OBJECTIVE: To explore and summarize the operation method and operation stage for cochlear implant with chronic suppurative otitis media, to provide the clinical reference for cochlear implant with chronic suppurative otitis media. METHOD: The clinical data of 6 cases of cochlear implant with chronic suppurative otitis media from Jun 2006 to Mar 2009 in our hospital was analyzed retrospectively. The operation stage. surgical skill, possible risk and prognosis was analyzed and summarized. RESULT: 3 of 6 cases received single stage subtotal petrosectomy and cochlear implant. 3 of 6 cases received subtotal petrosectomy, they received staged cochlear implant 1 to 6 months later. No complications occurred, all of the cochlear implanted had good open set speech perception. CONCLUSION Staged operation was the first choice for cochlear implant with chronic suppurative otitis media. Single stage operation took potential risks, it should be done cautiously. The key points for the operation was the clearance of the pathological tissue totally, this required good surgical skill and operation instrument.
Adolescent ; Aged ; Chronic Disease ; Cochlear Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; surgery ; Retrospective Studies ; Treatment Outcome

Objective To improve the diagnosis and treatment of the kidney injury.Methods 136 cases of the kidney injury were analyzed retrospectively.Results 5 cases died,the other cases were cured.69 cases were followed up for 1～3 years,the cystic kidney function was all normal.Conclusion On time,accurate proceed assessment for the kidney injury,controlling strictly the digit advertises for the operation or not operation is a key to treating kidney injury.

Objective To explore the prevention and cure methods of the urethra prostate electricity cutting(TURP) on the bleeding after the benign prostatic hyperplasia(BPH) treating.Methods 35 cases with BPH of the bleeding patients after TURP were statistically analyzed.Results 26 examples turned for the better after general treatment;6 examples turned for the better after resectoscope wash gore and gave or got an electric shock the hemostasis;3 examples changed to the surgical operation hemostasis cured.Conclusion Accurate disposal inside operation and process behind operation is a key to decrease bleeding after the TURP of the BPH.

Objective To explore the correlation between coagulation and coagulation suppresion system disorders of portal vein thrombosis in patients of portal hypertension undergoing splenectomy.Methods Clinical data of 33 patients with postoperative portal vein thrombosis were enrolled.The clotting and coagulation inhibitor in portal vein blood and peripheral blood was detected and analyzed.Results The Hb,APTT,FIB,factor Ⅶ,protein C,AT-Ⅲ,CD62P of portal vein blood and peripheral blood before the surgery and on postoperative day 1,day 7,day 14 were no significant difference (P ＞ 0.05).The WBC,PLT,PT,D-Dimer of in portal vein blood before surgery were (2.9 ± 1.4) × 109/L,(37.5 ± 20.7) × 109/L,(16.1 ± 2.9) seconds,(0.7 ± 0.3) μg/ml,which were significantly different from those on postop day 1 (13.7 ±4.4) × 109/L,(86.3 ±34.6) × 109/L,(6.9 ±5.7) seconds,(16.1 ±2.9) μg/ml; day 7 (10.7 ±4.3) × 109/L,(312.4 ±137.2) × 109/L,(14.4 ±2.9) seconds,(7.6 ±4.4) μg/ml and day 14 (7.7 ± 3.3) × 109/L,(486.3 ± 216.7) × 109/L,(14.4 ± 2.9) seconds,(5.5 ± 4.4) μg/ml (P ＜ 0.05).WBC,PLT,PT,D-Dimer in preop peripheral blood were (2.4 ±0.8) × 109/L,(44.4 ± 25.8) × 109/L,(16.3 ± 3.0) seconds,(0.6 ± 0.4) μg/ml,which were significantly different from those on postop day 1 (13.7 ± 5.7) × 109/L,(75.1 ± 29.3) × 109/L,(13.7 ± 2.6) seconds,(6.8 ± 5.3) μg/ml; day 7 (10.6 ± 4.8) × 109/L,(337.9 ± 141.3) × 109/L,(14.0 ± 2.1) seconds,(7.6 ± 5.5) μg/ml and day 14 (7.8 ±3.9) × 109/L,(504.9 ±237.4) × 109/L,(14.0 ±2.1) seconds,(5.4 ±4.9) μg/ml postoperative (P ＜ 0.05).Conclusions The cause of postsplenectomy portal vein thrombosis is multifactorial.The dysfunction of coagulation-coagulation suppression system was just one of the conditions conducive to portal vein thrombosis after splenectomy.

