Objective:To summarize the essential elements of clinical doctors′ ward rounds etiquette norms from the perspective of whether doctors′ speech and behavior in actual ward rounds pay attention to patients′ feelings and reflect humanistic care, in order to provide references for improving patients′ treatment effects and medical experience management.Methods:From July to October 2023, a purposeful sampling method was employed to select 16 clinical doctors with ward rounds experience from the eastern, central, western, and northeastern regions across the country. Semi-structured interviews were conducted online via video, focusing on issues related to etiquette norms during ward rounds. The Colaizzi′s seven-step analysis method was used to conduct an inductive analysis of the interview materials.Results:four themes were distilled: friendly and caring body language; accurate, understandable, clear, and timely explanations; appropriate praise and affirmation to encourage patients to actively participate in their disease management; and admonitions to patients and their families regarding disease-related precautions. These four themes were summarized as the " four essentials of ward rounds, " which could be encapsulated as " altruistic inquiry; accurate explanation; affirmative engagement and adequate advice" .Conclusions:The " four essentials of ward rounds" can be made a mandatory part of the clinical doctors′ workflow in the medical quality management process and are recommended for nationwide promotion. This can further enhance the communication skills of clinical doctors, strengthen patients′ trust, improve treatment compliance, and improve doctor-patient relationships, thereby improving the treatment effects, satisfaction, and experience of inpatients.

Objective:To summarize the essential elements of clinical doctors′ ward rounds etiquette norms from the perspective of whether doctors′ speech and behavior in actual ward rounds pay attention to patients′ feelings and reflect humanistic care, in order to provide references for improving patients′ treatment effects and medical experience management.Methods:From July to October 2023, a purposeful sampling method was employed to select 16 clinical doctors with ward rounds experience from the eastern, central, western, and northeastern regions across the country. Semi-structured interviews were conducted online via video, focusing on issues related to etiquette norms during ward rounds. The Colaizzi′s seven-step analysis method was used to conduct an inductive analysis of the interview materials.Results:four themes were distilled: friendly and caring body language; accurate, understandable, clear, and timely explanations; appropriate praise and affirmation to encourage patients to actively participate in their disease management; and admonitions to patients and their families regarding disease-related precautions. These four themes were summarized as the " four essentials of ward rounds, " which could be encapsulated as " altruistic inquiry; accurate explanation; affirmative engagement and adequate advice" .Conclusions:The " four essentials of ward rounds" can be made a mandatory part of the clinical doctors′ workflow in the medical quality management process and are recommended for nationwide promotion. This can further enhance the communication skills of clinical doctors, strengthen patients′ trust, improve treatment compliance, and improve doctor-patient relationships, thereby improving the treatment effects, satisfaction, and experience of inpatients.

Humans ; China/epidemiology* ; SARS-CoV-2 ; COVID-19

Objective To explore the outcomes of open reduction and internal fixation ( ORIF ) with transarticular screws for Lisfranc injuries and the postoperative incidence of symptomatic tarsometatarsal os-teoarthritis ( OA ) . Methods This retrospective study involved 28 patients who had been treated surgically at our institution between January 2009 and January 2015 for Lisfranc injuries. They were 18 males and 10 females, with an average age of 36. 1 years ( from 19 to 54 years ) . According to the Quenu-Kuss classifica-tion, 5 patients had type-A injury, 10 type-B injury ( 4 cases of type-B1 and 6 ones of type-B2 ) , and 13 type-C injury ( 8 cases of type-C1 and 5 ones of type-C2 ) . The patients underwent ORIF with screws for the 1st to the 3rd tarsometatarsal joints and ORIF with Kirschner wires for the 4th to the 5th tarsometatarsal joints within 2 weeks. After the Kirschner wires were removed 8 to 10 weeks postoperatively, progressive weight-bearing began. Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society ( AOFAS ) midfoot scores and visual analog scale ( VAS ) at final follow-ups. Results The mean duration of follow-up was 29. 9 months ( from 26 to 72 months ) . AOFAS scores revealed one excellent case, 22 good ones and 5 poor ones with an excellent to good rate of 82. 1％. The mean VAS score was 2. 8. Radiographic evidence of OA was noted in 20 patients ( 71. 4％, 20/28 ) , in 18 of whom ( 90. 0％) symp-tomatic OA was observed. There was no significant difference ( P=0. 399 ) in the incidence of symptomatic OA either between the patients with anatomic reduction ( 60. 9％, 14/23 ) and those without anatomical re-duction ( 80. 0％, 4/5 ) . Conclusions ORIF with transarticular screws can lead to good therapeutic outcomes for Lisfranc injuries. The incidence of symptomatic OA may not be related to the injury type or re-duction quality.

