Objective To explore the causes, treatments, and outcomes of delayed facial paralysis(DFP)after different types of middle ear surgery. Methods A retrospective study was done on the clinical data of 1 124 cases experienced middle ear surgery from January 2017 to December 2018, including onset, risk factors, treatment and rehabilitation of DFP. Results Among the 1 124 patients who underwent middle ear surgery, 17(1.51%)presented DFP 3-20 days after surgery, with an average incidence at 10.00±4.11 days. The incidence of DFP after type Ⅰ tympanoplasty, type Ⅱ tympanoplasty, and tympanoplasty with mastoidectomy of the canal wall down were 2.30%, 1.62%, and 0.95%, respectively, and the differences were not statistically significant. The incidence of DFP in 776 patients with intact facial canal and 348 with dehiscent facial canal were 1.55% and 1.44%, respectively, and this difference also was not statistically significant. In addition, postoperative infection with Pseudomonas aeruginosa occurred in one of the patients with DFP who was later treated with a great auricular nerve graft and facial nerve anastomosis. The patient's condition improved to grade III a year after surgery. The remaining 16 patients were treated with steroids as conservative management, and their conditions were fully restored after 0.5-3 months. Conclusion The possible cause of DFP following middle ear surgery has nothing to do with surgical approaches and facial canal dehiscence. Notably, conservative management resulted in good outcomes.

Objective This study aimed to observe and analyze the characteristics of distortion product otoacoustic emission(DPOAE)and high stimulation rate auditory brainstem response(ABR)in tinnitus patients with normal hearing and to explore their application value in tinnitus assessment. Methods Thirty-one(46 ears)young tinnitus patients with normal hearing were selected as the tinnitus group, and 25(50 ears)young people without tinnitus with normal hearing results were selected as the normal control group. Pure tone audiometry, acoustic conductance audiometry, DPOAE, and high and low stimulus rate ABR were detected, and the results in the tinnitus and healthy controls were compared. Results We found no significant difference in the detection rate of DPOAE and ABR wave Ⅰ, Ⅲ, and Ⅴ amplitudes with different stimulation rates between the two groups. The signal-to-noise ratio at 8 kHz in the tinnitus group was significantly lower than that in control group. Further, under a high stimulation rate, the Ⅰ~Ⅴ wave interval of tinnitus group was longer than that of the control group, and the difference was statistically significant(P<0.05). At two stimulus rates,the the wave Ⅰ latency difference was shorter and the wave Ⅴ latency difference was longer in the tinnitus group, indicating that the wave Ⅰ~Ⅴ interval difference was longer in the tinnitus group than in the control group(P<0.05). Conclusion DPOAE and high stimulation rate ABR can be used as an objective method to diagnose tinnitus and evaluate early tinnitus. Increasing the stimulation rate of ABR could improve the sensitivity of tinnitus detection.

Objective To analyze the therapeutic effect of low-temperature plasma radiofrequency ablation(LPRFA)on rhinitis medicamentosa. Methods Twenty-six patients with rhinitis medicamentosa were treated using LPRFA in the bilateral inferior turbinates. The visual analog scale(VAS)score, Lund-Kennedy endoscopic nasal score, and nasal resistance measurements were collected and analyzed statistically at 3 months after surgery. Results The preoperative, 3-month postoperative, and 6-month postoperative VAS endoscopic scores were 7.82±0.92, 2.15±0.99, and 2.26±1.06, respectively. The preoperative, 3-month postoperative, and 6-month postoperative Lund-Kennedy nasal endoscopic scores were 3.22±0.58, 1.15±0.86, and 0.63±0.56, respectively. Patients who underwent LPRFA had significantly lower VAS and Lund-Kennedy endoscopic scores at 3 and 6 months postoperatively than the preoperative scores(P<0.05). Sinus CT and nasal endoscopy showed that the nasal mucosa had recovered well. The total nasal tract was unobstructed postoperatively compared with that before surgery. Furthermore, the patient-reported symptoms of nasal obstruction were significantly improved. The preoperative total nasal inspiratory resistance value was 0.97±0.50 kPa/L·s. The total nasal expiratory resistance value was 0.35±0.23 kPa/L·s. The total nasal inspiratory resistance value 3 months postoperatively was 1.01±0.84 kPa/L·s. The total expiratory nasal resistance was 0.35±0.19 kPa/L·s. The total inspiratory and expiratory nasal resistance significantly decreased at 3 months after surgery(P<0.05). Conclusion After treating rhinitis medicamentosa using LPRFA, the nasal symptoms such as nasal congestion were relieved, and the patient's quality of life improved. During the follow-up period(6 months), nasal obstruction and other nasal symptoms were gradually relieved. Hence, LPRFA should be recommended for the clinical treatment of rhinitis medicamentosa.

