3D-FLAIR MRI findings in idiopathic sudden sensorineural hearing loss and the correlations with clinical features and prognosis / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the correlations of different appearances of labyrinthine 3D-FLAIR MRI with clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: Clinical data of patients with unilateral ISSNHL hospitalized from May 2017 to January 2019 were retrospectively analyzed. According to the results of 3D-FLAIR MRI, the patients were divided into three groups including hyperintense with absorption, hyperintense without absorption and normal. The differences and correlations among the three groups in clinical characteristics (gender, age, deafness side, duration, treatment days, dizziness/vertigo, basic diseases, vestibular function, deafness classification and typing) and prognosis were analyzed by SPSS 20.0 software. Results: Data were collected from 1 245 cases, including 739 (59.36%) with normal signal, 288 (23.13%) hyperintense without absorption, and 218 (17.51%) hyperintense with absorption. The side ratio, treatment days, dizziness/vertigo incidence, vestibular dysfunction, deafness classification and typing were different among the three groups (P<0.001). The incidence of right side was significantly higher in both the hyperintense with and without absorption groups than that in the normal. The vestibular dysfunction was more common in the hyperintense with absorption group than in the normal and hyperintense without absorption groups. It showed statistical differences in the dizziness/vertigo incidence, deafness classification, treatment days, and deafness typing compared between groups, which was the most significant in the hyperintense with absorption group, followed by the hyperintense without absorption group. There was no statistical difference in the total effective rate among the three groups (P=0.139), whereas a significant difference in the recovery rate (P<0.001). The prognosis was significantly correlated with duration, age, treatment days and dizziness/vertigo in the normal group (all P<0.001), correlated with duration and treatment days in the hyperintense with absorption group (both P<0.001), only correlated with the duration in the hyperintense without absorption group (P<0.001). Conclusion: 3D-FLAIR MRI manifestation is closely related to the clinical features and efficacy of ISSNHL. It is helpful to clarify the pathology of inner ear, which is expected to be a new imaging indicator for disease evaluation.

Significance of ocular surface interferometer in the diagnosis of Meibomian gland dysfunction / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the significance of ocular surface interferometer in the diagnosis of Meibomian gland dysfunction (MGD). ·METHODS: Prospective case-control studies. Totally 62 patients with MGD and 38 healthy volunteers were selected in Peking University Third Hospital from October to November in 2017. All subjects of both groups were examined respectively for Ocular Surface Disease Index Questionnaire ( OSDI ), slit - lamp anterior segment check, the eye surface interferometer inspection, and break up time. Independent sample t- test and chi-square test were used for comparison between the two groups. Spearman correlation analysis was used in the group of patients with MGD. ·RESULTS: In both groups, there were changes on the morphology of the eyelid, and the lesions were different. The score of OSDI, the discharge ability and the loss score of the MGD group were significantly higher than those in the control group (P<0. 05). However, the lipid layer thickness (LLT) was significantly lower than that in the control group (P<0. 05). There was no significant difference in BUT, the proportion of incomplete blink time, the score of Meibomian gland orifice and the quality score of the Meibomian gland discharge ability between the two groups ( P > 0. 05 ). The Spearman correlation analysis indicated that the negative correlation between LLT and the OSDI questionnaire score (rs= -0. 730, P<0. 01), LLT and the Meibomian gland orifice (rs=-0. 639, P<0. 01), LLT and the loss of Meibomian gland (rs=-4. 15, P=0. 001); however, the positive correlation was shown between the loss of Meibomian gland and the OSDI questionnaire score (rs=0. 790, P<0. 01). · CONCLUSION: Meibomian gland dysfunction symptoms and signs significantly correlates with LLT, loss of Meibomian gland detected by ocular surface interferometer, so ocular surface interferometer can be used for rapid, noninvasive and objective diagnosis of Meibomian gland dysfunction and assess the stage of disease progression.

