the treatment, and the safety of the treatment was observed. Results After 2 weeks of treatment, the MoCA scores were significantly higher than those before treatment in both groups (all P ＜ 0. 05). The MoCA scores of the treatment group were significantly higher than those of the control group (20. 82 ± 1. 96 vs. 19. 61 ±2. 02, t =2. 315, P =0. 023). No obvious adverse reactions were found. Conclusions The efficacy of GM1 is positive in the treatment of vascular cognitive impairment, and there is no obvious adverse reactions. It is worthy of using widely in clinical practice.

OBJECTIVE: To investigate the diagnosis and treatment of the simple congenital malformation of ossicular chain. METHOD: Curative effect analysis for 4 cases of treatment of simple congenital malformation of ossicular chain were performed in our department from June 2005 to August 2009, retrospectively. 4 patients underwent middle ear exploration and ossicular chain reconstruction were followed up for 1-4 years, and air conduction threshold of speech frequency(0.5, 1.0, 2.0 kHz) were detected, 15 dB increase of which were as the standard of successful operation. RESULT: Three cases was abnormal incus, 2 cases were absence of instruction on the stapes footplates, and stapes footplates fixed, one case was absence of the incus. Hearing level had significantly improve after hearing reconstruction in 3 patients. The averaged postoperative air conduction threshold of speech frequency had 47 dB increase, bone conduction threshold have no change, while one case of hearing level without change. Tinnitus, vertigo, facial paralysis and other complications occurred were found in all the patients. CONCLUSION The congenital conductive hearing loss without external ear malformations should be suspected of congenital malformation of ossicular chain, which could be diagnosed by tympanic exploration. Ossicular chain reconstruction can improve the hearing effectively.
Adolescent ; Ear Ossicles ; abnormalities ; Hearing Loss, Conductive ; congenital ; diagnosis ; surgery ; Humans ; Male ; Retrospective Studies ; Young Adult

Objective To study spiral CT features and pathological basis of nodular goiter ,so that to improve the diagnostic accuracy of nodular goiter.Methods CT findings in 34 patients with nodular goiter confirmed by pathology were retrospectively analyzed and compared with pathological findings. Results Thyroid density in the patients with NG was lower than that in the normal. There was no statistically significant difference in the density between single and multi-NG. Most lesions(28/34) were multiple, round or oval, with different size and smooth edges. The density of majority lesions was lower than nearby normal tissue. Most lesions (27/34) were uniform in density. Central necrosis(5/34)often appeared in the bigger lesions(diameter＞3.0 cm). The CT value of the lesions was increased (47.1±42.2) HU after enhancement,but lower than surrounding thyroid tissue. Calcifications in the lesions(6/34)were puncticular,plaque or crustiform. Single or multiple cystic-solid or solid nodules could be seen in pathology, without a continuous capsule in the majority. Some patients (5/13) with single NG shown on imaging study were multi-NG in the pathology. Three cases of diffuse NG showed by CT were malignant in pathology. Conclusion There are certain characteristics for NG on spiral CT. Comprehensive evaluation may improve the accuracy of CT diagnosis.

Objective:To explore the feasibility and validity of tubo-tymanoaerodynamic graphy(TTAG)determinating the Eustachian tube function of health adult group.Mthod:The ventilation function of Eustachian tube was measured by the TTAG method in health adlut group(132 ears),the results and the graphs were also analyzed.Reslut:The positive rate in health adult group using Valsalva method was 93.93%(124/132).The positive ears were divided into typeⅠand typeⅡ, the mean value of nasopharynx press of type Ⅰand Ⅱ has no significant differences(P>0.05),but the mean value of external auditory canal press had significant differences(P<0.01).Conclusion:TTAG meathod has the clinical value in determinating the states of Eustachian tube function of health group.

OBJECTIVE: To explore the feasibility and validity of tubo-tymanoaerodynamicgraphy (TTAG) determinating the Eustachian tube function of health adult group. METHOD: The ventilation function of Eustachian tube was measured by the TTAG method in health adult group (132 ears), the results and the graphs were also analyzed. RESULT: The positive rate in health adult group using Valsalva method was 93.93% (124/132). The positive ears were divided into type I and type II, the mean value of nasopharynx press of type I and II has no significant differences (P>0.05), but the mean value of external auditory canal press had significant differences (P<0.01). CONCLUSION TTAG method has the clinical value in determinating the states of Eustachian tube function of health group.
Acoustic Impedance Tests ; methods ; Adolescent ; Adult ; Ear Canal ; physiology ; Eustachian Tube ; physiology ; Female ; Humans ; Male ; Young Adult