Objective: To investigate the possible association between globus pharyngeus and thyroid abnormalities. Methods: Forty six patients with globus pharyngeus and 50 non globus pharyngeus patients were investigated by using 7.5 MHz high resolution thyroid ultrasound. The micro abnormatities in 2 groups were compared. Results: The incidence of thyroid abnormalities in globus pharyngeus group was 58.9%(27/46),and it was significantly higher than that(18.0%,9/50)in non globus pharyngeus group( P

0.05). CONCLUSION The secar of oropharynx can be regarded as a predictive index for OSAHS severity and guideline for operation, but the change of secar after operation can not be used as a predicitive index for therapeutic effectiveness.

OBJECTIVE: To explore the clinical characteristic and diagnosis of modern laryngeal tuberculosis. METHOD: A retrospective research among 33 patients of laryngeal tuberculosis, with definitive pathological result, had been done in the laryngeal-endoscope room in our department. RESULT: The main symptoms of laryngeal tuberculosis are hoarseness and sore throat. Most of the patients did not accompany with pulmonary tuberculosis (TB) (63.6%). Few of them accompany with low-grade fever, night sweat and malnutrition (24.2%). There are three types in the laryngeal-endoscope vision: edema type, hyperplasia type and ulcer exudation type. The positive rates of PPD and phlegm bacteria examination are respectively 87.9% and 68.4%. There can be seen in the pathological slides the interstitial phagocytes and giant cell reaction. Granuloma consisting of epithelioid cell and Langhans' cells is coexistent with necrotic tissue. Cheese necrosis is the typical characteristic of the disease. CONCLUSION Severe local symptoms of laryngeal with slightly general symptoms are the clinical characteristics of modern laryngeal tuberculosis. The diagnosis of it depends mainly on the process of the disease, laryngeal-endoscope examination and PPD examination combined with phlegm bacteria examination. And the final diagnosis is based on the pathological biopsy and tubercular bacillus culturing.
Adult ; Aged ; Female ; Humans ; Laryngoscopy ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Laryngeal ; diagnosis

On the basis of present hospital logistics management at home, the authors analyzed lean logistics management in hospitals and its practice in engineering works from the perspective of Changgung-featured management system, in terms of standard operating procedure, refined equipment maintenance, and routine skills training. It is held that refined logistics management can guarantee smooth operation and operating cost control for hospitals, which offers references for refined logistics management of hospitals in the country.

OBJECTIVE: To explore the clinic characteristic and curative effect of staging tympanoplasty for chronic suppurative otitis media and cholesteatoma otitis media. METHOD: Curative effects of 132 patients cured by staging tympanoplasty and 325 patients cured by no staging tympanoplasty were retrospectively analyzed. Curative effects include ABG value (the reduced value of air-bone conduct gaps after operation), recrudescence of cholesteatoma, tympanic membrane reperforation and wet ear after operation. RESULT: In staging tympanoplasty group, ABG is 28.4 dB, rate of tympanic membrane reperforation is 1.5%, recrudescence of cholesteatoma is 0% and rate of wet ear after operation is 0%. In no staging tympanoplasty group, ABG is 21.3 dB, rate of tympanic membrane reperforation is 2.2%, recrudescence of cholesteatoma is 4.0% and rate of wet ear after operation is 1.2%. CONCLUSION The ABG, the rate of recrudescence of cholesteatoma in staging tympanoplasty group is much better than that in no staging tympanoplasty group. Tympanic membrane reperforation and wet ear after operation rate have no significant difference in statistic between two groups. We can conclude that staging operations will maintain and improve hearing level more effectively compare to no staging operation.
Adolescent ; Adult ; Aged ; Child ; Cholesteatoma, Middle Ear ; surgery ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; surgery ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; Young Adult

Objective:To understand the attitudes of obstetricians and midwives towards the development of nurse practitioner in China.Methods:The phenomenological method in qualitative research was used to conduct semi-structured interviews with 24 medical staff in the third-A general hospitals and women and children's hospitals in Guangzhou and Dongguan City. The interview data were analyzed by Colaizzi's 7-step analysis method.Results:Four themes were extracted, namely, unanimous approval attitude, imperfect midwifery discipline and management system, insufficient independent practice capacity, low support and recognition in midwifery area.Conclusions:Obstetricians and midwives hold a positive attitude towards the development of midwifery nurse practitioner. At the same time,its development is restricted in many aspects. They can gradually develop midwife′s legislation, improve the management system, try some prescription rights, and increase the education and talents of midwifery subjects. Cultivation and promotion of social recognition will help gradually train midwifery nurse practitioner in China.

Objective:To investigate the factors influencing the short-term prognosis of patients with acute diquat poisoning (ADQP).Methods:Patients with ADQP admitted to the Affiliated Hospital of Xuzhou Medical University and Xuzhou Occupational Disease Prevention Hospital from August 2015 to July 2022 were retrospectively selected. Patients were divided into survival group and death group according to 30-day survival status after poisoning. The general data and the results of the first laboratory examination after admission were compared between the two groups. Logistic regression analysis was used to analyze the independent risk factors associated with prognosis. And the receiver operating characteristic (ROC) curve was drawn to evaluate the prognostic value of risk factors in patients with ADQP.Results:A total of 79 ADQP patients were included in this study, including 40 patients in the survival group and 39 patients in the death group. There were statistically significant differences in the age, poisoning dose, white blood cell, alanine aminotransferase, aspartate aminotransferase, serum creatinine, blood urea, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, and systemic immune inflammation index (SII) between survival and death groups (all P<0.05). Multivariate logistic regression analysis showed that the poisoning dose ( OR=1.018, 95% CI: 1.001-1.035, P=0.033), serum creatinine ( OR=1.049, 95% CI: 1.005-1.095, P=0.028), and SII ( OR=1.001, 95% CI: 1.000-1.002, P=0.029) were independent risk factors for the prognosis of patients with diquat poisoning. The areas under the curves of the combined detection of poisoning dose, serum creatinine and SII was 0.968, the sensitivity was 0.949, and the specificity was 0.900, which were higher than those of the single index. Conclusions:The poisoning dose, serum creatinine and SII are independent prognostic predictors of patients with ADQP. The combination of three independent factors has higher sensitivity and specificity in evaluating the prognosis of ADQP, which could be used as a reliable indicator to predict the prognosis of patients with ADQP.

