We characterized the clinical features of PTPN11-related deafness and evaluated the outcomes of cochlear implantation in affected patients. Whole-exome sequencing and bioinformatic analyses were performed in a cohort of 467 individuals with congenital sensorineural hearing loss to identify potential genetic etiologies. Four patients harboring PTPN11 variants were reviewed for their clinical characteristics and post-implantation auditory rehabilitation outcomes. PTPN11 variants were identified in four patients (Cases 1–4). A missense variant c.1391G > C (p.Gly464Ala) in exon 12 was detected in Case 1 and the recurrent variant c.836A > G (p.Tyr279Cys) in exon 7 was identified in Case 2. Both patients were diagnosed with Noonan syndrome with multiple lentigines. Missense variants c.1510A > G (p.Met504Val) in exon 13 and c.923A > G (p.Asn308Ser) in exon 8 were found in Cases 3 and 4, respectively; both were diagnosed with Noonan syndrome. Cases 1, 2, and 4 underwent cochlear implantation and demonstrated favorable postoperative auditory and speech outcomes. Our study provides a comprehensive characterization of auditory, speech and systemic phenotypes in PTPN11-related Noonan spectrum disorders and demonstrates that cochlear implantation is highly effective for severe-to-profound hearing loss. These findings emphasize the value of early genetic diagnosis and emphasize the importance of coordinated, interdisciplinary management.

Objectives:To explore molecular diagnoses in cochlear implantation (CI) recipients and evaluate CI outcomes in patients with PCDH15 mutations. Methods:Whole-exome sequencing and biomedical informatics were used to identify potential genetic causes in 467 individuals with congenital sensorineural hearing loss. We reviewed six CI recipients with PCDH15 mutations, assessing their CI outcomes and clinical features. Results:Nine PCDH15 variants and a heterozygous variant in CDH23 were identified in members of five families who underwent CI. Six of these were novel variants: exon 14-21 del, exon two del, exon 19 del, two splicing variants (c.2869-2A>C, c.1918-1G>A) in PCDH15, and c.209C>T in CDH23. All but one of the individuals with PCDH15 mutations exhibited autosomal recessive inheritance; one showed both digenic and autosomal recessive inheritance. Variants in PCDH15 contributed to Usher syndrome type 1F in patients 1 and 5, whereas the remaining four had isolated deafness (DFNB23). All six patients expressed satisfaction with their CI outcomes. Conclusion:CI significantly improved auditory and communication abilities in individuals with PCDH15 mutations. Early intervention is critical for achieving favorable outcomes. Preoperative genetic testing in individuals with hearing loss provides valuable insights for predicting CI success, offering potential treatments for retinal degeneration in Usher syndrome and facilitating personalized genetic counseling.

Objective:The aim of this study was to present an institution's experience with cochlear reimplantation（CRI）, to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI. Methods:We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features include caused of CRI, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance （CAP） and Speech Intelligibility Rating （SIR） scores were used to evaluate pre-and post-CRI outcomes. Our center's consecutive cohort of 1 126 patients had seven patients, while 69 patients were from other cochlear implant centers. Device failure was the most common cause of CRI（68/76）, with the remaining cases including flap complications（3/76）, magnet displacement（3/76）, secondary meningitis（1/76）, and foreign bodies around the implant（1/76）. Postoperative auditory and speech outcome improved in 31.6%（24/76） of patients, remained unchanged in 63.2%（48/76）, and decreased in CAP and SIR scores in 5.2%（4/76） of patients. Postoperatively, the seven patients with cochlear ossification and fibrosis scored lower on the overall CAP and SIR scale than non-ossification individuals, which is a significant factor in surgical success rates and auditory-speech outcomes. Conclusion:CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, minimally invasive CI has a positive significance for reducing the difficulty of CRI surgery and improving the CI performance.

