ABSTRACT
OBJECTIVE To explore the significance of intraoperative auditory monitoring(IAMA) in surgery of acoustic neuroma and to compare the value of auditory brainstem response(ABR) and cochlear nerve action potential(CNAP) in auditory monitoring.METHODS Retrospective analysis of 12 cases of acoustic neuroma from January 2016 to December 2016 was performed.All patients have a practical hearing(AAO-HNS,grade class a,b),the ABR waveform can be elicited,wave v differentiation,All tumors were removed via posterior sigmoid sinus approach.RESULTS ABR waveform of all patients were prolonged with different degrees of change(0.68±0.41) ms compared with the preoperative data.Amplitude of CNAP diverse in different individuals,with an average prolong compared to the data before operation(0.25±0.16) ms.In all 12 cases,8 (66.7％) patients remained usable hearing after the operation,4 cases(33.3％) failed to have a usable hearing.Among these 4 patients,3 showed disappearance of wave v,1 patient showed wave v latency prolong in the ABR,meanwhile,2 patients showed P1 dissapear,2 patients showed P1 latency prolong in CNAP.The intraoperative auditory monitoring could play a role in preventing the hearing damage in the procedure.Drilling,noise,surgical nerve stretch or thermal injury may cause the hearing damage.A 5 minutes pause could get some degree of regain,with the amplitude rise again.CONCLUSION A combination use of the ABR and CNAP monitoring has a certain significance in surgery of acoustic neuroma.ABR waveform is stable and reliable,but costs longer time;CNAP stack quickly and improve monitoring sensitivity,but waveform varies.Vibration and noise caused by drilling,nerve stretch during operation and heat damage can be monitored timely.Combined use of ABR and CNAP monitoring can enhance the auditory preservation rate during acoustic neuroma surgery.
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Objective To investigate the epidemiological characteristics and factors of hemorrhagic fever with renal syndrome (HFRS) during 1958 to 2007 in Fuyang.Methods Descriptive study method was used to analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome.The incidence peak of hemorrhagic fever with renal syndrome was computed by using rotundity distribution.The correlation was analyzed between incidence and virus index by Pearson correlation.Results 40 002 HFRS cases was reported during 1958 to 2007 in Fuyang and 2381 cases were dead.The average incidence and fatality rate of HFRS were 11.99 per 100 thousand and 5.95 percent respectively.Eight counties all had cases.Yingshang county had the highest cases and Jieshou city had the highest fatality rate.Since 1958,there're 4 incidence peak in Fuyang.The period of high incidence was during November to January of next year and the peak of incidence rate was on December 13.Indoor density and field density of mouse were 9.84 percent and 7.91 percent respectively.Virus rate of indoor and field of mouse were 9.21 percent and 6.99 percent respectively.During 1984 to 2007,the correlation coefficient between virus index and incidence was 0.58.In room brown mouse was the most before 2000,but then house mouse become the most.In open country heavy line Japanese fieldmouse is the most mouse all the time.Conclusions In Fuyang,the focus of HFRS is exist widely.Density and virus rate of mouse will directly affect the incidence.So surveillance among mouse should be strengthened.
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Objective To analyze the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Fuyang City of Anhui Province.Methods Epidemiological information was collected by case investigation questionnaire of tsutsugamushi disease.Diagnosis was determined by the detection of OXK antigen by Weil-Felix test.Results Seventy-eight cases with tsutsugamushi disease were discovered in the outbreak.All the patients had an experience of working in this area before the starting of symptoms.The clinical features of the patients were fever,headache,skin eschar,tetter and lymphadenectasis.No severe complications occurred in each patient.All the patients recovered after getting deoxycycline.Conclusions This was the first report for the tsutsugamushi disease occurred in Fuyang City of Anhui Province.And the declaration for the new happened tsutsugamushi disease would provide strong support evidence for the prevention and control of this event and ensure the safety for working in this area.Also the deoxycycline was very effective for the treatment of tsutsugamushi disease.