Review of 6 Years of Middle Ear Surgery in the ENT-Laryngology Department of the Donka National Hospital and a Literature Review

Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.

EARS计划在结直肠癌外科患者中的应用效果分析

目的对结直肠癌外科患者治疗过程中,快速康复(enhanced recovery after surgery,ERAS)计划的应用价值进行分析。方法选择2020年7月1日—2022年3月1日常德市第一人民医院普通外科结直肠癌患者150例,按随机数字表法分为研究组与对照组,每组各75例,分别对患者进行传统开腹手术+EARS计划与传统开腹手术治疗,分析两组并发症、炎症因子水平、首次下床活动时间、进食时间、术后住院天数、排气时间、排便时间、满意度。结果研究组术后住院天数、排便、首次下床活动、进食、排气时间等指标均短于对照组,差异有统计学意义(P<0.05)。治疗有效率比较,研究组高于对照组,差异有统计学意义(P<0.05)。对照组并发症发生率高于研究组,差异有统计学意义(P<0.05)。研究组炎症因子水平均低于对照组,差异有统计学意义(P<0.05)。结论EARS计划推广价值较高,可以抑制炎症因子水平,提升治疗效果,预后效果显著。

EARS2基因突变致丘脑脑干受累性脑白质病伴高乳酸血症1例并文献复习

目的探讨EARS2基因突变致丘脑脑干受累性脑白质病伴高乳酸血症(LTBL)的临床特征、实验室检查特点及基因型,提高对该病的认识和管理水平。方法总结和分析1例以肝功能衰竭为首发表现的LTBL病例的临床特点、实验室检查、基因检测结果及随访,并行文献复习。结果男,45 d,因"皮肤黄染43 d"就诊。患儿生后2 d发现皮肤、巩膜黄染,42 d后发现肝功能衰竭(严重胆汁淤积、低血糖、凝血功能异常)、四肢肌张力减低,高乳酸性酸中毒;颅脑MR提示多发脑损伤;外显子捕获与高通量测序检测线粒体基因未见异常,检测核基因发现16号染色体上EARS2基因存在2个致病性复合杂合突变[c.1355T>G(p.L452R),c.813C>A(p.F271L)],确诊为LTBL。随访中黄疸逐渐消退,15月龄时肝功能检查恢复正常,血乳酸水平降至正常;精神运动发育明显落后,颅脑MR提示严重脑积水,予以行脑室-腹腔引流术,术后半年脑积水好转,精神运动发育较前改善。结论肝功能衰竭可以是EARS2基因突变所致的LTBL早期主要发现之一,随着年龄增长,肝功能可逐渐好转,精神运动发育落后及脑积水逐渐成为本病较为显著的临床特点,LTBL表型和基因型的关系还需要进一步研究。

EARS2基因变异致新生儿丘脑脑干受累性脑白质病伴高乳酸血症1例报告并文献复习

目的探讨丘脑脑干受累性脑白质病伴高乳酸血症的临床表型及基因型。方法回顾分析1例新生儿丘脑脑干受累性脑白质病伴高乳酸血症患儿的临床资料并复习相关文献。结果女性患儿,出生26小时,临床表现为反应差、抽搐及顽固性高乳酸血症。患儿于妊娠期时头颅MRI示胼胝体缺如。全外显子测序发现患儿EARS 2核基因第7号外显子c.1294C>T杂合无义变异和第5号外显子c.971G>T杂合错义变异,分别来自父亲和母亲;线粒体基因二代测序未发现患儿线粒体基因变异,但MLPA检测发现患儿及其母亲线粒体基因MTND 1-1*异质性缺失变异。结论发现导致丘脑脑干受累性脑白质病伴高乳酸血症新的EARS 2核基因外显子c.1294C>T无义变异和c.971G>T错义变异。

Effect of ALA-PDT on the expressions of MMP-9, MMP-13 and TIMP-1 of hypertrophic scar model in rabbit ears

