Values of the Quantitative Parameters of Contrast-enhanced Ultrasound in the Diagnosis of Thyroid Benign and Malignant Nodules / 中国医学科学院学报

To investigate the value of contrast-enhanced ultrasound(CEUS)quantitative parameters in the diagnosis of thyroid benign and malignant nodules. The CEUS features of 85 histopathologically confirmed thyroid nodules were quantitatively analyzed using five parameters including rising time(RT),time to peak(TTP),area under the curve(AUC),maximum intensity(Imax),and mean transit time(mTT).The dynamic vascular pattern(DVP)curves were also drawn. The Imax(=-7.08,=0.01)and AUC(=-2.03,=0.04)of thyroid malignant nodules were significantly smaller than those of thyroid tissue,and the Imax(=-1.35,=0.02)and AUC(=-0.21,=0.02)of thyroid benign nodules were significantly larger than those of thyroid tissue.There were significant differences between thyroid benign and malignant nodules in Imax(=-4.16,=0.00),AUC(=-3.01,=0.01),and DVP curve types(=0.00).RT(=-0.28,=0.62),TTP(=-0.10,=0.89),and mTT(=-0.79,=0.05)were not significantly different between thyroid benign and malignant nodules. The quantitative parameters of CEUS,especially Imax and AUC parameters,are valuable in the diagnosis of benign and malignant thyroid nodules.

Relationship between the tinnitus frequency and the effects of medication and the prognosis in patients with chronic subjective tinnitus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of tinnitus frequency on medication and prognosis in patients with chronic subjective tinnitus.</p><p><b>METHODS</b>Seventy-two patients (Ninety-three ears) diagnosed as chronic subjective tinnitus were studied from October 2010 to March 2011. All cases were divided into low frequency(twenty-three ears), medium frequency(fourteen ears) and high frequency (fifty-six ears) according to tinnitus matching test. All cases were treated with microcirculation promotion and steroid therapy (5% glucose 250 ml + ginkgo biloba extract 87.5 mg + dexamethasone 10 mg intravenous drip). Curative effect was evaluated and the factors of prognosis were analyzed after three weeks.</p><p><b>RESULTS</b>After medication, results were acquired as follows: recovery in 0 ear (0%), excellent in 0 ear (0%), effective in 18 ears (19.4%), invalid in 75 ear (80.6%). The effective percentage was 39.1%, 35.7% and 7.1%, respectively. There was significant difference between these groups, but no significant difference between low frequency and medium frequency. Logistic regression analysis showed that the difference of frequency was significant prognostic factors for medication.</p><p><b>CONCLUSIONS</b>Microcirculation promotion and steroid therapy had a poor treatment effect in patients with chronic subjective tinnitus. The prognosis of chronic low-medium frequency tinnitus was better than chronic high frequency tinnitus. The difference of frequency retained significant influence on effects and prognosis of medication.</p>

Expression of metallothionein 2 in middle ear cholesteatoma and its correlation with interleukin 1α and interleukin 6 / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression and distribution of metallothionein 2 (MT-2) in middle ear cholesteatoma, and to explore the relationship of MT-2 with interleukin 1α (IL-1α) and interleukin 6 (IL-6), and well as to explore the role of MT-2 in the pathogenetic mechanism of middle ear cholesteatoma.</p><p><b>METHODS</b>Using the immunohistochemistry and reverse transcription polymerase chain reaction to examine the expressions of MT-2, IL-1α and IL-6 protein and MT-2 mRNA in twenty-five middle ears' cholesteatoma and seven normal external ears' canal skin. The influence of cholesteatoma debris on the MT-2 mRNA and protein of HaCaT cell were further analyzed.</p><p><b>RESULTS</b>According to immunohistochemistry research, the expressions of MT-2, IL-1α and IL-6 were extremely higher in middle ear cholesteatoma than those in normal external ears' canal skin (P < 0.05). The result of RT-PCR showed that there was significant difference between the expression of MT-2 mRNA of and middle ear cholesteatoma than those in normal external ear canal skin (t = 15.38, P < 0.05). There was a positive correlation between the expression of MT-2 and that of IL-1α (r = 0.856, P < 0.05). There was also positive correlation between the expression of MT-2 and that of IL-6 (r = 0.714, P < 0.05). MT-2 mRNA and protein of HaCaT cell significantly increased when exposed to cholesteatoma debris in a dose dependent manner.</p><p><b>CONCLUSIONS</b>MT-2, IL-1α and IL-6 may play an important role in the pathogenetic process of middle ear cholesteatoma. Cholesteatoma debris may involve in the proliferation of middle ear cholesteatoma by activation of MT-2.</p>