Objective To evaluate the clinical value of high-frequency ultrasound in the diagnosis of cervical lymph node metastasis in hypopharyngeal squamous cell carcinoma. Methods Forty-seven patients with hypopharyngeal cancer who underwent neck lymph node dissection in the Department of Otolaryngology in Qilu Hospital of Shandong University were recruited. The postoperative pathological results were used as the gold standard. The Kappa value was used to reflect consistency between the results of the three methods and the gold standard, and sensitivity and specificity were used to evaluate the diagnostic effect of the three methods; Pearson's chi-square test was used to compare the sensitivity and specificity of the three methods. Results A total of 47 patients with hypopharyngeal cancer, all of whom had no distant metastasis, were included in the study. Among the three methods, the consistency between ultrasound and pathological examination was highest(Kappa=0.718). According to the postoperative pathological examination results, the sensitivity of ultrasound in the diagnosis of cervical lymph node metastasis in hypopharyngeal cancer was highest(91.9%). The sensitivity was higher than that of palpation, and the difference was statistically significant. The sensitivity of ultrasound also tended to be higher than that of enhanced CT(78.9%), but the difference was not statistically significant. Palpation showed the highest specificity(94.74%), followed by ultrasound(78.95%)and enhanced CT(61.11%); however, the difference was not statistically significant. Conclusion High-frequency ultrasonography has high sensitivity and specificity in the diagnosis of cervical metastatic lymph nodes in hypopharyngeal carcinoma, which has important implications for clinical diagnosis. As it is non-invasive, portable, and repeatable, high-frequency ultrasound can be used as a common clinical examination method for cervical lymph node metastasis in hypopharyngeal carcinoma.

Objective To observe the postoperative efficacy and complications of endoscopic low-temperature plasma ablation for congenital piriform sinus fossa fistula(CPSF)in children with different inflammatory stages and explore the selection of surgical indications and the judgment of postoperative cure criteria. Methods The clinical data of 45 patients with congenital pyriform sinus fistula treated in our department in the past 3years were retrospectively analyzed. According to the clinical characteristics, it was divided into early infection, abscess, and inflammatory quiescence stages. All children were treated with low-temperature plasma under endoscopic guidance. The curative efficacy was observed. Results All children were followed up for 6 months to 3 years. A total of 33 cases(73.3%)were cured. In 17 cases, the secondary endoscopic exploration was completed, the internal fistula was closed, and no abnormalities were found on a postoperative B-ultrasound examination. Sixteen children underwent only B-ultrasound follow-up and no second surgical exploration, and no abnormalities were noted. Eleven cases(24.4%)improved. None underwent a second endoscopic exploration, and postoperative B-ultrasound follow-up showed microtubule residue but no clinical symptoms during more than 6 months of follow-up. One case(2.3%)was not cured. In this case, endoscopic exploration was completed, the internal fistula was closed, and a B-ultrasound reexamination showed microtubule residue. The neck of the affected side became re-infected 7 months postoperative, but it recovered after antibiotic treatment. The patient was followed up for 1 year without recurrence and remains under surveillance. Four children had early inflammation; of them, 2 had neck abscesses soon after surgery that were cured after incision and drainage. Among 15 cases in the abscess stage, no neck infection occurred during postoperative follow-up. Among the 26 children in the inflammatory quiescence stage,1 had recurrent neck swelling on the affected side at 7 months postoperative that recovered after anti-infective treatment. One patient(inflammatory quiescence stage)developed hoarseness postoperatively and recovered after 1 month of follow-up, while the rest had no complications. Conclusion Endoscopic low-temperature plasma ablation for the treatment of CPSF fistula in the period of quiescent inflammation and acute infection is effective, safe, and minimally invasive, making it the first choice for the initial treatment of CPSF.

