目的 系统评价影响我国新生儿听力筛查通过率的因素.方法 电子检索PubMed、Cochrane、CBM、CNKI维普、万方数据数据库,系统收集2022年9月之前国内外公开发表的关于新生儿听力筛查影响因素的相关文献,对符合纳入标准的文献进行Meta分析.结果 本研究共纳入文献12篇,包括37 030例新生儿.研究结果显示:早产[RR=0.77,95％CI(0.63,0.93),P＜0.05]、低体重儿[RR=0.74,95％CI(0.63,0.87),P＜0.05]、多胎[RR=0.89,95％CI(0.86,0.92),P＜0.05]对新生儿听力筛查通过率影响显著;分娩方式[RR=1.01,95％CI(1.00,1.01),P=0.11]、新生儿疾病[RR=0.63,95％CI(0.35,1.14),P=0.13]对新生儿听力筛查通过率无显著影响.结论 低体重、早产、多胎对新生儿听力筛查通过率有明显影响,分娩方式及新生儿疾病对新生儿听力筛查通过率无明显影响.

目的 观察乙状窦还纳术及窦壁重建术治疗乙状窦憩室及骨壁缺损引起的血管搏动性耳鸣的手术疗效.方法 回顾性分析2019年1月-2021年9月威海市立第二医院耳鼻咽喉头颈外科收治的7例血管搏动性耳鸣患者的临床资料,观察术后当天、1个月、6个月、1年耳鸣变化情况.结果 7例患者均为女性,右侧发病6例,左侧发病1例.根据临床表现及颞骨薄层CT及颅脑MRA、MRV检查确诊为乙状窦源性血管搏动性耳鸣,耳鸣致残量化表(THI)评分分级,均为3级以上,7例患者均在全麻下手术,其中6例乙状窦憩室伴发乙状窦骨质缺损患者接受乙状窦憩室回纳及窦壁重建术治疗,1例合并横窦憩室患者接受乙状窦、横窦憩室回纳+窦壁重建术治疗.术后1年随访,痊愈5例、显效1例、有效1例.结论 对乙状窦憩室或骨壁缺损引起的搏动性耳鸣进行乙状窦还纳术及窦壁重建术疗效确切,值得临床借鉴.

目的 系统评价脑白质异常患儿人工耳蜗植入术后康复效果,比较脑白质异常聋儿与脑白质正常聋儿术后听力及言语康复效果.方法 电子检索PubMed、Cochrane、CBM、CNKI维普、万方数据数据库,系统收集2020年2月之前国内外公开发表的关于脑白质异常聋儿行人工耳蜗植入术后听觉及言语康复效果相关资料,对符合纳入标准的文献收集资料进行Meta分析.结果 本研究共纳入文献9篇,包括795例患儿,术后6月脑白质异常与正常聋儿听力言语康复效果差异(以MD(95％CI,P)表示)分别为-0.88(-1.30～-0.46,P<0.01)和-0.45(-0.72～-0.71,P<0.01),差异显著;术后2年其听力言语康复效果差异分别为-0.08(-0.20～-0.03,P=0.16)和-0.04(-0.08～0.17,P=0.49),差异无统计学意义.结论 脑白质异常聋儿与脑白质正常聋儿相比行人工耳蜗植入术后听觉言语康复效果长期随访无明显差别.

目的 系统评价慢性化脓性中耳炎不同状态行I型鼓室成形术后疗效,分析术后鼓膜穿孔率及听力改善率.方法 电子检索PubMed、Cochrane、CBM、CNKI维普、万方数据数据库,系统收集2000年1月至2020年1月之间国内外公开发表的关于慢性化脓性中耳炎干耳与湿耳状态行I型鼓室成形术后患者鼓膜愈合情况及听力恢复情况相关资料,对符合纳入标准的文献收集资料进行Meta分析.结果 本研究共纳入文献12篇,包括1375例耳,干耳及湿耳术后鼓膜穿孔复发率分别为9.8％(69/704)和11.2％(64/571),差异无统计学意义(RR=0.81,95％CI为0.59-1.13,P=0.22).干耳及湿耳术后听力改善率分别为69.1％(385/557)和73.1％(301/412),差异无统计学意义(RR=0.81,95％CI为0.91-1.07,P=0.79).结论 慢性化脓性中耳炎不同时期(非急性感染期)行I型鼓室成形术后穿孔复发率及听力改善率无明显差别.