This study examined the relationships between electrophysiological measures of the electrically evoked auditory brainstem response (EABR) with speech perception measured in quiet after cochlear implantation (CI) to identify the ability of EABR to predict postoperative CI outcomes. Thirty-four patients with congenital prelingual hearing loss, implanted with the same manufacturer’s CI, were recruited. In each participant, the EABR was evoked at apical, middle, and basal electrode locations. The following EABR measures were analyzed: wave III and V input/output (I/O) function, latency, threshold, threshold0.5 μV and Gibson scoring. Patients’ speech perception abilities were assessed using the Mandarin Speech Perception (MSP) materials presented in quiet. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) were also used to assess CI outcomes. A regression model was developed to explore the relationship between EABR and each speech measure, to identify parameters with significant predictive ability. A significantly shorter eV latency, lower eV threshold, lower eV threshold0.5 μV and steeper I/O slopes for both eV and eIII were observed when these responses were evoked at the apical electrode, compared to the middle and basal positions. Implantation age was significantly negatively correlated with bisyllables recognition rate (R2 = 0.20, p = 0.0194). The eIII slope at the apical site and the eV slope at the basal site demonstrated the highest R2 values in positive correlation with CAP, both with R2 = 0.09. Among the EABR parameters, the regression models based on MSP bisyllables recognition rate, basal eV latency, eV thresholds and threshold0.5 μV recorded at the apical and middle positions were statistically significant. Our study identified an apex-to-base gradient in EABR responsiveness following prolonged CI use. The threshold and I/O slopes of EABR appear to be informative predictors of speech perception performance in CI users, especially in the low-to-middle frequency range. However, further validation is needed.

Objectives: The aim of this study was to present an institution's experience with cochlear reimplantation (CRI), to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI. Study design: Retrospective single-institution study. Setting: Tertiary medical center. Methods: We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features including etiology of hearing loss, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were used to evaluate pre- and post-CRI outcomes. Results: The CRI population comprises of 7 patients from our institute,69 referred patients from other centers. Device failure was the most common reason (68/76, 89.5 %) for CRI; in addition, there were 7 medical failures and 1 had both soft device failure. Medical failures included flap rupture and device extrusion, magnet migration, auditory neuropathy, leukoencephalopathy, foreign-body residue and meningitis. In 21/76 patients, the electrode technology was upgraded. The mean time to failure was 0.58-13 years, with a mean of 4.97 years. The mean (f SD) CAP and SIR scores before and after CRI were 5.2 f 1.2 versus 5.5 f 1.1 and 3.4 f 1.1 versus 3.5 f 1.1, respectively. Performance was poor in six patients with severe cochlear malformation, auditory nerve dysplasia, leukoencephalopathy, and epilepsy. Conclusion: CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, adequate preoperative preparation and atraumatic CRI should be carried out for optimal results.

OBJECTIVE:To analyze binaural integration, we used a new stimulation mode of the electrically evoked auditory brainstem response (EABR), to reflect bilaterally implanted cochlear function.DESIGN:EABR was tested using the following procedure: First, both ears were evaluated separately, with the contralateral speech processor closed (C), followed by another measurement with both processors open (O). Subsequently, the eV latencies and amplitudes were assessed. The Speech, Spatial, and Qualities of Hearing Scale (SSQ), Categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were used to assess binaural hearing ability subjectively.STUDY SAMPLE:Fifteen subjects with bilateral CI from 1997 to 2018 were recruited, each diagnosed with severe to profound hearing loss.RESULTS:All SSQ scores, except for one, were greater than six (the exception scored 1.3/0.8/1.0). All CAP/SIR scores except one were greater than 6/4 (the exception scored 0/1). All patients exhibited good quality EABR measurements. The open contralateral processor significantly reduced the eV latency while enhancing the eV amplitude compared to monaural stimulation. The objective EABR results were consistent with subjective speech perception and auditory ability assessed using the SSQ scale.CONCLUSION:The EABR accurately reflected auditory pathway maturation and development after CI; thus, reflecting accordance with subjective speech and hearing performances. Furthermore, bilateral CI facilitates binaural integration and auditory brainstem plasticity.

Background: Hearing loss (HL) is the most common form of sensory disorder in humans. Molecular diagnosis of HL is important for genetic counseling for the affected individuals and their families. Methods: To identify potential genetic causes, we performed whole-exome sequencing and related biomedical informatics for 351 non-syndromic HL patients and their family members. Results: In the present study, we report the identification of four compound heterozygous variants in the CDH23 gene from four affected families, including four novel variants (c.995C>A, p.T332K; c.2159G>A, p.R720Q; c.5534A>G, p.N1845S, and c.7055-1G>C) and two frequently reported variants (c.719C>T, p.P240L and c.4762C>T, p.R1588W). Conclusion: Our findings significantly expanded the mutation spectrum of CDH23-associated autosomal recessive hearing loss.