Objective: To investigate the effect of 5-aminolevulinic(ALA)-photodynamic therapy(PDT) on the expressions of MMP-9, MMP-13 and TIMP-1 of hypertrophic scar model in rabbit ears, and analyze the possible therapeutic mechanisms of ALA-PDT treatment to hypertrophic scars of rabbit ears. Methods: The experimental animals were randomly divided into normal control, negative control, high concentration of ALA-PDT, low concentration of ALA-PDT and PDT groups. The latter three groups received ALA-PDT treatment or PDT treatment once a week for 3 weeks. The specimens of the rabbits were collected respectively 1, 2 and 3 months after treatment to be used for RT-PCR and Western-blot test. Results: 1, 2 and 3 months after PDT treatment, the expressions of MMP-9 and MMP-13(including mRNA and protein) in hypertrophic scar tissues of three treatment groups were significantly higher than those of the negative control group(P<0.01), and the expression of TIMP-1 mRNA and protein of three treatment groups were significantly lower than that of the negative control group(P<0.01). There were also significant differences between high-concentration ALA-PDT treatment group and the low one(P<0.05). Conclusion: ALA-PDT is effective in treating hypertrophic scars of rabbit ears, and its possible therapeutic mechanisms are that ALA-PDT treatment generates oxidation activation effect to activate the activity of MMPs and induces the photoaging of fibroblasts of hypertrophic scar tissues of rabbit ears to inhibit the activity of TIMPs, which causes the up-regulation of MMPs and the down-regulation of TIMPs. Because of this, the degradation of collagen and ECM is accelerated and the formation of scars is suppressed.

Hyaluronic acid injection in the auricular base for the aesthetic correction of lying ears:A retrospective study

Background Ears play an important role in facial profiles.Lying ears are not perceived favorably in Asian cultures;therefore,surgical procedures are implemented to adjust this defect.However,surgery has complications and requires recovery time.We introduced a hyaluronic acid(HA)injection technique to aesthetically improve ear prominence.Methods This retrospective study examined 25 Chinese patients aged 20-47 years with congenital lying ears who received HA injections in the auricular base at Shanghai Ninth People’s Hospital and Hangzhou Yijie Medical Cosmetology Clinic between November 2019 and December 2022.The average injection volume was 6.32±1.22 mL in the auricular base unilaterally,and the follow-up time ranged from 6 to 24 months.Morphological measurement data were recorded.Two-dimensional(2D)and three-dimensional(3D)images were obtained to evaluate the effects.Results All patients showed improvements in ear prominence.The cranioauricular angle(CAA)increased from 22.24°±4.53°to 65.90°±5.38°immediately post-injection and was maintained at 49.18°±4.74°6 months later.The ear projection(EP)increased from 14.75±2.72 mm to 26.26±2.94 mm immediately post-injection and was 22.51±2.68 mm after 6 months.No serious complications were noted.Conclusion HA injection in the auricular base effectively corrected the lying ears and aesthetically optimized the facial profile.It also had a face-lift effect that made the face look younger and more compact.The injection procedure was minimally invasive and required no recovery period.The effect was maintained for a long time and was satisfactory.

Clinical Comparison and Analysis of Decoction of Traditional Chinese Medicine Combined with Ear Acupoint Application and Simple Artificial Tears in the Treatment of Dry Eye Syndrome

OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHODS:A total of 62 patients(124 eyes) with dry eye syndrome treated in the Department of Ophthalmology of The 4th People's Hospital of Shenyang from July 2017 to March 2018 were selected and equally divided into 2 groups according to the admission order. The observation group received the combination therapy of TCM decoction and ear acupoint application, while the control group was given the simple artificial tears. The symptom score after 2 weeks, 4 weeks, and 8 weeks as well as the indicators including break-up time(BUT), Schirmer I test(SIT) and fluorescein(FL) were recorded and compared between groups. RESULTS: The symptom scores had no difference before treatment(P > 0.05), and were better in the observation group than those in the control group after treatment(P < 0.05). At 2 weeks, 4 weeks, and 8 weeks after the treatment, the amelioration level of BUT, SIT, and FL indicators in the observation group was better than that of the control group(P < 0.05). CONCLUSION: Compared with the artificial tears treatment method, the TCM decoction combined with ear acupoint application can significantly ameliorate the tear film stability, tear secretion, and reduce ocular surface damage for dry eye patients.

