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Qiwen Dai,1 Yanhong Dai,1 Chunyu Zhang,1 Zhiming Meng,2 Zeyu Chen,1 Senlin Hu3 1School of Economics and Management, Guangxi Normal University, Guilin, People’s Republic of China; 2School of Innovation and Entrepreneurship, Guangxi Normal University, Guilin, People’s Republic of China; 3School of Urban Development Research, East China Normal University, Shanghai, People’s Republic of ChinaCorrespondence: Chunyu Zhang, School of Economics and Management, Guangxi Normal University, Guilin, Guangxi, 541004, People’s Republic of China, Email 468160345@qq.comPurpose: Drawing on the motivation theory, this study investigated the effect and consequences of personal motivation and innovative climate on innovative behavior among university students in mainland China. The study also examined whether the effect of personal motivation and innovative climate on Chinese university students’ innovative behavior is heterogeneous between disciplines and place of residence.Methods: A quantitative study was conducted to test the hypotheses. Data were collected from 245 undergraduate students at Chinese universities with paper-based questionnaires. Self-report scales were used to measure levels of personal motivation, innovative climate, and innovative behaviors. A confirmatory factor analysis was used to test the scale and questionnaire’s reliability and validity. The logistic model was applied to analyze the data and test the hypotheses.Results: Personal motivation and innovative climate have significant effects on Chinese university students’ innovative behavior. The effect of personal motivation and innovative climate on students’ innovative behavior is heterogeneous between disciplines and place of residence. Further, extrinsic motivation serves as a positive incentive. Mentor support, good academic climate, and knowledge sharing affect students’ innovative behavior positively. However, insufficient guaranteed resources has a significant negative influence. The data demonstrated no statistically significant difference between intrinsic motivation and students’ innovative behavior.Conclusion: This study contributes to the empirical literature on mechanisms that influence innovative behavior by testing the relation between personal motivation, innovative climate, and innovative behavior on the part of Chinese university students. In addition, these findings also provide evidence for ways to improve university students’ innovative consciousness and innovative ability, as well as universities’ management practice of innovative education.Keywords: innovative behavior, personal motivation, innovative climate, university students

Introduction: A significant number of sensorineural hearing loss (SSNHL) patients had no noticeable hearing improvement after glucocorticoid (GC) treatment. In the present study, we examined expression of the nuclear factor erythroid 2-related factor 2 (NRF2) and histone deacetylase 2 (HDAC2) in peripheral blood mononuclear cells (PBMCs) of refractory SSNHL patients to study the role of NRF2-HDAC2 pathway in GC insensitivity hearing improvement after GC treatment, which is usually referred to as refractory SSNHL or GC insensitivity. Materials and Methods: Forty-four refractory SSNHL patients were treated by intratympanic GC infusion. Hearing was tested in all patients before and after treatment by pure tone hearing test. NRF2/HDAC2 mRNA and protein levels were examined in PBMCs of refractory SSNHL patients before and after treatment. PBMCs from healthy volunteers were used as normal controls. Results: According to the hearing improvement after treatment, patients were assigned into 2 groups: the intratympanic GC sensitive (IGCS) group (hearing recovery ≥15 dB HL) and the intratympanic GC insensitive (IGCI) group (hearing recovery Conclusion: Low response of NRF2/HDAC2 proteins is associated with GC insensitivity in SSNHL. We speculate that the NRF2-HDAC2 pathway affects GC sensitivity in SSNHL patients.

Objectives To investigate glucocorticoid receptor (GR) and histone deacetylase 2 (HDAC2) gene expression and protein levels in peripheral blood mononuclear cells (PBMCs) of patients with severe or profound sudden sensorineural hearing loss (SSNHL) and to explore the roles of GRs and HDAC2 in glucocorticoid (GC) insensitivity. Methods Fifty-five severe or profound SSNHL patients were enrolled in the study. According to hearing improvement after GC treatment, patients were assigned into two groups: GC-sensitive and GC-resistant. A normal reference group included 20 healthy volunteers without hearing loss. Quantitative real-time polymerase chain reaction and Western blot analyses were used to detect the relative expression of GRα, GRβ, and HDAC2 in PBMCs at the mRNA and protein levels. Results The protein levels of GRs and HDAC2 in PBMCs of SSNHL patients were lower than the normal reference values before GC treatment. Compared with the GC-resistant group, both the mRNA and protein levels of GRα and HDAC2 were significantly increased in the GC-sensitive group after GC treatment. Conclusion A lack of GRα and HDAC2 induction following steroid treatment in GC-resistant SSNHL patients may play a fundamental mechanistic role in GC insensitivity. Response of GRα and HDAC2 to steroid treatment may, thus, predict the prognosis of hearing improvement in SSNHL patients.