Hereditary hearing loss is a highly genetically heterogeneous disorder. More than 150 genes have been identified to link to human non-syndromic hearing impairment. To identify genetic mutations and underlying molecular mechanisms in affected individuals and families with congenital hearing loss, we recruited a cohort of 389 affected individuals in 354 families for whole-exome sequencing analysis. In this study, we report a novel homozygous missense variant (c.233A > G, p.Lys78Arg) in the OXR1 gene, which was identified in a 4-year-old girl with sensorineural hearing loss. OXR1 encodes Oxidation Resistance 1 and is evolutionarily conserved from zebrafish to human. We found that the ortholog oxr1b gene is expressed in the statoacoustic ganglion (SAG, a sensory ganglion of ear) and posterior lateral line ganglion (pLL) in zebrafish. Knockdown of oxr1b in zebrafish resulted in a significant developmental defect of SAG and pLL. This phenotype can be rescued by co-injection of wild-type human OXR1 mRNAs, but not mutant OXR1 (c.233A > G) mRNAs. OXR1-associated pathway analysis revealed that mutations of TBC1D24, a TLDc-domain-containing homolog gene of OXR1, have previously been identified in patients with hearing loss. Interestingly, mutations or knockout of OXR1 interacting molecules such as ATP6V1B1 and ESR1 are also associated with hearing loss in patients or animal models, hinting an important role of OXR1 and associated partners in cochlear development and hearing function.

OBJECTIVES:To evaluate the efficacy and safety of first-line treatment with a dendritic cell vaccination for lung cancer (DCVAC/LuCa), standard of care chemotherapy and Shenqi Fuzheng injection in patients with advanced (stage IIIB/IV) non-small cell lung cancer. PATIENTS AND METHODS:Patients with histologically or cytologically confirmed recurrent metastatic or advanced NSCLC (stage IIIB/IV) with wild-type epidermal growth factor receptor (EGFR) or EGFR mutation which does not confer increased tumor susceptibility to EGFR-interacting drugs were recruited. For the treatment period, the first cycle of standard of care therapy (SoC) started 2 to 14 days after the leukapheresis procedure. SoC continued 4 to 6 cycles. DCVAC/LuCa was administered from the second cycle of SoC. DCVAC/LuCa was administered in a 3-week cycle schedule (5 doses) and then in a 6-week cycle schedule. Shenqi Fuzheng injection was administered 3 days before each DCVAC/LuCa administration for a total of 14 daily doses. Patients would undergo disease evaluation by computed tomography (CT) scan every 3 months. The primary and secondary endpoint was efficacy with regard to objective response rate (ORR) and progression free survival (PFS). The safety profile was measured by: incidence, type, and severity of all adverse events (AEs), laboratory abnormalities (blood routine test, urine test, and chemical test), physical status, and vital signs. Qi insufficiency was evaluated by tongue diagnosis and questionnaire survey with "Classification and Determination of constitution in TCM." RESULTS:Twenty-three patients from 3 hospitals who received combination therapy were included. ORR was 34.8% (95% CI:16.4%-57.3%). Median duration of response was 5.51 m (95% CI:2.70-8.32). Median PFS was 10.72 m (95% CI:4.52-16.93), 1-year survival was 77.8%. mOS was 21.97 m (95% CI:13.68-30.25). There was 1 severe AE related to a history of heart disease and there were no adverse events related to DCVAC/LuCa treatment. Qi insufficiency was improved significantly (P < .0001) from 41.19 ± 14.58 before treatment to 10.52 ± 16.58 after treatment. CONCLUSION:DCVAC/LuCa, combined with standard of care chemotherapy and Shenqi Fuzheng injection exhibited good benefit in Chinese patients with recurrent metastatic or advanced (stage IIIB/IV) NSCLC, and also significantly improved Qi insufficiency constitution. There were no related adverse events with DCVAC/LuCa treatment.