Objective Research the GLP-1 induced autophagy through regulation of mTOR signaling pathways, whether there is a protective role in diabetic retinopathy rats. Methods Conform to the requirements of the diabetic retinopathy rats model, divided into model group, insulin group and GLP-1 group, each group of 6, ALL the groups were measured to realise the fasting blood glucose level in rats after 0 d,4 w, 8 w and 12 w, after 12 w killing the rats, we removed the retinal tissue for HE staining and test the expression of P53, LC3 by immunohistochemical method. Collected blood serum to detect oxidative stress product ROS and MDA content with serum superoxide dismutase(SOD)method. Detected mTOR protein expression with Western blotting method. Results Compared with model group, insulin group and GLP-1 group can obviously reduce fasting blood glucose, the difference was statistically significant, and is no statistically significant difference in the two groups. HE staining showed the retinal ganglion cells of model group disordered arrangement and the cells reduced or missed, but in insulin group and GLP-1 group, retinal ganglion cells arrangement was neat, no significant decline, close to normal. Immunohistochemical display, The LC3 and P53 protein expression respectively(2.34±0.13,0.46±0.03)in GLP-1 group increased significantly compared with other groups, and the differences were statistically significance(P<0.05). Oxidative stress product ROS and MDA content respectively(74.68±4.08,55.60±1.50)in GLP-1 group reduced, compared with other groups, the differences between groups were statistically significant(P<0.05). Compared with other groups, mTOR protein content(0.43±0.04)in GLP-1 group decreased, and the differences between groups were statistically significant(F=105.447, P<0.05). Conclusion Glp-1 may through activation of autophagy by regulating mTOR signaling pathways, then reducing oxidative stress injury of retina, as to protect the retina.

Objective To investigate the long-term effectiveness of virtual reality-based vision therapy for convergence insufficiency,by evaluating the binocular visual function and subjective symptoms before and after vision therapy. Methods 36 participants with convergence insufficiency were enrolled. The participants were randomly allocated to virtual reality-based vision therapy and office-based vergence/accommodative therapy(OBVAT)groups. The duration of the training was 1 hour per week for 12 weeks. Binocular visual functions and subjective questionnaires.(Convergence insufficiency symptom survey, CISS)were completed before the training, after the 6th and 12th weeks of training, and 6 months after the vision therapy. A two-tailed t-test was used to assess differences between the two groups at baseline, and a two-factor repeated measures ANOVA was used to assess differences between the two groups before and after training. Results After 12 weeks of treatment for CI, significant improvements were found for near exophoria, near point of convergence, positive fusional vergence, and CISS score in both the VR and OBVAT(P<0.001)groups. No statistically significant difference was found between the results at the 6 months after training and the 12th week of training(P>0.05). No statistically significant difference was found in the improvements between the two groups(P>0.05). Conclusion Virtual reality-based vision therapy significantly improved binocular vision function and symptoms in young adults with CI, and the effect can be maintained for 6 months after the end of training. The efficacy of VR was not significantly different from that of OBVAT.

Objective Comparison of Nd: YAG laser posterior capsulotomy using contact lens and not using contact lens in the two groups of patients with accumulated energy, laser points, average energy and operation process time-consuming. Methods A prospective collection of 80 eyes of patients with after-cataract diagnosed in the outpatient clinic of our hospital from November 2019 to May 2021. Number 1-80 according to the random number method, lottery method, single-number do not use contact lenses during the laser process, as the experimental group, 40 people(40 eyes); double-number use contact lenses, as the control group, 40 People(40 eyes). Record the range of energy used in the laser process, the accumulated energy, the number of laser points, and the time of the laser operation process. Results Postoperative visual acuity of the two groups was significantly improved, and the difference was not statistically significant(P<0.001). There was no significant increase in intraocular pressure in all observed patients half an hour after the laser and 7 days after the operation, and there was no significant difference of intraocular pressure half an hour after the laser, the intraocular pressure 7th day, and the visual acuity after the laser between two groups(P>0.05). There was no significant difference in the cumulative energy between the experimental group and the control group(P=0.456). The number of laser intraoperative points in the experimental group was less than that in the control group, and the difference between the two groups was statistically significant(P<0.001). The operation time of the experimental group was less than that of the control group, and the difference between the two groups was statistically significant(P<0.001). Conclusions Nd∶YAG laser posterior capsulotomy, no contact lens was used compared with the use of contact lens, there was no significant difference in accumulated energy, and the average energy used was larger, but the number of laser points could be reduced, and the operation time was shorter. The clinical effect of the two groups of patients No difference was observed.

