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Ma X, Lu YQ, Zhao YX, Yu LS, Bai WP, Lai RC, E LJ. [Preliminary analysis of risk factors of tinnitus related to female menopause]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2024; 59:916-921. [PMID: 39289959 DOI: 10.3760/cma.j.cn115330-20240107-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Objective: To investigate the possible pathogenesis and possible risk factors of tinnitus related to female menopause. Methods: From April 2016 to October 2016, 59 female patients with menopausal syndrome were diagnosed in the menopause comprehensive management clinic. Tinnitus and menopause questionnaires were conducted, based on whether having tinnitus, those patients were divided into two groups: tinnitus group and no tinnitus group. Age, body mass index (BMI), Kupperman menopausal index (KMI) score, follicle-stimulating hormone (FSH) level of patients in the two groups were analyzed. Menopausal symptoms, related medical history and possible related factors of tinnitus were statistically analyzed. Results: A total of 59 cases were collected, 22 of which were accompanied by tinnitus. The incidence of idiopathic tinnitus was 35.1% (20/57) because 2 cases of thyroid related tinnitus with clear etiology were removed. Complete data were obtained from 17 of 20 patients with idiopathic tinnitus and 26 of 37 patients without tinnitus. Age, BMI, menopause KMI score, hormone level, menopause symptoms and possible factors related to tinnitus were statistically analyzed between the two groups, and the incidence of headache was statistically different between the two groups (χ2=9.098, P=0.003), but no other factors were statistically significant(P>0.05). The severity of insomnia and tinnitus were further analyzed (χ2=2.841, P=0.417), and there was no significant difference between the two groups. Conclusion: Headache history may be one of the high risk factors for the occurrence of menopausal tinnitus.
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Yu LS. [Progress and future of otological medicine]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2023; 58:28-32. [PMID: 38726519 DOI: 10.3760/cma.j.cn115330-20231203-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
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de Castro DG, Sanematsu PI, Pellizzon ACA, Suzuki SH, Fogaroli RC, Dias JES, Gondim GRM, Estrada DA, Silva MLG, Rassi MS, Chen MJ, Giacomelli R, Ramos H, Neto ES, Abrahão CH, Coelho TM, Yu LS, de Queiroz Tannous C, Calsavara VF, Giordano FA, de Oliveira JG. Intraoperative radiotherapy for brain metastases: first-stage results of a single-arm, open-label, phase 2 trial. J Neurooncol 2023; 162:211-215. [PMID: 36826700 DOI: 10.1007/s11060-023-04266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Focal stereotactic radiosurgery to the surgical cavity lowers local recurrence after resection of brain metastases (BM). To evaluate local control (LC) and brain disease control (BDC) after intraoperative radiotherapy (IORT) for resected BM. METHODS Adult patients with completely resected single supratentorial BM were recruited and underwent IORT to the cavity with a prescribed dose of 18 Gy to 1 mm-depth. Primary endpoints were actuarial LC and BDC. Local failure (LF) and distant brain failure (DBF), with death as a competing risk, were estimated. Secondary endpoints were overall survival (OS) and incidence of radiation necrosis (RN). Simon's two-stage design was used and estimated an accrual of 10 patients for the first-stage analysis and a LC higher than 63% to proceed to second stage. We report the final analysis of the first stage. RESULTS Between June 2019 to November 2020, 10 patients were accrued. Median clinical and imaging FU was 11.2 and 9.7 months, respectively. Median LC was not reached and median BDC was 5 months. The 6-month and 12-month LC was 87.5%. The 6-month and 12-month BDC was 39% and 13%, respectively. Incidence of LF at 6 and 12 months was 10% and of DBF at 6 and 12 months was 50% and 70%, respectively. Median OS was not reached. The 6-month and 12-month OS was 80%. One patient had asymptomatic RN. CONCLUSION IORT for completely resected BM is associated with a potential high local control and low risk of RN, reaching the pre-specified criteria to proceed to second stage and warranting further studies.
