[Correlation analysis of vertigo etiology and age in children].

Objective:To study the etiology of vertigo in children and analyze the relationship between the etiology of vertigo and the age category. Method:One hundred and forty-four cases of children with vertigo or dizziness were selected. All patients received the vertigo questionnaire, audiological, vestibular function and other related examinations. JMP 10.0 was used for statistical analysis. Result:Of 144 patients, 17 cases were preschool age (<6 years old), 101 cases were school age (6-12 years old) and 26 cases were puberty (>12 years old). All patients were mainly distributed between 6 and 10 years old. The most common diagnoses was benign paroxysmal vertigo. The second one was vestibular migraine. Incidence rate of the same disease in different ages was also different. Benign paroxysmal vertigo and vestibular migraine in preschool age, school age and puberty accounted for 58.8%, 42.6%, 0 and 0, 17.8%, 30.8%, respectively. Conclusion:Benign paroxysmal vertigo and vestibular migraine were the most common causes of vertigo in children. Prevalence rate and the etiology was various in different ages. Due to the physical and psychological development of children, analyzing the cause of vertigo in children should be fully considered these characteristics.

[Clinical treatment of congenital middle ear cholesteatoma in children].

Objective:To summarize the clinical characteristics and clinical treatment of congenital cholesteatoma (CC) of the middle ear in children, provide early diagnosis methods and explore standardized diagnosis and treatment plan.Method:A retrospective chart review of 94 patients with a diagnosis of middle ear cholesteatoma, in Beijing Children's Hospital, between 2009 and 2015 was carried on. 14 patients with CC were identified using the criteria proposed by Levenson, and were divided into two groups according to the course of disease. The course of disease in group A was less than 3 months, and group B was more than 3 months. The main complains, diagnostic methods and Potsic's stage of temporal bone CT findings were recorded.Result:①The age of 14 cases of congenital cholesteatoma of the middle ear ranged from 3.33 to 10.17 years, with the median age of 7.20 years. ②Hearing loss (13/14, 92.86%) was the most common complain. Finding methods included hearing screening and CT scan (11/14, 78.57%), tympanotomy (2/14, 14.28%) and otoscopic examination (1/14, 7.14%). ③There were 6 people in group A and 8 in group B. According to Potsic's grading standard, the difference between the two groups was statistically significant (P=0.043). ④The preoperative Air-Bone conduction threshold Gap (ABG) in A and B two groups were (38.10±7.43) dB and (42.09±9.96) dB, respectively, and there was no significant difference in analysis (P=0.427). ⑤The difference between pre-ABG and post-ABG ï¼»(36.26±5.56）dB and （21.70±3.80）dB, P=0.004ï¼½ was significant. Canal wall up mastoidectomy was the preferred procedure and 11/14 (78.57%) patients had this surgery done.Conclusion:The shorter the course of disease, the lower the stage of cholesteatoma of the middle ear indicates the importance of early detection. But congenital cholesteatoma is more occult, and even within 3 months, cholesteatoma can cause severe damage to the hearing and middle ear structure. Early screening programs can recommend hearing screening and CT scan to facilitate early intervention.

[Effects of noise competition on monosyllabic and disyllabic word perception in children].

Objective: The purpose of the present study was to investigate the effects of noise competition on word perception in normal hearing (NH) children and children with cochlear implantation (CI). Methods: To estimate the contribution of noise competition on speech perception, word perception in speech-shaped noise(SSN)and 4-talker babble noise(BN) with Mandarin Lexical Neighborhood Test were performed in 80 NH children and 89 children with CI. Corrected perception percentages were acquired in each group. Results: Both signal to noise ratio (SNR) and noise type influenced the word perception. In NH group, corrected percentages of disyllabic word perception in SSN were 24.2%, 55.9%, 77.1%, 85.1% and 88.9% at -8, -4, 0, 4 and 8 dB SNR, corresponding corrected percentages of monosyllabic word were 13.9%, 39.5%, 60.1%, 68.8% and 80.1%, respectively. In BN noise, corrected percentages of disyllabic word were 2.4%, 24.3%, 55.6%, 74.3% and 86.2%, corresponding monosyllabic word were 2.3%, 20.8%, 47.2%, 61.1% and 74.8%, respectively. In CI group, corrected percentages of dissyllabic word in SSN and BN at 10 dB SNR were 65.5% and 58.1%, respectively. Corresponding monosyllabic word were 49.0% and 41.0%. For SNR=5 dB, corrected percentages of disyllabic word in SSN and BN were 50.0% and 38.1%, corresponding corrected percentages of monosyllabic word were 40.8% and 25.1%, respectively. Analysis indicated that the masking effect were significantly higher in BN compared with SSN. Conclusions: Noise competition influence word perception performance significantly. In specific, the influence of noise on word perception is bigger in children with CI than in NH children. The masking effect is higher in BN noise when compared with SSN.