BACKGROUND Repetition disorder can be used as an important criterion for aphasia classification, and damaged arcuate fasciculus in the dominate hemisphere has been reported to be closely related to repetition disorder, but the underlying neurological mechanism remains unclear. MATERIAL AND METHODS Fifteen stroke patients with poststroke aphasia and 9 healthy controls were included in the study. The value of fractional anisotropy (FA) in the dominate arcuate fasciculus in stroke patients and healthy controls were measured using DTI. We also assessed their repetition dysfunction with the Aphasia Battery of Chinese (ABC) assessment and calculated the correlation between the FA values in the dominate arcuate fasciculus and ABC scores of word repetition and sentence repetition. RESULTS There was a moderate correlation between the total score of repetition evaluation and the FA value of injured arcuate fasciculus in the dominant hemisphere (r=0.551, P=0.033). We found no correlation between the score of word repetition and the FA value of injured arcuate fasciculus in the dominant hemisphere (r=0.330, P=0.230), but there was a strong correlation between the score of sentence repetition and the FA value of injured arcuate fasciculus in the dominant hemisphere (r=0.795, P≤0.001). CONCLUSIONS We found that unintegrated left arcuate fasciculus might be related to the repetition dysfunction after stroke, especially sentence repetition deficit, which suggests that sentence repetition evaluation could be used to indicate the integrity of the arcuate fasciculus in the dominant hemisphere after stroke.

BACKGROUND Sudden sensorineural hearing loss (SSNHL) is currently treated with a combination of drugs, predominantly with glucocorticoids (GCs). However, the mechanisms of action of GCs in SSNHL are unknown. This study aimed to analyze the role of endoplasmic reticulum stress (ERS) in SSNHL pathogenesis and prognosis. MATERIAL AND METHODS In this study, we evaluated the expression and activation status of the protein kinase RNA-like endoplasmic reticulum kinase (PERK)-C/EBP homologous protein (CHOP) pathway in peripheral blood mononuclear cells (PBMCs) from patients with SSNHL and compared them with those in healthy controls. We also compared differences in expression of activating transcription factor 4 (ATF4) and CHOP before and after glucocorticoid treatment in patients with improved and unimproved SSNHL. RESULTS Treatment with GCs significantly improved hearing in 55% of patients with SSNHL. Levels of phosphorylated PERK (p-PERK) and phosphorylated eukaryotic initiation factor 2alpha were increased in PBMCs from patients with SSNHL compared with healthy controls. ATF4 and CHOP expression were also significantly elevated. After treatment, the amount of ATF4 and CHOP proteins in PBMCs in the patients whose SSNHL improved was significantly reduced compared with the levels measured before treatment in all patients with SSNHL. The expression of the ATF4 and CHOP proteins in PBMCs in the unimproved group, however, was not significantly changed relative to pretreatment levels. CONCLUSIONS ERS may play a significant role in the pathogenesis of SSNHL, and the responsiveness of the condition to GC-mediated mitigation of ERS may be one of the key factors that affect patient prognosis.

Cisplatin‑induced cytotoxicity, such as nephrotoxicity, neurotoxicity and ototoxicity, restricts the clinical application of this compound. Panax notoginseng Saponins (PNS) exhibit potent free radical scavenging and antioxidant activity. PNS have been demonstrated to reduce cisplatin‑induced nephrotoxicity and neurotoxicity. The present study investigated the ability of PNS to protect the auditory HEI‑OC1 cell line against ototoxicity induced by cisplatin. PNS induced activation of the AKT/nuclear factor erythroid 2‑related factor 2 (Nrf2) signaling pathway. Following pretreatment with PNS, HEI‑OC1 cells were treated with cisplatin and cultured for 24 h. The viability of HEI‑OC1 cells was examined using a Cell Counting Kit‑8 assay. Double staining analysis was used to measure cell apoptosis. The ability of PNS to reduce reactive oxygen species (ROS) levels was assessed by flow cytometry. The levels of phosphorylated (p)‑AKT, heme oxygenase 1 (HO‑1), NAD(P)H quinone dehydrogenase 1 (NQO1), glutamate‑cysteine ligase catalytic (GCLC) and Nrf2 were measured by western blotting. HEI‑OC1 cells that were pretreated with PNS exhibited significantly increased cell viability compared with that noted in cells treated only with cisplatin. In addition, PNS suppressed the induction of apoptosis and ROS production following cisplatin treatment. The upregulation of NQO1, HO‑1 and GCLC expression in PNS‑pretreated cells was associated with p‑AKT levels and the activation of Nrf2. These findings suggested that PNS protected auditory cells against ototoxicity induced by cisplatin by activating AKT/Nrf2 signaling. PNS may serve as a potential candidate in regulating cisplatin‑induced cytotoxicity.