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Diao TX, Jing YY, Zhang JL, Wang YX, Yu LS, Ma X. [Reclassification of flat type sudden deafness]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2023; 58:111-116. [PMID: 36748151 DOI: 10.3760/cma.j.cn115330-20220406-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: To reclassify the flat type sudden deafness according to the types of audiogram shape, and to explore the correlation between different pattern of hearing loss and prognosis. Methods: All of 1 024 patients with unilateral sudden deafness (492 males and 532 females, aged from 19 to 65 years, with an average age of 41.2 years old) admitted to 33 hospitals nationwide from August 2007 to October 2011 were divided into four types according to Chinese Guideline of Sudden Deafness(2015): low-frequency, high-frequency, flat and total deafness. Then, 402 patients with flat type sudden deafness were further divided into ascending type, descending type and consistent type according to the audiogram shapes. First, we compared the clinical characteristics and prognosis among these three subtypes of flat deafness, then compared the clinical characteristics and prognosis between ascending flat deafness and low-frequency deafness, descending flat deafness and high-frequency deafness, consistent flat deafness and total deafness, explored the factors related to the prognosis of flat deafness. SPSS 21.0 software, ANOVA, χ2 test, t-test and Logistic regression were used to analyze the data. Results: The cure rates of flat ascending, flat descending and flat consistent sudden deafness groups were 70.7%, 17.1% and 34.0% respectively, with a statistically significant difference (χ2=33.984, P<0.001); However, there was no significant difference in age, sex and affected side (all P>0.05). The independent related factors for the recovery of flat type sudden deafness were as follows: whether there was dizziness [OR=0.459; 95% confidence interval (CI): 0.271-0.777], the type of audiogram shape (OR=0.721; 95%CI: 0.530-0.981), and days from onset to therapy (OR=0.903, 95%CI: 0.835-0.978), all of which had P values<0.05. There was no significant difference in the cure rates between ascending flat sudden deafness and low-frequency descending sudden deafness, descending flat sudden deafness and high-frequency descending sudden deafness (all P>0.05). The pure tone average(PTA) of flat consistent sudden deafness and total deafness were (69.1±18.9) and (101.7±17.7) dB HL, respectively, with a statistically significant difference (t=20.890, P<0.001), and the cure rates were 34.0% and 14.5%, respectively, with a statistically significant difference (χ2=29.012, P<0.001). Conclusion: According to the audiogram shape, the flat type sudden deafness can be further divided into ascending flat sudden deafness, descending flat sudden deafness and consistent flat sudden deafness, which can more effectively evaluate the prognosis. The cure rate of ascending flat sudden deafness is similar to that of low-frequency sudden deafness, and the prognosis is well; The cure rate of descending flat sudden deafness is similar to that of high-frequency descending sudden deafness, and the prognosis is poor. The cure rate of consistent flat sudden deafness is higher than that of total deafness. PTA plays an important role in the prognosis of consistent flat sudden deafness and total deafness. Total deafness can be regarded as a single type of sudden deafness.
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Diao TX, Wang J, Zhao YX, Zhang SL, Jing YY, Han L, Zheng HW, Wang YX, Yu LS, Ma X. [The peripheral blood inflammatory markers in Ménière's disease patients with and without migraine]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2022; 57:1426-1432. [PMID: 36707946 DOI: 10.3760/cma.j.cn115330-20220406-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective: To investigate the peripheral blood inflammatory markers including white blood cell count (WBC), monocytes, neutrophils, lymphocytes, platelets, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), high-density lipoprotein(HDL-C), low-density lipoprotein and fibrinogen (FIB) in Ménière's disease (MD) patients with and without migraine, and to explore the relationship between the inflammatory response with MD and migraine. Methods: The general physical condition, clinical manifestations, pure-tone audiometry, and peripheral blood inflammatory markers of 92 unilateral MD patients who were hospitalized in Peking University People's Hospital for surgical treatment from January 2017 to January 2021 were continuously collected. Meanwhile, 50 healthy controls matched with age and sex were included, and their general physical conditions and peripheral blood inflammatory markers were also collected. This study consisted of two parts. First, the differences in epidemical characteristics and peripheral blood inflammatory markers between MD patients and healthy controls were compared by univariate analysis. Second, all 92 MD patients were divided into two subgroups according to whether they were accompanied by migraine. The clinical characteristics and peripheral blood inflammatory markers of MD patients with and without migraine were compared by univariate analysis. Thereafter, binary Logistic regression was used to analyze the related factors of whether MD patients were accompanied with migraine. Results: Compared with the healthy control group, the peripheral blood WBC, neutrophils and FIB of MD patients were significantly increased (all P<0.05). Compared with MD patients without migraine, MD patients with migraine had higher female prevalence, longer disease history, lower low-frequency hearing threshold, higher frequency of vertigo attacks and higher HDL-C levels (all P<0.05), meanwhile, female, frequency of vestibular attacks and HDL-C were independent related factors of whether MD patients were accompanied with migraine. Conclusion: The occurrence of MD and migraine may be related to the inflammatory response. The level of anti-inflammatory factors in the blood of MD patients with migraine are higher, suggesting that the inflammatory response status of MD patients with and without migraine is different.
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Ma X, Wang FY, Yu LS, Wang Q, Jin X. [From guideline to clinical practice:discussion of guideline for diagnosis and treatment of sudden deafness (2015)]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2022; 57:1248-1253. [PMID: 36319134 DOI: 10.3760/cma.j.cn115330-20220615-00353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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de Castro DG, Pellizzon ACA, Braun AC, Chen MJ, Silva MLG, Fogaroli RC, Gondim GRM, Ramos H, Neto ES, Abrahão CH, Yu LS, Abdallah EA, Calsavara VF, Chinen LTD. Heterogeneity of HER2 Expression in Circulating Tumor Cells of Patients with Breast Cancer Brain Metastases and Impact on Brain Disease Control. Cancers (Basel) 2022; 14:cancers14133101. [PMID: 35804873 PMCID: PMC9264951 DOI: 10.3390/cancers14133101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Results from a previous study suggested that the number of circulating tumor cells (CTC) might have a role as a biomarker of early distant brain failure in patients with breast cancer brain metastases (BCBM). However, it remains largely underexplored whether heterogeneous HER2 expression in CTC may have a prognostic implication. We evaluated the status of HER2 expression in CTC before and after radiotherapy/radiosurgery for BCBM and observed that the presence of HER2 expression in any moment was associated with longer distant brain failure-free survival, irrespective of the primary immunophenotype of the breast tumor. This finding suggests that the status of HER2 expression in CTC has the potential to improve the treatment selection for patients with BCBM. Abstract HER2 expression switching in circulating tumor cells (CTC) in breast cancer is dynamic and may have prognostic and predictive clinical implications. In this study, we evaluated the association between the expression of HER2 in the CTC of patients with breast cancer brain metastases (BCBM) and brain disease control. An exploratory analysis of a prospective assessment of CTC before (CTC1) and after (CTC2) stereotactic radiotherapy/radiosurgery (SRT) for BCBM in 39 women was performed. Distant brain failure-free survival (DBFFS), the primary endpoint, and overall survival (OS) were estimated. After a median follow-up of 16.6 months, there were 15 patients with distant brain failure and 16 deaths. The median DBFFS and OS were 15.3 and 19.5 months, respectively. The median DBFFS was 10 months in patients without HER2 expressed in CTC and was not reached in patients with HER2 in CTC (p = 0.012). The median OS was 17 months in patients without HER2 in CTC and was not reached in patients with HER2 in CTC (p = 0.104). On the multivariate analysis, DBFFS was superior in patients who were primary immunophenotype (PIP) HER2-positive (HR 0.128, 95% CI 0.025–0.534; p = 0.013). The expression of HER2 in CTC was associated with a longer DBFFS, and the switching of HER2 expression between the PIP and CTC may have an impact on prognosis and treatment selection for BCBM.
