Recovery of hearing loss in atypical Meniere’s disease after treatment with orofacial and neck massage: A case report

BACKGROUND A 48-year-old female presented with sudden-onset right-sided aural fullness,low-frequency hearing loss,and tinnitus.Medical history included right-sided tempo-romandibular joint disorder(TMJD)with crepitation,and retro-orbital headaches.The patient was diagnosed with atypical Meniere’s disease(MD)and received in-tratympanic steroids,prednisone,betahistine,and began a low-sodium diet;how-ever,the patient’s symptoms worsened.CASE SUMMARY The patient sought physical therapy for TMJD;testing revealed reduced motion and dysfunction with vertical opening,lateral excursion of the mandible to the right,and tenderness to palpation.Treatment included soft tissue mobilization of right facial structures and temporal fossa,intraoral massage of the right pterygoid musculature,and massage of right neck structures.After 4 weeks,the patient noticed subjective improvement in hearing and decreased headaches.After 11 weeks,an audiogram showed that the hearing loss had recovered.The patient has continued the daily at-home intraoral/neck massage therapy and maintained normal hearing over 4 years to date.The temporal relationship between physical therapy and recovery of hearing loss suggests muscular or inflammatory etiology as at least partially causative of this patient’s symptoms.The mechanism of healing may have been due to decreased inflammation,improved blood flow,restored function of cranial nerves,or some combination of these and other unknown factors.CONCLUSION This report suggests that orofacial physical and massage therapy may be an effective treatment for the cochlear symptoms associated with MD.

Impacts of different methylprednisolone administration routes in patients with sudden hearing loss or Meniere’s disease

Background:Evidence suggests that glucocorticoids are important in the treatment of sudden hearing loss(SHL)and Meniere’s disease(MD).However,different glucocorticoid administration methods may have a significant impact on treatment outcomes.Objective:This study aimed to investigate effects of different glucocorticoid administration methods on sudden hearing loss and Meniere’s disease.Methods:In this study,glucocorticoids were administered orally in 18 patients,by retroauricular injection in 15 patients and by intratympanic injection in 15 patients.White blood cell(WBC)count,serum Kt,fasting plasma glucose(FPG),body temperature,heart rate and blood pressure were used to evaluate effects of glucocorticoids on patients with hearing loss.Visual analog scale(VAS)of pain and sleep disorders were also surveyed,and pure tone audiometry(PTA)results were compared among groups to evaluate efficacy of different glucocorticoids administration methods.Result:WBC count,heart rate and blood pressure were higher in patients taking oral glucocorticoids,while body temperature,serum Kt and FPG levels did not change in all three groups.However,patients who received intratympanic injection of glucocorticoids experienced more pain,while those taking oral glucocorticoids reported more sleep impairment.Treatment efficacy on hearing loss was not significantly different among the three groups.Conclusion:These findings suggest that systemic glucocorticoid administration can result in greater whole body responses than local administration,but with similar hearing treatment efficacy.

Identification of early-stage Meniere’s disease as a cause of unilateral tinnitus

Introduction:Meniere’s disease(MD)is characterized by episodic symptoms,including vertigo,hearing loss,and tinnitus.Objectives:in this study,cases of unilateral tinnitus were investigated for MD.Method:Twenty-two patients who presented with chronic unilateral tinnitus on puretone audiograms showing an average threshold better than 25 dB HL and thresholds in the lower frequencies worse than those in the higher frequencies by more than 10 dB were suspected to have early-stage MD and underwent electrocochleography(ECochG).Patients showing ECochG findings conclusive for MD were compared to a control group of patients presenting with chronic unilateral tinnitus on pure-tone audiograms showing an average threshold better than 25 dB and thresholds in the higher frequencies worse than those in the lower frequencies by more than 10 dB.Results:Eighteen of the 22 patients included in this study showed elevated summating potential amplitude to action potential amplitude ratios in ECochG(suggestive of endolymphatic hydrops due to MD)and were followed up for 2 months;14 of them experienced at least two attacks of vertigo or unsteadiness.In contrast,only one patient in the control group reported two or more attacks of vertigo or unsteadiness in the 2 month observation period.The incidence of this finding in the two groups was significantly different.Conclusion:Patients with early-stage MD can present with only unilateral tinnitus.Thus,the addition of“pure-tone audiograms showing lower-frequency thresholds worse than higher-frequency thresholds”to the probable MD category in the globally.

