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    16 August 2011 Volume 25 Issue 4
      
    Articles
    Sleep stage ratio of pediatric obstructive sleep apnea hypopnea  syndrome patients before and after the operation
    YANG-Yang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  1. 
    Abstract ( 639 )   PDF (302KB) ( 925 )   Save
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    Objective      To investigate adenotonsillectomy on the sleep stage ratio in pediatric obstructive sleep apnea hypopnea syndrome (OSAHS). Methods      41 children, who underwent adenotonsillectomy in the Otorhinolaryngol Department, Beijing Children′s Hospital, received polysomnography pre-and post-operation in 2009.  The sleep stages ratios were  analyzed and compared. Results      The ratios of sleep stage Ⅰ(8.67±5.63% vs 7.26±5.70%), sleep stage Ⅱ(43.17±10.08% vs 45.91±9.50), slow eye movement sleep(30.15±8.50% vs 30.98±9.84%) and rapid eye movement sleep(18.03±4.90% vs 15.83±6.55%), between pre- and postoperation, were not significant. Conclusion     Adenotonsillectomy had no influence on the sleep stage ratio in OSAHS children.

    Changes of growth hormone secretion in children with  obstructive sleep apnea syndrome
    XIE Li-sheng,HUANG Qun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  3-5. 
    Abstract ( 911 )   PDF (538KB) ( 973 )   Save
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    Objective     To observe changes of growth hormone (GH) secretion levels in children with obstructive sleep apnea syndrome (OSAS). Methods     60 in-patients in the Nanjing Children′s Hospital  had  polysomnography (PSG) performed. 45 OSAS cases served as the experimental group, and 15 non-OSAS cases as the control group. Growth hormone secretion levels in both groups were examined by enzyme-linked immunosorbent assay (ELISA). Results      GH secretion level in the OSAS group was (8.96±1.74) ng/mL, significantly lower than that in the control group (10.09±1.54)ng/mL. And in the experimental group, there was no significant difference between mild and moderate cases, while they were obviously reduced in severe cases.Further correlation and regression analysis showed that GH secretion levels were  negatively correlated with the oxygen de-saturation index (r=-0.507). Conclusion     Growth hormone secretion in OSAS patients was inhibited, especially in  severe OSAS cases with a decrease of the oxygen de-saturation index.

    Significance of apoptotic and proliferative indices and  P-glycoprotein expression in laryngeal squamous cell carcinoma
    LI Da-wei, DONG Pin, GAO Shang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  8-12. 
    Abstract ( 560 )   PDF (1246KB) ( 1203 )   Save
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    Objective      To explore the relationship of P-glycoprotein  expression with the  apoptotic index, proliferative index, clinicopathological  characteristics, and their prognostic values in laryngeal squamous cell carcinoma (LSCC). Methods      Samples from 86 patients with LSCC were analyzed for P-glycoprotein and Ki67 expression with immunohistochemistry, and the apoptotic index with the TUNEL method. The association of P-glycoprotein  expression with clinicopathological  parameters, apoptotic and proliferative activities, and patients′ overall survival was subsequently analyzed. Results    It was found that up-regulation of P-glycoprotein expression was associated with decreased apoptosis (P<0.05) but not with the changes in proliferation (P>0.05). Expression of P-glycoprotein was significantly related to the clinical stage, histological grading, lymph node metastasis and overall survival in LSCC (P<0.05). Conclusion      These results show that the overexpression of P-glycoprotein may abrogate the apoptosis of LSCC cells. Furthermore, the  results demonstrate that P-glycoprotein is predictive of malignant progression and prognosis of LSCC.