A cohort of 542 individuals in 166 families with congenital hearing loss was recruited for whole-exome sequencing analysis. Here, we report the identification of three variants in five affected individuals in two unrelated families. In family 1, a nonsense mutation (c.1516C>T, p.R506*) in the ATP6V1B2 gene, a known causal allele for dominant deafness-onychodystrophy (DDOD), was identified in the mother and son with DDOD. However, a novel heterozygous variant (c.1590T>G, p.D530E) in TJP2, a known causal gene for hearing-loss, was also detected in the patients. In family 2, the same mutation (c.1516C>T, p.R506*) of ATP6V1B2 was detected from the father and daughter with DDOD. Furthermore, a novel heterozygous variant (c.733A>G, p.M245V) in the KIF11 gene was identified from the spouse with sensorineural hearing-loss and epilepsy. Notably, genotype-phenotype analysis of KIF11-associated disorders revealed that the p.M245V and two reported hearing-loss-associated variants (p.S235C and p.H244Y) are all mapped to a single β-sheet (Ser235∼M245) in the kinesin motor domain. Together, this is the first demonstration that ATP6V1B2-caused DDOD is an autosomal dominant genetic disease, compared to previous cases with de novo mutation. Our findings expand the variant spectrum of hearing-loss-associated genes and provide new insights on understanding of hearing-loss candidate genes ATP6V1B2, TJP2, and KIF11.

Background: The development of hearing and plasticity of brain after cochlear implantation (CI) for prelingually deaf children with white matter changes (group A) is unclear. Objective: To investigate the development of hearing for children in group A during 1 year after CI activation, compared with non-complicated peers (group B). Materials and methods: Twenty-one and 22 children (average age is about 5 years old) were included in groups A and B, respectively. Questionnaires were used to assess the hearing ability at pre-CI, 1, 6 and 12 months after CI activation (called Mpre, M1, M6, M12 for short). In addition, MMRs to pure tones were investigated at the same three time points after CI. Results: There is no significant difference in scores on questionnaires, MMR incidence, latency or amplitude between children in two groups. Scores on questionnaires showed a significant progressive improvement in two groups during the first year after CI. Furthermore, MMR incidence at M6 was significantly higher than that at M1, and MMR latency at M12 was significantly shorter than that at M1.

PURPOSE:To review delayed-onset skin flap complications associated with pediatric cochlear implantation (CI) in our institute, analyze the etiology, and explore effective treatment strategies.METHODS:Retrospective analyses of 811 children who had undergone cochlear implantation between January 2003 and March 2019 were performed. Twelve (1.48%) patients developed skin flap complications after CI. We present a classification of flap issues and wound histopathology following cochlear implantation. The interventions for flap problems included drug treatment, aspiration, local wound care, revision surgery, and explantation depending on the clinical situation. The temporalis myofascial reconstructive option is discussed.RESULTS:Seven subjects were cured with conservative treatment. Five cases with flap infection or necrosis underwent revision surgery, with wound closure in three cases (60%) and revision surgery with explantation in the remaining two cases (40%). Explantation ultimately led to wound healing in all cases. They all achieved excellent performance through re-implantation.CONCLUSION:Flap complications after CI are rare but treatable. Comprehensive treatments should be developed to achieve a stable and healed wound for CI.

Background: There are some debates regarding the benefit from cochlear implantation (CI) for prelingually deaf children with white matter changes.Objective: To assess the hearing and speech outcomes of prelingually deaf children with white matter changes (group A), and those with complete deafness (group B), at 2 years after CI.Material and Methods: Study 1 included 32 and 34 children in group A and B, respectively. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR) were used to assess the performance on hearing and speech. Study 2 included eight children with white matter changes and eight with complete deafness at 2 years post-CI, and nine normal-hearing peers. The mismatch response (MMR) to the stimulus pair 'ba'/'pa' was investigated.Results: There was no significant difference on CAP or SIR scores between the children in group A and B. All children with white matter changes showed MMRs to Mandarin consonants at 2 years post-CI. And there was no significant difference on the incidence, the latency or amplitude of MMR among three groups.Conclusions and significance: Most prelingually deaf children with white matter changes got good outcomes from CI. CI is not a contraindication for most individuals with white matter changes.