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Castro DG, Pellizzon ACA, Braun AC, Chen MJ, Silva MLG, Fogaroli R, Gondim GRM, Ramos H, Neto ES, Abrahao CH, Yu LS, Abdallah EA, Calsavara VF, Chinen LT. Heterogeneity of HER2 expression in circulating tumor cells of patients with breast cancer brain metastases and impact on brain disease control. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.2029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2029 Background: The HER2 expression switching in circulating tumor cells (CTC) of breast cancer is dynamic and may have prognostic and predictive clinical implications. This study aims to analyse the association between expression of HER2 in CTC of patients with breast cancer brain metastases (BCBM) and brain disease control. Methods: Exploratory analysis of a prospective assessment (NCT02941536) of CTC before (CTC1) and 4–5 weeks after (CTC2) stereotactic radiotherapy/radiosurgery (SRT). CTC were isolated and quantified by a method of isolation by size of tumors and analyzed by immunocytochemistry to evaluate the expression of HER2. Distant brain failure-free survival (DBFFS), the primary endpoint, and overall survival (OS) were estimated by Kaplan-Meier estimator. Log-rank tests were applied in order to compare the survival curves. For multivariate analysis of prognostic factors that affected DBFFS and OS, the Cox proportional model was adjusted. Results: The median age at SRT was 54 (34-70), the diagnosis-specific graded prognostic assessment (DS-GPA) was 1–2 in 17.5% and 2.5–4 in 82.5% and the primary immunophenotype (PIP) was HER2-enriched in 51%, luminal B (LB) in 31% and triple negative (TN) in 18% of the total of 39 patients. CTC were detected in all 39 patients before SRT and the median CTC1 was 2 CTC/mL. After SRT, CTC were detected in 34 of 35 patients (4 deaths between CTC1 and CTC2) and the median CTC2 was 2.33 CTC/mL. HER2 was expressed in CTC1 and/or CTC2 in 9 patients, of which only 2 patients had PIP HER2-enriched. After a median follow-up of 16.6 months, there were 15 patients with distant brain failure and 16 deaths. The median DBFFS and OS were 15.3 and 19.5 months, respectively. Median DBFFS was 7 months in patients with PIP TN and was not reached in PIP LB and HER2-enriched (p = 0.036); 14 months in patients with DS-GPA 1-2 and 7 months with DS-GPA 2.5-4 (p = 0.017); 10 months in patients without HER2 expressed in CTC and not reached in patients with HER2 expressed in CTC (p = 0.012). Median OS was 4.8 months in patients with PIP TN and was not reached in PIP LB and HER2-enriched (p = 0.0026); 19.54 months in patients with DS-GPA 1-2 and 7.6 months with DS-GPA 2.5-4 (p = 0.00088); 17 months in patients without HER2 expressed in CTC and not reached in patients with HER2 expressed in CTC (p = 0.104). On multivariate analysis, DBFFS was superior in patients with PIP HER2-enriched (HR 0.128, 95% CI 0.025–0.534; p = 0.013) and OS was superior in patients with PIP HER2-enriched (HR 0.073, 95% CI 0.018-0.288; p < 0.0001) and LB (HR 0.224, 95% CI 0.062–0.816; p = 0.023). The status of expression of HER2 in CTC was not included in Cox model for DBFFS due to lack of events in patients with HER2 expressed in CTC. Conclusions: The expression of HER2 in CTC was associated with a longer DBFFS and the switching of HER2 expression between PIP and CTC may have impact on prognosis and treatment selection of BCBM.
