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Objective@#To analyze and discuss the parameters and clinical significance of nystagmus in patients with benign positional paroxysmal vertigo (BPPV) of posterior semicircular canal.@*Methods@#The subjects of the study were 564 BPPV patients diagnosed with posterior semicircular canal canalithis (PSC-can) from January 2016 to July 2017 in Tianjin No.1 Central Hospital, including 186 males and 378 females, with a median age of 57 years. The induced nystagmus in Dix-Hallpike test was recorded by video nystagmuo graph(VNG), and the direction, latency, duration time and intensity characteristics of nystagmus were compared with the position of hanging and sitting.SPSS17.0 software was used for statistical analysis.@*Results@#Vertical torsional nystagmus was both induced with the position of hanging and sitting during Dix-Hallpike test. The vertical direction of the induced nystagmus was upward and downward respectively. The latency, duration time and intensity of lesion side were L(2.65±1.92; 1.44±1.24), D(14.90±10.46; 15.28±8.06), and P(29.75±21.26; 14.08±9.48). The latency and intensity in hanging position were higher than those of sitting. The intensity rate was about 2∶1, with statistically significant difference (t=13.831, and 17.296, P all<0.01). The direction of the induced nystagmus was opposite to turning in HSC-Can BPPV. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2∶1, the difference was statistically significant (t=17.296, P<0.01). There was no statistical difference of nystagmus during time between the two positions(t=-0.735, P>0.05).@*Conclusions@#The nystagmus intensity rate in Dix-Hallpike test between hanging and sitting position of lesion side in PSC-Can is 2∶1, which conforms to the Ewald′s law. The direction, latency and intensity of nystagmus can be used as a reference index for the localization diagnosis of PSC-Canotolith.
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Objective@#To investigate the characteristics and clinical utility of vestibular autorotation test (VAT) in patients with vestibular migraine(VM).@*Methods@#This study included two groups, a VM group (441 patients from Tianjin First Center Hospital between January 2015 and May 2016) and a control group (65 healthy subjects). Both groups undertook VAT; the parameters evaluated were horizontal gain/phase, vertical gain/phase and asymmetry. The differences in VAT results between the two groups were investigated.@*Results@#There were statistically significant differences in VAT results between the VM and the control group, namely elevated horizontal gain at frequency 2, 3, 4 and 5 Hz, delay horizontal phase at frequency 2, 4, 5 and 6 Hz, elevated vertical gain at frequency 2-6 Hz and delay vertical phase at frequency 4-6 Hz. There was no significant difference in asymmetric values between the VM group and the control group.@*Conclusions@#The results of this study indicate that VM patients have elevated horizontal gain and vertical gain, and delay horizontal phase and vertical phase. It is suggested that VAT represents a useful diagnostic tool which may provide objective evidence for the diagnosis and differential diagnosis of VM.
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Objective@#To analyze the characteristics of nystagmus of horizontal semicircular canal cupulolithiasis(HSC-Cup) in Roll test and Dix-Hallpike test.@*Methods@#Between December 2016 and December 2017, a total of 164 patients with BPPV from Tianjin First Center Hospital, 124 HSC-Can BPPV and 40 HSC-Cup BPPV, were involved.The induced nystagmus in Roll test and Dix-Hallpike test were recorded by video-nystagmograph(VNG), whose direction and intensity characteristics were compared in various BPPV.@*Results@#HSC-Can patients were induced a horizontal nystagmus with Roll test, the nystagmus intensity of the disease and healthy side were (41.3±20.1)°/s (mean standard deviation)and(21.9±9.4)°/s respectively, the difference was statistically significant (t=6.709, P<0.05). HSC-Cup patients were induced a horizontal nystagmus that was opposite to the direction of the Roll test, the nystagmus intensity of the disease and the healthy side were (12.9±6.4)°/s and(29.1±9.3)°/s respectively, with significant difference (t=9.066, P<0.05). Among 124 cases of HSC-Can patients, 120 cases of horizontal nystagmus were recorded in the left and right sides of the Dix-Hallpike test in the same direction as the turning direction, the horizontal nystagmus intensity of the disease and the healthy sides were (15.1±10.0)°/s and(9.4±7.4)°/s respectively, the difference was statistically significant (t=2.365, P<0.05). And 40 cases of HSC-Cup patients were recorded at the head of the Dix-Hallpike test in the opposite direction to the horizontal eye earthquake.The horizontal nystagmus intensity of the disease and the healthy side were (5.3±2.8)°/s and(13.9±4.4)°/s respectively, the difference was statistically significant (t=10.579, P<0.05).@*Conclusions@#Characteristic horizontal nystagmus can be induced by HSC-Cup in both roll test and Dix-Hallpike test. Preliminary localization of Dix-Hallpike Test can also be used for HSC-Cup.