目的:分析肿瘤浸润炎症细胞在鼻咽癌中分布及预后相关性.方法:选取2009年10月至2013年10月间在本院进行治疗鼻咽癌患者石蜡标本158例,免疫组化法分析患者机体内FOXP3、CD8+、CD4+、NE+、CD56+、CD20+、CD83+、CD1a+及tryptase+细胞分布、含量和患者预后相关性状况.结果:依据炎症细胞密度将其分成高密度组与低密度组,CD3+、CD20+、CD83+及tryptase+浸润密度和患者不同病理分类相关(P＜0.05),FOXP3+、NE+及tryptase+浸润密度和患者不同N分级相关(P＜0.05),FOXP3+、NE+浸润密度和患者不同临床分期相关(P＜0.05);CD8+、tryptase+、NE+及FOXP3+低密度比高密度生存率高,CD1a+、CD56+高密度比低密度生存率高,差异均有统计学意义(P＜0.05).结论:肿瘤浸润肥大细胞、细胞毒性T细胞及调节性T细胞含量与鼻咽癌患者不良预后有紧密联系,CD56+NK细胞与CD1a+未成熟树突状细胞和患者良好预后有联系.

Objective The effects of miRNA on the invasion and migration of nasopharyngeal carcinoma cells were compared and analyzed in order to provide a theoretical basis for the treatment of nasopharyngeal carcinoma. Methods A total of 226 patients were enrolled in the study. 158 patients were diagnosed with nasopharyngeal carcinoma and treated in the department, and68 patients with non-nasal nasopharyngeal carcinoma. The patients were 35 ～ 75 years old with an average age of (57.7 ± 8.6) years. The cell scratch test was used to detect the migration ability of nasopharyngeal carcinoma cells in patients with nasopharyngeal carcinoma and non-nasal nasopharyngeal carcinoma. The expression of miRNA in nasopharyngeal carcinoma cell line HNE1 was detected by miRNA microarray technique. mRNA was detected by fluorescence quantitative RT-PCR. Level, observe and record the patient's name, age, height, weight, course of disease, tumor size and other basic information, timely monitor the patient's biochemical indicators, record the patient's treatment effect and patient satisfaction and other indicators. Results The concentrations of HNE1/DDP in the two groups were 28.59 ± 0.92, 15.23 ± 0.83, and the concentrations of HNE1 were 5.36 ± 0.35 and 4.02 ± 0.23, respectively. The difference was statistically significant (P ＜ 0.05). The migration of HNE1/DDP in tumor cells of patients with nasopharyngeal carcinoma The distance was 1.1 mm, HNE1 was 0.4 mm, the invasion distance of HNE1/DDP was 2.1 mm, HNE1 was 1.2 mm, the difference was statistically significant (P ＜ 0.05); the expression level of HNE1 cell intermediate marker was 1.1, which was significantly lower. At the HNE1/DDP level of 12.3, the expression level of the mesothelial marker molecule was 0.86, which was significantly higher than the HNE1/DD level of 0.23. Conclusion Differential expression of miRNA in nasopharyngeal carcinoma cells plays an important role in drug resistance of EMT and cisplatin. Mir-10 b-5 p promotes the invasion and migration of tumor cells, triggering the occurrence of EMT, so as to provide a scientific basis for research and treatment of nasopharyngeal carcinoma.

目的 探讨腺样囊性癌的临床病理特征、诊断和治疗，以避免误诊误治。 方法 回顾性分析青岛大学附属威海市立第二医院收治的1例翼腭窝腺样囊性癌误诊为颞下颌关节炎患者的临床资料，并复习相关文献。 结果 该患者行鼻内窥镜下右侧翼腭窝间隙探查后病理确诊为腺样囊性癌，在内窥镜辅助下切除肿瘤，术后随访1年，无复发。 结论 腺样囊性癌为多见于小涎腺的恶性肿瘤，少数可发生于腺体外，早期症状不典型，易漏诊、误诊。其确诊主要依靠组织病理学检查，治疗首选手术及术后放疗。