    Functional excision of 42 benign parotid tumors under a microscope
    LI Chen, HUANG Jian-min, WANG De-sheng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  13. 
    Abstract ( 1167 )   PDF (392KB) ( 1531 )   Save
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    Objective        To evaluate the clinical effectiveness of functional excision of benign parotid tumor under a microscope. Methods        42 patients with benign tumors in the superficial lobe of parotid gland were treated with functional excision under a microscope. Compared with the traditional operation, functional parotidectomy under microscope had several advantages, including direct-view, accurate and cosmetic incision, great preservation of parotid masseter fascia/post aurem of great auricular nerve/the duct of parotid gland, and limited exposure of facial nerves. The tumor can be removed by the partial resection of parotid gland superficial lobes and the skin deformity could be repaired with the sternocleidomastoid muscle flap. Results       Among the 42 cases,3 suffered from transient facial nerve palsy. Frey syndrome was identified in 1 case. 5 patients showed decreased sensation around the auricular lobule and anterior auricular region. There was no salivary fistula after the operation and facial deformity was not obvious. Patients were satisfied with their facial appearance. No re-occurrence was found during 1 to 5 year follow-up. Conclusion      Treating benign parotid tumor by functional parotidectomy under a microscope can not only reduce- postoperative complications, but also achieve an  aesthetic effect.

    Transfection of primary culture cortical neurons with recombinant adenovirus  carrying the X-linked inhibitor of the apoptosis protein gene
    HU Yue, CHEN Ji chuan, WU Xiaoping, REN Hongmiao, JI Changyou
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  16-19. 
    Abstract ( 701 )   PDF (758KB) ( 1349 )   Save
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    Objective         To construct the green fluorescence protein(GFP) labeled recombinant adenovirus vector carrying the XIAP gene and transfect it into cortical nerve cells.Methods       A method of primary culture cortical neurons of the C57BL/6J mouse  was developed and an  experiment cell model of the neurons was established. Morphological changes of neuron cells were observed by a light microscope. Double immunostaining of β-Tubulin and DAPI were applied to assess the culture purity. The XIAP gene recombinant adenovirus vector was constructed by the homologous recombination.  Ad-XIAP was transfected into cortical nerve cells after testing the virus titer determined by tissue culture infectious dose 50(TCID50). Results       The target gene XIAP amplified by PCR was identified by DNA sequencing. The adenoviral vector could be examined 24 hours after transfection,and the green fluorescence intensity became greatest at about 72 hours. Conclusion         The recombinant adenovirus vector containing XIAP was  successfully constructed  and a  highly efficient virus was obtained which could efficiently transfect cortical nerve cells and this  laid a foundation for following investigations.

    Clinical study on fat  plug  and  inlay  butterfly  cartilage  for  myringoplasty 
    OU Yongkang, XU Yaodong, CHEN Suijun, LIU Xiang, ZHENG Yiqing
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  20-23. 
    Abstract ( 996 )   PDF (637KB) ( 1160 )   Save
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    Objective      To evaluate the application of the inlay graft technique in myringoplasty. Methods      107 patients(111 ears) with dry central moderate or small drum perforations enrolled from March 2002 to December 2009 were divided into 3 groups for myringoplasty: 42 patients(44 ears) in the fat  plug myringoplasty group, 32 patients(32 ears) in the inlay butterfly cartilage tympanoplasty group, and 33 patients(35 ears)  in the underlay tympanoplasty group(control group). All the patients were treated by transmeatal approach under an oto-endoscope. Results       After a mean follow-up of 6 months, the graft acceptance rate in these three groups was 90.9%, 93.8%, and 91.4%, respectively. There was no significant difference among the three graft acceptance rates (P>0.05). There were also no significant differences in the mean air-conduct threshold (more than 10 dB) and the mean airbone gap (more than 10 dB) in these three groups (P>0.05). For  healed tympanic membranes, no recurrent defects were observed both in the fat  plug myringoplasty group and the inlay butterfly cartilage tympanoplasty group, but 2 recurrent defects happened in the control group after 12-38 months follow-up. Conclusion       Fat plug myringoplasty and inlay butterfly cartilage myringoplasty,using an oto-endoscope, are  reliable  and  minimally invasive technique for treatment of moderate or small size perforation with high success rates.

