Objective To constmct the training system of specialized nurses in operation room.Methods The Delphi method was used to organize two rounds of consultations by 20 experts from July 1st to Nov.1st 2012.Results In the two rounds of expert consultations,experts' positive coefficients were 95％ and 100％,the authoritative coefficients of experts were 0.86 and 0.89.The evaluation system included 10 first level entries and 38 second-level entries,all entries' importance assignment was more than 4.0,all variable coefficients were less than 0.25.Conclusions The positivity and authority of experts in this study were in high degree,the concentration and harmonization of experts' opinions were relatively high,all entries' weight were relatively high.So the system has high scientific nature and reliability to provide a theoretical basis for specialized nurses in operation room.

Objective To construct an index system of the performance appraisal to clinic nurses.Methods According to the BSC,KPI and SMART principal,we constructed the primary evaluation indexes.And then two rounds of Delphi consultation were conducted.Results An index system of the performance appraisal to clinic nurses was composed of 5 level-1 indexes,including 22 indexes.Conclusions The index system has high scientific nature and reliability to provide a theoretical basis for the performance appraisal to clinic nurses.

OBJECTIVE To explore the method of replacing nasal packing after septoplasty. METHODS A total of 158 patients who had undergone septoplasty were included in this study. The patients were randomly allocated into two groups: packing group and suturing group. Postoperative signs and symptoms were compared between the two groups by visual analogue scale(VAS). RESULTS The patients of packing group experienced significantly more postoperative nasal pain, headache, epiphora, tinnitus/ear fullness, sleep disturbance after surgery(all P<0.05). There were no statistically significant differences between two groups in terms of nasal congestion, hemorrhage, septal hematoma, nasal septum perforation and local infection(all P>0.05). CONCLUSION Nasal septum continuous suture is a simple technique to decrease patients' suffering. It does not increase the complications and is a feasible method to replace nasal packing after septoplasty.

Objective To discuss the clinical application of internal stent in tracheal stenosis.Methods 101 cases of large airway stenosis were treated with the self-expanding Ni-Ti alloy stents through oral cavity(41 cases)or nasal cavity(60 cases) under X-ray guided.Results The placement of Ni-Ti stents in all cases was successful one time.Of 64 cases,tracheal stents were introduced,bronchial stents,tracheal and bronchial stents were set up in 64,20 and 17 cases respectively.Shortness of breath was relieved obviously after process.Conclusion The placement of Ni-Ti stent is an effective and safe method for the treatment of large airway stenosis.

Objective To evaluate the efficacy of computed tomography guided radiofrequency(RF) ablation of non-small cell lung carcinoma with a clustered electrode.Methods 71 patients were allocated to 2 group:the group A(36 patients) were undergone RF tissue ablation 38 times and analysed image data,tumor size before and after the procedure were compared,the group B(35 patients) were treated with the combined chemotherapy of "FAP" or "CAP".Results The group A thirty-six cases at 10 days,twenty at 30 days,fifteen at 60 days after the ablation,all patients were repeatedly examined by CT scans,respectively.The tumor size was decreased by 20% at 10 days in 69% patients,decreased by 30% at 30 days in 75% patients,decreased by 50% at 60 days in 53% patients and disappeared in 13%,no operative death was noted,the effective rates were 66% in group A and 22 9% in group B respectively(P

Objective To explore the characte ristics of pure tone threshold (PTT) in auditory neuropathy. Methods The results of PTT audiometry were analysed in 48 patients with auditory neuropathy and compared with that of cochlear deafness. Results PTT audiograms in auditory neuropathy group r evealed curves including ascending slope, peak, spoon, letter W, lain letter S, flat, gentle slope. Binaural symmetric PTT audiograms were seen in 38 cases and asymmetric in 10 cases. The auditory threshold in auditory neuropathy showed a e levated range from mild to moderate degrees. Elevated degrees of auditory thresh old in left and right ears were consistent. The elevations of low-frequency audi tory threshold or in the main feature of low-frequency auditory threshold were 9 3.75% (90/96 ears) in the PTT audiograms. Conclusion The elevations of biauricular symmetric and ba sic symmetric low-frequency auditory threshold or in the main feature of low-fre quency auditory threshold were important characteristics of auditory neuropathy.

0.05). Upward-sloping and spoon audiogram were 60.83% (73/120 ears). Inducing rate of acoustic reflex(AR) was 21.95%.Speech discrimination scores(SDS) were 9.94?11.89%. Auditory brainstem response(ABR) was absent or severely abnormal.Distortion product otoacoustic emission(DPOAE) was normal or roughly normal.Conclusion Patients with auditory neuropathy were predominantely juveniles. Incidence of female cases and cases from rural areas were higher. Pure tone audiometry showed mainly bilateral mild and moderate hearing loss at low-frequencies.

Objective To study the clinical findings and audiological characteristics of auditory neuropathy. Methods Clinical findings, pure tone threshold, acoustic impedance audiometry, speech audiometry, auditory brainstem response (ABR) and distortion product otoacoustic emission( DPOAE) were analyzed in 23 cases of auditory neuropathy. Results The patients were predominantly youngster, female more than male. Pure tone audiometry revealed mainly binaural symmetric upward - sloping audiogram with mild and moderate hearing loss at low frequencies. Speech discrimination score was obviously reduced, which was disproportionately to the pure tone threshold. Ipsilateral and contralateral stapedial reflex were absent. ABR was severely abnor- mal. DPOAIE was normal or nearly normal. Conclusion Clinical findings and systemic audiometry revealed the main characteristics of auditory neuropathy, which could be used not only for the understanding, but also for the diagnosis of this disease.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease due to glucocorticoid biosynthesis enzyme deficiency,in addition to the common types such as 21-hydroxylase,11 β-hydroxylase deficiency,also include rare types such as 3 β-hydroxysteroid dehydrogenase deficiency,17α-hydroxylase deficiency and congenital lipoid adrenal hyperplasia (CLAH).These rare types of CAH have multiple clinical manifestations,which are easily missed or misdiagnosed.This article focus on molecular genetics,pathophysiology,clinical manifestations and treatment principles of above 3 rare types of CAH.

Objective The diagnosis of low frequency sensorineural hearing loss is examined for clinical applications.Methods Pure tone threshold (PTT),acoustic impedance,auditory brainstem response(ABR),distortion product otoacoustic emissions(DPOAE),electrocochleogram(ECochG) and imaging examinations of CT or MRI were performed on 56 cases with low frequency sensorineural hearing loss.Results Among 56 cases of low frequency sensorineural hearing loss,38 cases with sudden low frequency sensorineural hearing loss,9 with Meniere's disease,6 as auditory neuropathy,1 case of acoustic neuroma,1 case of multiple sclerosis and 1 case with arachnoid cyst of cerebellar hemisphere surface.Conclusion Low frequency sensorineural hearing losses occurred in varied diseases.A comprehensive approach should be taken to diagnose this hearing loss and if necessary,CT or MRI can be utilized to confirm the standard audiologic evaluations.