Objective To explore the clinical efficacy of lecithin complex iodine capsule combined with ranibizumab in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME). Methods 40 patients(40 eyes)with RVO-ME who were admitted to our hospital from January 2020 to February 2021 were randomly divided into two groups: ranibizumab group and lecithin combination group, 19 cases(19 eyes)in ranibizumab group and 21 cases(21 eyes)in lecithin combination group. The patients in ranibizumab group were treated with intravitreal injection of ranibizumab every 4 weeks, and the patients in lecithin combined group were treated with lecithin complex iodine capsule combined with ranibizumab every 4 weeks, follow-up every 4 weeks during the 12 weeks observation period, The changes of intraocular pressure(IOP), best-corrected visual acuity(BCVA), fundus bleeding area, central macular thickness(CMT), fovea avascular zone(FAZ), choriocaphillaris flow area(CFA), superficial capillary plexus(SCP)and deep capillary plexus(DCP)were observed before and after treatment. Results BCVA(LogMAR)and CMT of the two groups at each treatment time point were significantly improved compared with those before treatment, and there was no significant difference between the two groups. FAZ and SCP: there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups. Fundus hemorrhage area: the fundus hemorrhage area of the two groups at each treatment time point was significantly lower than that before treatment. The fundus hemorrhage absorption of the lecithin combined group at each treatment time point was better than that of the ranibizumab group, and the difference was statistically significant. CFA in the eyes of the two groups increased before and after teatment, the difference was statistically significant, and there was no significant difference between the two groups. After 12 weeks of follow-up, DCP in the eyes of the two groups showed a significant increase trend, the difference was statistically significant, and the improvement of DCP in lecithin combined group was better than that in leizumab group, the difference was statistically significant. Conclusions Lecithin complex iodine capsule in the adjuvant treatment of retinal vein occlusion can achieve a better result in promoting the absorption of fundus hemorrhage and increase the density of deep retinal capillaries.

Objective To evaluate the safety and effectivity of corneal collagen cross-linking(CXL)in the treatment of fungal keratitis. Methods In the experimental group, 92 patients(92 eyes)with “fungal keratitis” were treated with CXL from January 2017 to December 2019, whereas in the control group, clinical data of 47 patients(47 eyes)(control group)with fungal keratitis whoreceiveddrug treatment alone in our hospital from January 2016 to February 2017 were retrospectively analyzed. The inclusion criteria were as follows: lesion depth <2/3 of the corneal thickness,superficial corneal ulcer with a normal corneal thickness >400 μm, lesiondiameter between 3-6 mm, deviation or slight affectation of the pupil area due to the location of the lesion,fungi hyphae on confocal microscopy,and positive Fusarium resultson fungal culture. Therapeutic effects were compared and analyzed between the two groups. Results At 2 weeks postoperatively, the best corrected visual acuity significantly improved in the experimental group, showing a better treatment effect than that in the control group(P<0.001). At 3 months postoperatively, the best corrected visual acuity significantly improved as compared to preoperative findings, with a better treatment effect in the experimental group than that in the control group(P<0.001). In the experimental group, the lesion scope of all eyes remained stable orreduced after 2 weeks of treatment. At 3 months postoperatively, clouds were observed in the lesion area of all eyes with good epithelial healing. The positive rate of fungi was significantly lower in the experimental group than in the control group(P<0.001)at 2 weeks and 1 month postoperatively. During follow-up, all patients in the test group had no fungal recurrences and complications. Conclusion CXL is a safe and effective treatment for fungal keratitis cases with a small range and partial center, as it can significantly shorten the disease course and improve vision.