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Guedes de Castro D, Braun AC, Calsavara VF, Melo Gondim GR, Gobo Silva ML, Chen MJ, Fogaroli RC, Ramos H, Coelho TM, Scintini Herbst AC, Abdallah EA, Yu LS, Fidarova E, Zubizarreta E, Assis Pellizzon AC, Domingos Chinen LT. Prospective Assessment of the Association Between Circulating Tumor Cells and Control of Brain Disease After Focal Radiation Therapy of Breast Cancer Brain Metastases. Adv Radiat Oncol 2021; 6:100673. [PMID: 33912738 PMCID: PMC8071730 DOI: 10.1016/j.adro.2021.100673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose Predicting the risk of early distant brain failure (DBF) is in demand for management decisions in patients who are candidates for local treatment of brain metastases. This study aimed to analyze the association between circulating tumor cells (CTCs) and brain disease control after stereotactic radiation therapy/radiosurgery (SRT) for breast cancer brain metastasis (BCBM). Methods and Materials We prospectively assessed CTCs before (CTC1) and 4 to 5 weeks after (CTC2) SRT and their relationship with the number of new lesions (NL) suggestive of BCBM before SRT. CTC were quantified and analyzed by immunocytochemistry to evaluate the expression of the proteins COX2, EGFR, ST6GALNAC5, NOTCH1, and HER2. Distant brain failure-free survival (DBFFS), the primary endpoint, diffuse DBFFS (D-DBFFS), and overall survival were estimated. Analysis for DBF within 6 months, with death as competing risk, was performed. Results Patients were included between 2016 and 2018. CTCs were detected in all 39 patients before and in 34 of 35 patients after SRT. After median follow-up of 16.6 months, median DBFFS, D-DBFFS, and overall survival were 15.3, 14.1, and 19.5 months, respectively. DBF at 6 months was 40% with CTC1 ≤0.5 and 8.82% with CTC1 >0.5 CTC/mL (P = .007), and D-DBF at 6 months was 40% with CTC1 ≤0.5 and 0 with CTC1 >0.5 CTC/mL (P = .005) and 25% with NL/CTC1 >6.8 and 2.65% with NL/CTC1 ≤6.8 (P = .063). On multivariate analysis, DBFFS was inferior with CTC1 ≤0.5 (hazard ratio, 8.27; 95% confidence interval, 2.12-32.3; P = .002), and D-DBFFS was inferior with CTC1 ≤0.5 (hazard ratio, 10.22; 95% confidence interval, 1.99-52.41; P = .005). Protein expression was not associated with outcomes. Conclusions These data suggest that CTC1 and NL/CTC1 may have a role as a biomarker of early diffuse DBF and as a subsequent guide between focal or whole-brain radiation therapy in patients with BCBM.
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Diao TX, Zhang JL, Chen NS, Ma X, Yu LS, Zheng HW, Jing YY, Han L, Wang YX, Su L, Wang L, Li XS. [The correlation between age-related hearing loss and cognitive impairment]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2021; 56:187-192. [PMID: 33557494 DOI: 10.3760/cma.j.cn115330-20200314-00195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Yao Y, Huang JJ, Jin X, Zhao JX, Xia CJ, Tong Y, Gao Y, Yu LS, Fan YY. Function of IL-33 in Wound Age Estimation of Skin Wounds in Mice. FA YI XUE ZA ZHI 2020; 36:192-198. [PMID: 32530166 DOI: 10.12116/j.issn.1004-5619.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Indexed: 11/30/2022]
Abstract
Abstract Objective To explore the application value of interleukin-33 (IL-33) in wound age estimation in forensic practice by observing the sequential changes of IL-33 after skin wound. Methods Skin wound models were generated on the back of mice with a round file of 5 mm in diameter. Skin samples of the same size were taken from the same parts of mice in control group and injury group 1 h, 3 h, 6 h, 12 h, 1 d, 3 d, 5 d, 7 d and 10 d after skin wound. Hematoxylin-eosin (HE) staining method was applied to observe the morphological changes in the recovering process after skin wound. Western blotting, immunohistochemistry staining and double immunofluorescence staining methods were applied to detect the expression changes of IL-33 in the skin wound samples. Results The results of Western blotting showed that the expression of IL-33 protein decreased slightly at 3 h after skin wound, increased gradually at 6 h after skin wound, and reached the peak value at 3 d, then decreased gradually. Immunohistochemistry staining results showed that faint positive expression of IL-33 was observed in epidermis, hair follicles, sebaceous glands and dermal resident cells of the control group skin. The positive cell rate of IL-33 increased at 3 h after skin wound and reached the peak value at 3 d, then decreased gradually. The results of double immunofluorescence staining showed that the majority of IL-33 positive cells from 1 d to 3 d after wound were macrophages, while the majority of IL-33 positive cells from 5 d to 7 d after wound were myofibroblasts. In addition, the results of HE staining showed that the wound healing process of the skin wound model was consistent with the pathological development law of inflammation. Conclusion IL-33 could become a reference index for wound age estimation of skin wound in forensic practice.