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Objective@#To evaluate the data of unilateral centrifugation subjective visual vertical (UC-SVV) in healthy young people.To study the function of utricle.@*Methods@#Between Decem ber 2017 and May 2018, thirty-two healthy young volunteers were tested by static subjective visual vertical(SVV) and low velocity UC-SVV with Neuro Kinetics Inc I-portal 6.0 Video nystagmus recording system and NOTC rotating chair system.The static SVV preset angle were -15.00°, 15.00°, -20.00°, 20.00°, -12.00° and 12.00° respectively.UC-SVV test parameters: rotating chair′s peak speed was 60°/s.The shift time from the middle to the lateral position was 30 s and the displacement was 3.85 cm.The chair rotated at 60 s at left, right and middle positions.Subjects underwent SVV during this period.SPSS 17.0 software was used to analyze the data.@*Results@#The mean and standard deviation of static SVV deviation in 32 volunteers was 0.21°±0.17°, 95%CI (-0.14°, 0.55°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the clockwise was 0.24°±0.25°, -0.10°±0.27°, -0.63°±0.26°, 95%CI(-0.26°, 0.74°), (-0.65°, 0.44°), (-1.16°, -0.10°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the counter clockwise was 0.03°±0.27°, -0.11°±0.26°, -0.23°±0.26°, 95%CI(-0.52°, 0.59°), (-0.65°, 0.42°), (-0.76°, 0.30°). There was significant difference in the deviation between the left and the right side of counter clockwise rotation of UC-SVV(t=2.432, P<0.05), however, there was no significant difference in the angle of deviation between the left and right sides and the median position(t value was 0.951, -1.400, both P>0.05). There was no significant difference among each position in clockwise rotation of UC-SVV(F=0.253, P>0.05).@*Conclusion@#UC-SVV test with peak speed of 60°/s can cause vertical line deviation in the left and right lateral position, but the angle is small and the value of clinical application is limited.
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Objective To analyze the premature death rate and life expectancy caused by cancer, cardiovascular disease, chronic respiratory disease and diabetes and to provide the basis for the government to formulate residents' health promotion measures. Methods The data of deaths of permanent residents in Tongxiang in 2016 were derived from"Zhejiang Chronic Disease Surveillance Information System" . The mortality, premature death rate, years of potential life loss and life expectancy of four chronic diseases were descriptively analyzed. Results In 2016, a total of 5104 deaths were reported in Tongxiang, with a crude death rate of 738.77 / 100, 000 and a standardized mortality rate of 480.40 / 100, 000, 23.59％ were premature deaths. The mortality rate of the four types of chronic diseases was 8.44％ , malignant tumors, cardiovascular and cerebrovascular diseases, chronic respiratory diseases, diabetes were 5.68％, 2.06％, 0.65％ and 0.24％. Residents' life expectancy was 81.40 years, removal of cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes, the life expectancy increased 3.69, 2.78, 1.43 and 0.16 years, respectively. The four types of chronic diseases had a potential life-loss loss of 15, 239 person-years, with an average life-saving year of 4.25 years and a life-saving rate of 22.06 ‰. Mortality rate, premature death rate, years of potential loss of life, average life expectancy and longevity rate were higher in males than in females. Conclusion The probability of premature death of four types of chronic diseases in Tongxiang was 8.44％, and male residents were more likely to be affected.