Comparison and development of machine learning for thalidomideinduced peripheral neuropathy prediction of refractory Crohn’s disease in Chinese population

BACKGROUND Thalidomide is an effective treatment for refractory Crohn’s disease(CD).However,thalidomide-induced peripheral neuropathy(TiPN),which has a large individual variation,is a major cause of treatment failure.TiPN is rarely predictable and recognized,especially in CD.It is necessary to develop a risk model to predict TiPN occurrence.AIM To develop and compare a predictive model of TiPN using machine learning based on comprehensive clinical and genetic variables.METHODS A retrospective cohort of 164 CD patients from January 2016 to June 2022 was used to establish the model.The National Cancer Institute Common Toxicity Criteria Sensory Scale(version 4.0)was used to assess TiPN.With 18 clinical features and 150 genetic variables,five predictive models were established and evaluated by the confusion matrix receiver operating characteristic curve(AUROC),area under the precision-recall curve(AUPRC),specificity,sensitivity(recall rate),precision,accuracy,and F1 score.RESULTS The top-ranking five risk variables associated with TiPN were interleukin-12 rs1353248[P=0.0004,odds ratio(OR):8.983,95%confidence interval(CI):2.497-30.90],dose(mg/d,P=0.002),brainderived neurotrophic factor(BDNF)rs2030324(P=0.001,OR:3.164,95%CI:1.561-6.434),BDNF rs6265(P=0.001,OR:3.150,95%CI:1.546-6.073)and BDNF rs11030104(P=0.001,OR:3.091,95%CI:1.525-5.960).In the training set,gradient boosting decision tree(GBDT),extremely random trees(ET),random forest,logistic regression and extreme gradient boosting(XGBoost)obtained AUROC values>0.90 and AUPRC>0.87.Among these models,XGBoost and GBDT obtained the first two highest AUROC(0.90 and 1),AUPRC(0.98 and 1),accuracy(0.96 and 0.98),precision(0.90 and 0.95),F1 score(0.95 and 0.98),specificity(0.94 and 0.97),and sensitivity(1).In the validation set,XGBoost algorithm exhibited the best predictive performance with the highest specificity(0.857),accuracy(0.818),AUPRC(0.86)and AUROC(0.89).ET and GBDT obtained the highest sensitivity(1)and F1 score(0.8).Overall,compared with other state-of-the-art classifiers such as ET,GBDT and RF,XGBoost algorithm not only showed a more stable performance,but also yielded higher ROC-AUC and PRC-AUC scores,demonstrating its high accuracy in prediction of TiPN occurrence.CONCLUSION The powerful XGBoost algorithm accurately predicts TiPN using 18 clinical features and 14 genetic variables.With the ability to identify high-risk patients using single nucleotide polymorphisms,it offers a feasible option for improving thalidomide efficacy in CD patients.

Anti-CD-20 Therapy in Refractory Adult Still’s Disease

Adult Still’s disease is a relatively rare form of rheumatoid arthritis with systemic inflammatory features. The prevalence is around 1.5 cases per 100,000 - 1000,000. In the current case we display a 30-year-old male patient with refractory adult still’s disease who suffered recurrent attacks of fever 39.5°C, arthritis in proximal interphalangeal joints (PIPs), wrists, tempromandibular joints (TMJs), knees and ankles, stitching chest pain, dyspnea, erythematous rash over the trunk, sore throat, weight loss (15 Kilograms in 4 months). The patients’ disease remained uncontrolled despite of synthetic disease modifying anti-rheumatic drugs and repeated intramuscular corticosteroid injections. Laboratory workup revealed erythrocyte sedimentation rate (ESR) of 95, C-reactive protein (CRP) of 100 mg/L, hemoglobin 10.5 gm%, leukocytosis 12,000/microlitre, mild elevation of liver function tests and dyslipidemia. Serology revealed negative rheumatoid factor, anti-nuclear antibody titre of 1:80, elevated serum ferritin 4000 micrograms/litre. The patient was started on rituximab (375 mg/m2), prednisolone 20 mg/day and selective Cox-2 inhibitor. Follow up for over three months following the completion of his pulse therapy, revealed no relapse of fever or fatigue, with morning stiffness of 5 - 10 minutes, VAS of 3, DAS28 of 3.8, HAQDI of 0.62, ESR 23, CRP 4.9, Hb 12.5 gm%, leucocytic count 9000/microlitre, the dose of prednisolone was successfully reduced to a dose of 5 mg/day orally. Conclusion: Anti-CD20 therapy successfully controlled systemic and articular refractory disease with sustained efficacy over a follow up period of up to 24 weeks.

Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases

Both, autologous and allogeneic hematopoietic stem cell transplantation (HSCT) can be used to cure or ameliorate a variety of malignant and non-malignant diseases. The rationale behind this strategy is based on the concept of immunoablation using high-dose chemotherapy, with subsequent regeneration of naive T-lymphocytes derived from reinfused hematopoietic progenitor cells. In addition, the use of HSCT allows for the administration of high-dose chemotherapy (whether or not combined with immunomodulating agents such as antithymocyte globulin) resulting in a prompt remission in therapy-refractory patients. This review gives an update of the major areas of successful uses of HSCT in non-malignant gastrointestinal disorders. A Medline search has been conducted and all relevant published data were analyzed. HSCT has been proved successful in treating refractory Crohn’s disease (CD). Patients with refractory celiac disease type II and a high risk of developing enteropathy associated T-cell lymphoma have shown promising improvement. Data concerning HSCT and mesenchymal SCT in end-stage chronic liver diseases are encouraging. In refractory autoimmune gastrointestinal diseases high-dose chemotherapy followed by HSCT seems feasible and safe and might result in long-term improvement of disease activity. Mesenchymal SCT for a selected group of CD is promising and may represent a significant therapeutic alternative in treating fistulas in CD.

Biologic Agents in Behcet’s Disease:Our Experience and Review of the Literature

Behcet’s disease (BD) is a large vessel vasculitis with a wide range of clinical manifestations. Some of these manifestation may be life threatening and rapid suppression of the inflammation with effective immunosuppressive agent is crucial. There are traditional drugs with different response rates and all have efficacy on different manifestations of the disease. The most frightening manifestations of the disease are ocular, neurologic, intestinal and vascular types of involvement. Besides benign and easily treated manifestations there are also refractory cases with complicated involvement. The novel biologic agents have been used for these resistant patients and favorable response rates have been reported. In this review, we have shared our experience with biologic agents in BD and also reviewed the literature for the efficacy and safety for these novel agents for refractory patients.

Characteristics of the Cochlear Symptoms and Functions in Meniere＇s Disease

Background：Meniere＇s disease is a unique,progressive disease of the inner ear.The complex manifestation presents diagnostic challenges.The cochlear symptoms often present before vertigo and tend to be ignored.This study aimed to analyze the characteristics of cochlear symptoms and functions associated with Meniere＇s disease to investigate the regularity of the development of this disorder.Methods：One-hundred fifteen patients who were diagnosed with definite unilateral Meniere＇s disease at the Hearing and Vestibular Clinic of the Department of Otorhinolaryngology of Beijing Tongren Hospital from August 2013 to November 2015 were recruited in this retrospective study.Initial symptoms,duration from initial symptoms to the diagnosis,hearing thresholds,audiogram patterns,and caloric test results were collected and analyzed for each patient.Data were analyzed using SPSS 13.0 statistical software by Spearman＇s correlation,Kruskal-Wallis H test,Chi-square test,and Fisher＇s exact test.Results：The average hearing threshold of these patients was 45.24 ± 18.40 dB HL.A majority of the patients （55.65%） were in Stage 3.The initial presentation of the disorder in 58 cases （50.43%） comprised only cochlear symptoms without vertigo.A weak,positive correlation was found between the degree of hearing loss and duration of the disease from initial symptoms to the diagnosis （rs =0.288,P =0.002）.Upward-sloping,inverted ＂V,＂ downward-sloping,and flat pattern were the main audiometric patterns observed with a distinctive distribution between stages （P 〈 0.001）.Based on the configurations of audiograms,the audiometric patterns had a weak correlation to the duration （rs =0.269,P =0.004）,and there was a tendency of duration to rising from upward-sloping,inverted ＂V＂,downward-sloping to flat pattern.（H =10.024,P =0.018）.Frequencies of tinnitus in 56 patients （64.4%） were at the lowest points of the audiograms,i.e.,the frequencies of the poorest hearing threshold.The patients at an advanced stage （Stage 3 [56] and Stage 4 [73]） exhibited a significantly higher abnormality of canal paresis than those at the earlier stages （Stage 1 [23] and Stage 2 [42]） （χ^2 =5.973,P=0.015）.Conclusions：Patients with definite Meniere＇s disease always have a moderate to severe sensorineural hearing loss before diagnosis.Cochlear symptoms are the most common initial presentation.With the progression of the duration,the hearing impairment becomes more severe and the distribution of the audiometric pattem is distinctive between stages.