    Surgical treatment of aural atresia/stenosis in 15 cases
    GUO Lian-rong, ZHENG Shi-xin, SU Yong-jin
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  24-26. 
    Abstract ( 1527 )   PDF (314KB) ( 1504 )   Save
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    Objective       To investigate  suitable surgical treatment for aural atresia or stenosis.  Method      15 cases of aural atresia or stenosis  who received canalplasty were reviewed. Postoperative follow-up ranged from onehalf to two years. Result      In 14 ears,  the external auditory canal was  enlarged. However, the atresia occured again in the other 1 ear. Conclusion      Different surgical procedures can be applied in aural atresia or stenosis depending on the factors, such as congenital or acquired, and with or without inflammation of tympanic-mastoid area. The keys of the operation are canal-plasty and obtainment of a wide external auditory opening. The defect area must be covered by a skin graft.

    Comparison of three methods in the treatment of ear lobe keloid
    LI Xiang-zhao1, LI Yan2, MA Jian1, QIAO Xiu-jun1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  27. 
    Abstract ( 1040 )   PDF (309KB) ( 1250 )   Save
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    Objective       To find a safe, effective,and convenient method to treat ear lobe keloid by comparing the efficacy of three  different methods. Methods     Forty-five patients(84 sides) were retrospectively studied. Cases were divided into three groups according to the methods applied, including group A for surgical excision and triamcinolone injection, group B for surgical excision and Imiquimod, and group C for surgical excision(triamcinolone injected in the operation) and Imiquimod. Results       There was no significant difference between group B and group C, however, the efficacy of these two methods were better than group A. Conclusions       Surgical excision with triamcinolone injected in the operation and Imiquimod is reliable and simple, and  is easy for the patients to accept.

    Analysis of middle ear resonance frequencies in  patients with different types of tympanograms
    LIU Qi-ming, MA Zhao-en, ZHAI Jin-ming, QIU Li-zi, MAO Min, ZHANG Jian-guo
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  29-31. 
    Abstract ( 2219 )   PDF (313KB) ( 1988 )   Save
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    Objective       To investigate the degree and characteristic of hearing loss and analyze the corresponding middle ear resonance frequencies in  patients with different types of tympanograms. Methods        30 normal ears and 116 abnormal ears were tested by GSI60 pure tone audiometry and GSI-Tympstar middle ear analyzer. Based on the results of tympanograms,116 abnormal ears were divided into 30 type A,22 type Ad,21  type As and 43 type C. All groups were tested by multiple frequency tympanometry and their middle ear resonance frequencies were compared. Results      The average resonance frequency of normal ears was 951±198.85,while it was 861±137.60Hz (P<0.01) for type A, 725±158.14Hz(P<0.01) for type Ad, 499±146.27Hz(P<0.01) for type C, and 1088±199.38Hz(P<0.05) for type As. The average resonance frequency of type A, type Ad and the type C group was lower than the normal group, but the type As group was higher. Conclusion        Clinical testing of resonance frequency is helpful for  the diagnosis and treatment of middle ear pathologies.

    Molecular genetic analysis of the SLC26A4 IVS7-2A>G mutation  in patients with non-syndromic hearing loss
    LI Jian-rui1, LIU Tao1, YAN Jiang-wei2, YANG Ya-ran2, LI Qi3, DAI Pu4
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  32-35. 
    Abstract ( 3755 )   PDF (582KB) ( 1855 )   Save
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    Objective      To explore the signification of  genes by analyzing the prevalence of SLC26A4 IVS7-2A>G mutation in 95 patients with non-syndromic hearing loss from Erdos, Inner Mongolia. Methods       The medical history of 95 deaf school students was recruited by a questionnaire survey. An  audiological examination was conducted with pure-tone audiometry and acoustic immittance measurement.The SLC26A4 IVS72A>G mutation was identified by both the testing kit with PAGE silver staining and direct sequencing. Results        95 patients with non-syndromic hearing loss(SNHL) were all diagnosed as sensorineural hearing impairment. The positive rate was 10.5%. 6 homozygotes and 4 heterozygotes were found to carry the IVS7-2A>G mutation by testing  with PAGE silver staining. The results were all confirmed by sequence analysis. Conclusions        The rate of the SLC26A4 IVS7-2A>G mutation in this group was relatively high. SLC26A4 IVS7-2A>G is one of the most important mutation spot in  gene preventive testing for non-syndromic hearing loss. It is also significant evidence for diagnosing Dilated Vestibular Aqueduct Syndrome. The PAGE silver staining method is convenient, inexpensive and suitable.

