Family Health ; Humans ; Paraganglioma ; diagnosis

Objective To research the pathogen characteristics and influencing factors for peritonsillar peripheral space infections in acute tonsillitis patients,so as to take measure to reduce the peritonsillar peripheral space infections.Methods 898 acute tonsillitis patients who received treatment were chosen as study subjects.Bacteria analyzer was adopted to identify pathogens.Chi-square test was used to analyze the univariate factor,and logistic regression analysis was conducted to different factors.Results 228 patients were involved the complications of peritonsillar peripheral space infections(cellulitis in 52 cases or abscesses in 176 cases),and the infection rate was 25.4％.Bacterial cultivation performed in 177 patients and positive results were detected in 107.The top three infections bacteria were Staphylococcus aureus (21.5％),Streptococcus viridians (19.6％) and Klebsiella pneumoniae (15.9％).Univariate factor analysis found that the history diabetes and peritonsillar peripheral space infections,age,acute phase of smoking and drinking,fatigue,nutritional status,class of antibiotic use,tonsillitis type,educational level and the long first diagnosis time were risk factors for peritonsillar peripheral space infections,and the differences were significant (x2 =39.851,8.818,89.041,87.266,30.417,21.499,13.472,64.548,12.223,62.871,70.749,all P ＜ 0.05).Logistic regression analysis found that acute phase of smoking and drinking,age,fatigue,tonsillitis type and the long first diagnosis time were independent risk factors for peritonsillar peripheral space infections patients with acute tonsillitis (OR =2.873,5.311,5.876,0.290,2.244,2.369,all P ＜ 0.05).Nutritional status and educational level had beneficial effect to peritonsillar infections event (OR =0.290,0.461,all P ＜ 0.05).Conclusion Acute tonsillitis is easy to cause peritonsillar peripheral space infection,it should be paid much attention and strengthened prevention.The pathogens causing peritonsillar peripheral space infections in acute tonsillitis is still mainly Staphylococcus aureus.After the analysis of related factors,the certain measures should be taken to reduce the complications rate of peritonsillar peripheral space infections in acute tonsillitis.

Objective To review the recent diagnosis and treatment experience with deep neck infection and emphasize the importance of radiologic evaluation,microbiology and appropriate treatment selection in these patients.Methods A respective review was conducted in 95 cases who were diagnosed as having deep neck from Jan.2006 to March 2015.Results The primary diseases in 95 patients with deep neck infection were acute tonsillitis or acute laryngitis (27 cases),infection of upper respiratory tract (23 cases),odontogenic infection or oral inflammation (16 cases),foreign bodies in esophagus(9 cases),acute cervical lymphadenitis (5 cases) and cause uncertain (15 cases).Computed tomography was performed in all of patients to identify the location,extent,and character (cellulitis in 47 cases or abscesses in 48 cases) of the infections.The locations of abscess were parapharyngeal abscess (25 cases),retropharyngeal abscess (9 cases),submaxillary space abscess (6 cases),pretracheal space abscess (5 cases) and esophageal abscess (3 cases).Complications:mediastinitis (2 cases),pericarditis (1 case),bilateral pneumothorax (2 cases),and upper digestive tract (1 case).Bacterial cultivation performed in 35 patients and positive results were detected in 21.All patients were given intravenous antibiotic therapy.Tracheotomy was performed in 4 cases.Preoperative contrast enhanced CT was performed in 42 patients and indicated the formation of abscess.Three cases with the symptoms of septic shock were transferred to ICU and one was cured.All the patients were cured except two who died of massive hemorrhage of upper digestive tract and septic shock.Conclusions The airway patency in patients with deep neck infections must be ensured.Drainage may be mandatory in selected cases at presentation or in cases who fail to respond to parenteral antibiotics within the first 24-48 hours.Imaging evaluation plays a significant role in the diagnosis and rational therapeutic management in deep neck infection.Bacterial cultivation can help to make the effective treatment and provide reliable evidence for the etiopathogenisis.

In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.