SUMMARY: Noise- induced hearing loss usually refers to auditory impairment which is caused by long-term exposure to noise. The occupational noise problem is serious and urgently needs to be addressed, along with the lack of effective treatments. Recent studies have shown that the imbalance between oxidation and antioxidation is the source of the disease. To correct the redox reaction imbalance and to maintain an equilibrium of the redox reaction have always been the research focus of the prevention and treatment in noise induced hearing loss. This article reviews antioxidant therapy and prevention in noise induced hearing loss, including antioxidants, antioxidant enzymes and herbal medicine.

At present, the intelligent translation of computer is developing rapidly. In this paper, the overall design of interactive intelligent auxiliary translation platform based on multi-strategy is studied. In this paper, the algorithm of similarity of sentences is deeply studied. According to the needs of English–Chinese translation memory system, the similarity between sentences is calculated from the sentence syntax and semantic based on syntactic and semantic English sentence similarity calculation method. Finally, the author uses the English–Chinese translation of Navigator 7.0 manual to examine the effect of the algorithm platform developed in this paper. The experimental results show that the proposed algorithm improves the speed of translation by about 35%.

Glucocorticoids have been used to treat hearing loss and vestibular dysfunction for many years. However, some reports have indicated that a subset of patients with these disorders exhibit glucocorticoid insensitivity or resistance. A reduction in histone deacetylase 2 (HDAC2) activity and expression has been reported to play a critical role in glucocorticoid resistance. Here, we investigated the protective effects of aminophylline on HDAC2 expression and glucocorticoid sensitivity in lipopolysaccharide (LPS)-induced sudden sensorineural hearing loss in guinea pigs. We assessed hearing recovery in LPS-applied guinea pigs, which were either left untreated or were systemically treated with either dexamethasone, aminophylline, or a combination of the two. We utilized fluorescence microscopy and enzyme-linked immunosorbent assay to analyze the distribution patterns of HDAC2 and detect its levels in the cochlea. We used hematoxylin-eosin staining to examine cochlear histopathological changes. In the absence of treatment, significant hearing loss was detected in LPS-exposed animals. A synergistic effect was observed between aminophylline and dexamethasone in maintaining HDAC2 expression levels, preventing hearing loss in LPS-exposed animals and reducing cochlear damage. This study indicates that aminophylline can restore glucocorticoid sensitivity, which provides a new approach to treating patients with hearing disorders who are refractory to glucocorticoids.

ObjectiveTo examine the relationship between the therapeutic effect of intratympanic methylprednisolone perfusion and histone acetylation in refractory sudden sensorineural hearing loss.MethodsThirty-four refractory sudden sensorineural hearing loss patients were enrolled and treated with intratympanic methylprednisolone perfusion. Pure tone average, acetylated histone H3, acetylated histone H4 and histone deacetylase 2 (HDAC2) were measured in peripheral blood mononuclear cells before and after intratympanic methylprednisolone perfusion. Sixteen healthy volunteers were recruited to obtain normal reference values.ResultsPure tone average in sudden sensorineural hearing loss patients improved from 84.14 ± 13.54 dB to 73.56 ± 18.45 dB after intratympanic methylprednisolone perfusion. Up-regulations in HDAC2 protein level, and down-regulations in histone H3 and H4 acetylation were observed in the intratympanic methylprednisolone perfusion sensitive group (pure tone average gain of 15 dB or more), while no significant changes were observed in the intratympanic methylprednisolone perfusion insensitive group (pure tone average gain of less than 15 dB).ConclusionIntratympanic methylprednisolone perfusion can improve hearing in a considerable number of refractory sudden sensorineural hearing loss patients. The therapeutic effect is closely related to reduced histone acetylation.