Objective The study aimed to explore the characteristics of auditory mismatch response (MMR) in hearing-impaired children on the day when the cochlear implant (CI) was started (power-up) and the speech processor was programmed, and to investigate the effects of wearing hearing aids (HAs) before cochlear implantation on the early stage of postoperative auditory cortex plasticity, providing some demonstrative data for the objective evaluation of postoperative early auditory ability in children who underwent cochlear implantation. Methods The participants were 34 children with profound sensorineural hearing loss, who underwent cochlear implantation. The classical passive Oddball paradigm was adopted, using a pair of vowels which only have different lexical tones. The standard stimulus was /a2/ and the devious stimulus was /a4/. Results 1) On the day of CI activation, the auditory MMR has been elicited in 30 children; the MMR incidence was 88%. 2) We observed both positive and negative auditory MMR waveforms. And logistic regression analysis showed that it was influenced by the age at cochlear implantation. 3) The duration with HA before surgery significantly influenced the MMR latency. The children with longer duration of HA use have much earlier latency of MMR. 4) There was a significant positive correlation between the age at HA use initiation and MMR amplitude. Earlier initial HA use was associated with smaller amplitude. Conclusions MMR in response to Mandarin lexical tone can be recorded in most pediatric patients who had experience with HA on the day of CI power up. MMR is closely associated with the age at cochlear implantation, duration of HA use, and the age at HA use initiation. Hearing-impaired children should wear HA as early as possible and ensure consistent usage.

Objective:To evaluate the clinical efficacy of Qingyan lozenges for the treatment of chronic pharyngitis.Methods:A total of 209 patients with pharyngitis who visited ENT Departments of China-Japan Friendship Hospital and The First Affiliated Hospital of Guangzhou Medical University in July 2016 were randomly divided into observation group (101 cases)and control group (108 cases),according to age,gender and severity of the disease.The observation group were treated with Qingyan lozenges and the control group with Golden Throat lozenges(OTC)for two weeks.The main complaints and local signs were collected and compared at the beginning of treatment,1 week and 2 weeks after the treatment.Results:After taking Qingyan lozenges,the effective rate was 64.4％ 1 week later,and 87.1％ after 2 weeks;while the effective rate of the Golden Throat lozenges group was 64.8％ at 1 week,and 84.3％ 2 weeks later.There was no significant difference between the 2 groups (P＞0.05).After 1 week,the comprehensive scale improvement degrees of Qingyan lozenges group were 4.4 and 6.7 points,and Golden Throat lozenges patients' were 4.5 and 6.4 points.After 1 week and 2 weeks Qingyan lozenges therapy,the self-induction scale and signs of the scale improvement degrees were 2.1,2.7 and 2.3,4.0 points;and control group improvement degrees were 2.2,2.6 and 2.3,3.8 points.The differences between the 2 groups had not statistically significant(P＞0.05).Conclusion:Qingyan lozenges has the same clinical effect as Golden Throat lozenges for chronic pharyngitis and has good application value.

OBJECTIVE: To evaluate the efficacy of Shengjiangxiexin decoction(SXD), prepared with a formula from Traditional Chinese Medicine(TCM), in reducing irinotecan-induced hematological and gastrointestinal toxicities in patients with UDP-glucuronosyltransferase(UGT)1A1*28 and UGT1A1*6 polymorphisms.METHODS: This clinical trial included 115 patients receiving irinotecan combined with 5-fluorouracil plus l-leucovorin(FOLFIRI) treatment. All patients consented to UGT1A1*28 and *6 gene polymorphism detection prior to chemotherapy. SXD were administered from 1 day prior to chemotherapy to6 day post chemotherapy. Chemotherapy induced adverse reactions(neutropenia, diarrhea, nausea,vomiting, anorexia and infection) were recorded,and short-term effect of chemotherapy was evaluated regularly.RESULTS: A total of 50 patients had *1/*1 wild genotype, 58 patients had single allele variants with genotype *1/*6 or *1/*28, and 7 patients had twoalleles variants with genotype *6/*6, *28/*28 or *6/*28. In *1/*6 or *1/*28 patients(high risk group), 9patients(15.5%) developed Ⅰ-Ⅱ grade diarrhea and no patient developed severe diarrhea; neutropenia occurred in 19 patients(32.8%) and only 3 patients(8.6%) developed sever neutropenia. There were no significant differences in any toxic effects(neutropenia, diarrhea, nausea, vomiting, anorexia or infection) between *6 or *28 variant patients(high risk group) and wild type patients. No sever toxicity was found in high risk two alleles variants patients(*6/*6, *6/*28 or *28/*28). No significant differences were observed between UGT1A1*6/*28polymorphisms and clinical response of chemotherapy.CONCLUSION: SXD could significantly reduce irinotecan-induced hematological and gastrointestinal toxicities in UGT1A1*28 or *6 variant patients(high risk group), while this treatment didn’t affect clinical response of chemotherapy.

