1.The clinical characteristics and treatment progress of otitis media in children.
Zhongfang XIA ; Weijia KONG ; Zhinan WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(7):505-508
Otitis media is a common problem in children, which may cause hearing loss and complications sometimes. This topic will review the definition, causes, types, clinical characteristics and treatments of each type of ear infections in children, by reading recently literatures. It is important to make an accurate diagnosis and choose a appropriate treatment of otitis media in children to avoid antibiotics abusing. Sometime some cases need operations, which are effective, especially in chronic suppurative otitis media and cholesteatoma, and we need further studying focuse on when do the operations and how to shoose them.
Child
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Child, Preschool
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Humans
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Infant
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Otitis Media
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therapy
3.Pathogenic Bacteria Distribution and Antimicrobial Susceptibility of Children with Acute Otitis Media
Lili HAO ; Zhinan WANG ; Zhen ZHANG ; Jun LI ; Zhongfang XIA
Journal of Audiology and Speech Pathology 2015;(6):593-596
Objective To analyze pathogenic bacteria distribution and antimicrobial susceptibility in children with acute otitis media(AOM ) .Methods Otorrhea samples from 146 episodes of AOM were cultured .The antimi‐crobial susceptibility of the main pathogenic bacteria was determined .The results were analyzed by SPSS19 .0 .Re‐sults 1) The strains of bacteria were isolated from 109 children with the positive rate of 74 .66% .Streptococcus pneumoniae (SP ) was the major bacteria(64 episodes ,58 .72% ) ,followed by staphlococcus aureus(SA) (19 epi‐sodes ,17 .43% ) .2) Sp was all sensitive to vancomycin ,levofloxacin ,moderate to penicillin ,amoxicillin ,cefo‐taxime ,and highly resistent to erythromycin and clindamycin .Staphlococcus aureus were all sensitive to vancomy‐cin ,tetracycline ,and Amy card ,and moderate to amoxicillin clavulanic acid potassium ,cefoxitin ,and oxacillin ,all resistent to penicillin and ampicillin .3) The strains of SP in age≤1year ,>1 -3years ,and >3 years respectively were 31(50 .82% ) ,25(56 .82% ) ,8 (19 .51% ) .There were significant differences between them(χ2 =14 .073 ,P=0 .001) .4)The strains of SP in 2012 ,2013 ,2014 respectively were 16(30 .19% ) ,22(48 .89% ) ,26(54 .17% ) ,There were significant differences between them(χ2 =6 .557 ,P=0 .038) .The antimicrobial susceptibility of SP had no sig‐nificant differences among 2012 ,2013 ,2014 ,but a yearly resistance decreasing trend was seen .Conclusion SP was the main bacterial contributor for AOM in Wuhan children .SP detection rate increases every year ,mainly in chil‐dren less than 3 years old .T he antimicrobial susceptibility is stable .
4.Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis.
Long CUI ; Zhongfang XIA ; Zhinan WANG ; Zhongqiang XU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(12):1094-1097
OBJECTIVE:
To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis.
METHOD:
The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P<0. 05). Similarly, after SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 46; 3. 63], 4. 23[3. 65; 4. 96], respectively) and TMS (0. 42[0. 36; 0. 58], 0. 50[0. 34; 0. 72], respectively) in the polyallergen sensitized group were lower than that before the treatment (TNSS: 9. 00[8. 00; 10. 00], TMS: 2. 18[1. 95; 2. 37]), which have showed a statistically significant difference(P<0. 05). No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2 years after treatment, respectively. However, a statistically significant finding could be observed between two groups in the drug discontinuance for 3 years (P<0. 05). Eleven patients suffered local adverse effects, and the incidence of adverse effects showed no significantly difference (P>0. 05).
CONCLUSION
SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.