    Double tubes insertion for secretory otitis media in nasopharyngeal  carcinoma patients after radiotherapy
    DU Xiaodong, SONG Hongmao, MA Mei, XU Guirong, SHU Chang, CHENG Feng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  36. 
    Abstract ( 1163 )   PDF (311KB) ( 1058 )   Save
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    Objective       To discuss the clinical treatment for secretory otitis media (SOM) in nasopharyngeal carcinoma (NPC) patients after radiotherapy. Methods       60 NPC patients with SOM after radiotherapy were randomly divided into two groups: patients in the single tube group received singel tube insertion for water-spreading and patients in the double tubes group received double tube insertion for ventilation and water-spreading. The therapeutic effect and complications between the two groups were compared during a follow-up of ten months. Results       After a  10 month follow-up, the effective rate was 56.8% and 77.3%(P<0.05) and the complication rate was 47.4% and 20.5%(P>0.05) in the single tube and double tube groups respectively. Conclusion       For SOM in NPC patients after radiotherapy, the effect of double tube insertion is superior to that of single tube insertion.

    Relationship of trans-tympanic administration effect with inner ear MRI visualization in patients with Meniere′s disease  and idiopathic sudden hearing loss
    WU Jiali1, CHEN Wenwen1, LUO Yu2, TONG Jun1, DENG Yaxin1, SHAN Liang1, FANG Xuhua1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  38-40. 
    Abstract ( 1019 )   PDF (618KB) ( 1340 )   Save
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    Objective       To explore and analyze the relationship of transtympanic administration effect with inner ear MRI visualization in patients with Meniere′s disease and idiopathic sudden hearing loss. Methods       17 cases (13 cases of idiopathic sudden hearing loss and 4 cases of Meniere′s disease)were enrolled in the study. Gadolium, dexamethason or gentimycin were transtympanically  injected, and all patients were scanned with MRI 1h, 1d, and 6d after operation. The relationship of the effect with MRI visualization was observed and analyzed. Results       9 cases(5 cases of idiopathic sudden hearing loss and 4 cases of Meniere′s disease) of the 17 had inner ear high signal 1h to 6d after gadolium was injected. The other 8 cases had neither signal in the inner ear nor improved hearing. Conclusion    If transtympanically injected gadolium can permeate into the inner ear, dexamethoson and gentimycin would also permeate into it, and the therapy would have a good effect.

    Effect of patient-controlled intravenous analgesia for endoscopic sinus surgery on plasma IL-6 and IL-10
    WU Hongliang1, GAO Yanyong1, YU Junxiong2, TAO Zanying3, LIU Qianghe1, HE Xiaosong1, GENG Wanping1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  44-47. 
    Abstract ( 640 )   PDF (383KB) ( 1154 )   Save
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    Objective      To evaluate patient-controlled intravenous analgesia for endoscopic sinus surgery and its effect on cytokines IL-6 and  IL-10. Methods     40 patients(ASAⅠⅡ) undergoing elective endoscopic sinus surgery were randomly divided into two groups: GroupⅠ (n=20, Sufentanil 0.002mg/kg normal saline diluted to 100mL )and Group Ⅱ (n=20, Nimesulide 0.1g,P.O,when VAS>4 or analgesic requirements in patients). Differences of VAS, blood pressure, blood oxygen, heart rate, breathing and adverse reactions were compared between the two groups at each time point. Blood serum concentrations of IL-6 and IL-10 were measured before and at postoperative 8h, 24h and 48h. Results      Satisfaction with the analgesic effect of the groupⅠ.VAS score: group Ⅱ was significant higher than  group Ⅰ(P<0.05). No significant differences between the two groups were found in blood pressure, blood oxygen, heart rate, breathing (P>0.05).There was a significant increase in the levels of IL-6 and IL10 in both groups comparing with those before anesthesia(P<0.05), IL-6 in group Ⅱ increased  significantly compared with that in the  group Ⅰ at post-operative time points(P<0.05), IL-10  in the  group Ⅰ increased significantly compared with that in the group Ⅱ at post-operative time points (P<0.05). Conclusion      Intravenous patient-controlled analgesia in endoscopic sinus surgery has a good analgesic effect,which can provide efficient effect in maintaining the balance of pro/antiinflammatory cytokines, and ease postoperative immune injury.

