OBJECTIVE: To investigate the clinical efficacy of self-made 32P applicator for treating different kinds of keloid. others were treated with surgical excision combined with self-made 32P applicator. The 32P applicator was shaped according to the size and shape of the diseased region and the application time was calculated according to the dose rate and the decay correction. 4.0-5.0 Gy was applied in every diseased region in each of the four days (one course), and 4-6 courses in total was required, with 4 weeks of intervals following each course. For children, dose was reduced to 4 Gy or less once a day in every diseased region. Patients in the operation combined with application group were performed keloids excision first. Then 32P applicators were applied to the wound without any exudation in the same way as above. RESULTS: Of all the 39 patients (lesion thickness≤0.3 cm, 32P applicator therapy only), 32 ones was cured (82.1%), with the total effective rate of 98%. For patients with lesion thickness > 0.3 cm, the total effective rate of 32P applicator therapy and surgical excision combined with self-made 32P applicator were 55.6% and 93.3% respectively, and the difference was ofsignificance (P < 0.01 ). Among these patients, those with disease course less than 9 months had the effective rates of 25.0% and75.0% corresponding to 32P applicator therapy only and surgical excision combined with self-made 32p applicator respectively.For those with long course of disease, the effective rates were 13% and 77% respectively. A total of 26 patients experienced local buming and slight pain during the 32P applicator treatment, and all the symptoms were relieved by using calamine lotion; 5 patients and 2 patients expedencad grade Ⅰ and Ⅱ radio dermatitis respectively, which were relieved by using Mupirocin Ointment. No radio dermatitis of grade Ⅲ or above occurred to any patient. In addition, pigmentation or color changing occurred at local skins of cured patients.CONCLUSION: 32P applicator therapy is safe and effective for treating keloid. For patients with short disease course and lesion thickness ≤0.3 cm, 32P applicator therapy only is enough. Otherwise, patients are suggested to use 32P applicator after operation.

OBJECTIVE: To explore the causes of chronic cough in children and its outcome after treatment of chronic rhinosinusitis (CRS). METHOD: Fifty-six cases of children who were previously diagnosed as chronic cough by pediatrician with poor treatment outcomes, were made a definite diagnosis of CRS and then treated by otolaryngologist. RESULT: Fifty-six cases of children were made a definite diagnosis of CRS according to CT and/or nasal endoscopy examination. The cardinal symptom was cough in all cases, in which 35 cases (62.5%) with nasal congestion and rhinorrhea, 15 cases (26.8%) with snoring and mouth breathing, 6 cases (10.7%) with postnasal drip and expectoration. Among all the patients, stick purulent secretion in nasal cavity and posterior pharyngeal wall was found in 45 cases (80.4%), nasal polyps in 5 cases (8.9%), adenoidal hypertrophy in 21 cases (37.5%), nasal polyps and adenoidal hypertrophy in 4 cases (7.1%), allergic rhinitis in 19 cases (33.9%). After the combined treatment of CRS, 45 cases (80.4%) were cured, 9 cases (16.1%) relieved and 2 cases (3.6%) ineffective. CONCLUSION Chronic cough is the commonly cardinal symptom of CRS in children and it can be cured or relieved by combined treatment of CRS.
Child ; Child, Preschool ; Chronic Disease ; Combined Modality Therapy ; Cough ; etiology ; therapy ; Female ; Humans ; Male ; Rhinitis ; therapy ; Sinusitis ; therapy ; Treatment Outcome

Objective To assess the effectiveness of the clinical pathway for the treatment of advanced schistosomiasis he-patic fibrosis. Methods The duration of hospital stay,gross hospitalization expense,individual-paid expense,interior diame-ter of portal vein,levels of four serum hepatic fibrosis-related parameters(PIIIP,CIV,HA,and LN),and activities of ALT, AST andγ-GT were assessed and compared between the advanced schistosomiasis patients receiving the clinical pathway and ones receiving non-clinical pathway. Results There were 142 advanced schistosomiasis patients with hepatic fibrosis receiving the clinical pathway of anti-hepatic fibrosis. Compared with the patients receiving non-clinical pathway ,the gross hospitalization expenses reduced by 11.2％(t=6.310,P<0.05),and the individual-paid expenses reduced by 16.1％(t=4.326,P<0.05). The mean HA level was twice higher than the normal range,with a positive rising from 70.4％to 83.1％,and the abnormal rates of CIV andγ-GT were 64.1％and 28.9％respectively. Conclusions The clinical pathway can drastically reduce the treatment expenses in advanced schistosomiasis patients with hepatic fibrosis. However,the patients have a trend towards the persistent disease progression. Therefore,the researches of more effective therapeutic methods for advanced schistosomiasis hepatic fibro-sis are urgently needed.