基于EARS理念下联合延续性护理干预对泌尿外科微创术后患者下肢深静脉血栓形成的应用价值分析

探讨基于加速康复外科(EARS)理念下的联合延续性护理干预对泌尿外科微创术后患者住院期间及出院后下肢深静脉血栓形成的应用价值。方法 选取2021年8月至2022年8月于济南市第八人民医院泌尿外科病区就治的泌尿外科微创术后患者100例,根据随机数字表法将其分为对照组和观察组两组。比较两组患者临床情况。结果 干预一个月后,观察组FBG、PLT、D-二聚体低于对照组,差异具有统计学意义(P值均<0.05)。干预一个月后观察组的疼痛程度评分低于对照组,日常生活活动能力评分高于对照组,差异有统计学意义(P值均<0.05)。干预一个月后,两组生理舒适度评分、心理精神舒适度评分、GCQ总分均高于干预前(P值均<0.05),且观察组显著高于对照组(P值均<0.05)干预一个月后,观察组患者的霍曼斯征阳性、下肢深静脉血栓发生率显著低于对照组,差异有统计学意义(P值均<0.05)。结论 基于EARS理念下的联合延续性护理干预有助于维持患者的凝血稳定性,缓解患者疼痛。此外,该干预能够有效降低医院相关性血栓形成的风险,并提高患者的舒适度和日常生活活动能力。

Contribution of ear photosynthesis to grain yield under rainfed and irrigation conditions for winter wheat cultivars released in the past 30 years in North China Plain

To understand the contribution of ear photosynthesis to grain yield and its response to water supply in the improvement of winter wheat, 15 cultivars released from 1980 to 2012 in North China Plain（NCP） were planted under rainfed and irrigated conditions from 2011 to 2013, and the ear photosynthesis was tested by ear shading. During the past 30 years, grain yield significantly increased, the flag leaf area slightly increased under irrigated condition but decreased significantly under rainfed condition, the ratio of grain weight：leaf area significantly increased, and the contribution of ear photosynthesis to grain yield changed from 33.6 to 64.5% and from 32.2 to 57.2% under rainfed and irrigated conditions, respectively. Grain yield, yield components, and ratio of grain weight：leaf area were positively related with contribution of ear photosynthesis. The increase in grain yield in winter wheat was related with improvement in ear photosynthesis contribution in NCP, especially under rainfed condition.

Postaurical injection is a systemic delivery supported by symmetric distribution of Gd-DOTA in both the ipsilateral and contralateral ears

Postaurical injection of therapeutics was recently applied in clinical practice to treat inner ear diseases based on supposed existence of a direct channel from the postaurical area to the inner ear. Doubting on the associated reports and aiming to provide evidence on the inner ear uptake mechanism, the present study tracked the dynamic distribution of gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) in rat inner ears after postaurical injection using MRI. A targeted tympanic medial wall delivery was utilized as control. The results showed that, at the early time points after postaurical injection, Gd-DOTA distributed mainly in tissues surrounding the bulla, temporal bone and skull and neck space. In the inner ear, there was gradual uptake of Gd-DOTA on both the ipsilateral and contralateral sides with equal signal intensities. There was no sign of direct channel carrying the agent from the postaurical area to the inner ear. Targeted tympanic medial wall delivery induced significantly greater uptake of Gd-DOTA in the inner ear than did postaurical injection. At 30 min post-administration, targeted tympanic medial wall delivery yielded 4.6-folds higher signal intensity than did postaurical injection. The total dose of Gd-DOTA delivered by the targeted tympanic medial wall approach was only 0.1% of that delivered by postaurical injection. In conclusion, postaurical injection is a systemic administration, which is similar to hypodermic injection, rather than a focal delivery method. By contraries, targeted tympanic medial wall delivery induces fast and abundant uptake of Gd-DOTA in the ipsilateral inner ear without significant distribution in unwanted areas.