[Clinical characteristics in children with cleft palate associated with middle ear cholesteatoma].

Objective: To summarize the characteristics of children diagnosed as cleft palate associated with middle ear cholesteatoma. Methods: There were five middle ear cholesteatoma cases who had previously received cleft palate repairment surgery. All of the patients were followed up for 17 to 47 months. Median follow-up time was 31 months. Results: There were three males and two females with three to eleven years old , and the average of age was seven years and ten months. The time of cleft palate repairment surgery was from six months to four years, and the average age was one year and nine months. No history of grommet insertion. Three cases were unilateral choleateatoma (right ear in two cases and left ear in one case, of which two cases of contralateral ear with secretory otitis media) and two cases were bilateral choleateatoma. Five cases(seven ears) received surgeries. Radical mastoidectomy + canal wall down tympanoplasty were performed in three ears, in which we found stapes disappeared. Radical mastoidectomy + canal wall up tympanoplasty were performed in four ears, in which we found intact foot plate, with recurrence occurred in one case nine months after the first surgery. No recurrence occurred after the second canal wall down tympanoplasty. The postoperative average hearing thresholds of air conduction were improved in different degrees. Conclusions: There may be a relationship between cleft palate associated with middle ear cholesteatoma and no grommet insertion history. The incidence of bilateral cases is relatively high, and otitis media with effusion may occur because of poor Eustachian tube function in the unilateral cases. Choice of surgical methods should be decided basing on combination of decreasing the recrudescence and improving the hearing.

Cleft relapse and oronasal fistula after Furlow palatoplasty in infants with cleft palate: incidence and risk factors.

This study was performed to investigate the incidence of and risk factors for postoperative cleft relapse and oronasal fistula after Furlow palatoplasty in infants. Sixty-two infants with cleft palate, aged 6-12 months (mean 8.25 months), who underwent cleft repair by Furlow double opposing Z-plasty between March 2012 and August 2014, were enrolled in the study. Risk factors for postoperative cleft relapse and oronasal fistula after Furlow palatoplasty were identified by logistic regression analysis. The incidence rates of cleft relapse at 1 week and oronasal fistula at 3 months after surgery were 24.2% (15/62) and 9.7% (6/62), respectively. Among all of the variables screened, only the width of the cleft was significantly associated with the incidence of postoperative cleft relapse (P=0.001) and oronasal fistula (P=0.011); the incidence rates were positively correlated with the width of the cleft when it exceeded 6.8mm and 7.5mm, respectively. Based on these findings, in order to reduce the incidence of postoperative cleft relapse and oronasal fistula, Furlow repair is not recommended for patients with wide clefts. An appropriate angle between the Z-flap incision and the central axis, use of a bilateral relaxation incision, and postoperative nursing care can help reduce the incidence of postoperative cleft relapse.

Molecular phylogenetic and dating analysis of pierid butterfly species using complete mitochondrial genomes.

Pieridae is a butterfly family whose evolutionary history is poorly understood. Due to the difficulties in identifying morphological synapomorphies within the group and the scarcity of the fossil records, only a few studies on higher phylogeny of Pieridae have been reported to date. In this study, we describe the complete mitochondrial genomes of four pierid butterfly species (Aporia martineti, Aporia hippia, Aporia bieti, and Mesapia peloria), in order to better characterize the pierid butterfly mitogenomes and perform the phylogenetic analyses using all available mitogenomic sequence data (13PCGs, rRNAs, and tRNAs) from the 18 pierid butterfly species comprising the three main subfamilies (Dismorphiinae, Coliadinae and Pierinae). Our analysis shows that the four new mitogenomes share similar features with other known pierid mitogenomes in gene order and organization. Phylogenetic analyses by maximum likelihood and Bayesian inference show that the pierid higher-level relationship is: Dismorphiinae + (Coliadinae + Pierinae), which corroborates the results of some previous molecular and morphological studies. However, we found that the Hebomoia and Anthocharis make a sister group, supporting the traditional tribe Anthocharidini; in addition, the Mesapia peloria was shown to be clustered within the Aporia group, suggesting that the genus Mesapia should be reduced to the taxonomic status of subgenus. Our molecular dating analysis indicates that the family Pieridae began to diverge during the Late Cretaceous about 92 million years ago (mya), while the subfamily Pierinae diverged from the Coliadinae at about 86 mya (Late Cretaceous).

