Influential factors of the efficacy of tinnitus multivariate integrated sound therapy for the treatment of subjective tinnitus / 中国基层医药

Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.

Role of narrow band imaging in the diagnosis of premalignant and malignant lesions of oral cavity / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the role of narrow band imaging (NBI) endoscopy in diagnosing oral premalignant and malignant lesions.@*Methods@#NBI and white light (WLI) endoscopy were performed on 85 patients (47 females, 38 males, aged from 12 to 83 years old, the medium age was 58 years) with 144 oral lesions from July 2016 to October 2017 in the First Affiliated Hospital of Xiamen University. NBI findings were classified into 5 types according to the Ni′s classification and compared with histopathological results. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of NBI and WLI were calculated. Accuracy of NBI on premalignant and malignant lesions were compared with that of WLI. The connection between NBI findings and pathological results were investigated. SPSS 22.0 software was used to analyze the data.@*Results@#Sensitivity, specificity, PPV, and NPV of NBI vs WLI were 96.5% vs 81.2%, 98.3% vs 98.3%, 98.8% vs 98.6%, and 95.1% vs 78.4%, respectively. NBI findings showed high accordance with the phathological results (kappa=0.943,P<0.01). However, consistency between WLI findings and the phathological results was relatively low (kappa=0.765, P<0.01). NBI was more accurate in diagnosing both premalignant (P<0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, P<0.01) than WLI. There was remarkable correlation between NBI findings and the phathological results (r=0.836, P<0.01).@*Conclusions@#NBI shows high accuracy in detecting premalignant and malignant lesions of oral cavity. Ni′s NBI classification is helpful to diagnose the premalignant and early malignant lesions as well as to evaluate tumor invasion. Thus, NBI can contribute more to early diagnosis and therapy of premalignant and malignant lesions of oral cavity.

Analysis of vestibular function in patients with sudden deafness / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze the damage range and objective evaluate the vestibular function impairment in patients with sudden deafness at the same time of cochlea damage. To explore the difference of vestibular function damage in patients with sudden deafness with different hearing loss curve types. METHODS Sixty patients with unilateral sudden deafness and vertigo who were hospitalized in our department from August 2016 to August 2018 were selected as experimental group. There were 11 cases of low frequency descending type, 15 cases of flat descending type, 18 cases of high frequency descending type and 16 cases of total deafness type. Sixty healthy volunteer as control group. Two groups of patients underwent caloric test, ocular vestibular evoked myogenic potential(oVEMP), cervical vestibular evoked myogenic potential(cVEMP) and video head impulse test(vHIT). RESULTS The abnormal positive rate of caloric test, oVEMP and cVEMP in the control group was 10.3％, 26.7％, 16.7％ respectively. The abnormal positive rate of caloric test, oVEMP and cVEMP in the experimental group was 68.3％, 60.3％, 43.7％ respectively. The difference between the two groups is statistically significant. The abnormal positive rate of vHIT in the control group was 13.3％. The abnormal positive rate of vHIT in the experimental group was 51.6％. The difference between the two groups is statistically significant. The positive rate of vestibular dysfunction in patients with total deafness and ascending type was higher than that of flat type and descending type, but there was no significant difference between f lat type and descending type. CONCLUSION Patients with sudden deafness may be accompanied by impaired cochlea and vestibular function in different ranges. The vestibular function of patients with sudden deafness can be evaluated effectively by combined caloric test, oVemp, cVEMP and vHIT. The incidence of vestibular dysfunction in patients with total deafness and ascending sudden deafness was higher than that of flat type and descending type. And there was no significant difference in the incidence of vestibular function injury between flat type and descending type patients.

Application of narrow band imaging in the detection of premalignant and malignant lesions of the larynx / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the role of narrow band imaging (NBI) endoscopy in the diagnosis of laryngeal lesions.@*Methods@#A total of 136 patients with laryngeal lesions were examined by NBI and white light (WLI) endoscopy from July 2016 to May 2017. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) of NBI and WLI were calculated. SPSS 20.0 software was used to analyze the data.@*Results@#Compared to WLI, NBI showed higher sensitivity (94.9% vs 83.3%), specificity (95.6% vs 84.4%), PPV (94.9% vs 82.3%), and NPV (95.6% vs 85.4%). There was high consistency of the results etween NBI and pathology (kappa=0.904, P<0.01). However, consistency of the findings between WLI and pathology was relatively weak (kappa=0.677, P<0.01). NBI showed the higher accuracy in diagnoses of both benign lesions (especially for premalignant lesions, P<0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, P<0.05) than WLI. NBI findings correlated with the pathological results (r=0.739, P<0.01).@*Conclusions@#NBI demonstrates higher accuracy in the detection of premalignant and malignant lesions of the larynx.