Objective To evaluate the expression of histone deacetylase 2 (HDAC2) in peripheral blood mononuclear cells (PBMCs) from patients with sudden sensorineural hearing loss (SSNHL) who were refractory to systemic glucocorticoid treatment and to identify the relationship between the level of HDAC2 and glucocorticoid insensitivity. Study design Prospective clinical study. Setting This study was conducted in Nanjing Drum Tower Hospital, Nanjing University Medical School. Subjects and methods PBMCs were collected from 42 refractory SSNHL patients. After a 10-day intratympanic methylprednisolone perfusion (IMP) and systemic Ginkgo biloba extract treatment, the SSNHL patients were divided into 2 groups according to their hearing recovery after IMP (IMP sensitive and insensitive). Real-time polymerase chain reaction and HDAC2 protein assays were used to detect the relative expression levels of HDAC2 in PBMCs. The HDAC2 mRNA expression and protein levels in PBMCs collected from 17 volunteers were used as normal HDAC2 reference levels. Results Compared with normal reference levels, HDAC2 protein levels were significantly reduced, while the HDAC2 mRNA expression was much higher in all refractory SSNHL patients before IMP. HDAC2 mRNA expression and HDAC2 protein levels were significantly elevated in the IMP-sensitive group, while no change was observed in the IMP-insensitive group after IMP plus systemic antioxidant treatment. Conclusions Reduced HDAC2 protein levels may be 1 of the mechanistic underpinnings of corticosteroid insensitivity in refractory SSNHL patients. IMP can increase HDAC2 protein levels and the expression of HDAC2 mRNA in IMP-sensitive patients. HDAC2 protein levels might be regulated through posttranslational modifications.

The relationship between the left arcuate fasciculus (AF) and stroke-related aphasia is unclear. In this retrospective study, we aimed to investigate the role of subcomponents of the left AF in predicting prognosis of aphasia after stroke. Twenty stroke patients with aphasia were recruited and received language assessment as well as diffusion tensor tractography scanning at admission. According to injury of the left AF, the participants were classified into four groups: group A (4 cases), the AF preserved intactly; group B (6 cases), the anterior segment injured; group C (4 cases), the posterior segment injured; and group D (6 cases), completely injured. After a consecutive speech therapy, language assessment was performed again. Changes of language functions among the groups were compared and the relation between these changes with segments injury of the AF was analyzed. After therapy, relatively high increase score percentage changes in terms of all the subcategories of language assessment were observed both in group A and C; by contrast, only naming in group B, and spontaneous speech in group D. Although no statistical difference was demonstrated among the four groups. In addition, there was no significant correlation between improvement of language function with segments injury of the AF. The predictive role of subcomponents of the left AF in prognosis of aphasia is obscure in our study. Nevertheless, it indicates the importance of integrity of the left AF for recovery of aphasia, namely that preservation of the left AF on diffusion tensor tractography could mean recovery potential of aphasia after stroke.

To better understand the response of Ipomoea cairica (Cairo morningglory) to herbivory, the compensatory growth and photosynthetic characteristics of plants were measured after simulated herbivory by leaf trimming at four intensities: 25, 50, 75, and 100% removal, starting from the apex. Defoliation at 25% had no significant influence on plant biomass, but the total biomass (−19 to −66%) and root biomass (−31 to −75%) of the plants decreased significantly when defoliation intensity was ≥ 50% (P < 0.05). Photosynthetic rates (Pn) increased with defoliation intensity (P < 0.01), and Pn values in the defoliated plants were 10 to 72% greater than those in the control plants, a relationship that could be attributed to a decrease in stomatal limitation (−11 to −34%) and the increase in rubisco content (9 to 18%) as well as higher photosynthetic efficiency and less light energy dissipated as heat. At defoliation intensities up to 50%, plants needed more energy to compensate photosynthetically, which could influence the plant photosynthetic characteristics as well as the allocation of assimilates, resulting in less root development. Since the spread of I. cairica depends primarily on clonal growth, smaller roots could limit uptake of nutrients from the soil. These direct and indirect effects indicate that leaf-feeding herbivores may have potential for biological control of I. cairica but to have any effect the herbivores would need to consume ≥ 50% of the leaf biomass.

This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation.We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered.The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75.Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.

Objectives:Investigate the efficacy of intratympanic methylprednisolone perfusion (IMP) for severe and profound sudden sensorineural hearing loss (SSNHL).Methods:Hearing recovery was analyzed retrospectively in SSNHL patients, who received IMP after not fully responding to conventional treatments and were hospitalized in our department between January 2008 and December 2012.Results:Eighty-seven patients with SSNHL were divided into 4 types according to primary hearing curve: total deafness (77.01%), mild to moderate hearing loss in all frequencies (18.39%), hearing loss in low-tone frequencies (2.30%), and hearing loss in high-tone frequencies (2.30%). The effective rate was 66.7% and average pure tone average (PTA) improvements were 18.53 ± 13.54 dB in the patients of interval from onset to IMP within 15 days, 21.2% and 5.92 ± 15.18 dB in the patients of interval between 16 and 30 days, 4.8% and 3.69 ± 7.00 dB in the patients of interval more than 30 days, respectively. The effective rate had significant...