Administration, Sublingual
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Animals
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Antigens, Dermatophagoides
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therapeutic use
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Humans
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Pyroglyphidae
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Retrospective Studies
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Rhinitis, Allergic
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therapy
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Skin Tests
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Sublingual Immunotherapy
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Treatment Outcome
5.The value of combination of the mortality in emergency department sepsis score and blood lactate level in the risk stratification of severe sepsis in the emergency department
Dingyu TAN ; Zhongfang XIA ; Aidong ZHENG ; Chun ZHOU
Chinese Critical Care Medicine 2014;26(3):159-164
Objective To evaluate the combination of the mortality in emergency department sepsis (MEDS) score with blood lactate level in the risk stratification of patients with severe sepsis in the emergency department (ED).Methods 665 adult patients with severe sepsis admitted from May 2011 to December 2012 in ED were found to be eligible for the study.MEDS score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and arterial blood lactate was determined,and the outcomes in 28 days were recorded.Logistic regression analysis was used to evaluate the relationship between each predictive factor score and prognosis.Each predictive factor was compared with the areas under the receiver operating characteristics (ROC) curve (AUC).Results The mortality in 28 days was 34.6% in 665 patients.The mortality in group of MEDS score 12-27 was significantly higher than that group of MEDS score<12 [51.0% (156/306) vs.20.6% (74/155),x2=28.414,P=0.000].In the meantime,APACHE Ⅱ score and blood lactate level were also significantly higher in group of MEDS score 12-27 than those in group with MEDS score<12 [APACHE Ⅱ score:26.4 ± 10.6 vs.21.7 ± 8.1,t=-3.555,P=0.002; lactate (mmol/L):4.9 (2.3,9.9)vs.3.9 (1.5,8.9),Z=-2.352,P=0.023].Kaplan-Meier survival analysis showed significantdifference in the two groups (the Log Rank test 36.71,P <0.01).The levels of 3 predictive factors were predominantly higher in non-survivors than survivors [MEDS score:14.1 ± 6.7 vs.8.2 ± 4.5,t=-6.929,P=0.000; APACHE Ⅱ score:28.1 ±7.1 vs.22.2± 11.3,t=-6.472,P=0.000; lactate (mmol/L):5.4 (2.9,11.0) vs.3.8 (1.2,9.1),t=-6.472,P=0.004].The AUCs were 0.813,0.706 and 0.727 for MEDS score,APACHE Ⅱ score and blood lactate respectively.The predictive ability for 28-day mortality of MEDS score was better than blood lactate (P=0.008) and APACHE Ⅱ score (P=0.005).The AUC of MEDS score combined with lactate was 0.865,and 28-day mortality prediction was better than MEDS score (AUC 0.865 vs.0.813,P<0.001).The sensitivity (83.1%),specificity (93.2%),positive prediction value (PPV,62.4%),and negative prediction value (NPV,92.1%) for MEDS score combined with lactate were highest among all predictors.Conclusion MEDS score combined with lactate is a good risk stratification tool for emergency patients with severe sepsis,and its prognostic capability is better than either MEDS score,APACHE Ⅱ score or blood lactate.
