Application value of interferon gamma release assay combined with tuberculin skin test in diagnosis of intraocular tuberculosis and latent tuberculosis infection / 中国医师进修杂志

Objective To explore the application value of interferon gamma release assay (IGRA) combined with tuberculin skin test (TST) in diagnosis of intraocular tuberculosis and latent tuberculosis infection. Methods One hundred and ten patients with pulmonary tuberculosis (observation group) and 80 healthy persons (control group) in Hebei Chest Hospital from January 2016 to December 2018 were selected. Among the 110 patients with pulmonary tuberculosis, intraocular tuberculosis was in 35 cases, and latent tuberculosis infection was in 75 cases. All the patients were examined by ocular secretions IGRA and TST. Results The positive rates of IGRA and TST in observation group were significantly higher than those in control group: 88.18% (97/110) vs. 11.25% (9/80) and 83.64% (92/110) vs. 41.25% (33/80), and there were statistical differences (χ2=113.138 and 36.971, P﹤0.01). The positive rate of IGRA in patients with intraocular tuberculosis was significantly higher than that in latent tuberculosis infection: 97.14% (34/35) vs. 84.00% (63/75), and there was statistical difference (χ2=3.955, P﹤0.05). There was no statistical difference in the positive rate of TST between the patients with intraocular tuberculosis and patients with latent tuberculosis infection: 91.43% (32/35) vs. 80.00% (60/75), χ2 = 2.277, P＞0.05. The consistency rate of IGRA and TST was 89.90% (Kappa=0.867, P＞0.05). The sensitivity of IGRA combined with TST was significantly higher than the single detection of IGRA and TST (97.83% vs. 88.18% and 83.64% ), while the specificity of IGRA combined with TST was significantly lower than the single detection of IGRA and TST (61.11% vs. 92.31% and 83.33% ), and there were statistical differences (P﹤0.05). The receiver operating characteristic curve analysis result showed that the area under curve of IGRA in diagnosis of intraocular tuberculosis and latent tuberculosis infection was 0.781, area under curve of TST was 0.604, and area under curve of IGRA combined with TST was 0.679. Conclusions IGRA has high value in the diagnosis of intraocular tuberculosis and latent tuberculosis infection, and can be used as a diagnostic means of intraocular tuberculosis.

Application value of interferon gamma release assay combined with tuberculin skin test in diagnosis of intraocular tuberculosis and latent tuberculosis infection / 中国医师进修杂志

Objective@#To explore the application value of interferon gamma release assay (IGRA) combined with tuberculin skin test (TST) in diagnosis of intraocular tuberculosis and latent tuberculosis infection.@*Methods@#One hundred and ten patients with pulmonary tuberculosis (observation group) and 80 healthy persons (control group) in Hebei Chest Hospital from January 2016 to December 2018 were selected. Among the 110 patients with pulmonary tuberculosis, intraocular tuberculosis was in 35 cases, and latent tuberculosis infection was in 75 cases. All the patients were examined by ocular secretions IGRA and TST.@*Results@#The positive rates of IGRA and TST in observation group were significantly higher than those in control group: 88.18% (97/110) vs. 11.25% (9/80) and 83.64% (92/110) vs. 41.25% (33/80), and there were statistical differences (χ2 = 113.138 and 36.971, P<0.01). The positive rate of IGRA in patients with intraocular tuberculosis was significantly higher than that in latent tuberculosis infection: 97.14% (34/35) vs. 84.00% (63/75), and there was statistical difference (χ2 = 3.955, P<0.05). There was no statistical difference in the positive rate of TST between the patients with intraocular tuberculosis and patients with latent tuberculosis infection: 91.43% (32/35) vs. 80.00% (60/75), χ2 = 2.277, P>0.05. The consistency rate of IGRA and TST was 89.90% (Kappa = 0.867, P>0.05). The sensitivity of IGRA combined with TST was significantly higher than the single detection of IGRA and TST (97.83% vs. 88.18% and 83.64%), while the specificity of IGRA combined with TST was significantly lower than the single detection of IGRA and TST (61.11% vs. 92.31% and 83.33%), and there were statistical differences (P<0.05). The receiver operating characteristic curve analysis result showed that the area under curve of IGRA in diagnosis of intraocular tuberculosis and latent tuberculosis infection was 0.781, area under curve of TST was 0.604, and area under curve of IGRA combined with TST was 0.679.@*Conclusions@#IGRA has high value in the diagnosis of intraocular tuberculosis and latent tuberculosis infection, and can be used as a diagnostic means of intraocular tuberculosis.