[The application of 3D simulationtemporal-bone-system for temporal bone anatomy training].

Objective:The aim of this study is to investigate the application of 3D simulation temporal-bone-system for temporal bone anatomy training.Method:3D simulation temporal-bone-system in the anatomy workshop was introduced in Beijing Children's Hospital from 2014 to 2015.Each participant was trained by cadaver dissection and 3D simulation temporal-bone-anatomy,and they also completed the questionnaires and evaluated the procedure.Then the difference was analyzed.Result:①In stage of mastoid outline,the damage of structure in 3D systemis higher than that in cadaver dissection(33.3%>22.2%),but there were no significant difference between them in the proportion of exposure.On the opening of attic,facial recess,facial nerve,the damage and the proportion of the non-exposed of cadaver dissection is higher.②There were no significant difference between them in the anatomical structures,levels of pollution,taste,cost and reproducibility(P>0.05),but in the aspect of time,relevance of CT with temporal bone,the similarity,and the force feedback,they had significant differences(P<0.01).Conclusion:3D simulation temporal-bone-system had better training effect in specialized otolaryngologist.It not only to help clinicians better understanding the temporal bone and surrounding structures,but also to emphasize the knowledge of the anatomy in temporal bone.

Complete mitochondrial genome sequence of Cheirotonus jansoni (Coleoptera: Scarabaeidae).

We sequenced the complete mitochondrial genome (mitogenome) of Cheirotonus jansoni (Coleoptera: Scarabaeidae), an endangered insect species from Southeast Asia. This long legged scarab is widely collected and reared for sale, although it is rare and protected in the wild. The circular genome is 17,249 bp long and contains a typical gene complement: 13 protein-coding genes, 2 rRNA genes, 22 putative tRNA genes, and a non-coding AT-rich region. Its gene order and arrangement are identical to the common type found in most insect mitogenomes. As with all other sequenced coleopteran species, a 5-bp long TAGTA motif was detected in the intergenic space sequence located between trnS(UCN) and nad1. The atypical cox1 start codon is AAC, and the putative initiation codon for the atp8 gene appears to be GTC, instead of the frequently found ATN. By sequence comparison, the 2590-bp long non-coding AT-rich region is the second longest among the coleopterans, with two tandem repeat regions: one is 10 copies of an 88-bp sequence and the other is 2 copies of a 153-bp sequence. Additionally, the A+T content (64%) of the 13 protein-coding genes is the lowest among all sequenced coleopteran species. This newly sequenced genome aids in our understanding of the comparative biology of the mitogenomes of coleopteran species and supplies important data for the conservation of this species.

Complete mitochondrial genomes of the Bright Sunbeam Curetis bulis and the Small Copper Lycaena phlaeas (Lepidoptera: Lycaenidae) and their phylogenetic implications.

In this study, the complete mitochondrial genomes of Curetis bulis and Lycaena phlaeas were determined and analyzed. The circular genomes are 15,162 bp long for C. bulis and 15,280 bp long for L. phlaeas, with a total A+T content of 82.6 and 83.1%, respectively. Both mitogenomes contain 37 genes, and their gene orders are similar to those of other lepidopterans. All protein-coding genes (PCGs) are initiated by ATN codons, except for cox1, which is started with the CGA codon; all PCGs terminate in the typical stop codon TAA, except for cox1, cox2, and nad4, which end with a single T. The codons TTA (Leu), ATT (Ile), TTT (Phe), ATA (Met), and AAT (Asn) appear the most frequently. Both of the mitogenome A+T-rich regions harbor the motif ATAGA, followed by a 19-bp poly(T) stretch, with C. bulis containing a microsatellite-like (AT)5 element next to the ATTTA motif, and L. phlaeas containing a microsatellite-like (TA)6 (AT) element next to the ATTTA motif. The phylogenetic trees of the 17 representative butterfly species, including the two species of this study, were reconstructed with the maximum likelihood and Bayesian inference methods, based on the 13 PCG nucleotide sequence data. The results of the phylogenetic analyses strongly supported the relationships of ((((Lycaenidae + Pieridae) + Nymphalidae) + Hesperiidae) + Papilionidae), which was markedly different from the traditional morphological view of the Lycaenidae and Nymphalidae considered to be sisters of each other.