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Jin X, Zhao JX, Yao Y, Huang JJ, Zhang F, Li XB, Ye GH, Fan YY, Huang DP, Xia NZ, Zou DH, Liu NG, Yu LS. Application of Virtual Anatomy Technology in Postmortem Examination of Medical Dispute Cases. FA YI XUE ZA ZHI 2020; 36:72-76. [PMID: 32250083 DOI: 10.12116/j.issn.1004-5619.2020.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Indexed: 11/30/2022]
Abstract
Abstract Objective To discuss the application value of CT scanning technology in cause of death determination of medical dispute cases. Methods From July 2017 to December 2018, postmortem CT imaging data of 12 medical dispute cases were collected. CT imaging diagnosis results and anatomy findings as well as differences between antemortem and postmortem CT diagnosis were compared. The advantages and disadvantages of CT routine tests of the cadavers in terms of the diagnosis of disease and damage were analyzed. Results The comparison between CT imaging diagnosis and anatomical findings showed that CT scans had advantages in the diagnosis of disease and damage with large differences in density changes, such as atelectasis, pneumonia, calcification, fracture and hemorrhage, etc. The comparison of CT diagnosis in antemortem and postmortem examination showed that the cadavers of medical dispute cases were well preserved and that postmortem CT scan was meaningful for the diagnosis of antemortem diseases. Conclusion Virtual anatomy technology has a relatively high application value in postmortem examination of medical dispute cases. It can provide effective information for the appraisers before the autopsy and can also provide a reference for cause of death analysis when the anatomy cannot be performed.
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Zhang JL, Fang X, Lee S, Ma X, Yu LS, Jing YY. [Correlation analysis of incidence, season and temperature parameters of different types of sudden deafness]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2019; 33:692-695. [PMID: 31446719 DOI: 10.13201/j.issn.1001-1781.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Indexed: 06/10/2023]
Abstract
Objective:The objective of this study was to investigate the correlation between the onset of different types of sudden sensorineural hearing loss(SSNHL) with temperature parameters and seasons. Method:We retrospectively reviewed the medical charts of 175 patients who were diagnosed as SSNHL, precisely collected the exact date and city of onset, confirmed the season, and obtained the meteorological data including maximum temperature(Tmax), minimum temperature(Tmin), mean temperature(T), day-to-day change of mean temperature(ΔT), and diurnal temperature range(Trange) at the same day, then analyzed the relation between season and temperature with the onset of different types of SSNHL. Result:There was a significant difference of Trange between different types of SSNHL(P=0.001). Trange on the onset date of all-frequency SSNHL(including flat and profound type) was significantly higher than low and high frequency descending type(P=0.001, P<0.05 respectively). Types of SSNHL had weak association with Trange groups(P=0.03, Cramer's V=0.220). An increase of 1℃ in Trange increased the risk of flat type SSNHL by 23.9% and 16.5% compared with low and high frequency descending type, respectively, and for profound type, the risk was increased by 22.4% and 15.1%. No significant differences were observed between seasons and SSNHL types(P=0.666). Conclusion:The incidence of different types of sudden sputum may be related to the worse temperature on the day, and has nothing to do with the disease season.
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Chen NS, Zhao YX, Ma X, Yu LS. [Advances in the relevance of laryngopharyngeal reflux and tinnitus]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2019; 54:554-557. [PMID: 31315368 DOI: 10.3760/cma.j.issn.1673-0860.2019.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Tinnitus is the most common symptom in otorhinolaryngology. In the past, tinnitus was often localized in the auditory system lesions, causing a great amount of idiopathic tinnitus patients inadequately treated. At present, it is believed that the pathogenesis of tinnitus not only originates from auditory system itself, but also participates in systemic disorders. In recent years, investigating in the effects of laryngopharyngeal reflux on tinnitus is undergoing rapid progress. This review highlights the current state of relationship between laryngopharyngeal reflux and tinnitus, which may provide a new systemic insight into diagnosis and treatment on tinnitus as well as laryngopharyngeal reflux.
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Lee SJ, Lin Y, Fang X, Yu LS, Jing YY. [The correlation between plasma fibrinogen level and different types of sudden sensorineural hearing loss]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2019; 33:425-428. [PMID: 31163550 DOI: 10.13201/j.issn.1001-1781.2019.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Indexed: 11/12/2022]
Abstract
Objective: To investigate the correlation between plasma fibrinogen level and the incidence of sudden hearing loss. Method: A total of 225 patients (age ranging from 18 to 70 years) with sudden sensorineural hearing loss(SSNHL) were selected. The disease onset was within 2 weeks. No patient received previous medical intervention. Depending on the types of auditory threshold curve, SSNHL was divided into low frequency descending type, high frequency descending type, flat desending type and total deafness type. Two hundred and twenty-nine cases with normal hearing and no inflammatory diseases in the same period was selected as control group. Fibrinogen level and Blood Routine Indexes were detected for the purpose of retrospective cohort study.Result: The levels of fibrinogen in SSNHL group(2.98±0.59) g/L were significantly higher than that in control group(2.66±0.36) g/L (P<0.01). According to the types of auditory threshold curve, SSNHL groups were divided into group A(55 cases, 24.44%), Group B(36 cases, 16.00%), Group C(43 cases,19.11%) and Group D(91 cases, 40.44%). The average fibrinogen levels before treatment were at(2.75±0.46)g/L, (3.16±0.61) g/L, (3.02±0.63) g/L and(3.03±0.63) g/L respectively. There was no significant difference in fibrinogen level(P=0.286) between group A and the control group. Fibrinogen levels of group B, group C and group D were significantly elevated compared to control group (P<0.01). Conclusion: The level of fibrinogen is not significantly correlated with development of sudden deafness of low frequency descending type. The incidence of high frequency descending type, flat descending type and profound deafness type are all correlated with the level of high fibrinogen at the onset of sudden deafness. The classification of sudden deafness based on audiogram curves could be of great significance for analysis of possible causes and selection of treatment options.