6.Gut Protective Effect of Rhubarb and Glutamine on Intestinal Ischemia Reperfusion Rats
Jiayan SUN ; Dingyu TAN ; Hairong ZHU ; Zhongfang XIA
Journal of Medical Research 2006;0(10):-
Objective To observe and compare the protective effect of rhubarb and Gln on morphology and permeability of rats intestine after SMA ischemia reperfusion.Methods 40 male rats were divided into rhubarb ,Gln, control and pseudosugery group(n=10)randomly. The intestinal I/R model of rhubarb ,Gln and control group rats was established and TPN was done.Rhubarb ,Gln and normal saline were given orally in rhubarb,Gln and control group respectively. SMA was decoherenced but not blocked in control group. Urine ,intestine,MLN and portal vein blood were collected for L/M,morphology and bacterial translocation study.Results (1)L/M was significant high in control group compared with pseudosugery group(P
7.Effects of Perioperative Application of ELP Enteric Soft Capsules on Therapeutic Efficacy and Prognosis in Children after Grommet Insertion of Chronic Secretory Otitis Media
Yufeng ZHANG ; Shufen WANG ; Zhinan WANG ; Zhongfang XIA
China Pharmacy 2016;27(35):4995-4997
OBJECTIVE:To investigate the effects of perioperative application of Eucalyptol,limonene and pinene(ELP)en-teric soft capsules on therapeutic efficacy and prognosis in children after grommet insertion of chronic secretory otitis media. METH-ODS:92 cases(145 ears)of chronic secretory otitis media were divided into 2 groups by random number table method,including 46 cases in observation group(68 ears)and 46 cases in control group(77 ears). Both groups received grommet insertion under gen-eral anesthesia by otomicroscope. Control group was not given any drugs;observation group was given ELP enteric soft capsules 1.2 g,bid,from 3 d before operation to 5 d after operation. Subjective therapeutic efficacy and pure tone audiometry of 2 groups were observed 3 days,5 days,2 weeks,1 month and 3 months after surgery as well as acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery. RESULTS:The total effective rates of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were 72.06%,82.35%,85.29%,89.70%and 95.59%;those of con-trol group were 59.74%,66.23%,80.52%,87.01% and 92.21%,with statistical significance(P<0.05). The pure tone audiome-try score of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were significantly lower than those of control group,with statistical significance(P<0.05). Therapeutic effective rates of acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery were 77.78% and 90.48% in observation group,which were signifi-cantly higher than 61.54% and 81.48% in control group,with statistical significance(P<0.05). CONCLUSIONS:The periopera-tive application of ELP enteric soft capsules can significantly improve function recovery and hearing level in children after grommet insertion of chronic secretory otitis media.
8.The observation and analysis the function and morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children.
Zhongfang XIA ; Zhinan WANG ; Zhongxiang XU ; Long CUI ; Cuifen WEI ; Yan LIU ; Fang HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(13):929-931
OBJECTIVE:
To observe and analyze the function and morphology of pharyngeal ostium of the eustachian tubes in secretory otitis media and chronic rhinosinusitis in children under direct vision,in order to provide an objective basis for clinical treatments.
METHOD:
Fifty cases of secretory otitis media,50 cases of chronic rhinosinusitis and a control group of 50 cases with hoarseness were examined under video laryngoscope to observe the pharyngeal ostium morphological changes of the eustachian tubes, and their functional statuses were tested by using acoustic impedance instrument. All the data were analyzed by statistical methods.
RESULT:
(1) In the secretory otitis group, the abnomal rate of the pharyngeal ostium of the eustachian tubes was 94% while the chronic rhinosinusitis group was 80%,and between them there was no significant differences (P > 0.05). But both of them had significant differences with the control group (P < 0.05). (2) In the secretory otitis group, the rate of the eustachian tube dysfunction was 70% while the chronic rhinosinusitis group was 26%, and between them there was significant differences (P < 0.05), and both of them have significant differences when compared with the control group (P < 0.05).
CONCLUSION
There are some abnormal points exist in the function and the morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children. Eustachian tube dysfunction played a dominant role in the pathogenesis of secretory otitis media in children rather than the morphological change did compared to the chronic rhinosinusitis in children.