    Perforation of the nasal septum as a complication of nasal  endoscope surgeries (with a report of 7 cases)
    ZHANG Qingquan, WANG Li
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  48-49. 
    Abstract ( 1113 )   PDF (281KB) ( 1145 )   Save
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    Objective       To explore the causes and preventions of perforation of the nasal septum after nasal endoscopic operations. Methods       7 cases of nasal septal perforation were retrospectively analyzed. Results      Application of local or systemic glucocorticoid before endoscopic surgery, systemic diseases, operating damage,  excessive pressure and prolonged period of nasal pluggings can lead to perforation of the nasal septum. Conclusions        Treatment of systemic diseases, preoperative medications, careful operation, type and pressure of nasal pluggings, and local regional dealing after the operations should be considered before the operation so as to avoid perforation.

    Endoscopic intranasal structure reconstruction surgery  in treating rhinogenic headache
    SUN Yiqing, PENG Bengang, WANG Xin, MIAO Xutao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  50-52. 
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     Objective      To explore the effect of endoscopic intranasal structure reconstruction surgery for rhinogenic headache. Methods        50 patients were treated with endoscopic intranasal structure reconstruction surgery. Lesions in the nasal cavity and the sinus were removed and the sinus ostium was opened, the anatomic abnormality was corrected, nasal septal and middle turbinate and inferior turbinate were reconstructed and sinusitis dissipated. Results      Followed up from 3 to 18months postoperatively, 30 cases (60%)were cured, 12cases were obviously recovered(24%), and 5 cases were effectively recovered(10%). The clinical effective rate was 94%. 3 cases had no recovery. Conclusion       Endoscopic intranasal structure reconstruction surgery can accurately and clearly remove the ill tissue with a good therapeutic effect and has important clinical value. 

    Balloon catheter frontal sinusotomy
    XIAO Jianxin, YU Qingqing, TANG Jun, ZHANG Chao, CHEN Weixiong, WANG Yuejian
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  53. 
    Abstract ( 1065 )   PDF (880KB) ( 1201 )   Save
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    Objective      To evaluate the safety and effectiveness of balloon catheter devices to dilate obstructed frontal sinus ostia or perform sinusotomy.  Methods      14 patients(21 ballooned sinuses)who had frontal sinus ostia dilated with balloon catheters were  evaluated 48 weeks after surgery, and sinus symptoms were determined by the SinoNasal Outcome Test (SNOT 20).  Results      Endoscopy determined that sinusotomy was present  in 12 patients (19 ballooned sinuses) and stenotic in 2 patients (3 ballooned sinuses). No serious post-operative complications such as cerebrospinal rhinorrhea, vision change or  diplopia occurred. 24-week and 48-week SNOT-20 scores respectively showed  significant improvement from baseline (1.08 vs 2.28, P<0.001) and (1.17 vs 2.28, P<0.001).  Conclusions      Besides durable clinical results, balloon catheter technology appears safe and effective in relieving ostial obstruction. Patients were pleased and indicated that they experienced significant symptomatic improvement.

    Application of kpetrolatum gauze plugging in  treating maxillary-zygoma fracture
    LIANG Fei, CHEN Miaoan, CAI Zhiliang, ZHAN Xiaoyan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  56-58. 
    Abstract ( 1011 )   PDF (737KB) ( 1157 )   Save
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    Objective      To explore the effect of kpetrolatum gauze plugging after reduction of maxillary-zygoma fracture. Method     The clinical data of 15 cases were retrospectively analyzed. Results      All cases reverted to the original facial state after operation and had no limitations of mouth opening, enophthalmos and diplopia after rehabilitation. Conclusion     It is convenient and cosmetic after precise reduction of maxillary-zygoma fracture.