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Objective@#To analyze the objective characteristics of roll test and Dix-Hallpike test in benign paroxysmal positional vertigo(BPPV)patients, discussing the premier solution of positional test.@*Methods@#A total of 230 patients with BPPV, whereas 170 posterior semicircular canal canalithiasis (PSC-Can) BPPV and 60 horizontal semicircular canal canalithiasis (HSC-Can) BPPV were involved respectively. The induced nystagmus in roll test and Dix-Hallpike test was recorded by video nystagmuo graph (VNG), and the direction, intensity and time characteristics of nystagmus were compared in various BPPV.SPSS19.0 software was used for statistical analysis.@*Results@#Vertically upward nystagmus was induced by hanging in 170 PSC-Can Dix-Hallpike test, and the nystagmus reversed and turned weaker when the subjects came to sit. The intensity of nystagmus at turning to lesion side by hanging and sitting were (30.3±14.1)°/s and (12.6±7.5)°/s respectively, the difference was statistically significant (t=20.153, P<0.05). However, no nystagmus was induced in PSC-Can roll test. Horizontal nystagmus in the same direction with turning was induced in 60 HSC-Can roll test. The intensity of nystagmus at turning to lesion side and normal side was (42.0±18.0)°/s and (20.3±8.7)°/s respectively, the difference was statistically significant (t=12.731, P<0.05). Furthermore, horizontal nystagmus in the same direction with turning was induced in 57 HSC-Can Dix-Hallpike. The coherence was 95% with the results of roll test.@*Conclusions@#Dix-Hallpike test can not only be used to diagnose PSC-Can, but also induce nystagmus in HSC-Can effectively. Whereas the roll test only show significance in diagnosing HSC-Can. To avoid uncomfortable stimulation to patients as much as possible, we suggest to use Dix-Hallpike test at first, and to judge whether using roll test based on the result of the horizontal nystagmus.
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Objective@#To evaluate semicircular canal damage and its frequency characteristics in Meniere disease patients.@*Methods@#Sixty-seven Meniere disease patients accepted the video-head impulse test(vHIT)which responses to semicircular canal function of high frequency area, head shaking test(HST) which responses to semicircular canal function of middle frequency area, and caloric test(CT) which responses to semicircular canal function of low frequency area.Preferences were recorded including the video head impulse test gain (vHIT-G), head shaking nystagmus (HSN) and parameters of the unilateral weakness (UW) as observation index, and results of all the three tests were analyzed according to Meniere disease patients. SPSS 17.0 software was used to analyzed the data.@*Results@#The positive rate of CT, HSN and vHIT were 70.1%(47/67), 41.8%(28/67) and 23.9%(16/67) respectively. Comparation of the positive rate among CT, HST and vHIT showed statistically significant difference (χ2=10.93, P=0.001; χ2=28.79, P=0.000). Comparation of the positive rate between HST and vHIT showed statistically significant difference(χ2=4.87, P=0.027).@*Conclusions@#Semicircular canal function damage in Meniere disease patients mainly presents in the low frequency area, which indicates a characteristic phenomenon that low-frequency function area (caloric test results) is more predisposed to be involved than that of middle-frequency function area (head shaking testing)and high-frequency function area (video head impulse testing) in Meniere disease patients.