Study of cochlear hydrops analysis masking procedure in patients with Meniere＇s disease and otologically normal adults

Background The cochlear hydrops analysis masking procedure （CHAMP） is a new diagnostic technique for Meniere＇s disease （MD）. But its value has not been well proven. This study aimed to evaluate the diagnostic value of CHAMP for MD. Methods CHAMP test was taken in three populations using the Auditory Evoked Potential system delivered by Bio-logic Systems Corporation： （1） otologically normal subjects; （2） patients clinically diagnosed with definite MD; （3） patients clinically diagnosed with probable and possible MD. Results According to the comparison between the normal and definite MD group, if the abnormal criterion of CHAMP was defined as latency delay less than 0.3 ms, then the corresponding sensitivity was only 52%. However, if the abnormal criterion was defined as latency delay between 0.6 and 3.8 ms, then a sensitivity of 93% and a specificity of 100% can be achieved. The complex amplitude ratio showed a significant overlap between normal and definite MD group. If the abnormal criterion was defined as a complex amplitude ratio less than 0.95, the corresponding specificity was only 50%. However, if the abnormal cdtedon was defined as less than 0.80, the corresponding sensitivity was 60%, and the specificity was 97%. If the abnormal criterion of CHAMP was defined as latency delay less than 0.6 ms or the complex amplitude ratio less than 0.80, CHAMP result can be obtained in all subjects with good sensitivity and specificity. Conclusions CHAMP can differentiate patients with Meniere＇s disease from otologically normal subjects with high sensitivity and specificity. The recommended cdterion of abnormal CHAMP was a latency delay less than 0.6 ms or a complex amplitude ratio less than 0.80.

Cochlear implantation in patients with Meniere’s disease:A systematic review

Background:Meniere’s disease(MD)is an idiopathic disorder of the inner ear,which manifests as cochleo-vestibular dysfunction.Hearing loss will progress to a profound levelin a subset of patients with MD,and vestibular interventions can independently cause loss of hearing.The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.Materials and methods:A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI.Demographic information,disease history,MD symptoms,outcomes measures,and complications related to CI were extracted from included studies.Results:In total,17 studies were included,and 182 patients with MD underwent CI.The weighted-mean age was 61.9 years(range 27-85).Study objective and methodology varied,and there was significant heterogeneity in CI outcome measures reported.In total,179(98.3%)of 182 patients reported objective improvements in at least one hearing metric after CI.A total of 69 patients(37.9%)reported vertigo or severe dizziness prior to CI,compared to 22 patients(15.4%)postoperatively.Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score(THI).Quality of life assessments varied between studies.Complications rates were low with only nine patients(4.9%)reporting a serious CI-related complication.Conclusions:This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes,and heterogeneity in study design and outcomes measured.Despite these limitations,this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD.The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.

磁共振3D-CISS序列诊断梅尼埃病的价值和限度

目的:探讨磁共振3D-CISS序列诊断梅尼埃病(MD)的价值和限度。方法:回顾性分析22例MD患者和20例健康志愿者的内耳3D-CISS序列图像,观察耳蜗、前庭、半规管、内淋巴管和内淋巴囊的显示情况,测量后半规管至颞骨岩部后缘的最短距离(PP值)并绘制工作者特征曲线(ROC)曲线。结果:3D-CISS序列不能区分内、外淋巴。健康志愿者内淋巴管和内淋巴囊的显示率仅为7.5%,MD患者为4.5%,其差异无统计学意义(P>0.05)。MD患者PP值为(1.55±1.48)mm,健康志愿者为(3.30±1.06)mm,两者差异有统计学意义(t=6.20,P<0.001),其ROC曲线下面积为0.81(95%可信区间0.72～0.91),最佳诊断截断点为2.04mm,诊断敏感度为72.7%,特异性度85.0%。结论:3D-CISS序列虽然尚不能直接显示内淋巴积水,但能显示后半规管内侧颞骨发育不良,对MD的诊断和治疗有一定作用。

The efficacy and safety of thalidomide in the treatment of refractory Crohn’s disease in adults:a double-center,double-blind,randomized–controlled trial