Keratoconus(KC)is a disease characterized by corneal thinning and ectasia. Hepatolenticular disease is an inherited disorder that primarily affects hepatic copper deposition with the characteristic ocular sign of Kayser-Fleischer ring(K-F ring). KC is considered to be associated with multiple diseases but not with hepatolenticular degeneration. Here, we present a very rare case of keratoconus with Kayser-Fleischer ring, suggesting that there may be a potential relationship between the two diseases.

Objective To investigate the effect of microRNA-30-5p(miR-30-5p)on the proliferation of retinoblastoma cells. Methods The expression of miR-30-5p in retinoblastoma cell lines and normal human retinal epithelial cells(HRECs)was determined using quantitative Real-time polymerase chain reaction(qRT-PCR). Bioinformatic analysis and prediction of miR-30-5p target genes were performed using the TargetScan database. Dual-luciferase reporter experiments verified the 3'-UTR binding ability and targeting relationship of miR-30-5p and FOXG1. The effect of miR-30-5p on the mRNA and protein expression of FOXG1 was determined using qRT-PCR and Western blotting, respectively. The effects of the miR-30-5p-FOXG1 pathway on cell proliferation were examined in Y79 cells by transient transfection. Results miR-30-5p expression was decreased and FOXG1 expression was increased in retinoblastoma cells compared with that in HRECs. Bioinformatics prediction results revealed the binding sites of miR-30-5p and FOXG1. qRT-PCR and western blot results showed that miR-30-5p negatively regulated FOXG1 mRNA and protein expression. Dual-luciferase assay confirmed a targeting relationship between miR-30-5p and FOXG1 3'-UTR. Transient transfection of miR-30-5p increased the expression level of miR-30-5p in Y79 cells. Overexpression of FOXG1 reversed the inhibition of Y79 cell proliferation. Conclusion miR-30-5p inhibits the proliferation of Y79 retinoblastoma cells by downregulating FOXG1 expression.

Ocular toxoplasmosis is a unilateral necrotizing retinochoroiditis caused by intraocular infection with Toxoplasma gondii. When people are infected with T.gondii, tachyzoites can cross the blood-retinal barrier and infect most nucleated cells to directly cause tissue damage. At the same time, they can also cause a series of excessive cellular immune responses to further aggravate tissue damage and cause visual impairment. Finally, tachyzoites can create an equilibrium between parasite invasion and host resistance, thus forming tissue cysts in the host. Aside from the traditional drug treatment of pyrimethamine and sulfadiazine in clinical practice, new combined treatment programs and anti-T.gondii compounds have also been studied and applied to achieve precise treatment and reduce the toxic and side effects of systemic drugs. This article focuses on reviewing the pathogenesis and control of ocular toxoplasmosis, together with the current clinical predicaments, so as to provide a theoretical basis for the diagnosis and treatment of this disease in the future.

Optical coherence tomography angiography(OCTA)enables clinical monitoring of vascular changes in glaucoma by stratifying and quantifying the retinal microvasculature. In recent years, many studies have found that superficial peripapillary vessel density, especially the vessel density of the radial peripapillary capillaries layer, had a high diagnostic utility for glaucoma and a good correlation with glaucomatous optic neuropathy, which is helpful to the structural and functional examination of glaucoma. Thus, OCTA may further improve the diagnosis and treatment of different types of glaucoma at different stages.

Glaucoma is a degenerative optic neuropathy, and is characterized by irreversible and progressive visual impairment. The protection of retinal ganglion cells from further damage of optic nerve has become the focus of glaucoma research. HSP72 is one of the important members of heat shock protein family. It is an inhibitor of apoptosis and has a close relationship with neuroprotection. Studies on the anti-apoptotic and cytoprotective properties of HSP72 in glaucoma retinal ganglion cells have important guiding significance for theoretical research and clinical treatment of the pathogenesis of glaucoma. This article reviews the protective effects of HSP72 in glaucomatous retinal ganglion cells.

