ABSTRACT
Objective:To investigate the clinical efficacy of microscopic myringoplasty versus endoscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media. Methods:The clinical data of 91 patients with tympanic membrane perforation caused by chronic suppurative otitis media who received treatment in Jiaxing Second Hospital, China between February 2017 and March 2019 were retrospectively analyzed. These patients were divided into a control group ( n = 45) and an observation group ( n = 46) according to different surgery methods. The control group was given microscopic tympanoplasty, while the observation group was given endoscopic tympanoplasty under the otoendoscope. Results:Blood loss in the observation group was significantly lower than that in the control group [(7.2 ± 2.0) mL vs. (13.7 ± 3.1) mL, t = 11.912, P < 0.001]. Operation time in the observation group was significantly shorter than that in the control group [(59.4 ± 5.4) min vs. (91.5 ± 11.2) min, t = 17.474, P < 0.001]. Postoperative pain score in the observation group was significantly lower than that in the control group [(2.9 ± 0.7) points vs. (4.8 ± 1.3) points, t = 8.707, P < 0.001]. Hospital stay in the observation group was significantly shorter than that in the control group [(4.3 ± 1.0) d vs. (6.5 ± 1.5) d, t = 8.249, P < 0.001]. Pure tone hearing thresholds at 1, 2 and 4 kHz frequencies in the observation group were significantly higher than those in the control group (all P < 0.05). Patient satisfaction regarding the aesthetic effect of the surgical incision in the observation group was significantly higher than that in the control group [97.8% (45/46) vs. 77.8% (35/45), χ2 = 8.604, P = 0.003]. Conclusion:Endoscopic myringoplasty has the advantages including shorter operation time, less blood loss, lower degree of pain, better hearing improvement and higher patient satisfaction over microscopic myringoplasty in the treatment of tympanic membrane perforation caused by chronic suppurative otitis media.
ABSTRACT
To analyze the clinical, molecular genetic and biochemical characteristics of a family diagnosed with creatine deficiency syndrome (CDS) due to SLC6A8 gene mutation diagnosed in Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University in September 2018.The boy was referred at the age of 13 for intermittent vomiting and symptoms were relieved after symptomatic treatment, 7 months later, the patient was diagnosed again.He ate less and constipated as an infant, and had intermittent vomiting and severe constipation from 12 years old.He could walk at the age of 1 year and 6 months, could speak his first word at 2 years old, and only spoke simple sentences at the diagnosis.He rarely communicated with his parents.His brother has severe intellectual deficiency and seizures.His mother has cognitive impairment and had repeated stillbirths and miscarriages.When visiting the doctor, his weight was 22 kg (< P3), height was 131 cm (< P3), and head circumference was 52 cm.Besides, he had severe mental retardation and sluggish expression, poor communication, broad forehead, musculoskeletal atrophy and arched foots.His brain magnetic resonance imaging showed mild enlargement of the lateral ventricles.Magnetic resonance spectroscopy showed normal signals in the bilateral hippocampuses.The boy′s exon sequencing related to intellectual deficiency revealed the hemizygous mutation of SLC6A8 gene c. 626(exon3)-c.627(exon3)delCT.His mother and brother were carriers of the variant gene, but his father and grandmother had no such mutation.The urinary creatine to creatinine ratio was elevated but guanidinoacetate was normal, it was further confirmed that CDS can be caused by the novel mutation c. 626(exon3)-c.627(exon3) delCT in SLC6A8.In clinical practice, boy with mental retardation of unknown origin and often have gastrointestinal symptoms, especially when feeding difficulties and growth retardation occur in infancy, the early diagnosis of CDS can be achieved by examination of urinary creatine to creatinine ratio and gene detection.
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Objective To identify the scientific research status of Ershiwuwei-Shanhu pill among the literature review. Methods The literature were retrieved from CNKI, Wanfang and VIP databases (from databases built up to 2017), and quantitative analysis was carried out in the fields of time, journals and types of literature published. Results There were 58 literatures, including 33 clinical studies, 9 pharmacological studies, 14 pharmacological studies and 2 reviews. The literature published 39 kinds of journals, among which there were 81.0％ studies published in the journals holding the impact factors more and equal to 0.15 and 7 were core journals. Conclusions The results showed that the Ershiwuwei-Shanhu pill was in the developing period, mainly focused on clinical research, although there are some studies on pharmacology and pharmacy.The study of the ancient Tibetan medicine to the mature period there is still much space for development.