Minimally invasive sinus tarsal approach versus conventional L-shaped lateral approach in treating calcaneal fractures: a Meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>To compare efficacy and safety of minimally invasive sinus tarsal approach versus conventional L-shaped lateral approach in treating calcaneal fractures.</p><p><b>METHODS</b>The studies concerning about randomized controlled trial and non-randomized controlled trial of minimally invasive sinus tarsal approach versus conventional L-shaped lateral approach in treating calcaneal fractures from the time of creating database to March, 2017 were searched from PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMbase, ISI Web of Knowledge databases, VIP, CNKI, CBM and Wan Fang. The literatures which screened by randomized controlled trial and non- randomized controlled trial were extracted and performed quality assessment by two people. Meta analysis were performed by RevMan 5.3 software and GRADE system were used to evaluate quality.</p><p><b>RESULTS</b>Four randomized controlled trial and 4 non-randomized controlled trial were included, totally 493 patients. Meta-analysis results showed compared with conventional L-shaped lateral approach, minimally invasive sinus tarsal approach had shorter operative time [MD=-5.41, 95%CI(-6.71, -4.12),<0.000 01], lower incidence of postoperative complications[OR=0.10, 95%CI(0.05, 0.21),<0.000 01], and higher AOFAS score [MD=-3.09, 95%CI(-1.72, 4.46),<0.000 01] at the final follow-up. Böhler angle in conventional L-shaped lateral approach was better than that of minimally invasive sinus tarsal approach [MD=-0.80, 95%CI(-1.45, -0.14),<0.05]. While there were no significant differences in postoperative Gissanes angle [MD=0.35, 95%CI(-0.77, 1.47),>0.05] and Maryland score[MD=2.12, 95%CI(-0.71, 4.95),>0.05] between two groups.</p><p><b>CONCLUSIONS</b>Minimally invasive sinus tarsal approach and conventional L-shaped lateral approach has similar clinical effect for the treatment of calcaneal fractures. However, minimally invasive sinus tarsal approach has advantages of shorter operation time, lower incidence of complication and better safety. For the limited quantity of the original studies, operative approach should be chosen according to the patient.</p>

Multi-center study on the treatment for intermediate and high-frequency sudden sensorineural hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the therapeutic effect of treatment for intermediate and high-frequency sudden sensorineural hearing loss (SSNHL).</p><p><b>METHODS</b>A prospective clinical multicentre research was conducted using international standardized approach of clinical research. SSNHL Cases with intermediate and high-frequency hearing loss, that accepted no medication from onset of hearing loss within two weeks duration and ages ranged between 18 and 65, were collected. All patients were treated by one of four treatments plans chosen by unified random table.</p><p><b>RESULTS</b>141 patients with intermediate and high-frequency SSNHL were recruited in the research. Twenty subjects were treated with lidocaine, 21 cases with lidocaine and hormone, 40 cases with Ginaton, and 60 cases with Ginaton and hormone. 42 out of 141 (29.79%) patients were total recovery, 24 (17.02%)achieved excellent recovery, 27 (19.15%)achieved partial recovery, and 48 (34.04%) were ineffective. The total effective rate was 65.96%. In lidocaine group, the total effective rate was 55.00%, 66.67% in lidocaine and hormone group, 67.50% in Ginaton group, and 68.33% in Ginaton and hormone group. Considering the total effective rate, there was no statistical difference between four groups (P > 0.05). However, the recovery rate in Ginaton group was significant difference comparing with that in lidocaine group (P = 0.0496). 119 had concomitant symptom of tinnitus, and the tinnitus was improved in patients of 81.51%. With regard to total effective rate of tinnitus in four treatment groups, it was 57.89% (11/19) in lidocaine group, 100.00% (18/18) in lidocaine and hormone group, 88.57% (31/35) in Ginaton group, 78.72% (37/47) in Ginaton and hormone group. There was significant ascendancy in lidocaine and hormone group versus that in lidocaine group (P = 0.002) and Ginaton and hormone group (P = 0.029). And the difference between lidocaine and Ginaton groups was statistical significance (χ(2) = 6.705, P < 0.05). In 43 patients with muffled symptom in aural region, 90.70% was partial recovery. There was no statistical difference between each groups (χ(2) = 5.97,P = 0.74). There were 17 with dizziness or vertigo improved in all cases. Another 10 patients accompanied other complaints all improved.</p><p><b>CONCLUSIONS</b>for the treat of intermediate and high-frequency SSNHL, the therapeutic effect in hearing has no significantly different between single and combined drug therapies. Considering the recovery rate, there is an obvious advantage in Ginaton group compared with lidocaine group. Tinnitus is the major concomitant symptom in intermediate and high-frequency SSNHL, and lidocaine and hormone therapy should be used.</p>