Background Thalidomide is applied in therapy for refractory Crohn’s disease(CD)in adults,but systematic and rigorous clinical evidence is scant.The aim was to provide theoretical references for the efficacy of thalidomide in the therapy for refractory CD in adults.Methods A double-center,double-blind,placebo-controlled,randomized clinical trial of refractory CD in adults in two inflammatory bowel disease centers in China.In the double-blind trial,patients were randomly assigned to 100mg of thalidomide or placebo daily for 8 weeks.The primary outcome was considered as the clinical remission rate calculated based on the Crohn’s disease activity index at the eighth week following thalidomide or placebo treatment.In open label,nonresponse to placebo was additionally treated with 8 weeks of thalidomide;all responders were continuously treated with thalidomide until the 48th week.Results Twenty-five patients were randomly assigned to each group.At the eighth week,the clinical remission rate in the thalidomide group was significantly higher than that in the placebo group(68.0%[17/25]vs 16.0%[4/25];relative risk,4.2;95%confidence interval,1.8–10.9,P<0.001).After a 48-week follow-up,the continuous treatment rate of thalidomide was 46.3%(19/41).Adverse events during the whole process were reported in 58.5%of patients,mainly involving drowsiness,rash,and peripheral neuropathy that were mild and tolerable.Conclusion Thalidomide can be used in the induction and maintenance therapy of refractory CD in adults.And it could be one of the treatment options for refractory CD.

ZHANG Ren＇s Needling Experience in Treating Refractory Diseases

Chief doctor ZHANG Ren has been engaged in acupuncture practice and literature research for about forty years, with abundant knowledge and clinical experience, particularly in the application of needling techniques. This article presents his experience in the treatment of refractory diseases.

Contralateral delayed endolymphatic hydrops: Clinical features and long term outcome

Background:Contralateral delayed endolymphatic hydrops(CDEH)is a clinical entity characterized by fluctuating low frequency hearing loss and/or vertigo,mimicking Meniere’s disease(MD),that manifests after the appearance of severe non-hydropic hearing loss(NHHL)at the other ear.Objectives:to describe the clinical features and the course of 57 patients affected by CDEH.Method:this is a retrospective study;57 patients affected by CDEH,out of 1065 patients seen in the same period and affected by MD,were subjected to otoscopy,PTA threshold evaluation,impedance testing,ABR,research of positioning nystagmus,vestibular function evaluated by means of bithermal caloric test under video-oculographic,and MRI with gadolinium.Results:the CDEH was definite in 24 cases(42%),probable in 2(4%)and possible in 31(54%).The mean PTA threshold at the hydropic ear was 41 dB.At the last follow-up,40 patients(70%)did not report vertigo or fluctuating hearing loss.Among the 17 patients who still reported symptomatology,11(64%)were affected by fluctuating hearing loss alone,4(23%)reported a subjective worsening of hearing loss and 2(12%)an acute vertigo crisis.Conclusions:contralateral delayed endolymphatic hydrops is a relatively rare form of Meniere disease that manifests more frequently as a definite form or with fluctuating low-frequency hearing loss.The prognosis at a long term follow-up is relatively good in terms of vertigo resolution.Contralateral delayed endolymphatic hydrops rarely determines a severe hearing loss in the better ear.

Integrating cupping therapy in the management of tinnitus and dizziness:a pilot study

Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases.In recent years,huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss,tinnitus,and vertigo.Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy.The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies.Methods:This is a prospective interventional pilot study in which pre and post intervention outcomes(tinnitus handicap inventory and dizziness handicap inventory)were assessed and compared.27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy.Results:There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing.No adverse events were reported in this study.Conclusion:Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus.A large scale randomized controlled trial is recommended.

Comparison of Transtympanic and Extratympanic Electrocochleography

Electrocochleography (ECoG) has been an important tool in the diagnosis of Meniere’s disease or endolymphatic hydrops. There are two methods employed, transtympanic and extratympanic. Many have regarded the results of these methods as being equally reliable. The purpose of this study is to determine any differences in sensitivity between the two methods. In this study patients with known endolymphatic hydrops or Meniere’s disease underwent ECoG testing with both the extratympanic method and the transtympanic method on the same day in the same ear. The results show a significant difference between the two methods, with the transtympanic wave values being smaller and therefore more sensitive than the extratympanic method. In addition, transtympanic ECoG resulted in better waveform morphology and better correlation with the audiometric findings in endolymphatic hydrops and Meniere’s disease. The results emphasize the superior role of transtympanic ECoG over extratympanic ECoG as a valuable component in the confirmation of Meniere’s disease or endolymphatic hydrops along with history and audiometric findings characteristic of the disease. Implications of the study promote the use of transtympanic ECoG rather than extratympanic ECoG in patients with symptoms suggestive of Meniere’s disease or endolymphatic hydrops.