    Endoscopic surgery for chronic dacryocystitis
    LI Yuguang, SONG Xiaoping, ZENG Jingyu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  59-61. 
    Abstract ( 1023 )   PDF (362KB) ( 1491 )   Save
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    Objective      To gain experience in curing chronic dacryocystitis under endoscopic surgeries and to explore the qualities of the anastomosis by applying Ear-brain glue after incising the dacryocyst. Methods       213 patients (225 eyes) underwent endoscopic dacryocystorhinostomy between May 1, 2006 and March 31, 2010 because of sufferings of chronic dacryocystitis or nasolacrimal duct obstruction (among them, 25 eyes had  recrudescence of chronic dacryocystitis after facial incision surgeries). Of the 213 cases, 16 eyes had nasal polyps; 33 high deviation of nasal septum, rectified; 20 uncinatus hypertrophy, excised; 19 nasal polyps hyalinosis at  forward of the middle turbinate, removed. All the anastamoses were treated with ear-brain glue. Result       199 eyes were completely  cured without any epiphora, 19 highly improved  and 7 eyes proved to be ineffective. Conclusion       1) The most important steps are to locate and incise the lacrimal sac during dacryorhinocystotomy operation. 2) It is an indispensible step for surgical therapy to change dressings at regular intervals under nasal endoscopy. 3) It is reliable and stable to treat the fistulas with Ear-brain glue.

    Endoscopic treatment of 448 cases of intractable epistaxis
    SHI Yuyong, LIU Dingrong
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  62. 
    Abstract ( 1154 )   PDF (289KB) ( 1278 )   Save
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    Objective       To study the endoscopic treatment method of intractable epistaxis and to explore its effect. Method       The bleeding sites  were searched and treated under nasal endoscopy. Result       426 cases of bleeding were successful after one-time treatment with a success rate of 95.1%.  Conclusion        Epistaxis treatment under nasal endoscopy has advantages of clear field of vision, complete bleeding, and stable effect.

    Clinical effects of a network multimedia amblyopia training  system on refractive error amblyopia
    DENG Zhifeng1, FAN Qingxia2, WU Qi1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  81. 
    Abstract ( 1075 )   PDF (320KB) ( 1331 )   Save
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    Objective      To discuss the clinical effects of the network multimedia amblyopia training system on refractive error amblyopia. Methods      35 cases (60 eyes) with refractive error amblyopia were selected to use the training system in the amblyopic treatment center. The effects were evaluated, and the relationships between  amblyopia degree, age and  effects were analyzed. Results      After 5 treatment courses, the general effective rate was 96.7%. The effective rate was 100% in the mild and moderate groups and 33.3% in the severe group (P<0.05). The effective rate was 100% in the <10-year group and 50% in the ≥10-year group (P<0.05). Conclusion      The network multimedia amblyopia training system provides an interesting and effective ambloypia treatment with low costs.

    Clinical analysis of risk factors of dry eye
    XIN Zhaoting1, YANG Shasha1,2, WU Xinyi1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  83-86. 
    Abstract ( 932 )   PDF (362KB) ( 1613 )   Save
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    Objective      To investigate the distribution of dry eye and analyze the factors associated with dry eye and provide clinical guidance for prevention and treatment.  Methods    112 dry eye outpatients were taken as the research objects. We did a questionnaire survey and several related tests(including tear film break-up time, Schirmer I test, and corneal fluorescein staining) were used to obtain  information of these dry eye patients. Results     In 112 cases of dry eye (31 males and 81 females), the prevalence progressively increased with age. The incidence of dry eye syndrome was related to a variety of factors, including local antibiotics drops, overuse of eyes, chronic ocular surface diseases, connective tissue disease and diabetes. Conclusions      Dry eye is a symptom of eye diseases caused by age, sex and many other factors. Patients with clinical symptoms need to take related tests to get a clear diagnosis and treatment.