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Zhao JX, Jin X, Huang JJ, Yao Y, Yu LS, Fan YY. Time-dependent Expression and Distribution of AChE during the Skin Incised Wound Healing in Mice. FA YI XUE ZA ZHI 2019; 35:143-148. [PMID: 31135106 DOI: 10.12116/j.issn.1004-5619.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Indexed: 11/30/2022]
Abstract
Abstract Objective To study the time-dependent expression and distribution of acetylcholinesterase (AChE) during skin incised wound healing in mice, and discuss its effect in wound healing as well as the feasibility of using it as a reference index for wound age estimation. Methods A total of 45 C57BL/KsJ mice were randomly divided into one control group and eight incised groups. The skin incised wound model was established in the incised groups with samples of skin wounds taken at 6 h, 12 h, 1 d, 3 d, 5 d, 7 d, 10 d and 14 d post-injury respectively, while the uninjured skin tissue was extracted in the control group. Expression and distribution of AChE in skin samples were detected by immunohistochemistry, double immunofluorescence and Western blotting. Results Immunohistochemistry results indicated that AChE was mainly detected in infiltrating polymorphonuclear cells (PMNs) 6 to 12 h post-injury. A large number of AChE-positive mononuclear cells (MNCs) were observed 1 to 3 d post-injury. The AChE-positive cells were mainly fibroblastic cells (FBCs) 5 to 14 d post-injury. The ratio of the AChE-positive cells increased initially 6 h post-injury, and reached the peak at 1 d post-injury. Double immunofluorescent staining showed that the majority of AChE-positive MNCs and FBCs expressed macrophage marker and myofibroblast marker, respectively. Western blotting results showed that the relative expression level of AChE in the incised group was higher than that in the control group averagely, reached the peak at 1 d post-injury, then reached a second peak at 7 d post-injury. Conclusion The expression of AChE is found in PMNs, macrophages and myofibroblast during skin wound healing, which indicates it might be involved in the adjustment of inflammatory response and fibrotic repair after injury. Moreover, combined use of various methods for the detection of the expression of AChE would provide reference for skin wound age estimation.
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Huang JJ, Yao Y, Xia CJ, Zhao YD, Yu S, Gao Y, Ye GH, Yu LS, Fan YY. Relationship between the Number of Neutrophils and Myofibroblasts during Diabetic Wound Healing and Wound Age. FA YI XUE ZA ZHI 2019; 35:149-153. [PMID: 31135107 DOI: 10.12116/j.issn.1004-5619.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Indexed: 11/30/2022]
Abstract
Abstract Objective To investigate the sequential changes of the number of neutrophils and myofibroblasts during diabetic wound healing, and discuss its application value in wound age estimation. Methods Diabetic DB mice and mice of the same age in the normal control group were selected, a wound healing model was established, wound samples were taken at different time points, while the number of neutrophils and myofibroblasts during diabetic wound healing were determined by immunohistochemical staining technique. Results The number of infiltrated neutrophils in the wounds of control and diabetic groups reached the peak respectively at 12 h and 5 d after injury. Compared with the control group, the number of neutrophils in the diabetic group decreased significantly from 6 h to 1 d after injury, but increased markedly from 5 d to 14 d. From 5 d to 10 d after injury, the average number of neutrophils at high magnification in wounds of the diabetic group was over 30, while that of neutrophils in wounds of the control group was less than 20. Myofibroblasts appeared in wounds from 3 d to 14 d after injury in the control group and from 5 d to 14 d after injury in the diabetic group. The difference in the number of myofibroblasts in wounds between control group and diabetic group from 3 to 7 d after injury had statistical significance. Conclusion In comparison with normal wound healing, the number of neutrophils and myofibroblasts during diabetic wound healing shows different sequential changes. The results of this study can provide reference for wound age estimation of patients with severe diabetes.
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Jin X, Zhao JX, Yao L, Huang JJ, Fan YY, Yu LS. Expression of Annexin A1 during Skin Incised Wound Healing in Mice. FA YI XUE ZA ZHI 2019; 35:5-10. [PMID: 30896112 DOI: 10.12116/j.issn.1004-5619.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the expression changes of annexin A1 (ANXA1) during the process of skin incision healing, and to explore its expression and function during skin injury repair. METHODS The skin injury model of mice was prepared, and skin tissues of the controls and the injured group at 6 h, 12 h, 1 d, 3 d, 5 d, 7 d, 10 d and 14 d after injuries were taken. The morphological changes of the wound were observed by hematoxylin-eosin (HE) staining, and the expression of ANXA1 was detected by immunohistochemistry (IHC) and Western blotting. RESULTS HE staining showed normal healing of skin wounds. IHC results revealed that ANXA1 was expressed in the epidermis, hair follicle, sebaceous gland and vascular endothelium. In the injured group, the expression of ANXA1 was enhanced in epidermis and skin appendages around the wound 6-12 h after injury, and ANXA1 was also highly expressed in neutrophils and a small number of mononuclear cells. ANXA1 was mainly positively expressed in monocytes, neovascular endothelial cells and fibroblasts, and small amount of fibroblasts at 1-3 d, 5-10 d, and 14 d after injury, respectively. Western blotting showed that, compared with the controls, the expression of ANXA1 was significantly increased at 6 h after injury, peaked at 1 d, and then decreased gradually in the injured group. CONCLUSIONS ANXA1 may be involved in the regulation of skin damage repair, with time-dependent expression during skin wound healing, and thus is expected to be a biological marker for inferring the wound formation time.