OBJECTIVE: To explore the clinical characteristics, diagnosis and surgical management of tympanosclerosis. METHOD: The data of 73 patients who underwent surgery for tympanosclerosis were retrospectively analyzed with respects to the clinical characteristics, diagnosis and management. RESULT: Seventy-three patients with tympanosclerosis (involving 73 ears) , including 17 patients with sclerosis of tympanic membrane (type I), 23 patients with fixed Malleus-incus complex (type II), 8 (type III) with fixed stapes, and 25 (type IV) with extensive typannosclerosis. Sclerosis was seen most frequently in the malleus, incus and attic, followed by the tympanic membrane, incudomalleolar joint and other regions. Audiometry was performed for all the patients 1 weeks before and 1 year( the least) after operation, which were (51.70 ± 14.93)dB HL and (36.24 ± 11.58) dB HL respectively, with success rate 83% (61/73). CONCLUSION Most of the patients suffer from conductive hearing loss. Teatment of the sclerosis around stapes is a key point. Acording to the sites of lesion and hearing level, hearing structures should be reconstructed by the rules of tympanoplasty and stapes surgery.
Audiometry ; Ear, Middle ; pathology ; Hearing ; Hearing Loss, Conductive ; complications ; Humans ; Incus ; pathology ; Malleus ; pathology ; Myringosclerosis ; diagnosis ; surgery ; Retrospective Studies ; Stapes ; pathology ; Stapes Surgery ; Tympanic Membrane ; pathology ; Tympanoplasty

To investigate the effects of complex danshen solution and heparin on the changes of blood coagulation factors in rats with hemorrhagic shock, and to explore the therapy of coagulopathy by compound danshen solution, the rat model of hemorrhagic shock was set up, 40 SD rats were randomized into four groups: sham operation, shock, compound danshen solution and heparin groups, each group was composed of 10 SD rats. Plasma SFMC, TM, ATIII, D-D, t-PA, PAI levels and APTT were detected, incidences of bleeding complications between heparin and danshen group were compared. The results showed that plasma SFMC, D-D levels in shock group were higher but ATIII level in shock group was lower than that in sham operation group, compound danshen solution group and heparin group (P < 0.001), TM levels obviously increased in shock group and heparin group (P < 0.001). There was no significant difference between compound danshen solution and sham-operation groups. Plasma t-PA, D-D levels obviously increased after shock for 2 hours, PAI level reached the peak after shock for 4 hours, but t-PA decreased. After shock for 6 hours, plasma PAI descended, t-PA continually drop in, but PAI and D-D remained in higher levels. Plasma D-D level in heparin group was lower than that in shock group, t-PA level was higher than that in shock group, but there was no significant difference between in heparin and shock groups. Plasma t-PA, PAI and D-D levels in compound danshen solution group were lower than that in shock group. APTT of danshen group was lower than that of shock group and heparin group. Bleeding incidences was 30% in heparin group and 0% in danshen group, respectively. It is concluded that compound danshen solution may used to treat hypercoagulation and hyperfibrinolysis. In comparsion with heparin, danshen posses-ses advantages of safety with less bleeding complication and needs not tight monitor.
Animals ; Anticoagulants ; therapeutic use ; Blood Coagulation ; drug effects ; Blood Coagulation Factors ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Heparin ; therapeutic use ; Male ; Partial Thromboplastin Time ; Phytotherapy ; Plasminogen Activator Inhibitor 1 ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; chemistry ; Shock, Hemorrhagic ; blood ; drug therapy ; Thromboplastin ; metabolism ; Tissue Plasminogen Activator ; blood

Objective To explore the requirements of patients with recovery cerebral infarction and their family and the related factors. Methods 81 patients in hospital were investigated by a self-designed questionnaire. Results Needs score of 81 patients was 85 -230, and the average was (150.84 ±32.40).Medication care was the most needs of all the seven dimensions. 6 medication cares were in the top 10 needs,and 6 ordinary nursing in the last 10 items and pipeline nursing was the lowest and accounted for 14.8％. Male family members were different from the female in the nursing requirements [(21.70 ± 6. 11 ) vs ( 17.63 ±5.50) ; t =3.13, P ＜0. 01] ; Family members with and without care vigorous were also different [( 164.90 ±30.28) vs ( 142. 12 ± 30.81 ) ; t =- 3. 26, P ＜ 0. 01]. Other related needs of family members were care workers, relationship between the patients and the family members, and education status of family members, all the needs were statistically different ( P ＜ 0. 05 ). Conclusions Family members of patients with recovery cerebral infarction has several needs of different extent, such as medication care, psychological care of patients,self-needs of family members, safe family environments, recovery care and complication prevention care. Nurses should pay attention to the needs specifically.