Clinical analysis of sudden sensorineural hearing loss in patients with different ages / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical materials of sudden sensorineural hearing loss (SSNHL) in different ages of patients, and explore their clinical characteristics and prognosis.</p><p><b>METHODS</b>A retrospective review was conducted by the clinical symptoms, predisposing factors and prognosis in SSNHL patients with different ages in the past two years (from 2008 to 2010). All patients were divided into three groups according to age, including Group 1 (0-18 years old), Group 2 (19-59 years old), and Group 3 (over 60 years old).</p><p><b>RESULTS</b>Part of patients (28.1%) had a clear history of virus infection in Group 1. Some patients (18.7%) had obvious history of emotional fluctuations or fatigue before the onset of SSNHL. Three groups of patients with "aural fullness" symptom accounted for 3.1%, 41.3% and 29.4% respectively. The proportions of patients with profound hearing loss in three groups were 62.5%, 40.0% and 33.3% respectively. Most patients improved hearing level during systemic internal medicine treatment. However, many patients (68.8%) in Group 1 showed poor therapeutic effect.</p><p><b>CONCLUSIONS</b>SSNHL in different age stages has different clinical features. We can improve the personalized treatment program to this disease through the classification and grading treatment.</p>

Analysis of TGFBI gene mutation in a Chinese family with Avellino corneal dystrophies / 中华实验眼科杂志

Background Researches demonstrated that corneal dystrophy is associated with the mutation of transforming growth factor beta induced gene(TGFBI)located at chromosome 5q31 domine.Recent study showed that the gene mutation location is in R124H of TGFBI gene. Objective This study was to identify the mutation characteristics of TGFBI gene in a Chinese family with Avellino corneal dystrophy. Methods This Chinese family with Avellino corneal dystrophy were determined and surveyed in Peking University Third Hospital.Periphery blood from 8 patients with Avellino corneal dystrophy and 2 unaffected subjects were collected from a Chinese family with corneal dystrophy for the extraction of DNA.Exons 4,11,12 of the TGFBI gene were amplified by polymerase chain reaction(PCR),and the amplified products were sequenced directly and compared the gene sequence with that of TGFBI in GenBank.Written informed consent was obtained from each Subject prior to any medieal process. Results This family included 27 members of consecutive 4 generation.The hereditary pattern W88 in accordance with the autosomal dominant inheritance.Directly sequencing of 8 affected members revealed a G tO A transition at codon 124 (CGC to CAC),producing R124H mutation of TGFBI gene.Two synonymous single nucleotide polymorphism(SNP)of TGFBI gene occurred in the family.including a C to T transition at eodon 472(CTC to CTT)in 8 members,and a T to C transition at codon 540(TTT>TTC)in 9 members,which wag unrelated with disease. Conclusion R124H mutation of the TGFBI gene is found in this Chinese family with Avellino corneal dystrophy.

Suppressive effect and its frequency selection of dopamine on the cochlear auditory afferent nerve activity in guinea pigs / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the suppressive effect and its frequency selection of dopamine on the cochlear auditory afferent nerve activity. To offer an important step in understanding the modulation of dopamine in the inner cell synaptic complex.</p><p><b>METHODS</b>Forty guinea pigs were randomly divided into four groups and the whole intracochlear perfusions were performed: (1) perfused with artificial perilymph solutions; (2) perfused with artificial perilymph solutions containing 10 mmol/L dopamine; (3) perfused with artificial perilymph solutions containing 30 mmol/L dopamine; (4) perfused with artificial perilymph solutions containing 50 mmol/L dopamine. Compound action potential (CAP) evoked by different frequencies (250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz, 16 000 Hz) and cochlear microphonics (CM) evoked by 4000 Hz tone burst were recorded from the round window of guinea pigs before perfusion and 1 hours, 2 hours after perfusions.</p><p><b>RESULTS</b>There was no significant difference in CAP threshold before and after perfusion in the artificial perilymph solutions group (P > 0.05). An increase of CAP threshold of most detecting frequencies were observed in the three dopamine-perfused groups (P < 0.05). The inhibition effect intended with the increasing of the concentration of dopamine in the perfusion solution. There was significant difference in CAP threshold shift between different frequencies, especially in the group perfused with 30 mmol/L dopamine. The maximal threshold shift was found at 4000 Hz and 8000 Hz. No significant changes of CM amplitude and non-linearity of input-output function were observed before and after perfusion with artificial perilymph solutions and dopamine.</p><p><b>CONCLUSIONS</b>Dopamine can inhibit the cochlear auditory afferent nerve, but there is no obvious influence on outer hair cell produced by dopamine. The inhibition effect has frequency selection, the suppression on high frequencies is more stronger than low frequencies.</p>