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Diao TX, Han QH, Shan HJ, Wu XQ, Lin YJ, Li Q, Wang GH, Jing YY, Ma X, Shen M, Yu LS, Han L, Wang YX. [Study on the relationship between age-related hearing loss and cognitive impairment]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2019; 54:110-115. [PMID: 30776862 DOI: 10.3760/cma.j.issn.1673-0860.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the correlation between age-related hearing loss and cognitive impairment. Methods: 201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People's Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. Results: Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). Conclusions: Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.
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Tan J, Han L, Jing YY, Zheng HW, Shen JX, Zhang LH, Yu LS. [Study on the effects of microRNA-203 on the invasion and apoptosis of laryngeal cancer cells via targeting LASP1]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2019; 33:171-175. [PMID: 30808147 DOI: 10.13201/j.issn.1001-1781.2019.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Indexed: 11/12/2022]
Abstract
Objective: To explore the role of microRNA-203 in laryngeal cancer and its underlying mechanism and clarify the relationship between microRNA-203 and LASP1.Method: microRNA-203 expression in laryngeal cancer tissues and paracancerous tissues was detected by quantitative real time-polymerase chain reaction(qRT-PCR). The regulatory effects of microRNA-203 on invasion and apoptosis of laryngeal cancer cells were detected by Transwell assay and flow cytometry, respectively. Dual-luciferase reporter gene assay was performed to access the binding condition of microRNA-203 and LASP1. Both mRNA and protein levels of LASP1 in laryngeal cancer cells were detected after transfection with microRNA-203 mimic or microRNA-203 inhibitor by qRT-PCR and Western blot. Rescue experiments were finally performed to detect whether microRNA-203 regulates laryngeal cancer development via targeting LASP1. Result: microRNA-203 was lowly expressed in laryngeal cancer tissues and cell lines.Knockdown of microRNA-203 in Hep-2 cells can promote the invasiveness and inhibit apoptosis of laryngeal cancer cells. Subsequently,LASP1 was predicted to be the target gene of microRNA-203,which was further verified by dual-luciferase reporter gene assay.LASP1 expression was negatively regulated by microRNA-203. Furthermore,rescue experiments showed that microRNA-203 regulates invasion and apoptosis of laryngeal cancer cells via targeting LASP1. Conclusion: Low expression of microRNA-203 could promote the invasion and inhibit apoptosis of laryngeal cancer cells viainhibiting LASP1. microRNA-203 and LASP1 both play a very important role in the development of laryngeal cancer..
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Zhao YX, Yu LS. [The application of cartilage in middle ear surgery]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 32:1912-1916. [PMID: 30550140 DOI: 10.13201/j.issn.1001-1781.2018.24.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Indexed: 11/12/2022]
Abstract
Summary The aim of this study is to review the application, techniques and procedures of cartilage in the middle ear surgery. Cartilage offers the advantage of higher mechanical stability in tympanoplasty, which is the most common procedure in the middle ear surgery, thus apply to much complicated situation especially for tubal dysfunction and adhesive processes. There are many variations on the shape, size, thickness and technical matters of the cartilage grafts. The past decades and literature have observed excellent graft take rates and good postoperative hearing outcomes for cartilage tympanoplasty and the reservation of perichondrium seems to show better long-term survival. There have been concerns regarding malacia of cartilage struts, as a result, cartilage struts for ossiculoplasty have not gained popularity except for combined application with synthetic materials. Meanwhile, the benefits of cartilage in the reconstruction of posterior canal wall and attic, mastoid obliteration and adhesive otitis media have been demonstrated in the previously published studies. It is well to be reminded that cartilage could be applied in some unusual cases such as vibrant soundbridge, meningoencephalocele.
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Tan J, Jing YY, Han L, Zheng HW, Liu Y, Geng CL, Diao TX, Wang L, Li XS, Zhao YX, Shen JX, Yu LS. [The study about the role of laryngopharyngeal reflux for the hemorrhage after tonsillectomy]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 32:1387-1390. [PMID: 30550168 DOI: 10.13201/j.issn.1001-1781.2018.18.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 11/12/2022]
Abstract
Objective:To assess the role of LPR in the development of complications, such as hemorrhage, following tonsillectomy in adult patients. We want to provide a guidence for future clinical practice.Method:Totally 70 adult patients who had indication of tonsillectomy were recruited and divided into two groups, the laryngopharyngeal reflux (LPR) group and the control group, which were identified by the results of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). We observed and compared the postoperative complications of the two groups and analyzed the role of LPR.Result:All the patients complained pain after surgery. The duration of the pain in LPR group was much longer than that of control group. The mean body temperature in both groups was not significantly different (P>0.05). There were six cases of bleeding in the LPR group, while only one case of bleeding occurred in the control group. The difference was statistically significant (P<0.05). There were no cases of infection or pulmonary complications in both groups. All patients were discharged successfully.Conclusion:LPR is closely related to the complications following tonsillectomy.