Objective To design and develop a treatment unit selecting system in aim of enhancing work efficiency and safety,adjusting treatment unit workload,improving quality of medical care.Methods Various treatment techniques,immobilization devices and setup verification devices were modeled in software.Workload of treatment units were extract from the Record and Verify System.These two types of information were then combined with the unit's workload capability to calculate the optimal radiotherapy apparatus for tumor patient.Results The system had finished selecting radiotherapy apparatusv for more than 5 000 patients since its taking place of the old patient selecting methods.Maximum variation of daily treatment duration between treatment units had decreased from 4-5 hours (mean 4.22 hours) to 1-2 hours (mean 1.84 hours) since the system have been put into operation.Workload and device configuration of various units could be controlled by easily editing of the system configuration file.Conclusions The system developed not only accomplish patient selecting in an optimal and safe way,but also provide a way of easily control the treatment unit workload.

Objective To compare the prognostic value of different inflammation-based prognostic scores and Tumor Node Metastasis ( TNM) stage for patients undergoing radical resection of pancreatic cancer with the routine TNM stage in clinical practice.Methods Clinical data of 185 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed.Based on the inflammation-based prognostic scores ( Glasgow prognostic score ( GPS ) , neutrophil lymphocyte ratio ( NLR ) , platelet lymphocyte ratio ( PLR) , prognostic nutritional index ( PNI ) and prognostic index ( PI ) ) before surgery, univariate and multivariate analyses were used for identifying influential factors on patients′survival.Homogeneity of different scoring systems was compared using likelihood ratio chi-quare test, and linear trend chi-square test, and receiver operating characteristic ( ROC) curve were performed to compare the differentiating ability and single trend of the selected scores with those of routine TNM stage.Results In univariate analysis, preoperative weight loss, serum C-reactive protein, serum albumin, CA19-9, radical surgery, NLR, PLR, GPS, PI, PNI and TNM stage were all significantly associated with patients′overall survival after surgery (P<0.001).In multivariate cox risk model analysis, TNM stage, radical surgery, GPS, NLR, PLR, PI and PNI were independent risk factors for patients′survival after surgery.ROC curve showed that GPS had higher AUC than other scoring systems, but TNM stage had the highest AUC.The homogeneity, differentiating ability and single trend of GPS were higher compared to other inflammation-based prognostic scores, but those of TNM stage were the highest.Conclusions The inflammation-based prognostic scores like GPS, NLR, PLR, PI and PNI were independent prognostic factors for pancreatic caner patients′survival after surgery, and the prognostic value of GPS was superior to that of NLR, PLR, PI and PNI.

Objective To evaluate the short-and long-term outcomes of laparoscopy-assisted gastrectomy (LAG) for gastric cancer.Methods After studying the patients' demographic data,extent of gastrectomy and lymphadenectomy,as well as differentiation and tumor TNM stage,85 patients who underwent LAG were individually matched to 85 patients who underwent open surgery (OG) between October 2004 and March 2008.The operative time,intraoperative blood loss,postoperative recovery,complications,pathological findings,and follow-up data were compared between the two groups.Results The mean operative time was significantly longer in the LAG group than in the OG group (277 ± 62) min vs.(211 ±46) min,t =7.882,P ＜0.05,whereas intraoperative blood loss was significantly lower (161 ±90) ml vs.(267 ± 141) ml,t =-5.854,P ＜0.05.In addition,there was a significant reduction in the time to first flatus and postoperative hospital stay (3.7 ± 1.3) days vs.(4.2 ± 1.1) days and (10 ± 3) days vs.(12 ± 6) days,respectively t =-2.318,-2.325,P ＜ 0.05.There was no significant difference between the LAG group and OG group with regard to the number of harvested lymph nodes and overall postoperative complications.The 5-year disease-free survival rates and overall survival rates were 76％,78％,respectively,in LAG group and 75％,73％,respectively in OG group (all P ＞ 0.05).Conclusions LAG is suitable and minimally invasive for treating gastric cancer.Compared to OG,the LAG will not increase the risk of recurrence and mortality after surgery.