Inhibition of nifedipine on inward current of Hensen cell induced by ATP / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of nifedipine on the non-selective inward current of cochlear Hensen cell induced by ATP in high concentrations.</p><p><b>METHODS</b>The organ of Corti was treated using enzyme, and then dissociated mechanically to isolate Hensen cells. The whole cell patch-clamp technique was used to record ion currents in Hensen cells which had integrated border, round shape and translucent intracellular cytoplasm. Drugs were delivered to the cell by a micro-manifold consisting made by three 100 microm diameter microtubules, including 0.1 mmol/L ATP, 1 mmol/L ATP, 10 mmol/L ATP, 0.1 mmol/L ATP + 0. 1 mmol/L suramin (purinergic antagonist), stimulation of extracellular fluid alone, 140 mmol/L CsCl (replace KCL in intracellular fluid) + 1 mmol/L ATP, 40 mmol/L TEA (blocker of potassium channel) + 1 mmol/L ATP, and 1 mmol/L ATP + 10 micromol/L nifedipine, respectively.</p><p><b>RESULTS</b>When isolated Hensen cell was given 0.1 mmol/L (n = 10), 1 mmol/L (n = 10), 10 mmol/L( n = 6) ATP separately, an inward ion current could be recorded, which enhanced with increased ATP concentration and showed dose-dependence. Further study indicated that the inward ion current could be inhibited by 0.1 mmol/L suramin (n = 5), 140 mmol/L CsCl (n = 5) and 40 mmol/L TEA (n = 5). There was no ion current be recorded when the cell was stimulated with the extracellular fluid alone, neither inward nor outward. However, the inward ion current vanished and an outward ion current appeared instead, when 1 mmol/L ATP and 10 micromol/L nifedipine were given together (n = 5).</p><p><b>CONCLUSIONS</b>An inward current was evoked in isolated Hensen cell by ATP in high concentrations. This inward current seems to be associated closely with potassium channels without the participation of mechanical channels. Nifedipine can inhibit this inward current and induce an outward current, which is similar to the normal potassium current in isolated Hensen cell. It suggests that nifedipine have partly protective effect on the function of cochlea by inducing modulate of the potassium circle of cochlea in Hensen cell's tache.</p>

Mutation analysis of PAX6 gene in a large Chinese family with aniridia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mutations in PAX6 gene have been shown to be the genetic cause of aniridia, which is a severe panocular eye disease characterised by iris hypoplasia. However, there is no study to do genetic analysis of aniridia, although there are several case reports in China. Here, we describe a mutation analysis of PAX6 in a large Chinese family with aniridia.</p><p><b>METHODS</b>Genomic DNA from venous blood samples was prepared. Haplotype analysis was performed with two genetic markers (D11S904 and D11S935). Fourteen exons of the PAX6 gene were amplified from genomic DNA. Polymerase chain reaction (PCR) products of each exon were analysed by single strand conformational polymorphism (SSCP). The PCR products having an abnormal pattern were sequenced to confirm the mutation.</p><p><b>RESULTS</b>Significant evidence for allele sharing in affected patients was detected suggesting that PAX6 mutation links to aniridia in this family. An extra band corresponding to exon 9 in PAX6 was found by single strand conformational polymorphism analysis in all the aniridia patients in this family, but not detected in the unaffected members. A mutation of C to T was detected by sequencing at the nucleotide 1080 that converts the Arg codon (CGA) to the termination codon (TGA).</p><p><b>CONCLUSIONS</b>Aniridia is caused by a nonsense mutation of PAX6 gene in the large Chinese kindred. Genetic test is important to prevent the transmission of aniridia to their offsprings in the kindred by prenatal diagnosis.</p>