    Clinical curative effect of vitrectomy combined with implantation of Artisan iris-fixated intraocular  lens in traumatic dislocation of the lens
    LIU Bei1, WANG Lili2, ZHU Zhongqiao1, DU Shanshuang1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  87-89. 
    Abstract ( 1172 )   PDF (479KB) ( 1319 )   Save
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    Objective     To observe the clinical curative effect of vitrectomy combined with implantation of Artisan iris-fixated intraocular lens in traumatic dislocation of the lens. Methods     From January 2008 to October 2010, 7 patients(7 eyes) with traumatic dislocation of the lens underwent vitrectomy combined with implantation of Artisan irisfixated intraocular lens. In 1 month of  follow up,  surgical indications, related complications and clinical curative effect were summarized. Results     The difference between  postoperative natural visual acuity in 1 month of the follow up and  preoperative best corrected vision was not significant. The difference between  postoperative best corrected vision acuity in 1 month of the follow up and the preoperative best corrected vision acuity was not significant. The difference of corneal endothelium cell density between preoperative count and postoperative count in 1 day and 1 week of the follow up was not significant. The difference of corneal endothelium cell density between preoperative count and postoperative count in 1 month of the follow up was significant. In the follow up,  postoperative hyphema happened in 1 case, postoperative edema of corneal endothelium happened in 2 cases and postoperative intraocular pressure  increased in 1 case. All became selfhealing or were cured by medicine. Conclusions     Vitrectomy combined with implantation of Artisan iris-fixated intraocular lens is feasible for traumatic dislocation of the lens corresponding with internalized conditions, and is a safe and effective method for traumatic dislocation of the lens.

    Corneal epithelium damage in teenagers undergoing  overnight orthokeratology
    MEI Fang, CHEN Zhijun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  90-92. 
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    Objective      To evaluate corneal epithelium damage in teenagers undergoing overnight orthokeratology treatment. Methods      201 teenagers  (375 eyes) who accepted overnight orthokeratology treatment from September 2009 to December 2010 were observed. The relationship between the degree of myopia before treatment(-1.00~-2.00D, -2.25~-4.00D and -4.25~-6.00D), the occurrence time and the incidence rate of corneal epithelium damage after  orthokeratology treatment were statistically analyzed. Results      The incidence rate of corneal epithelium damage was 17.1%,31.4% and 42.4% in the three groups respectively, and the difference was significant(χ2=13.4394,P=0.001). The occurrence time of the corneal epithelium damage among the three groups was also statistically significant(χ2=12.45,P=0.002). Conclusion     Myopia degree is positively related with  incidence rate and  time of corneal epithelium damage. Therefore,  earlier orthokeratology treatment should be given in order to get better control of myopia.

    Association between foveal photoreceptor integrity and visual outcome  in central serous chorioretinophy
    XIA Xinchang, CHEN Xuan, LIU Jian, ZHANG Shaoguang, WANG Yu
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2011, 25(4):  93-96. 
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    Objective     To evaluate the correlation between visual outcome and foveal photoreceptor integrity after treatment of eyes with chronic central serous chorioretinophy(CSC). Methods    The medical records of 30 patients (30 eyes) with chronic CSC who were treated with verteporfin photodynamic therapy (PDT) were retrospectively studied. Using spectraldomain optical coherence tomography, the status of the inner segment and outer segment photoreceptor junction (IS/OS) was assessed as a hallmark of the integrity of the foveal photoreceptor layer. Results      At the finial visit, 26(86.7%) eyes had stable or improved vision. A complete or discontinuous IS/OS line was detected beneath the fovea in 20 (66.7%) and 6 (20.0%) eyes, respectively, whereas 2 (6.7%) eyes had no IS/OS line. Eyes with a continuous or discontinuous IS/OS line had better final visual acuity than eyes without an IS/OS line. Conclusion      Integrity of the photoreceptor layer beneath the fovea is associated with the final visual acuity in chronic CSC after PDT.