Case-Control Studies
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Child
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Chronic Disease
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Eustachian Tube
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pathology
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physiopathology
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Humans
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Otitis Media with Effusion
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pathology
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physiopathology
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Rhinitis
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pathology
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physiopathology
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Sinusitis
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pathology
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physiopathology
9.Analysis of early clinical risk factors of severe acute organic fluorine inhalation poisoning
Ping GENG ; Jiyang XU ; Zhongfang XIA ; Lu FAN ; Min XU ; Dingyu TAN ; Aiwen MA ; Jinsong ZHANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2014;(5):345-349
ObjectiveTo investigate the early clinical risk factors of severe acute inhaled organic fluorine poisoning.Methods The clinical data of patients with acute poisoning of organic fluorine inhalation admitted since 2004 in Northern Jiangsu People's Hospital were retrospectively analyzed. According toDiagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning(GBZ66-2002), all the patients were divided into three groups: mild, moderate and severe poisoning groups, the severe cases were included in the intensive group, and the others were grouped in the non-intensive group. The contents in the survey were as follows: gender, age, vital signs on admission (body temperature, pulse rate, respiratory rate, systolic blood pressure), arterial blood gas analysis record〔arterial oxygen saturation(SaO2), oxygenation index(PaO2/FiO2), lactic acid(Lac) and arterial partial pressure of carbon dioxide(PaCO2), pH value(pH)〕. Before treatment, the white blood cell(WBC) count, platelet(PLT) count, levels of alanine transaminase(ALT), creatinine(Cr), blood glucose, electrolytes(potassium, sodium, chloride, calcium), creatine kinase isoenzyme(CK-MB), etc. were examined and recorded. All the patients were immediately arranged for bedside chest X-ray examination, and the chest X-ray lung injury scores were recorded. By univariate and multivariate logistic regression analyses, the receiver operating characteristic curve(ROC curve) was drawn to evaluate the diagnostic value of the clinical risk factors.Results Sixty-two cases consisting with the standard criteria of enrollment were collected in the study, 36 cases being in intensive group and 26 cases in non-intensive group. The univariate analysis showed that the differences in pulse rate, respiratory rate, PaO2/FiO2, WBC, SaO2, Lac, pH, and lung injury score were statistically significant(P<0.05 orP<0.01). Logistic multiple regression analysis showed that PaO2/FiO2, WBC, Lac and chest X-ray lung injury score were the four indexes for predicting the independent risk factors of severe acute inhaled organic fluorine poisoning. The area under ROC curve(AUC) of PaO2/FiO2 was the highest(0.884), 95% confidence interval(95%CI) was 0.784 - 0.984, the critical value was 96.5 mmHg(1 mmHg=0.133 kPa), with the sensitivity of 75.6%, specificity of 95.2%, positive predictive value(PPV) of 92.3% and the negative predictive value(NPV) of 71.4%, in sequence, the rest were WBC(AUC 0.846, 95%CI 0.728 - 0.965, the criticalvalue 12.15×109/L), Lac(AUC 0.800, 95%CI 0.662 - 0.938, the critical value 4.2 mmol/L), chest X-ray lung injury score(AUC 0.795, 95%CI 0.652 - 0.938, the critical value 2.50), the sensitivity of the above three items was 90.2%, 83.6%, 88.5%, specificity was 90.2%, 83.6%, 88.5%, the PPV was 86.7%, 82.4%, 85.8% and NPV was 72.0%, 73.9%, 69.2% respectively.ConclusionThe blood WBC count, Lac, PaO2/FiO2 and chest X-ray lung injury score can be used as the early clinical risk factors of severe acute inhaled organic fluorine poisoning.
10.A case of Keutel syndrome in child (review the literature).
Liangbo XU ; Zhongfang XIA ; Xinxian LIU ; Sui HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(18):793-794
OBJECTIVE:
The purpose is to report a calcification of the cartilaginous of the tracheobronchial case in child, and to recognize the clinical and imaging features on Keutel syndrome.
METHOD:
A comprehensive analysis of the clinical data and X-ray,CT. Some literatures involving some symptoms of this child were reviewed.
RESULT:
This patient diagnosed with Keutel syndrome finally.
CONCLUSION
When we meet calcification of the cartilaginous of the tracheobronchial patient in clinic, it may be Keutel syndrome.
Abnormalities, Multiple
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diagnosis
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pathology
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Calcinosis
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diagnosis
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pathology
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Cartilage Diseases
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diagnosis
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pathology
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Hand Deformities, Congenital
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diagnosis
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pathology
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Humans
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Infant
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Male
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Pulmonary Valve Stenosis
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diagnosis
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pathology