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Objective@#To investigate the clinical characteristics, prognosis and affected branches of vestibular neuritis in children.@*Methods@#Twenty-five patients with vestibular neuritis in ENT department, Beijing Children′s Hospital, from October 2015 to October 2016, were collected. All patients were 4-14 (mean 9.8) years old including 17 boys and 8 girls. The clinical manifestations history, pure tone audiometry (PTA), vestibular function tests were done for each patient. We also took the blood samples for pathogenic virus in order to analyze the premorbid risk factors.@*Results@#Rotational vertigo were complained by all presents. There were 17 cases (68%, 17/25) with nausea and vomiting and 19 cases (76%, 19/25) with balance dysfunction. There were 12 cases (60%, 12/20) with positive results in 20 blood samples for virology, among which 6 cases of influenza B virus and 4 cases of herpes simplex virus, 1 case of cytomegalovirus and 1 case of coxsackie were identified. The results of PTA were normal. Bithermal caloric test was abnormal in 22 cases (88%, 22/25). The ocular vestibular-evoked myogenic potential (oVEMP) in 12 cases (48%, 12/25) and cervical vestibular-evoked myogenic potential (cVEMP) in 5 cases (20%, 5/25) were abnormal. The bithermal caloric test along with oVEMP and cVEMP in 4 cases (16%, 4/25) were abnormal. The bithermal caloric test and oVEMP in 7 cases (28%, 7/25) were abnormal. The bithermal caloric test in 11 cases (44%, 11/25) were abnormal. The oVEMP in 1 cases (4%, 1/25) was abnormal. The cVEMP in 1 cases (4%, 1/25) was abnormal. All patients recovered well, but the time varied. The symptoms of 21 patients were complete recovery within 1 month. 3 patients were complete recovery within 2 months (aged 8 - 14 years old). One patient was complete recovery within 6 months (aged 13 years old).@*Conclusion@#Rotary vertigo is most commonly in children with vestibular neuritis, accompany with imbalance and vomiting. The vestibular neuritis in children might be related with upper respiratory tract infection. Audiometry test is normal. Because of the bithermal caloric test and oVEMP are obvious abnormality, therefore it is speculated that the superior vestibular nerve may most commonly be affected. The younger patients with vestibular neuritis recovered more quickly than the older children.
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Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.
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Objective To investigate the vestibular functions ,especially the semicircular canal function in children with secretory otitis media (SOM ) .Methods A total of 24 children with SOM of median age of 8 .5 years had effusion that lasted about 3 to18 months ,compared with 12 children without effusion in the middle ear with the median age of 7 .9 years .The two groups received pure tone audiometry ,acoustic immitance and semicircular canal functions ,including the saccadic test ,the tracking test ,the gaze test and spontaneous nystagmus test .Results The 24 children with SOM had conductive hearing loss ,including 11 mild cases and 13 moderate case .The 12 children without SOM had the normal hearing .There were significant differences in semicircular canal functions between the two groups (8/24 & 0/12 , P<0 .05) .Age ,genders ,hearing -loss degrees and vertigo were not the significant factors which affected the semicircular canal function .Conclusion The function of semicircular canal was affected in children with SOM ,but the mechanisms were still not clear .
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Objective To study the relationship between hearing loss and serum bilirubin of neonates with hypercholesterolemia .Methods The serum bilirubin level and auditory brainstem response thresholds of 70 hyper_cholesterolemia neonates of full term pregnancy and normal weight were tested ,and the correlations of serum biliru_bin ,and occurrence time of jaundice with hearing threshold were analyzed .ResuIts Among the 70 neonates ,there were 17 cases with normal ABR thresholds and 53 with abnormal ABR thresholds ,including 27 with middle and se_rious hearing loss .In the cases of serum bilirubin less than 342μmol/L ,the percentage of cases with middle and se_rious hearing loss and with occurrence time of jaundice less than 48 hours was higher than theses cases with occur_rence time of jaundice more than 48 hours (P<0 .05) .In the cases of serum bilirubin higher than 342μmol/L ,there was no obvious difference between the percentage of cases of middle and serious hearing loss with occurrence time of jaundice less than 48 hours and those with occurrence time of jaundice more than 48 hours .Among the 53 cases with abnormal hearing thresholds ,positive correlation was observed between serum bilirubin and ABR threshold (r=0 .041) ,whereas negative correlation was observed between occurrence time of jaundice and ABR threshold (r=-0 .291) .ConcIusion The higher probability of hearing loss for hypercholesterolemia neonates with earlier occur_rence of jaundice ,the more serious hearing loss with higher serum bilirubin .