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Yuan Q, Liu DL, Yu LS, Zhang QF. [Flunarizine in the prophylaxis of vestibular migraine:a randomized controlled trial]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 30:805-810. [PMID: 29798059 DOI: 10.13201/j.issn.1001-1781.2016.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Indexed: 11/12/2022]
Abstract
Objective:To evaluate the efficacy and safety of flunarizine in patients with vestibular migraine(VM)as a prophylactic medication. Method:This randomized control trial was undertaken in patients with definite VM. Behavior changes were advocated to all the patients to avoide certain foods and beverages, as well as changes in lifestyle and habits.Patients in arm A received 10-mg flunarizine daily for 3 months along with betahistine 12 mg Tid for 48 h during episodes, and arm B received only betahistine for 48 h during episodes. Frequency. duration and intensity of vertiginous episodes and the main sideeffects were noted at the start of the study and at the end of 3 months.Result:A total of 23 patients who were diagnosed with definitive migrainous vertigo completed the study. The frequency,duration and intensity of vertiginous episodes showed a significan improvement in both group(P <0.05).Analysis of the frequency, duration and intensity between arm A and arm B showed that frequency improved to a significant degree(P <0.05),but the duration and intensity of vertigo between the two groups did not improve to a significant degree(P >0.05). Severe adverse events were not found. Conclusion:Flunarizine is safe and effective for the prophylaxis treatment of VM.
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Han L, Wang ZJ, Diao TX, Li XS, Wang L, Xia RM, Yu LS. [The correlation between the hearing frequency and staging of Meniere's disease]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2018; 53:776-779. [PMID: 30347538 DOI: 10.3760/cma.j.issn.1673-0860.2018.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To study the relationship between the average hearing of different frequencies and the audiometry staging in patients with Meniere's disease. Methods: A total of 259 patients from 1996 to 2016 were collected .All patients underwent pure tone audiometry, of which 93 patients underwent 3 000 Hz audiometry. The patients were divided into five groups according to the frequencies of hearing(Ⅰ: 500, 1 000, 2 000, 3 000 Hz; Ⅱ: 250, 500, 1 000, 2 000, 3 000 Hz; Ⅲ: 250, 500, 1 000, 2 000; Ⅳ: 500, 1 000, 2 000, 4 000 Hz; Ⅴ: 500, 1 000, 2 000 Hz), then calculated the average audiometry and made the hearing staging. The obtained data were analyzed by chi-square test and Bonferroni correction was performed among the groups, P<0.05 was defined as a statistically significant criterion. Result: There were no significant difference between the five groups(P=0.441>0.05). Conclusions: The choice of different pure tone audiometry frequency has no significant effect on the hearing staging. It would be more likely upstaging when plus 250 Hz. There is no statistically significant difference in staging between the latest guidelines and the 1995 guidelines.500, 1 000 and 2 000 Hz are recommended when 3 000 Hz examine is not available.
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Lin YJ, Wu XQ, Shan HJ, Ma X, Yu LS, Lai RC. [Analysis of nystagmus and medical history of 121 patients positive with positional test]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2018; 32:1491-1494. [PMID: 30550195 DOI: 10.13201/j.issn.1001-1781.2018.19.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Indexed: 11/12/2022]
Abstract
Objective: To observe the characteristics of positional nystagmus and clinical profile of patients with positive positional test, and to explore its possible pathogenesis.Method: One hundred and twenty-one patients with positive positional test in the vestibular function examination were enrolled in the Peking University International Hospital from January to June in 2017. According to the 2017 BPPV guidelines, patients with test positive positional nystagmus were divided into two groups: definite BPPV and the controversial syndrome. Analyses of gender, age and characteristics of nystagmus, with or without recurrent dizziness, headache, and motion sickness were undertaken between the two groups, as well as response to the repositioning maneuver. Result: Of the total 121 cases, 49 cases were diagnosed as definite BPPV, accounting for 40.5%, 72 cases as controversial syndrome, accounting for 59.5%. The proportion of women in the two group was 76.2% and 78.9%, respectively. The average age of definite BPPV and the controversial syndrome was 51.2±16.8 and 51.3±15.7, respectively.There were significant differences in nystagmus duration, spontaneous nystagmus and nystagmus after headshaking between the two groups by chi square test(P<0.01). The mean intensity of horizontal and vertical nystagmus in posterior semicircular canal BPPV was(10.2±7.4) °/s and(36.6±17.5) °/respectively. And the mean intensity of nystagmus in the strong and weak side in horizontal semicircular canal BPPV was(40.8±25.1) °/s and(20.7±11.1) °/respectively. The intensity of horizontal and vertical nystagmus of the controversial syndrome group was(7.2±7.7) °/s and(7.2±4.3) °/s respectively. The incidence of headache in the controversial syndrome group was significantly higher than that in the BPPV group, P=0.013. According to the guidelines, patients were evaluated one day after the initial treatment. The cure rate and effective rate of the definite BPPV group was 75%(36/48) and 87.5%(42/48),and was 0 and 30.4% in the controversial syndrome group respectively. Conclusion: The patients in controversial syndrome group have a preponderance of exhibiting positive nystagmus during positional test. Nystagmus were usually of low velocity and sustained. Most of these cases presented spontaneous nystagmus and headshaking induced nystagmus, as well as headache and lacunar infarctions in history, and the response to the repositioning maneuver were often poor. It may be related to vestibular migraine and central nervous system. The diagnosis of BPPV must be prudent.Both characteristics of nystagmus and medical history should be carefully analyzed to avoid overdiagnosis.
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