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<p><b>OBJECTIVE</b>Using simultaneous multi-gene mutation screening to investigate the new method molecular epidemiological basis of 225 patients with nonsyndromic hearing loss in Tianjin, and verifying the for simultaneous multi-gene mutation screening.</p><p><b>METHODS</b>Two hundred and twenty-five patients with severe non-syndromic deafness from Tianjin CDPF and Association of the Deaf were included in the study. The single nucleotide polymorphisms scan, (SNPscan) technique was used for screening the 115 spots mutations in three common deafness-related genes (GJB2, SLC26A4, mtDNA 12S rRNA) of patients with nonsyndromic hearing loss in Tianjin. We verified the results by Sanger sequencing.</p><p><b>RESULTS</b>Among the 225 patients, there were 111 cases of deafness caused by mutation (49.3%). Using this method, up to 50% of the patients in our study were identified to have hereditary HL caused by mutations in the three genes. 56 patients with the GJB2 mutations were detected (24.9%), including 30 cases of homozygous mutations (13.3%), 26 patients (11.6%) of compound heterozygous mutations, and 21 cases (9.33%) of single heterozygous mutations. 50 patients with the SLC26A4 mutations were detected (22.2%), including 22 cases of homozygous mutations(9.8%), 28 patients (12.4%) of compound heterozygous mutations, and 22 cases (9.8%) of single heterozygous mutations. mtDNA 12S rRNA A1555G mutation was detected in 5 patients (2.2%). mtDNA 12S rRNA 1494C>T mutation was not detected. We verified the results by Sanger sequencing. The accuracy of the sequencing results was 100%. The SNPscan cost eight hours and 160 yuan (each sample).</p><p><b>CONCLUSIONS</b>Applying SNPscan technology can be accurate, rapid and cost-effective diagnostic screening in patients with hearing loss for etiology investigation. It is expected to become an effective means of large-scale genetic testing for hereditary deafness.</p>
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Humans , Connexin 26 , Connexins , Genetics , DNA Mutational Analysis , Methods , DNA, Mitochondrial , Genetics , Deafness , Genetics , Genetic Testing , Methods , Heterozygote , Homozygote , Membrane Transport Proteins , Genetics , Mutation , Polymorphism, Single Nucleotide , RNA, Ribosomal , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal, SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation.</p><p><b>METHODS</b>69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH, spontaneous nystagmus (SN), caloric test (CT) and other vestibular function tests. 49 healthy people (control group) accepted SVV/SVH only. SVV/SVH, SN and unilateral weakness (UW) were selected as for the observation indicators. The correlations between SVV/SVH, SN, UW and courses were investigated respectively, as well as the characteristic of SVV/SVH, SN in period of vestibular compensation.</p><p><b>RESULTS</b>Among case group SVV, SVH positive in 42 patients(60.9%) and 44 patients(63.8%), the absolute values of the skew angle were in the range between 2.1°-20.0°, 2.1°-22.2°. Skew angles of SVV/SVH in control were in the range between -1.5°-2.0° and -2.0°-1.6°, and had no statistical significance with case group(t=5.336 and 5.864, P<0.05). SN-positive 28 cases (40.6%), the range of intensities at 2.4°-17.1°; UW-positive 50 cases (72.5%). In case group, positive correlation between SVV and SVH(r=0.948, P=0.00), negatively correlated between SVV/SVH and SN respectively(r values were -0.720, -0.733, P values were 0.00), no correlation between the skew angle of SVV/SVH, strength of SN and UW value(r values were 0.191, 0.189, and 0.179, P>0.05), there was no correlation between the absolute value of SVV, SVH, SN, UW with the duration (rs values were -0.075, -0.065, -0.212, and 0.126, P>0.05).</p><p><b>CONCLUSION</b>Subjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction, but also help assess the static compensatory of otolithic, guidance and assessment of vestibular rehabilitation.</p>
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Humans , Caloric Tests , Gravitation , Otolithic Membrane , Pilot Projects , Vestibular Diseases , Vestibular Function Tests , Vestibule, Labyrinth , Visual PerceptionABSTRACT
Objective To know the plasma lipids level and influencing factors among adults in Tongxiang city,and to provide evidence for prevention and intervention of dyslipidemia.Methods Multistage stratified cluster sampling method was conducted to select participants in Tongxiang city.Questionnaire interview,physical examination and blood lipid detection were performed among the selected subjects.Models of the univariate and multivariate unconditional logistic regressions were used to analyze the influencing factors of dyslipidemia.Results A total of 600 people were involved in this study.The prevalence and standardized rates of dyslipidemia were 36.33% and 36.11 %,and abnormal rates of HDL -C,TG,TC and LDL -C were 27.33%,15.67%,4.83% and 4.83%,which standardized were 29.17%,15.1 3%,3.1 8% and 3.12%, respectively.The abnormal rate of LDL -C in females was higher than that in males (P <0.05).Borderline abnormal rate of TC and dyslipidemia rates were increased with age (P <0.05),and the abnormal rate of HDL -C were decreased with age (P <0.05).Multivariate logistic regression analysis showed that BMI (OR =3.398),diabetes mellitus(OR =1.694), hypertension (OR =1.717)and total static time(OR =1.712)were the risk factors for dyslipidemia.Conclusion The prevalence of dyslipidemia was high among the adults in Tongxiang city,especially the abnormity of HDL -C and TG. Community comprehensive prevention and control of dyslipidemia should be carried out according to its risk factors.