Efficacy and safety of thalidomide in the treatment of 29 refractory Crohn's disease patients

Objective To evaluate the efficacy and safety of thalidomide(100 to 200 mg per day)in the treatment of adult refractory Crohn’s disease(CD).Methods From July 2008 to February 2013,29 refractory CD patients were enrolled in thalidomide(100 to 200 mg per day)cohort study.The clinical activity was evaluated by

基于三维真实重建反转恢复序列对比不同评估方法对梅尼埃病内淋巴积水的诊断价值

目的:采用三维真实重建反转恢复(3D-real IR)序列,对比基于耳蜗和前庭的不同评估方法对梅尼埃病(MD)内淋巴积水的检出效能。方法:回顾性收集2018年8月-2022年2月于首都医科大学附属北京友谊医院就诊,符合2017年中华医学会耳鼻咽喉头颈外科学分会诊断标准,且经鼓膜注入钆对比剂24小时后行3D-real IR序列检查的MD患者38例(45耳);同时纳入因单侧耳部症状就诊且行内耳MR钆造影检查、临床纯音测听、声阻抗、声放射检查未见明确异常的患者或MD患者的非症状侧作为对照组,共28例(30耳)。采用国内外最常用的4种基于耳蜗和前庭的评估方法(分别于2009年、2011年、2014年、2019年提出)分别判定有无内淋巴积水,分析每种方法诊断MD内淋巴积水的不同观察者间一致性、敏感度和特异度,采用MedCalc软件绘制受试者操作特征(ROC)曲线,对比不同方法诊断MD内淋巴积水的ROC曲线下面积(AUC)差异。结果:2009年、2011年、2014年、2019年评估方法的不同观察者间Cohen′s K系数分别为0.752、0.911、0.820、0.820,敏感度/特异度分别为91.1%/50%、93.3%/70%、82.2%/56.7%、82.2%/56.7%。2011年方法检出MD内淋巴积水的AUC显著高于其他三种方法(Z_(2009)=2.866,P_(2009)=0.0042;Z_(2014)=2.647,P_(2014)=0.0081;Z2019=2.647,P_(2019)=0.0081)。结论:2011年评估方法在3D-real IR序列上的观察者间一致性好、诊断效能高,推荐临床应用。

宽频声导抗对梅尼埃病诊断价值的Meta分析

目的探讨宽频声导抗对梅尼埃病的诊断价值。方法检索1999~2023年PudMed、Medline、Embase、Cochrane Library、中国知网(CNKI)和万方数据库发表的关于宽频声导抗诊断梅尼埃病的文献。由2位研究者独立根据纳入排除标准筛选文献、提取数据、并进行偏倚风险质量评价,对符合标准的纳入文献采用StataMP进行Meta分析,全面评估宽频声导抗在梅尼埃疾病诊断上的准确性。结果宽频声导抗在诊断梅尼埃病中的合并特异度为79%(95%CI:69%~87%);合并灵敏度为61%(95%CI:47%~73%);合并诊断比值比为5.87(95%CI:3.33~10.33);合并阳性似然比为2.91(95%CI:2.00~4.24);合并阴性似然比为0.50(95%CI:0.36~0.67);SROC曲线下面积为0.77。结论宽频声导抗在梅尼埃病的诊断中表现出良好的准确性,可于未来用作诊断梅尼埃病的标准之一。

KCNE单核苷酸多态性与心血管疾病及内耳疾病的相关性研究

KCNE辅助亚基参与调控多种电压门控钾离子通道,对维持机体正常的生理功能十分重要。目前许多研究显示,KCNE家族的单核苷酸多态性(SNP)与心血管疾病和内耳疾病的发生密切相关,但由于其复杂的遗传机制及其易受到地域、种族和个体差异等的影响,还需对KCNE SNP与疾病易感性之间的相关性及遗传规律进行探索,以探讨KCNE SNP作为诊断某些疾病的潜在生物标志物的可能。故该文主要就KCNE SNP与心血管疾病和内耳疾病之间相关性的研究进展进行综述,旨在为疾病的预防及治疗提供理论依据。