OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.

Objective: To establish the quality control standard of Xiangshapingwei Pills (Rhizoma Atracylodis Pericarpium Citri Reticulatae Cortex Magnoliae Officinalis Radix Aucklandiae etc.)Methods: Rhizoma Atractylodis , Radix Auklandiae, Cortex Magnoliae Officinalis, Pericarpium Citri Reticulatae in Xingshapingwei Pills were identified by TLC. The content of hesperidin in Xiangshapingwei Pills was determined by RP HPLC with C 18 reversed phase column, mobile phase (methanol∶water∶acetic acid=30∶65∶5),detection wavelength at 283nm and flow rate 1.0mL?min -1 .Results: Hesperidin showed a good linear relationship at a rang of 0.8～4.0?g. r = 0.9993 . The average recovery was 96.7%, and RSD was 2.42%.Conclusion: The method is accurate and quick, and can be used for the quality control of Xiangshapingwei Pills.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.