Complete sequence of the mitochondrial genome of the Japanese buff-tip moth, Phalera flavescens (Lepidoptera: Notodontidae).

We sequenced the complete mitochondrial genome of Phalera flavescens. The mitogenome is 15,659 bp in length, including 13 protein-coding genes (atp6, atp8, cox1-3, nad1-6, nad4L, cob), two ribosomal RNAs (rrnS and rrnL), 22 transfer RNAs and an AT-rich region, a putative control region (D-loop). Gene order and orientation were found to be identical to those of other completely sequenced lepidopteran mitogenomes. All 13 protein-coding genes start with the common codon ATN, except for the cox1 gene, which uses CGA as the initial codon. Nine of the 13 protein-coding genes stop with codon TAA, while the cox1, cox2, nad5, and nad4 genes stop with the single nucleotide T. All tRNA genes can be folded into canonical cloverleaf secondary structure, except for trnS1, which loses the ''DHU'' arm. Six overlapping sequences totaling 20 bp (1-8 bp for each sequence) and 16 intergenic spacer sequences, totaling 276 bp (1-58 bp for each sequence) are scattered throughout the genome; the largest intergenic spacer is located between the trnQ and nad2 genes. A microsatellite-like structure (AT)(6)ACC(AT)(6) and 16-bp poly-T elements preceded by the ATTTA motif are present in the D-loop region. Additionally, unexpectedly, an extra 190-bp insertion, with unknown function, was found in the small subunit rRNA gene (rrnS); this gene is the longest known (1020 bp) among all of the Lepidoptera.

[Transdermal iontophoresis of insulin: effect of penetration enhancers on blood glucose level in diabetic rats].

The effects of many usual penetration enhancers such as azone (AZ), oleic acid (OA), poloxamer 188 (POL 188) and propylene glycol (PG) on the blood glucose level in diabetic rats after transdermal iontophoresis of insulin were studied. The change of blood glucose level (D%), defined as the percent ratio of the concentration of blood glucose in rats after the iontophoretic application of insulin to that before administration of insulin, was used to present the data. The results showed that following iontophoretic application of insulin for 3 h, the D% in diabetic rats treated with 100% AZ and 5% AZ/PG was 38.58% and 25.28% respectively, and the D% in diabetic rats untreated with enhancers was 45.48%. The D% in diabetic rats treated with 100% OA, 10%-OA/PG, 10% POL 188/PG and 100% PG was 66.28%, 60.47%, 76.75% and 57.93% respectively. So, AZ showed a synergistic effect on the ability of iontophoresis to promote skin permeation of insulin, and PG further increased this effect. The combination of AZ, PG and iontophoresis increased the permeation of insulin significantly. OA, POL 188 and PG did not display synergistic effect on iontophoresis enhancement. The combination of iontophoresis and some enhancers provided a novel idea and possibility for the administration of polypeptide drugs.

CHD and its risk factors in the People's Republic of China.

Mortality data obtained from the Health Statistics Office of the Ministry of Health, People's Republic of China (PRC), were compared to data for other countries taken from the World Health Statistics Annual. The crude death rate for coronary heart disease (CHD) in China in 1984 is estimated to be about one-tenth of that for North America and Australia. However, a high stroke to CHD ratio of about 5.0 was observed in China. The age-standardized CHD mortality rates were significantly higher for Beijing in north China than for Shanghai and Guangzhou in the south, and for urban than rural populations in all years from 1976 to 1986. Data on hospital admissions and autopsy material provide evidence for an increase in CHD incidence and prevalence in the last three to four decades. A low mean serum total cholesterol, related to a low habitual dietary intake of fat and cholesterol, is considered to be the main cause underlying low CHD mortality rates in China.