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Objective To know the influencing factors for the severity of motor vehicle road traffic injures ,and to provide scientific basis for making appropriate intervention measures.Methods 7 977 patients with motor vehicle road traffic injuries who were first diagnosed in injury surveillance sentinel hospital of Tongxiang City in 2012 and 2013 were selected, and the factors influencing the severity of injury were analyzed.Results The multivariate logistic regression analysis showed an increased risk of the injure severity among the people aged over 65 years old,alcohol drinking before the injury and migrant workers,the values of OR(95%CI)were 3. 231(2. 091 -4. 993),2. 796(1. 697-4. 607)and 1. 424(1. 217-1. 666)respectively.However,women,motor vehicle drivers,collision with non motor vehicle driver and using safety belt may contribute to the less serious damage,and the values of OR (95%CI)were 0. 837 (0. 753 -0. 930 ),0. 769 (0. 622-0. 952),0. 753 (0. 598-0. 948)and 0. 691 (0. 492-0. 970)respectively.Conclusion The risk factors for the severity of motor vehicle road traffic injures are elderly people,migrant workers and alcohol drinking.The safety education should be provided among the people and the targeted interventions should be developed and implemented.
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<p><b>OBJECTIVE</b>To explore the clinical values of Sensory Organization Test (SOT) of dynamic posturography in the diagnosis of peripheral vertigo.</p><p><b>METHODS</b>A total of 112 patients with peripheral vertigo were retrospectively analyzed. All the patients firstly underwent the inspection of SOT followed by caloric test. The results were conducted a comparative analysis. Assessments of SOT evaluated the patient's effective use of visual, vestibular, and somatosensory information for balance control during a variety of changing task conditions. The unilateral weakness was selected as assessment parameter of caloric test. Fourty-two healthy subjects were selected as control group underwent the dynamic posturography.</p><p><b>RESULTS</b>Among the 42 cases of control group, results of SOT in dynamic posturography were normal. The SOT composite scores owned a significant difference between control and peripheral vertigo subjects. Among the 112 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 37 cases, with a sensitivity of 33.0%; caloric test was abnormal in 72 cases, with a sensitivity of 64.3%. There existed a significant difference between dynamic posturography and caloric test.</p><p><b>CONCLUSION</b>SOT is a key test in dynamic posturography that reflects the balance reconstruction after peripheral injury, and provides information about the integration and proportion of the visual, proprioceptive, and vestibular components of balance.</p>
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Humans , Caloric Tests , Case-Control Studies , Postural Balance , Retrospective Studies , Sensitivity and Specificity , Vertigo , Diagnosis , Vestibular Diseases , Diagnosis , Vestibule, LabyrinthABSTRACT
<p><b>OBJECTIVE</b>To discuss the video head impulse tests (vHIT) application values in assessment of the vestibular nerves, function in sudden deafness patients with vertigo.</p><p><b>METHODS</b>There were 60 cases (120 ears) of healthy volunteers as control group, and 182 cases (182 ears) of sudden deafness with vertigo patients as study group. The study group received vHIT and caloric test, and the control group received vHIT. Functions of vestibular superior and inferior nerves were analyzed by the gains of vHIT and the nystagmus, s unilateral weakness of caloric test, with SPSS17.0 software.</p><p><b>RESULTS</b>The values of vHIT-G of the six semicircular canals in the control group were normal distribution and no statistical significance among them (F = 0.005, P = 1.000). The vHIT-G averages of both sides of anterior, horizontal and posterior semicircular canals were (15.20 ± 11.00) %, (15.30 ± 13.30) %, and (15.15 ± 14.72) % respectively. In the study group, the vHIT-G of the affected side were (21.73 ± 14.84) %, (21.20 ± 28.24) %, and (19.22 ± 23.50) %, with normal distribution, and in which statistical significance was detected comparing with those in the control group (P < 0.05). The positive rates were 26.9% (49/182) in vHIT, 70.3% (128/182) in caloric test. Significant difference (P < 0.05) was observed between vHIT and caloric test examined by chi-square test. According to the results of vHIT, there were 15 cases (8.2%) damaged vestibular superior and inferior nerves areas, 19 cases (10.4%) damaged the superior vestibular nerve area, and 15 cases (8.2%) damaged the inferior vestibular nerve area. In combination with caloric test results, it was shown that there were 29 cases (15.9%) damaged vestibular superior and inferior nerves areas, 101 cases (55.5%) damaged the superior vestibular nerve area, and 1 case (0.5%) damaged the inferior vestibular nerve area.