ABSTRACT
Objective To investigate the clinical effects and safety differences of endoscopic hormone injection by tympanic membrane puncture and eustachian tube in the treatment of patients with chronic secretory otitis media.Methods From January 2015 to September 2016,90 patients with chronic secretory otitis media in Zhoushan Hospital were chosen.They were randomly divided into two groups according to the digital table.The tympanic membrane puncture group (65 patients) was treated with hormone injection by tympanic membrane puncture and the eustachian tube group(65 patients) was treated with endoscopic hormone injection by eustachian tubeThe total clinical effective rate,the bone conduction threshold value in 1 kHz,2kHz,4kHz and 8kHz,the ETDQ-7 score and the levels of laboratory index before and after treatment,the secondary tympanic effusion rate and the recurrence rate with follow-up of both groups were compared.Results The total clinical effective rate of the tympanic membrane puncture group and eustachian tube group were 77.78％ and 93.33％,respectively.The total clinical effective rate of the eustachian tube group were significant higher than that of the tympanic membrane puncture group (x2 =9.84,P ＜ 0.05).The bone conduction threshold value in l kHz,2kHz,4kHz and 8kHz of the tympanic membrane puncture group after treatment were (10.42 ± 1.60) kHz,(12.86 ± 2.50) kHz,(16.09 ± 2.81) kHz,(15.26 ± 2.68) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were (9.75 ± 1.36) kHz,(11.13 ± 2.02) kHz,(14.82 ± 2.44) kHz,(13.78 ± 2.11) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.10,3.56,3.29,3.96,2.87,3.15,2.91,3.28,2.67,2.81,2.78,2.50,all P ＜ 0.05).The ETDQ-7 scores of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.31,3.87,2.89,all P ＜ 0.05).The levels of laboratory index of the eustachian tube group after treatment were significant higher than those of the tympanic membrane puncture group and those before treatment (t =3.36,3.77,3.71,4.02,2.83,3.06,all P ＜ 0.05).The secondary tympanic effusion rate and the recurrence rate with follow-up of the eustachian tube group were significant lower than those of the tympanic membrane puncture group(x2 =9.87,12.33,10.67,all P ＜ 0.05).Conclusion Compared with endoscopic hormone injection by tympanic membrane puncture,endoscopic hormone injection by eustachian tube in the treatment of patients with chronic secretory otitis media possess the advantages including relieve the clinical symptoms,improve the bone conduction threshold and eustachian tube function,regulate the laboratory indexes and reduce the risk of recurrence and effusion.
ABSTRACT
BACKGROUND:In palatorrhaphy, iodoform gauzes are often used to fill the bilateral relaxation incisions and cover the wound. However, there are a series of postoperative complications, such as fever, loss of appetite, foreign body sensation, secondary bleeding. In order to avoid or reduce the complications after palatorrhaphy, the use of gelatin sponge to fill bilateral relaxation incisions has achieved good clinical results.OBJECTIVE:To compare the clinical effects of different treatments on wound healing after palatorrhaphy.METHODS:110 child patients with cleft palate were selected and assigned into two groups according to admission time. Fifty-four patients who admitted from January 2013 to December 2015 (experimental group) were obturated with gelatin sponge, while the other 56 patients who admitted from January 2008 to December 2012 (control group) were obturated with idoform gauze. The postoperative results of patients were assessed in various aspects, including psychological impact, diet, body temperature, bleeding, and wound healing. The incision scar width was measured at 4 weeks postoperatively.@RESULTS AND CONCLUSION: (1) Patients in the experimental group experienced shorter recovery time than those in the control group (P < 0.05). (2) Patients in the experimental group had substantialy lower incidence of fever postoperatively, and shorter duration of fever than those in the control group (P < 0.05). (3) In comparison to the control group, the experimental group showed less postoperative complications such as bleeding and vomiting (P < 0.05). (4) The incision scar width in the experimental group was significantly narrower than that in the control group (P < 0.05) after 4 weeks. These experimental findings demonstrate the superior effect of gelatin sponge over iodoform gauze and its value in clinical application with better healing, less bleeding, shorter recovery time and no impact on eating.
ABSTRACT
BACKGROUND:The autologous oxygen-delivering biomimetic nanoscaffold is composited with chondrocytes in simulated microgravity to construct the active tissue-engineered bone, which not only has excel ent osteogenic potential characteristics, but also has autologous releasing oxygen, and additional y can effectively prevent early transplant failure caused by sufficient revascularization and hypoxia. OBJECTIVE:To investigate the effects of autologous oxygen-delivering biomimetic nanoscaffold composited with chondrocytes on repairing different types of temporomandibular joint condylar fractures. METHODS:Total y 30 Sprague-Dawley rats were randomly divided into control group, experimental groups 1 and 2 (n=10 per group). The autologous oxygen-delivering nano-hydroxyapatite/chitosan scaffold composited with chondrocytes were transplanted into rats with temporomandibular joint condylar longitudinal fracture in the experimental group 1 and those with temporomandibular joint condylar transverse fracture in the experimental group 2, respectively. At 1, 3 and 6 weeks after transplantation, the number of proliferating cel nuclear antigen-positive cel s was detected by immunofluorescence assay;the chondrocyte apoptosis was detected using TUNEL method, and expressions of col agen type II, Sox9 and vascular endothelial growth factor were observed by RT-PCR technology. RESULTS AND CONCLUSION:The number of proliferating cel nuclear antigen-positive cel s in the experimental groups 1 and 2 were significantly higher than that in the control group at different time points after transplantation (P<0.05). At 3 and 6 weeks after transplantation, the number of apoptotic chondrocytes in the experimental groups 1 and 2 was significantly lower than that in the control group (P<0.05);significantly higher and highest expressions of col agen type II, Sox9 and vascular endothelial growth factor were found in the experimental groups 2 and 1 compared with the control group, respectively (P<0.05). Additional y, compared with the experimental group 2, the number of proliferating cel nuclear antigen-positive cel s was significantly lower in the experimental group 1 at 3 and 6 weeks after transplantation (P<0.05);the number of apoptotic chondrocytes was significantly lower in the experimental group 1 at 3 weeks after transplantation (P<0.05). These results indicate that autologous oxygen-delivering biomimetic nanoscaffold composited with chondrocytes to repair different types of temporomandibular joint condylar fractures presents some different outcomes.