One stage surgical treatment of multiple primary carcinoma of hypopharynx and esophagus / 中国耳鼻咽喉头颈外科

OBJECTIVE To discuss the therapeutic effect of one stage surgical treatment in the multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma.METHODS The thoracoscopy group: dissecting the esophagus and mediastinal lymph node assisted with thoracoscope, and then opened abdominal cavity to make gastric tube. Head and neck group: doing the cervical lymph node dissection, total laryngectomy, total hypopharyngectomy and total esophagectomy, and then anastomosis of the pharynx with gastric tube. All cases were received conventional radiotherapy and chemotherapy after operation.RESULTS All the cases in this group were successfully underwent the one stage operation. The postoperative complications were pulmonary infection in 3 cases, pleural effusion in 2 cases and tracheal tear in one case. No anastomotic fistula or postoperative deaths occurred. The 3 and 5 year survival rates were 63.6% and 50.0% respectively.CONCLUSION It should take necessary examinations of cervical thoracic esophagus to prevent missing the multiple primary carcinoma of the hypopharyngeal carcinoma. The total laryngectomy, total hypopharyngectomy and total esophagectomy, and anastomosis of the pharynx with gastric tube for multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma is a feasible and active treatment method.

Airborne fine particle decreases the cell viability and induces inflammation in human bronchial epithelial cells / 中南大学学报(医学版)

Objective:To investigate the effects of airborne fine particle on cell viability and inflammation in human bronchial epithelial cells.Methods:Atmospheric PM2.5 samples were collected by PM2.5 sampler.PM2.5 morphology was observed by scanning electron microscope (SEM).Human bronchial epithelial cells (BEAS-2B) were treated with PM2.5 at different concentrations (0,50,100,200,400,800 μg/mL) for 12,24 or 48 hours,and the cell activity were evaluated by cell counting kit-8 (CCK-8).The mRNA expression levels of (granulocyte-macrophage colony stimulating factor,GM-CSF) and TNF-α were detected by quantitative real-time PCR (qRT-PCR).Western blot was used to detect the protein expressions of GM-CSF and TNF-α.Results:According to SEM,the shape of PM2.5 varied,and the diameter was different and mostly equal to or less than 2.5 μm.CCK-8 assay showed that different concentrations of PM2.5 exposure for 12 hours,24 hours and 48 hours resulted in loss of cell viability of BEAS-2B cells (P＜0.05).Different concentrations of PM2.5 increased the mRNA and protein expression of GM-CSF and TNF-α,and the higher concentration of PM2.5 induced higher expression,which have statistical significant difference between the groups (P＜0.05).Conclusion:Atmospheric PM2.5 can cause inflammatory response in human bronchial epithelial cells.They can reduce cell viability,which may be related to the PM2.5 trigger and aggravation of bronchopulmonary inflammatory diseases.

Clinical analysis of 17 cases of giant infant branchial cleft cyst / 中国基层医药

Objective To summary the experience in the diagnosis and treatment of enormous infant bran-chial cleft cyst(EIBCC).Methods 17 cases of EIBCC inpatient were retrospectively analyzed,with the clinical char-acteristics,CT imaging materials.17 cases were treated with operation.The surgical operation was performed with the L curve of the external jugular incision.The the clinical effect was observed.Results The 17 EIBCC cases clinically appeared as difficult breathing in different degrees.The results of CT were consistent with the pathological diagnosis. There was no necrosis of the cervcal iskin flap.There was no post -operative recurrence after a half to 6 years following -up.Conclusion Dyspnea is the common clinical manifestation of EIBCC.Spiral CT is of great importance to diagnose the IBCC.Airway maintenance is the premise of safe cure.Surgical ablation is the main treatment of EIBCC.

Raman spectral characteristics of oral squamous cell carcinoma, epithelial dysplasia and normal mucosa / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the Raman spectral characteristics of oral squamous cell carcinoma, high-grade epithelial dysplasia and normal mucosa.</p><p><b>METHODS</b>Fifty- six fresh samples of oral carcinoma, 50 of high-grade epithelial dysplasia and 32 of normal mucosa were collected. The i-Raman spectrometer with an optical fiber tube was applied to acquire Raman spectrum. The diagnostic model established by principle component analysis (PCA) and discriminant function analysis (DFA) was used to analyze and classify the spectra of different samples.</p><p><b>RESULTS</b>There were significant differences among the Raman spectra of these samples. Compared with the spectra of normal mucosa, the spectra of oral carcinoma and dysplasia showed strong peaks which were contributed to nucleic acids, proteins and lipids. The diagnostic models established by PCA-DFA could successfully classify these Raman spectra of different samples with a high accuracy of 96.4% (133/138). The model was evaluated by 'Leave one out' cross-validation and reached a high accuracy of 92.8% (128/138).</p><p><b>CONCLUSIONS</b>The proliferation and metabolism of oral squamous cell carcinoma and epithelial high-grade dysplasia are more active than normal mucosa. The diagnostic models established by PCA-DFA can classify these Raman spectra of different samples with a high accuracy.</p>

Surgical treatment experience of different approaches in eight cases with parapharyngeal space foreign bodies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the surgical treatment of parapharyngeal space foreign body and to discuss feasibility of Endoscopic transoral approach.@*METHOD@#Reviewing surgical treatment in eight cases of parapharyngeal space foreign body, nature and location of foreign body. surgical methods, and treatment results were analyzed.@*RESULT@#Eight patients' foreign bodies were all removed by surgical treatment, there were no postoperative infection. Three cases of foreign body were removed through laterocervical approaches, one removed through submandibular approach. In four cases the foreign body were removed through Endoscopy, two of them were transoral approach and the other two were taken out after antiotomy.@*CONCLUSION@#Different approaches should be taken in the surgery treatment of parapharyngeal space foreign body according to imaging positioning.

Endoscopic thyroidectomy via suprasternal approach / 中国耳鼻咽喉头颈外科

OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50～70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection .The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.