To detect genetic cause of two Chinese siblings (patient 1 and 2) with Pendred syndrome.Patients and their parents underwent clinical and genetic evaluations. To identify genetic mutations, sequencing of SLC26A4 was carried out.Two siblings and their parents.Clinical evaluations showed that patient 1 suffered from bilateral postlingual progressive sensorineural hearing loss with enlarged vestibular aqueduct and slight diffuse multinodular goiter with euthyroid, and patient 2 suffered from bilateral prelingual progressive sensorineural hearing loss with enlarged vestibular aqueduct and no goiter with euthyroid. Furthermore, the sequence analysis of SLC26A4 indicated that either of the two siblings presented a compound heterozygote for the c.919AG mutation in the splice site of intron 7 and for the c.1548insC mutation in exon 14. Their mother was a heterozygous carrier of the splice site mutation in intron 7, and their father was a heterozygous carrier of the insertion mutation in exon 14.Mutation analysis identified a compound heterozygous mutation (c.919AG/c.1548insC) in SLC26A4 in two Chinese siblings with Pendred syndrome. Also, c.1548insC was first reported in the Chinese population. Although the two siblings from the same family carried the same genotype, they presented different phenotypes.

BACKGROUND: Glucocorticoids (GCs) are widely used to treat sudden sensorineural hearing loss (SSNHL) and significantly improve hearing. However, GC insensitivity has been observed in some patients of SSNHL. OBJECTIVE: To study the correlation between GR expression in peripheral blood mononuclear cells (PBMCs) and in the cochlea of guinea pigs at mRNA and protein levels. METHODS: One group of guinea pigs received dexamethasone (10 mg/kg/day) intraperitoneally for 7 consecutive days (dexamethasone group), and another group of guinea pigs received normal saline (control group). Real time PCR and Western blotting were used to detect the expression of GR mRNA and GR protein in PBMCs and the cochleae. RESULTS: The GR mRNA and GR protein were detected in both PBMCs and the cochlear tissue of guinea pigs. GR mRNA and GR protein levels in PBMCs were positively correlated with those in the cochlea. The expression of GR mRNA and GR protein was significantly increased in the dexamethasone group compared to the control group. CONCLUSIONS: Levels of GR mRNA and GR protein in the PBMCs were positively correlated with those in the cochlea of guinea pigs. Systemic dexamethasone treatment can significantly up-regulate GR expression in PBMCs and in the cochlea. Measurement of the GR level in PBMCs could be used as an indicator of GR level in the cochlea.

To study the bone conductive hearing loss in adults of otitis media with effusion (OME).Fifty adults of OME treated in our hospital, from Mar. 2009 to Feb. 2010, were enrolled for analyzing bone conduction hearing loss (BCHL) before auripuncture and after auripuncture, the difference between which were compared in 51 ears. BCT of pre auripuncture 24 subjects, BCT of post-auripuncture 22 subjects, and BCT recovered from OME 9 subjects compared with the contralateral ear respectively. High and extend high frequency (8, 10, 12, 16 kHz) air conduction threshold (ACT) after recover from OME was compared to the normal contralateral ear in 4 adults.BCT improved significantly after auripuncture at the frequencies (0.5-4.0 kHz), and the improvements in 4.0 kHz are more than that in 0.5 kHz significantly (P0.05). In the unilateral OME subjects, BCT, of post auripuncture and recovered from OME, nearly recovered to the same level as the contralateral ear in most cases. While high and extend-high frequency (8, 10, 12, 16 kHz) ACT elevated in 3 of 4 patients recovered from OME.Both effusion in middle ear and injury in inner ear could result in the elevation of BCT. Elevation of BCT at regular frequencies (0.5-4.0 kHz) is frequently associated with the effusion in middle ear, while these frequencies were insensitive in the early inner ear injury. The high and extend high frequency ACT elevation may be sensitive for the early sensorineural hearing loss. As the disease prolonged, sensorineural hearing loss of the lower frequencies (0.5-4.0 kHz) could be detected of OME patient.