OBJECTIVE: To evaluate the safety and efficacy of Tongkuaixiao ointment(TKXO) in treating moderate-to-severe cancer induced somatalgia.METHODS: Totally 130 patients with moderateto-severe cancer induced somatalgia were randomly divided into a TKXO group and a control group.The patients were treated with either TKXO applied externally or placebo, with opioid analgesics orally at the same time. Observation parameters were included numerical rating scale(NRS) scores,analgesic efficacy, initiation effective time, persistent analgesic time, equivalent morphine dose,National Comprehensive Cancer Network(NCCN)grade in Impact of Pain Measurement Scores, and safety and satisfaction extent investigation.RESULTS: NRS scores and NCCN grade in Impact of Pain Measurement Scores decreased significantly after 5-days’ treatment in the two groups(P <0.0001). Compared to the control group, initiation effective time was significantly shorter(P < 0.05)and persistent analgesic time was significantly longer(P < 0.01), equivalent oral morphine doses of the first day and the whole treatment course were significantly decreased in the TKXO treatment group(P < 0.01 or P < 0.05). No obvious adverse effects were found in the TKXO group.CONCLUSION: TKXO combined with opioid analgesics possesses the advantages of high efficacy,fast action, long persistent action, safety and convenience in use, and it can reduce the dose of opioid.

Objective To study the effects of FM system on children with cochlear implants.Methods The speech recognition scores of 25 cochlear implant recipients with and without FM system were tested in quiet and noise. The results were statistically analyzed.Results (1) FM system and SNR had significant effects on the speech recognition scores. (2) Under the same SNR, the speech recognition scores of hearing-impaired children with FM system were significanly higher than those without FM system.Conclusion It is recommended that the children with cochlear implants use FM system in rehabilitation training,thus enhancing the efficacy of integrated education.

BACKGROUND:Malignant pleural effusion (MPE) is a common complication in most malignancies. Despite its frequent occurrence, current knowledge of MPE remains limited and the effect of the management is still unsatisfying. Traditional Chinese medicine (TCM) external treatment has unique advantages, such as quicker efficacy and fewer side effects.OBJECTIVE:To observe the effects and safety of Kang'ai Xiaoshui ointment (TCM herbal ointment) in MPE.DESIGN:This was a placebo-controlled double-blinded randomized study. A total of 80 patients were enrolled, of which 72 were randomized to receive Kang'ai Xiaoshui ointment or placebo at an allocation ratio of 1:1. Kang'ai Xiaoshui ointment or placebo was applied on the thorax wall for 8 hours daily. The intervention lasted 2 weeks. Kang'ai Xiaoshui ointment consisted of Astragalus membranaces （）, Semen pharbitidis （）, Cassia twig （）, Pericarpium arecae （）, Curcuma zedoary （）, Borneol （), and other substances. In both groups, diuresis and drainages were used as needed. Outcomes covered the quantity of pleural effusion evaluation, TCM Symptom Scale, Karnofsky Performance Scale, and safety indicators such as routine blood test, blood biochemistry test, and response table of skin irritation.RESULTS:Of 72 patients randomized to receive Kang'ai Xiaoshui ointment or placebo along with symptomatic treatment, the response rate was documented as 42.4% for the treatment group and 25.0% for the placebo group ( P = .138). As for the TCM symptom scale, the treatment group showed improvement in chest distress ( P = .003), fullness and distention ( P = .042), shortness of breath ( P < .001), no statistical significance in palpitation ( P = .237), and pain ( P = .063), whereas the placebo group did not show statistical significance in any of the 5 symptoms. Major adverse events related to the treatment, mainly skin irritation, were distributed equally.CONCLUSIONS:Kang'ai Xiaoshui ointment showed a potential of reducing MPE, and it could alleviate symptoms of dyspnea. Thus, it may be appropriate as a supplementary intervention for MPE. There were some flaws in the study design. A larger scale and better designed trial is advocated.

我国正在迈入老龄化社会,老年性聋的发病率逐年升高.听力障碍不仅妨碍了老年人正常的联络沟通,也影响到他们的生活质量和精神状态,不少人还伴自卑、孤独等心理症状.在门诊,常常会遇到一些老年听力损失患者前来探讨耳聋的治疗方法,其中不乏咨询关于人工耳蜗植入的问题.诸如:什么是人工耳蜗?它和助听器有什么不同?我是否需要植入人工耳蜗呢?等等.下面我们就来介绍人工耳蜗植入方面的一些相关知识.