</p><p><b>CONCLUSIONS</b>vHIT can assess the function of six semicircular canals and illustrate high frequency of vestibular nerves. Caloric test combined with vHIT have more advantages to comprehensive assess vestibular damage of sudden deafness patients with vertigo.</p>
Subject(s)
Humans , Caloric Tests , Case-Control Studies , Head Impulse Test , Hearing Loss, Sudden , Diagnosis , Nystagmus, Pathologic , Semicircular Canals , Pathology , Vertigo , Diagnosis , Vestibular Nerve , Pathology , Vestibule, Labyrinth , PathologyABSTRACT
<p><b>OBJECTIVE</b>The aim of this study was to evaluate the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) on semicircular canal function.</p><p><b>METHODS</b>By means of a series prospective study at Department of Otolaryngology Head and Neck Surgery of our hospital, the study was performed on 77 patients suffering from OSAHS in a period from 2012 to 2014, who underwent polysomnography (PSG) and caloric test. The maximal slow-phase velocity (SPV) and unilateral weakness (UW) were used to measure the vestibular function. Severity of OSAHS was evaluated by the lowest oxygen saturation (LSaO₂) and apnea hypopnea index (AHI). The SPV after cool was signed, warm test was performed for each ear, and the sum of left ear SPV were calculated, and then, the SPV of right ear was counted as the same way. Finally, the relationships between LSaO₂, AHI, age, BMI, and SPV of caloric test were analyzed.</p><p><b>RESULTS</b>Caloric vestibular tests in the 77 OSAHS patients demonstrated abnormal findings in 52 patients (67.5%) and normal vestibular functions in the remaining 25 patients (32.5%). Of the 52 patients with an abnormal test result, 16 (20.8%) patients had unilateral vestibular hyporeflexia and 36 (46.7%) patients revealed a bilateral vestibular hyporeflexia. There was no linear relationship between AHI, age, BMI with SPV of caloric test (P > 0.05). The SPV had significant difference between Lower LSaO₂group (LSaO₂< 50%) and higher LSaO₂group (LSaO₂≥ 80%) (P < 0.05). LSaO₂was lower in patients undertaken bilateral vestibular hyporeflexia.</p><p><b>CONCLUSIONS</b>OSAHS patients with long-term intermittent hypoxia can disturb the vestibular organs and reduce semicircular canal function. The heavier hypoxemia will lead to the lower reflex of semicircular canal, with the heavier degree of hypoxemia, and the bilateral horizontal semicircular canal involvement may also be higher at the same time. Due to the effect of vestibule centre compensatory, OSAHS patients lack of dizziness and symptoms from balance disturbances such as typically acute vestibular damage.</p>
Subject(s)
Humans , Caloric Tests , Hypoxia , Polysomnography , Prospective Studies , Semicircular Canals , Sleep Apnea, Obstructive , Diagnosis , VertigoABSTRACT
Objective To exam the influence of psychological factors,occupational factors and dietary habits on malignant tumors.Methods A total of 2 471 patients with malignant tumor were selected from 2010 to 2012 and 1 to 1 matching method was used controlling sex and age distribution in the case and control groups.Data collected by interviewing was analyzed by univariate and multivariate conditional logistic regression.Results 12 related factors including 6 psychological factors were found in relation to malignant tumor after univariate logistic regression analysis.The multivariate logistic regression analysis showed that harmful occupational history (OR =1.731,95%CI:1.337 ~2.242),often having fried food (OR =1.889,95%CI:1.398 ~2.551),heavy salty diet(OR =1.457,95%CI:1.169 ~1.818),psychological problems (OR =1.274,95%CI:1.003 ~1.617),poor marital life (OR =2.007,95%CI:1.111 ~3.623)and lack of self -regulation (OR =1.460,95%CI:1.189 ~1.793 )were the risk factors.Conclusion Malignant tumor was related to a variety of exposure factors and psychological factor has become an important risk factor for malignant tumor in Tongxiang city.