To evaluate the clinical efficacy of the intratympanic methylprednisolone perfusion for patients of intractable Meniere's disease (MD).Ten cases (10 ears), collected from Janu 2008 to Janu 2010, of intractable MD were studied retrospectively. The micro-catheter was placed into the tympanum of the affected ear, then methylprednisolone was imported into the tympanum once a day for 10 days. The average followed-up duration was (15. 4 +/- 5. 4) months after the perfusion. The treatment effect of vertigo, hearing loss and activity capacity was evaluated with Diagnostic Criteria for MD set by the Guiyang Meeting in 2006. The efficacy of tinnitus was analyzed by comparing the score of tinnitus handicap inventory (THI) before and after treatment.The vertigo was absolutely controlled in 7 patients (grade A), partially controlled in 2 patients (grade B) and no efficiency in 1 patient (grade C). The 2 patients in grade B had a vertigo again in 9 months and 11 months after intratympanic perfusion, respectively, while the frequency, severity and duration of their vertigo softened obviously. Puretone threshold average (PTA) at the affected frequencies was decreased to within the level of 20 dB in one patient and was improved more than 30 dB in another one (grade A), improved 15 dB to 30 dB in 4 patients (grade B), and improved less than 15 dB in the other 4 patients. The average score of THI was 48.80 +/- 7.25 and 41.9 +/- 7.78 before and after perfusion respectively. The ability capacity of all the 10 patients after treatment was as normal (grade A), i. e. All of them could lead an independent life. There was no irreversible tympanic perforation in the operated ear and there was no other complications left.Intratympanic methylprednisolone perfusion through the micro-catheter is a safe and effective method for the intractable Meniere's disease.

To investigate the effectiveness and safety of intratympanic methylprednisolone perfusion (IMP) through a microcatheter in patients with sudden sensorineural hearing loss (SSNHL) who failed a conventional treatment.Prospective clinical study.This study was conducted in Nanjing Drum Tower Hospital, Nanjing University Medical School.Patients who had failed a minimum 10-day conventional treatment were included. Twenty-six patients in the study group (SG) received methylprednisolone perfusion through a microcatheter placed into the tympanum once a day for 10 days and the conventional treatment. Twenty-three patients who received a second conventional treatment (no steroid) served as the comparison group (CG). All patients were followed up for three months after the end of treatment.The effective rates for SG and CG were 50 percent (61.9% when only patients with an interval from onset to IMPor = 60 days were included) and 21.7 percent, respectively (chi(2) = 4.194, P = 0.041). The pure-tone average improvement was 20.2 +/- 15.6 dB in SG, and 9.2 +/- 13.7 dB in CG (z = 2.51, P = 0.011). In SG, hearing improvement at low frequencies was better than that at high frequencies. The interval from onset to IMP affected the efficacy of IMP.IMP through a microcatheter is a promising treatment for refractory SSNHL. The data suggest that the treatment may be more effective when administered at the earlier stages of SSNHL when the conventional treatment has failed.

Over the last decade, more and more otologists have been using the intratympanic perfusion of steroids to treat SSHL, tinnitus, and vertigo. However, results of the treatment in the literature are controversial because most of the reports were retrospective and uncontrolled. Therefore a prospective random single-blind trial was conducted at the Affiliated Drum Tower Hospital of Nanjing University Medical School, P. R. China. The results were compared with oral carbamazepine treatment. Carbamazepine is a medication routinely used to treat tinnitus.Seventy-nine patients (84 ears) with subjective tinnitus which failed to respond to a minimum of four-week systemic medical therapy were assigned to a study group and a control group by a random, single-blind method. The study group was further randomly divided into two subgroups. The participants in the study group received either 0.5-ml intratympanic injections of prednisolone (study group 1) or dexamethasone (study group 2). The patients in the control group only took carbamazepine. The effective rates at the end of the therapy and the control rates at the end of a six-month follow-up were analyzed statistically.There were no statistical differences in the effective and control rates among the three groups.Intratympanic steroid injection has positive effects similar to those of oral carbamazepine in subjective tinnitus. Intratympanic steroid injection may be considered an alternative treatment for subjective tinnitus.

To diagnose the mycotic otitis media correctly and to explore the most adequate treatment for the disease.Thirty-six inpatients (39 ears) with mycotic otitis media in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2007 were analyzed retrospectively. Morphous of the fungi, the methods and efficacies of the treatment were analyzed respectively.According to the fungal cultures, 27 ears were induced by mold fungus and 12 ears were induced by budding fungus. Among these 36 patients (39 ears), myringoplasty accompanied local antifungal cream were applied in one ear, mastoidectomy with canal wall down and/or tympanoplasty accompanied with oral antifungal medication were administrated in 35 ears, only oral antifungal drugs were used in 3 ears (the control ears of the bilateral mycotic otitis media, which was not treated by surgery). All of the patients were followed up for 3 to 36 months, otorrhea occurred in the patients who refused to oral antifungal medication for 3 weeks after the myringoplasty, then dry again by local antifungal cream, but otorrhea recurred 3 times within 2 years. Thirty-five patients (38 ears) acquired dry ear after surgery and/or oral antifungal drugs, but 2 of the 38 ears recurred separately at the fourth and sixth month after their surgeries, then dry again by irrigation with hydrogen peroxide and by administrating local antifungal cream for 3 weeks.Otologists should elevate suspicion of mycotic otitis media when they meet patients with continuous otorrhea and patients who did not respond to the antibacterial treatment. The diagnosis based on microbiological findings, such as direct microscopy or fungal cultures should be done as soon as possible. If the otomycosis is decided, we suggest that topical treatment should be selected firstly, although most patients in present study were treated by surgery accompanied with oral antifungal medications. If there is obvious bone erosion, surgery is necessary to excise the pathological tissues, minificate the mastoid cavity and close the middle cavity in order to improve the hearing and prevent the infection from the outer ear.