Quantifying.Associations among Dimensions of Ears and Their Form Factors in Maize(Zea Mays)Using Dimensional Analysis

Ear morphological traits such as volume and shape are important features of maize and the quantitative associations among them can help understand kernel yield determination. 150 mature ears each of 4 maize cultivars were collected from field experiments, and ear length(L), diameter(D), area(S) and volume(V) were recorded for individual ears, kernel weight per ear also recorded for a portion of the examined ears. Following principles of dimensional analysis, 8 theoretical equations of 3 sets,which relate ear higher dimensions to its length and diameter, were developed and parameterized and validated with the field observations. The 3 optimized equations showed that the shape of ears in maize can be featured with 3 dimensionless form factors, namely diameter-to-length ratio(c=D/L), areal form factor(b=S/L/D), and volumetric form factor(a=V/L/D/D). Statistically,all of them were significantly different among cultivars, and a's values varied from 0.582 to 0.612, and b's 0.839-0.868, and c's 0.242-0.308. Volumetric form factor and areal form factor could estimate precisely ear volume and area respectively, but diameter-to-length ratio was not suitable to estimate ear diameter by its length. Ear volume explained almost all variation of ear kernel weight and product L*D*D did the same substantially. Dimensional analysis proved to be promising in understanding relationship among morphological traits of ears in maize. Its application in crop researches should improve our knowledge of the physical properties of crop plants.

Chong-Chet Anterior Scoring Technique for the Correction of Prominent Ears: Results in 30 Patients

A lot ofotoplasty techniques have been developed during the past years. However, there is no single perfect technique which is worldwide accepted. We present our assessment of a Chong-Chet anterior scoring technique for the correction of prominent ears which we applied in 30 patients between 2005 and 2010. This study is a report of creating a natural fold of cartilage using Chong-Chet anterior scoring technique by cartilage incision at the border between the antihelix and scapha, with medial scoring of the scapha and lateral scoring of the antihelix. Sutures were used to maintain the created fold. There were no major complications at the 1-year follow-up evaluation. None of the patients developed a recurrence, or retro protrusion of the helix which required a second operation for correction. The procedure is a simple surgical technique. The reconstructed ear shows reliable results in stability, size and normal convolutions. Furthermore, sharp cartilaginous ridges and hidden helix are avoided.

SONY IN EARS在你耳边轻轻唱

那些戴着耳机摇头晃脑的年轻人都有不同程度上的自闭症。在walkman诞生之初就有心理学家提出了这个说法,那时候是1982年。而现实证明,正是这些患有自闭症的家伙发明了电脑、互联网和数字音乐,从而改变了整个世界沟通的方式。扯远了,戴耳机的人确实喜欢沉浸在自己的小天地里,因为外面有太多他们不喜欢的声音,那些劣质的、沉闷的、毫无质感的高中低频。所以把耳朵堵起来是个好办法,这样音乐就可以直接钻进你的身体里,嘘……

The Eyes and Ears of War

位于波斯湾附近的“美国空军联合空战中心”的一整面墙就是一个巨大的、不断闪烁、不断变幻画面的屏幕,这面屏幕显示伊拉克上空每架美军战机的准确位置。

Research Progress of Acupuncture-moxibustion for Insomnia: An Analysis of Literature in Recent 5 Years

By searching and analyzing the literature related to acupuncture- moxibustion in treating insomnia in both Chinese and English databases from 2007 to 2012, this paper systematically elaborated the up-to-date research progress of acupuncture-moxibustion therapy in treating insomnia, i.e. acupuncture, electroacupuncture, auricular point, abdominal acupuncture, scalp acupuncture, acupoint injection, and moxibustion. It also analyzed the existing problems and highlighted the future studies.