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OBJECTIVE To find the differences in QOL between patients treated with total laryngectomy with voice rehabilitation or without voice rehabilitation and subtotal laryngectomy, to analysis the factors affecting QOL of patients after laryngectomy by HNQOL. METHODS With HNQOL,a survey was conducted in patients treated with total laryngectomy (30cases) with voice rehabilitation, 30 cases without voice rehabilitation, and 30 cases treated with subtotal laryngectomy for laryngeal cancer. We discuss changes of QOL with time went by,and analysis the factors affecting QOL of patients after laryngectomy. RESULTS There is no difference between patients treated with total laryngectomy with .voice rehabilitation and the one treated with subtotal laryngectomy in their quality of life, however, there is difference between patients treated with total laryngectomy without voice rehabilitation and the one treated with subtotal laryngectomy. CONCLUSION Through voice rehabilitation ,we could advance quality of life of the patients treated with total laryngectomy. Through the integration of psychological, clinical and social intervention, the quality of life of patients may have an overall improvement.
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<p><b>OBJECTIVE</b>To test and evaluate the olfactory function of patient after total laryngectomy, seek to a practical method to ameliorate olfactory function and rise the qualitative character of these patients.</p><p><b>METHODS</b>Using the T&T olfactory examination to evaluate the olfactory function of 60 cases. Four cases olfactory mucosae were observed by electron microscope. Observing relation among the remains olfaction, the time after operation and whether or not undergone the voice reconstruction. And analyse the reasons of the above hyposomnia. Using the closing-mouth and nasal out-word airflow maneuver (CNOAM) as the intervention in the patients of tracheoesophageal fistula voice reconstruction after total laryngectomy to observe the amelioration after intervention.</p><p><b>RESULTS</b>It shows various degree of hyposmia and anosmia in the cases after total laryngectomy with or without tracheoesophageal fistula voice reconstruction, with significant deference (P < 0.01) compared to the normal person respectively. There are precisely correlation among the time after operation and whether or not undergone the voice reconstruction. The longer time leads to less remaining olfaction. The patients after total laryngectomy without tracheoesophageal fistula voice reconstruction have lost their olfaction thoroughly within 5 years. But for the patients after total laryngectomy with tracheoesophageal fistula voice reconstruction, they have a middle hyposmia within 5 years, with significant deference (P < 0.01) between the patients in 5 years and after 5 years. There were significant differences (P < 0.01) between the values of patients with and without tracheoesophageal fistula voice reconstruction. The ultrastructure of 4 cases of olfactory epithelium shows the apoptosis change. After the treatment of CNOAM, the remaining olfaction of most patients were improved, with significant deference (P < 0.01) compared to those before the treatment of CNOAM.</p><p><b>CONCLUSIONS</b>The proceed hypofunction of olfaction may be influenced by the reform of respiratory air, the extinction of air velocity bypass the nasal cavity and the apoptosis of epithelial cells in the patients after total laryngectomy. But if we give an early intervention study such as tracheoesophageal fistula voice reconstruction and CNOAM, the olfactory function may be maintenance. During the intervention, the ending of olfactory nerves may be get uninterrupt stimulation. This may help the patients keep a better existing quality than those fail to accept the interventions.</p>