To study the efficacies of intratympanic prednisolone and dexamethasone injection for the subjective tinnitus.A prospective study was designed to compare the efficacies of intratympanic prednisolone injection, intratympanic dexamethasone injection and carbamazepine by oral administration for subjective tinnitus. Seventy-three cases (78 ears) with subjective tinnitus for more than one month and treated by conservative therapy (such as vasodilator agent, Vitamin B, etc. by oral intake. ) were involved. The patients were randomized into 3 groups. Thirty-four cases (35 ears) were included in prednisolone group, 18 cases (18 ears) in dexamethasone group with intratympanic injection of prednisolone or dexamethasone, and 21 cases (25 ears) in carbamazepine group as a control group with oral administration of carbamazepine. All of the cases in intratympanic perfusion group were injected twice in the first week, then once a week consecutively. The patients were acupunctured 4-5 times in the whole course of treatment. All of the cases accepted Betahistine Mesylate, Mecobalamin and Vitamin B1 by oral intake at the same time. Pure tone audiogram and tinnitus matching were tested before the treatment immediately after the course of treatment, and were tested again after half a year's following up.All of the cases accepted the whole treatment and were followed up for half a year successfully. The effective rate of the prednisolone group, dexamethasone group and the carbamazepine group was 48.6%, 33.3%, 44.0%, respectively; the control rate half a year after the treatment was 45.7%, 27.8%, 36.0%, respectively. There was no statistically significant difference in the effective rate and control rate between intratympanic perfusion group and carbamazepine group. There is a statistically significant difference both in the effective rate and the control rate between the prednisolone group and the dexamethasone group. Prednisolone may be better than dexamethasone in intratympanic perfusion for subjective tinnitus.Intratympanic steroid injection has a positive effect on subjective tinnitus and may be considered to be an alternative treatment to subjective tinnitus.

To investigate the clinical feature, diagnosis and endoscopic surgery of choanal polyps (CP) from posterior ethmoid sinus.Eleven cases with CP from posterior ethmoid sinus treated by endoscopic endonasal surgery between January 2002 to June 2007 were retrospectively reviewed. Clinical manifestation, intranasal and intrasinus lesions, methods and attentions of endoscopic surgery and therapeutic effects were analysed.All cases were treated by endoscopic surgery and CP were found originated from posterior ethmoidal ostium. Lesions in posterior ethmoid sinus included 3 (27.3%) cyst, 5 (45.4%) polyp and 3 (27.3%) mucosal edema. No operation complications were observed. The follow-up period ranged from 6 months to 3 years (mean 1.2 years) and no recurrence was founded.Most of CP originated from posterior ethmoidal ostium and its formation might be related to the cyst in the sinus. Endoscopic surgery represents a minimally invasive and highly successful procedure, complete removal of CP and lesions in the sinus can reduce the recurrence.

To evaluate the effect of over-under myringoplasty technique on repairing tympanic membrane perforation regarding with the rate of perforation closure, the frequency of postoperative complications occurrence and the level of hearing improvement.In this retrospective study, a total of 74 patients (77 ears) underwent myringoplasty and had been followed up for over 6 months, which was performed by means of the underlay technique in 44 patients (45 ears) and over-under technique in 30 patients (32 ears) from Jan 2002 to Jan 2007. In the underlay group, the grafted membrane was placed medial to the remaining drum and the manubrium of the malleus. In the over-under group, the grafted membrane was placed under the remaining drum and over the malleus. Comparatively evaluate the effect of the underlay technique and that of the over-underlay technique on repairing tympanic membrane perforation.The rate of perforation closure and hearing improvement in the underlay group of 45 ears was 89.0% and 57.5% respectively, while that in the over-under group of 32 ears were 87.5% and 71.9% respectively. The air-bone gap decreased by 4.9 dB in the underlay group, while it decreased by 9.7 dB in over-under group. After more than 6 months of following-up, the frequency of postoperative atelectasis of the underlay group and the over-under group was 17.8% and 6.25% respectively. Meanwhile, the frequency of postoperative reperforation of these two groups was 5.9% and 6.25% respectively. Blunting of the anterior angle of the tympanic membrane occurred in 3 ears in the over-under group. Lateralization of the graft was not observed in either group.Over-under technique could reduce the occurrence of the adhesions between the grafted membrane and promontorium tympani by placing the grafted membrane between the remaining drum and the malleus. Furthermore, the level of hearing improvement in over-under group was higher than that in underlay group. Over-under myringoplasty is a more effective technique as comparison to underlay myringoplasty for repairing middle to large tympanic membrane perforations.