Direct differentiation of ears and tassels from cultured shoot apices of maize

In vitro morphogenesis of inflorescences from the cultured corn seedling shoot tips was obtained on modified Murashige and Skoog (MS) medium in complete darkness. Some shoot tip meristems excised from seedlings of inbred line 515, inbred line 8112 and their filial generations would directly give rise to florets on modified MS medium supplemented with 2.0 mg/L N6-bezyladenine (6-BA) in five or six weeks. On the medium with 1.0 mg/L 6-BA and 0. 2 mg/L 2, 4-dichlorophenoxy acetic acid (2, 4-D), the explants swelled first, and produced multiple shoot clumps, then the culture of the shoot tips from all of the six inbred lines in experiment would ultimately initiate to develop ears and tassels accompanied by multiple shoot clumps developing on the medium with 1.0 mg/L 6-BA and 0. 2 mg/Lin-dole-3-butyric acid (IBA). The developmental patterns of the corn inflorescences were similar to the controls of normal plants in the field, but the number of the ears was much more than that of the tassels in vitro. It seemed that proper kinds and concentrations of exogenous hormones were necessary for the initiation and development of the inflorescences. The genotype of explants was responsible for the response to culture conditions. It could be inferred that there were different control mechanisms existing in the vegetative and reproductive developmental processes of maize, because the cultured shoot tips could directly produce the reproductive organs.

REMOVABLE EARS OF 1-EXTENDABLE GRAPHS

Carvalho, Lucchesi and Murty proved that any 1-extendable graph G different from K2 and C2n has at least A（G） edge-disjoint removable ears, and any brick G distinct from K4 and C6 has at least A（G） - 2 removable edges, where A（G） denotes the maximum degree of G. In this paper, we improve the lower bounds for numbers of removable ears and removable edges of 1-extendable graphs. It is proved that any 1-extendable graph G different from K2 and C2n has at least x′（G） edge-disjoint removable ears, and any brick G distinct from Ka and Ce has at least x′（G） - 2 removable edges, where x′（G） denotes the edge-chromatic number of G. Key words 1-extendable graphs, removable ear, removable edge.

Dynamic detection method for falling ears of maize harvester based on improved YOLO-V4

Traditional maize ear harvesters mainly rely on manual identification of fallen maize ears,which cannot realize real-time detection of ear falling.The improved You Only Look Once-V4(YOLO-V4)algorithm is combined with the channel pruning algorithm to detect the dropped ears of maize harvesters.K-means clustering algorithm is used to obtain a prior box matching the size of the dropped ears,which improves the Intersection Over Union(IOU).Compare the effect of different activation functions on the accuracy of the YOLO-V4 model,and use the Mish activation function as the activation function of this model.Improve the calculation of the regression positioning loss function,and use the CEIOU loss function to balance the accuracy of each category.Use improved Adam optimization function and multi-stage learning optimization technology to improve the accuracy of the YOLO-V4 model.The channel pruning algorithm is used to compress the model and distillation technology is used in the fine-tuning of the model.The final model size was only 10.77%before compression,and the test set mean Average Precision(mAP)was 93.14%.The detection speed was 112 fps,which can meet the need for real-time detection of maize harvester ears in the field.This study can provide technical reference for the detection of the ear loss rate of intelligent maize harvesters.

全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中的临床应用

目的探究全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中的临床应用。方法选取2020年6月~2023年6月间徐州市中心医院收治的58例进行上鼓室外侧壁重建的胆脂瘤患者,根据采用修复材料的不同分为对照组及观察组各29例。对照组采用耳屏软骨膜进行上鼓室外侧壁重建,观察组采用耳屏软骨-软骨膜复合体进行上鼓室外侧壁重建,两组患者均于全耳内镜下进行手术。统计患者术中出血量、手术时间,术后3个月复查听力情况、干耳情况及耳道功能改善情况,术后随访6个月鼓膜愈合情况。结果与术前比较,术后3个月气导听阈、气骨导差降低(P<0.05),与对照组比较,观察组气导听阈、气骨导差降低(P<0.05);与对照组比较,观察组干耳率、耳道功能良好率、听力提高成功率均升高,干耳时间缩短,但耳屏愈合时间增加(P<0.05);与对照组比较,观察组手术时间缩短,术中出血量减少(P<0.05);观察组、对照组术后并发症总发生率分别为13.79%、24.14%,二者比较差异无统计学意义(P>0.05);观察组愈合良好率高于对照组(86.21%vs.62.07%)(P<0.05),两组患者耳膜穿孔(10.34%vs.24.14%)、鼓膜移位(3.45%vs.6.90%)及鼓膜回缩(0.00%vs.6.90%)发生情况比较,差异无统计学意义(P>0.05)。结论全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中有利于改善患者听力,有利于术后恢复。