Objective To compare the severity of sensorineural hearing impairment resulted from radiotherapy (RT) and radiochemotberapy (CRT) in patients with nasopharyngeal carcinoma (NPC). Methods Between March 2002 and May 2007, 100 initially diagnosed NPC patients in Shandong Tumor Hospital and Qi Lu Hospital were randomized to RT group and CRT group. All patients underwent intensity modulated radiation therapy. In CRT group, concurrent and adjuvant CDDP were administered (CDDP 25 mg/m2/d for 3 days to 4 cycles). Pure tone auditory threshold examination was performed 1 week ,6 months, 1 year and 2 years after the completion of radiotherapy. Statistical analyses were performed using Mann-Whit-ney U test,chi-square test and Fisber's exact probability test. Results The high-frequency threshold was significantly increased in CRT group comparing with RT group at 1- and 2-year after the treatment. In RT group, the hearing threshold was impaired immediately after the treatment, partially recovered within the first year but impaired again after 2 years. In CRT group, hearing threshold was impaired at the same time and kept getting worse until 1 year after radiotherapy, which could not be recovered. Conclusions Patients with NPC treated with radiotherapy and concurrent/adjuvant chemotherapy have more severe sensorineural hearing impairment comparing with those with radiotherapy alone, especially to the high frequency sound in the speech range. Inner ear tissue tolerance should be redefined for patients receiving radiochemotherapy.

Objective? To explore the effects of the problem-oriented intervention model on major nursing issues, self-care behavior and illness perception in elderly patients with type 2 diabetes. Methods? Totally 112 elderly patients with type 2 diabetes admitted in the First Hospital of Jiaxing from September 2016 to September 2017 were selected by convenient sampling and divided into the control group (n=56) and the observation group (n=56) based on the time of admission. Patients in the control group received conventional nursing care, while patients in the observation group received conventional nursing care in addition to problem-oriented nursing interventions. The Omaha Problem Classification Scheme was used to evaluate the nursing issues in the two groups, and the Chinese version of Summary of Diabetes Self-Care Activities (SDSCA) and the Brief Illness Perception Questionnaire (BIPQ) were used to evaluate the intervention effects between the two groups. Results? After 6 months, the resolution rate of major nursing issues in the observation group was 82.93% (68/82), while that in the control group was 63.16% (48/76); (χ2=7.898, P＜ 0.05). The self-care behavior and illness perception in the observation group totaled (27.33±7.36) and (38.49±5.76), respectively, both higher than that in the control group (t=5.180, 7.201; P＜ 0.01). Conclusions? The problem-oriented nursing intervention model can effectively enhance the self-care ability and illness perception in elderly patients with type 2 diabetes.