The vessels of eye and brain have close anatomical connections and similar physiological characteristics. Ocular ischemic syndrome(OIS)is an ischemic eye disease related to carotid artery stenosis, and ischemic stroke is the most representative ischemic cerebrovascular disease. Several studies have shown that OIS-related signs have some predictive value for the occurrence of ischemic stroke. Conversely, various ocular ischemic changes have been found to be secondary to ischemic stroke. This article reviews the findings on the association between OIS and ischemic stroke to promote multidisciplinary cooperation and optimize clinical diagnosis and treatment strategies.

Diabetic retinopathy is the leading cause of poor vision and blindness in adults. A reasonable model for diabetic retinopathy can not only simulate its pathogenic mechanism, but also reduce economic investment. Therefore, screening and constructing suitable cell models is the core of research. In this paper, the mechanisms of inflammatory response, apoptosis, vascular dysfunction, and neurovascular unit dysfunction in diabetic retinopathy were discussed. Moreover, several models of endothelial cells, pericytes, retinal pigment epithelial cells, and glial cells were summarized to provide a useful reference for further studies on the mechanism of diabetic retinopathy and the development of relevant drugs.

With the increasing prevalence of myopia worldwide, researchers are gradually using multifocal soft corneal contact lenses have been increasingly used for myopia correction and control. Although there are Despite differences in the design of multifocal soft corneal contactthese lenses for myopia control, they are based on the peripheral defocus theory, which aims to decelerate the growth of the axial length by reducing the amount of peripheral retinal hyperopic defocus in patients with myopia. However, the aforementioned design intends to alter the position of image surface structural parameters, in relation to the retina through additional orthofocus at the lens periphery, thereby leading to additional aberrations that may affect the quality of life and satisfaction of the wearer. This paper reviews the progress of research and the application of multifocal soft corneal contact lenses for myopia control, with the aim of facilitating better clinical application of these lenses and providing a reference for related research.

Anlotinib is a multi-targeting tyrosine kinase inhibitor that can play an anti-tumor role by regulating angiogenesis in cancer or an immunosuppressive microenvironment. Anlotinib shows therapeutic effects in patients with advanced or recurrent cancer and has been approved for the clinical treatment of non-small cell lung cancer, soft tissue sarcoma, small cell lung cancer, medullary thyroid cancer, and other types of tumors. Clinical studies have found that anlotinib combined with chemotherapy, radiotherapy, and immune-checkpoint inhibitors could inhibit tumor growth and showed significantly better therapeutic effects than anlotinib monotherapy. In this article, we review the mechanism of action of anlotinib and the progress in research on anlotinib in combination with other cancer treatments.

Objective To study the value of three-dimensional image processing technologr combined with image navigation technology in the perioperative teaching of advanced doctors in rhinology. Methods The data of 55 advanced doctors in the Department of Otolaryngology-Head and Neck Surgery of Xijing Hospital from January 2014 to December 2020 was retrospectively analyzed. 25 doctors received traditional teaching methods(Group A)and 30 doctors received three-dimensional image processing technology combined with image navigation technology teaching methods(Group B). The teaching results were evaluated after four months. The satisfaction with teaching methods is evaluated in the form of questionnaire survey, and the condition of relevant knowledge mastering is evaluated in the form of theoretical test. Results In the general condition analysis, there is a statistical difference in the age data(P=0.011), but there is no significant difference in professional time, gender and educational background between the two groups(P=0.092,P=0.584,P=0.783). In the teaching satisfaction assessment, there is no significant difference in the improvement of disease recognization between the two groups(P=0.234). But in the improvement of surgical understanding, anatomical identification and teaching satisfaction, Group B is better than Group A(P<0.001). In the theoretical test, the results of the Group B are better than thoseof Group A(P=0.004). Finally, according to the multiple linear regression analysis, the teaching method changing is the main influencing factor of the improvement in evaluation results. Conclusion For advanced doctors in rhinology, three-dimensional image processing technology combined with image navigation technology can effectively help them establish three-dimensional anatomical structure, understand and quickly master more complicatied surgical approaches.Then the teaching quality will be improved.