Objective:To explore the optimal matching of the current parameters about artificial facial nerve (AFN) for inducing contraction of the orbicularis oris muscle (OOM) in rabbit with peripheral facial paralysis.Methods:According to the combinations of different stimulus parameters, at different time points, we used AFN to induce contraction of the affected side OOM of the paralyzed rabbit in waking state. We recorded the current amplitudes of the threshold stimulation and peak stimulation under each combination, then compared the total charge of the stimulus consumption under different combinations.Results:Compared the total stimulus charge consumption of the AFN threshold stimulation and that in the peak stimulation respectively under different stimulus frequency and pulse width matching combinations, we found that the frequency, the pulse width and the interaction of the frequency and pulse width among different groups could affect the total charge, the differences were statistically significant ( P<0.05). Conclusions:When AFN stimulus frequency is 60 Hz and the stimulus pulse width is 100 μs, the output current intensity is relatively lowest and the total consumed charge is the lowest under the premise of effectively inducing the paralytic side OOM contraction. Thus we recommend this stimulus parametric combination as the optimal combination for meeting the low power consumption of AFN.

Objective:To investigate the therapeutic effect of exosomes derived from remote ischemic conditioning on neurological dysfunction after cardiopulmonary resuscitation in a rat model of cardiac arrest and the relationship with glycocalyx protection.Methods:Exosomes were isolated from the blood of healthy adult male Sprague-Dawley rats using ultracentrifugation after undergoing remote ischemic conditioning for use as intervention drugs. Nanoparticle tracking analysis technology was used for exosome detection. Thirty-six adult male Sprague-Dawley rats were randomly assigned to 3 groups ( n=12 each) :Sham group, Control group and Exosome group. Cardiac arrest was induced by asphyxia for 7 min in the Control and Exosome groups. Placebo or exosomes (1×10 10 Particles) were infused intravenously at 5 min after the rats had returned of spontaneous circulation. Neuropsychological deficit score (NDS), open field test, Y maze and Morris water maze were used to assess neurological outcomes. The levels of plasma Hyaluronic acid (HA) and syndecan-1 (Sdc-1) were detected by Elisa. The expression levels of matrix metalloproteinase-2/9 (MMP-2/9) in hippocampal CA1 region were detected by Western blot. Results:After undergoing remote ischemic conditioning, the plasma levels of exosomes were elevated in rats compared to normal rats. Compared with the control group, the behavioral experiment of rats in the exosomes group were significantly improved, as evidenced by an increase in horizontal locomotor distance (5.86±2.89 vs. 17.53±5.51, P< 0.05), an increase in the correct rate of spontaneous alternation (13.29±15.07 vs. 42.63±10.25, P< 0.05), and a shortening of avoidance latency (25.83±8.54 vs. 13.49±4.55, P< 0.05). Plasma HA and Sdc-1 levels were significantly lower 24 h after resuscitation (HA: 26.34±9.83 vs. 14.84±6.26, P< 0.05; Sdc-1: 0.05±0.03 vs. 0.02±0.02, P<0.05), along with significantly lower MMP-2/9 levels in hippocampal tissue. Conclusions:Exosomes extracted from the plasma of rats undergoing remote ischemic conditioning can improve neurological dysfunction after cardiac arrest in rats, and the mechanism may be related to the inhibition of metalloproteinases and the reduction of endothelial glycocalyx degradation.

Objective:To investigate the predicting value of high sensitivity C-reactive protein (hs-CRP) and albumin (Alb) ratio on prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A total of 107 patients with IHCA and spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) in the Affiliated Hospital of Xuzhou Medical University during January 1, 2017 and September 30, 2020 were selected as the subjects and divided into the survival group and death group according to the survival condition on day 14 after IHCA. The correlation between ratio of high sensitivity C-reactive protein/albumin (hs-CRP/Alb) and the prognosis of patients was analyzed.Results:No statistical significant differences were found between the survival and death groups in sex, age, medical history, ECG monitoring, recovery ventilation mode, percentage of first monitoring of heart rate and pre-resuscitation Alb (all P > 0.05). However, there were significant differences in the percentage of non-cardiogenic CA and adrenaline dose > 5 mg, time of CPR, concentrations of blood lactic acid, Alb, hs-CRP, and ratio of hs-CRP/Alb (all P < 0.05). Logistic regression analysis showed that percentage of adrenaline dose > 5 mg, concentration of blood lactic acid, time of CPR, and ratio of hs-CRP/Alb were independent risk factors for predicting death. ROC curve analysis showed that hs-CRP/Alb ratio, and concentration of hs-CRP and Alb had predictive value on the death of patients with IHCA; the areas under the curves of hs-CRP/Alb ratio, hs-CRP and Alb concentration were 0.876, 0.864 and 0.745, respectively. The predictive efficiency of hs-CRP/Alb ratio was better than that of hs-CRP concentration or Alb concentration. Conclusions:hs-CRP/Alb ratio has predictive value for the prognosis of patients with IHCA and the predictive value is superior to that of hs-CRP and Alb concentration.