To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media.The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant.Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty.In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.

To evaluate the effect of nitric oxide synthase (NOS) and nitric oxide(NO) on sensorineural hearing loss (SNHL) secondary to secretory otitis media (SOM).Samples of middle ear effusion were collected at the time of tympanocentesis from 16 cases of SOM with SNHL(group A) and 16 cases of SOM without SNHL(group B). And the concentration of NO and NOS activity in middle ear effusion were detected by colorimetric assay (Griess method).The concentration of NO in group A (181.19 +/- 44.31) micromol/L was significantly higher than that in group B (137.00 +/- 40.67) micromol/L (P0.01). The NOS activity in group A (97.69 +/- 29.62)U was also significantly higher than that in group B (75.50 +/- 26.99)U (P0.05).Excess generation of NO in middle ear effusion which synthesized by NOS may hurt inner ear directly by its cytotoxic action or enhance local inflammatory reaction with other inflammatory factors. This study suggests that NO play a significant role in the process and pathogenesis of SNHL secondary to SOM.

To approach clinical feature of thyroid malignant tumor with Flare up glottic paralysis for first symptom, and analysis that should be avoided missed diagnosis and misdiagnosis during diagnosis and treatment.Retrospective research five cases of thyroid malignant tumor with flare up glottic paralysis papillary adenocarcinoma of thyroid by pathology. Four cases had one side glottic paralysis, the same side thyroid were moved after dissecting the recurrent laryngeal nerve. Three cases of them recovered normal vocal cord function, the function of one case was compensated by another side vocal cord. The last one had right gliotic paralysis first, then both cricoarytenoid joint had been fixed, hoarse voice was worse and developed to dyspnea since the tumor invaded in larynx one year later. We only did cut the right thyroid and right half larynx, but the tumor came back again in larynx in three months, then had to removal whole larynx without recurrence follow up two years.For the flare up glottic paralysis with same side tiny thyroid tumor, we suggest that the thyroid must be made operation research if no other reasons, dissecting and protecting the recurrent laryngeal nerve during operation, and cut reasonable thyroid and others according to fast pathologic diagnosis.

BACKGROUND: It has been believed that location of the perforation has a significant impact on hearing loss. However, recent studies have demonstrated that the perforation sites had no impact on hearing loss. We measured the velocity and pattern of the manubrium vibration in guinea pigs with intact and perforated eardrum using a laser Doppler vibrometer in order to determine the effects of different location perforations on the middle ear transfer functions. METHODS: Two bullas from 2 guinea pigs were used to determine stability of the umbo velocities, and 12 bullas from six guinea pigs to determine the effects of different location perforations on sound transmission. The manubrium velocity was measured at three points on the manubrium in the frequencies of 0.5-8 kHz before and after a perforation was made. The sites of perforations were in anterior-inferior (AI) quadrants of left ears and posterior-inferior (PI) quadrants of right ears. RESULTS: The manubrium vibration velocity losses were noticed in the perforated ears only below 1.5 kHz. The maximum velocity loss was about 7 dB at 500 Hz with the PI perforation. No significant difference in the velocity loss was found between AI and PI perforations. The average ratio of short process velocity to the umbo velocity was approximately 0.5 at all frequencies. No significant differences were found before and after perforation at all frequencies (p>0.05) except 7 kHz (p = 0.004) for both AI and PI perforations. CONCLUSIONS: The manubrium vibration velocity losses from eardrum perforation were frequency-dependent and the largest losses occur at low frequencies. Manubrium velocity losses caused by small acute inferior perforations in guinea pigs have no significant impact on middle ear sound transmission at any frequency tested. The manubrium vibration axis may be perpendicular to the manubrium below 8 kHz in guinea pigs.