Small nucleolar RNA host gene 20 (SNHG20) has been reported to serve roles in several types of malignancies, while its role in nasopharyngeal carcinoma remains unknown. In the present study, tumor tissues and adjacent healthy tissues of patient with nasopharyngeal carcinoma, as well as blood samples from patients with nasopharyngeal carcinoma and heathy controls were collected, and expression levels of SNHG20 were detected by reverse transcription-quantitative polymerase chain reaction. Receiver operating characteristic curve and survival curve analyses were performed to evaluate the diagnostic and prognostic values of SNHG20 expression for nasopharyngeal carcinoma, respectively. Associations between serum expression levels of SNHG20 and clinical data of patients with nasopharyngeal carcinoma were analyzed using χ2 test. A SNHG20 expression vector was constructed and transfected into nasopharyngeal carcinoma cells, and cell migration and invasion were detected by Transwell assays. Expression of transforming growth factor-β1 (TGF-β1) was detected by western blotting. Results indicated that the expression level of SNHG20 increased in cancer tissues compared with healthy tissues of patients with nasopharyngeal carcinoma. Serum level of SNHG20 increased in patients with nasopharyngeal carcinoma compared with healthy controls. Significant association was identified between serum levels of SNHG20 and distant tumor metastasis. Serum SNHG20 could serve as a potential diagnostic and prognostic marker for nasopharyngeal carcinoma. Overexpression of SNHG20 promoted nasopharyngeal carcinoma cell migration and invasion, and promoted the expression of TGF-β1. TGF-β1 inhibitor reduced the effects of SNHG20 overexpression on nasopharyngeal carcinoma cell migration and invasion, and exhibited no significant effect on SNHG20 expression. Therefore, the results of the present study indicated that lncRNA SNHG20 could promote the migration and invasion of nasopharyngeal carcinoma cells by upregulating TGF-β1.

Objective To investigate the value of combined detection of viral capsid antibody(VCA -IgA), early antigen antibody(EA -IgG),and Rta protein antibody IgG(Rta -IgG)in the diagnosis of EB virus associated nasopharyngeal carcinoma(NPC).Methods A total of 47 nasopharynx cancer patients,45 patients with benign rhinitis and 45 healthy controls were recruited.The serum levels of VCA -IgA,EA -IgA and Rta -IgG were tested by enzyme -linked immunosorbent assay (ELISA).Specificity and sensitivity of the indicators alone and combined detection were compared using the clinical diagnosis as the gold standard.Results The expression levels of serum VCA -IgA,EA -IgA and Rta -IgG in the rhinitis group were (0.82 ±0.25),(0.74 ±0.13),(0.89 ±0.27),the levels in the NPC group were (2.16 ±0.39),(1.26 ±0.24),(3.95 ±0.76),and the levels in the healthy control group were (0.65 ±0.14),(0.51 ±0.11),(0.41 ±0.16)respectively.The levels of VCA -IgA,EA -IgA and Rta-IgG in the rhinitis group,NPC group and healthy group were significantly different (F =400.065,232.803, 740.215,P =0.000,0.000,0.000).The levels of VCA -IgA,EA -IgA and Rta -IgG in the NPC patients with different TNMstages were significantly different(F =195.679,30.878,38.561,P =0.000,0.000,0.000),and the trend of each antibody was increased with the severity of the disease.The sensitivity of VCA -IgA was the highest (85.11%),and the specificity of EA -IgA was the highest(95.56%).The sensitivity of the combined assay was 95.74%,which was higher than that of the other three combinations.Conclusion The combination of VCA -IgA, EA -IgA and Rta -IgG can reflect the expression of EBV -associated antigen to a greater extent,and it is superior to single or two combined detection in the diagnosis of EB -associated NPC,with a high clinical value.

Background Ebstein-Barr virus (EBV) plays a critical role in nasopharynx cancer, which can be effectively monitored by serum levels of early antigen antibody (EA-IgA) and viral capsid antigen antibody (VCA-IgA). This study explored the diagnostic value of combined assays of sialic acid (SA), EA-IgA, and VCA-IgA via the expressional assay. Material/Methods A total of 42 nasopharynx cancer patients and 42 benign rhinitis and healthy controls were recruited in this study. Serum EA-IgA and VCA-IgA were tested by enzyme-linked immunosorbent assay (ELISA) and enzymatic assay of serum SA. Specificity and sensitivity of those 3 assays were compared. The diagnostic value of each parameter was evaluated by ROC curves. Results All 3 indexes (SA, EA-IgA and VCA-IgA) showed elevated serum levels in nasopharynx cancer patients when compared to those with rhinitis, who had higher levels than healthy individuals. Concentrations of these factors were also positively correlated with the TNM staging of cancer. The sensitivity and specificity were 30.95% and 83.33% (in SA), 57.14% and 95.24% (in EA-IgA), and 76.19% and 92.86% (in VCA-IgA), respectively. VCA-IgA had the highest sensitivity among all 3 indexes. The combined assay increased the diagnostic sensitivity to 92.86% without compromising specificity. Conclusions SA, EA-IgA, and VCA-IgA levels were significantly elevated in nasopharynx patients’ serum. The combined assay may have clinical value in diagnosis and monitoring.