Establishment and rudimentary application of the method of recording auditory brainstem responses electrically stimulated via round-window niche in cochlear implants / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish the method of recording auditory brainstem responses electrically stimulated via round-window niche in cochlear implants.</p><p><b>METHODS</b>Self-made platinum iridium alloy as a spherical electrode stimulation electrode, modified cochlear implants connected to in vitro speech processor as a electro-stimulator and evoke potential instrument for Bio-logic Navigator Pro, 17 cochlear implant patients with various ages and of different causes, including auditory neuropathy (2 cases), ossified cochlea (1 case), inner ear malformation (5 cases), leukodystrophy (1 case), unknown and reason (8 cases) were investigated during cochlear implant surgery. Before cochlear implantation, stimulation electrode was placed in the round-window niche while charge balanced biphasic constant current was used as electrical stimulation via round window niche, and then electrically evoked auditory brainstem response was recorded.</p><p><b>RESULTS</b>Electrically evoked auditory brainstem response waveforms were clearly recorded in all 17 cases. The latencies of III and V waves were (2.12 +/- 0.18) ms and (4.18 +/- 0.19) ms respectively, with threshold as (220.0 +/- 16.04) CL. The waveforms of the 2 patients with auditory neuropathy, 5 patients with inner ear malformation, 1 patient with ossified cochlea and 1 patient with leukodystrophy were well differentiated.</p><p><b>CONCLUSIONS</b>Monitoring electrically evoked auditory brainstem response was an objective nerve electrophysiological testing method that accurately reflects function completeness of auditory pathway. It had important value for helping making the judgment whether patients could acquire auditory response after cochlear implantation. This method was safe and gave high emission of auditory response, therefore should be spread widely.</p>

Management of intractable epistaxis and bleeding points localization / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the common nasal bleeding points and the management of intractable epistaxis.</p><p><b>METHODS</b>The bleeding points and its correlation with age distribution, surgical techniques as well as its effects were studied retrospectively in 92 patients, in whom the bleeding points were not found by routine nasal endoscopy and the hemorrhage was not controlled with standard nasal packing.</p><p><b>RESULTS</b>The bleeding points were found in the following different sites: superior wall of inferior nasal meatus (56.5%, 52/92), olfactory cleft of nasal septum (27.2%, 25/92), posterosuperior wall of middle nasal meatus (8.7%, 8/92) and uncertain (7.6%, 7/92). The results showed that the bleeding points had correlation with age. Epistaxis was well controlled by electrocoagulation in 83 cases, gelfoam packing in 8 cases, and transcatheter maxillary artery embolization in 1 case. There were no complications during a followed-up for 1 - 3 months after management. Among the 92 cases, the numbers of treatment needed to stop bleeding were 82 cases (89.1%) after 1 time of treatment, 9 cases (9.8%) after 2 times and in one case (1.1%) after 4 times.</p><p><b>CONCLUSIONS</b>Endoscopy combined with displacement of the middle and inferior turbinate gives good visualization and direct management of the deeply-sited bleeding points, which were difficult in localization. The combined method provides an effective and safe way to control intractable epistaxis.</p>