Application of computer-assisted techniques in osseous genioplasty / 中华整形外科杂志

Objective@#To discuss the efficacy of computer aided design (CAD) and computer aided manufacturing (CAM) in the treatment of microgenia by osseous genioplasty.@*Methods@#From July 2015 to January 2018, 17 cases (Male, n=5, Female, n=12), aged from 17 to 32 years, with the meanage of 24 years, were enrolled. All patients had microgenia, and underwent osseous genioplasty. Computed tomography (CT) was performed preoperatively and 7-10 days postoperatively for all cases. Based on preoperative CT data, CAD was applied to make individualized surgical plan, surgery simulation, todetermine the movement of mentum. CAM was used to prefabricate the individualized surgical templates and transfer the CAD into intraoperative guidance. The registration of CAD and postoperative CT were performed to evaluate the surgical accuracy.@*Results@#All patients were satisfied with the surgical outcomes. The deformity of microgenia was significantly corrected. The Pg error was (0.24±0.08) mm, and the Me error was (0.15±0.17) mm.@*Conclusions@#The application of CAD increases the accuracy of surgical planning, and CAM provides areliable guidance with individualized template. Anoptimal surgical outcome can be achieved.

Cochlear implant approach in children patients with sigmoid sinus antedisplacement / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the operation approach and management during cochlear implant operation in children with sigmoid sinus antedisplacement.@*METHOD@#Five hundred and thirty-eight profound hearing loss children were performed auditory and imagiological examinations before cochlear implant. We analyzed the location of the sigmoid sinus from the high resolution CT scan and then performed cochlear implant to all these patients.@*RESULT@#In all these 538 cochlear implant children, 4 cases (0.74%) had significant sigmoid sinus antedisplacement which cause the operation more difficult, 64 cases (11.9%) had slight sigmoid sinus antedisplacement which did not impact the ordinary cochlear implant procedures.@*CONCLUSION@#Significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures were seldom happen in children. In 538 cochlear implant children of our center, 4 cases had significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures, we successfully complete these 4 operation through removal of the incus and abrasive reduction the posterior wall of bony external acoustic meatus.

Indication and approach of cochlear implantation with common cavity / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the indication and approach of cochlear implantation with common cavity inner ear malformation.@*METHOD@#Through imaging examination preoperatively for profound sensorineural hearing loss patients, we found 6 cases with common cavity inner ear malformation, in which cochlear, vestibule and lateral semicircular canal formed a big cavity. Among these cases, five had residual hearing, in the others, residual hearing was not detected.@*RESULT@#Among these cases with common cavity, 5 cases with residual hearing were treated with cochlear implantation, in 3 cases we selected round window approach, in the other 2 cases, we implanted the electrodes through the joint of the common cavity and posterior semicircular canal. Postoperatively, All these 5 patients have auditory response with cochlear implantation. The patient without residual hearing was not given cochlear implantation.@*CONCLUSION@#In patients with common cavity inner malformation, those who have residual hearing have indication for cochlear implantation, but it must be emphasized that their effect may not be as good as patients without inner ear malformation. In those patients without residual hearing, cochlear implantation should better not be performed.

The choice of approach in chronic otitis media surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the choise of operation approach for chronic otitis media surgery. METHODS Auditory and high resolution computed tomography (HRCT) assessment were carried out prior to the operation in 160 ears with otitis media. Tympanoplasty or mastoidectomy and tympanoplasty were performed. RESULTS Thirty-one patients received tympanoplasty and 129 patients received mastoidectomy and tympanoplasty. Closed and opened surgery were performed in 49 and 80 cases respectively. The ear-drying time ranged from 7 to 51days with an average of 23 days. Mean hearing increased by 15dB. CONCLUSION Assessing the HRCT scan prior to the surgery can help us choose a reasonable approach in chronic otitis media surgery.

Role of Measuring Facial Recess in Cochlear Implantation / 听力学及言语疾病杂志

Objective To introduce the development of facial recess of 210 cases who recieved cochlear implantation and experienced the opening of the facial recess under the direction of high resolation computed tomography(HRCT).Methods The facial recess was assessed and measured using the HRCT before cochlear implantation in 210 patients who suffered from severe and profound sensorineural hearing loss.A statistic analysis was performed according to the age group,and the findings during the operation were compared with that before the surgery.Results The facial recess of 13 cases (6%) did not developed.The mean volume of the rest facial recess was 4.26 mm3 in 197 cases,while in 12.0 years group(group C) it was 3.09 mm3.The differences among three groups were statistically significant. The findings during the operation was agreed with the assessment results prior to the surgery.Conclusion 94% facial recesses developed in all 210 cases.Employment of HRCT scan prior to the surgery allows auurate determination of the location of facial recess to ensure successful surgery.