<正>侵袭和转移是恶性肿瘤主要生物学特征之一,是临床上影响肿瘤患者预后的最主要的原因之一。故研究肿瘤侵袭转移的机制及探讨如何阻断这一过程具有重要临床意义。近年来的研究发现,细胞外基质(ECM)的破坏是肿瘤侵袭转移要突破的第一道屏障,基质金属蛋白酶(MMPs)通过对ECM的降解而促进肿瘤的浸润和转移。本文将对细胞外基质、基质金属蛋白酶的结构功能及与头颈部恶性肿瘤等相关疾病的研究方面对其进行系统阐述。

<正>胆脂瘤中耳炎是耳科常见病,早期诊治能够有效避免严重并发症的发生。在各种影像学检查方法的选择中,CT尤其是高分辨率CT(HRCT),能够清晰显示中耳内胆脂瘤软组织影像及病灶周围骨质破坏情况,对临床诊断及治疗方法的选择具有重要指导意义。现就胆脂瘤中耳炎的HRCT影像学特征及诊断意义综述如下。

Objective To study the expression of β-catenin(β-cat) and P65 in laryngeal carcinoma and its correlation with pathological classification and clinical stages.Methods S-P immunochemical method was performed to detect the expression of β-cat and P65 in 42 specimens of laryngeal carcinoma and 20 of para-carcinoma tissue.The correlation between expression and pathological classification and clinical stages was analyzed.Results ① The abnormal expression rates of β-cat and P65 in laryngeal carcinoma tissue were66.7% and71.4% respectively.The differences of expression rates between laryngeal carcinoma and para-carcinoma tissue were statistically significant(P0.01).② Abnormal expression of β-cat was closely related with pathological differentiation,clinical stages,lymph node metastasis and 5-year survival rate;its abnormal expression rate increased with the rise of pathological classification and clinical stages(P0.05).Abnormal expression of P65 was closely related with clinical stages,lymph node metastasis(P0.05),but not with pathological classification and 5-year survival rate(P0.05).③ P65 and β-cat were simultaneously expressed in 22 specimens of laryngeal carcinoma and the expression of P65 was significantly correlated with that of β-cat(r=0.392,P0.05).Conclusion The expression of P65 is closely correlated with that of β-cat in laryngeal carcinoma.The abnormal expression of P65 and β-cat is closely related with differentiation,clinical stage,metastases in this tumor.

目的 探讨甲状腺腺叶切除术中解剖暴露喉返神经两种不同方法的临床优缺点.方法 将60例甲状腺腺叶切除的病例随机分为两组:环甲关节后方喉返神经入喉处解剖暴露组(A组)、甲状腺下动脉下气管食管沟全程解剖暴露组(B组),对比分析两组的平均手术时间、手术中平均出血量及喉返神经损伤发生率.结果 平均手术时间及手术中平均出血量,A组优于B组,有显著性差异(P＜0.05).A、B两组的喉返神经损伤发生率经统计学处理两者相仿(P＞0.05).结论 在甲状腺腺叶部分或全切除术中,采用两种不同解剖暴露喉返神经的方法,喉返神经的损伤率无显著性差异.但暴露喉返神经的喉返神经入喉处解剖暴露组平均手术时间较短,手术中平均出血量较少,对手术初学者来说是较为安全实用的方法.

OBJECTIVE To explore the effective management of allergic rhinitis. METHODS Sixty five cases with allergic rhinitis were treated by spheno- palatine nearotomy , submucosal anterior ethmoid nearotomy,and submucosal blood vessels ligation of inferior turbinate. All the patients were followed up for 2 years. RESULTS The effective rates were 95.38 %, 90.77 % and 86.15 % at 6 month, 1 and 2 year after operation respectively. CONCLUSION The technique is a effective method to treat allergic rhinitis.

Objective To investigate the clinical feature and early diagnosis of congenital cholesteatoma in children. Methods A review of documents and 3 cases of congenital cholesteatoma in children were analysed. Results The group of cases was diagnosed as congenital cholesteatoma; when it happened to children, such as earache, hearing impairment and the other complications. We should have a thorough and detailed examination on ear, though the drum membrabe was found to be normal. CT scan of temporal bore might provide definite imformation for early diagnosis. Conclusion When diagnosis was made, we should perform the radical mastoid operation and tympanoplasty early. The principle we must strike to is that to remove pathological tissue, thoroughly; protect the facial nerve and preserve or rehabilitate the hearing.