Objective To compare the effects of high negative pressure drainage and conventional drainage on postoperative blood loss and wound healing in patients with calcaneal fracture. Methods A prospective randomized controlled single-blinded trial was conducted on the 66 patients with closed calcaneal facture who had been treated from June 2012 to March 2016 in our hospital. They were randomized by coin into 2 groups: 36 patients (aged from 21 to 65 years with a mean age of 38.1 years) were treated with a high vacuum drainage system while the other 30 (aged from 19 to 66 years with a mean age of 37.5 years) with a conventional silicone tube and a drainage vessel. The 2 groups were treated by the same team of surgeons and the same surgical procedures. The 2 groups were compared in terms of postoperative drainage volume, hemoglobin (HGB), bleeding volume, wound healing time, incision complications and wound infection. Results The high negative pressure group incurred significantly greater drainage volume (516.7 ± 138.8 mL) and bleeding volume (612.9 ± 179.5 mL) than the conventional drainage group (305.8 ± 95.4 mL and 437.8 ± 102.0 mL) (P <0.05). The former incurred significantly less HGB (116.8 ± 6.9 g/L) and wound healing time (15.2 ± 3.1 d) than the latter (124.1 ± 7.8 g/L and 18.5 ± 4.2 d) (P <0.05). The rate of incision complications for the high negative pressure group (5.6%, 2/36) was significantly lower than that for the conventional drainage group (26.7%, 8/30) (χ2=4.150, P=0.042). There was no significant difference between the 2 groups in the rate of wound infection (0 versus 3.3%) (P=0.927). Conclusion After surgery for calcaneal fractures, high negative pressure drainage may lead to faster wound healing and fewer postoperative wound complications but greater blood loss and lower HGB than conventional drainage.

OBJECTIVE To investigate the safety, efficacy, specific injection mode and injection dose of Lauromacrogol for treating laryngopharyngeal hemangioma. METHODS a total of 18 patients with hemangioma of pharynx and larynx from Oct 2015 to Dec 2016 in were collected in our hospital. Among them, there were 18 cases of solitary hemangioma and 2 cases sporadic hemangioma. According to the location and depth of the lesions, different routes were used. Observe the therapeutic effect of local injection. RESULTS All the 18 patients were followed up for 3 months to 1 years. Among them, 1 case of multiple hemangioma patients were significantly affected by the local inflammatory swelling after the injection. 3 patients complained of mild dyspnea after operation, and 10 patients complained of postoperative pain. None of the patients had cough, chest tightness, embolism, adverse ischemic shock and severe amaurosis. CONCLUSION Lauromacrogol injection is safe, reliable and effective to treat hemangioma of pharynx and larynx. Different injection methods should be based on the size of hemangioma, depth and other factors.

Objective To discuss the differences of clinical features and characteristics and features of polysomnography be‐tween elderly patients and middle‐aged patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,so as to provide refer‐ence for the diagnosis and individualized intervention of elderly OSAHS .Methods Totally 81 aged OSAHS cases and 123 youth OSAHS cases were analyzed in terms of general condition ,clinical manifestations and polysomnographic characteristics ,and the clin‐ical manifestations and polysomnographic difference indicators of the two groups were matched according to body mass index (BMI) .Results Most OSAHS patients were males in both groups ,with BMI and neck waist circumference in the aged group less than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05) ,while the bust was larger than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05);clinical symptoms of senile groups such as drowsiness ,snoring ,morning headaches ,dry mouth and nighttime awakenings were lower than the middle‐aged group ,the difference was statistically significant (P<0 .05) ,and complications such as hypertension ,diabetes and other risk disease were significantly higher than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05);in the aged group ,the degree of OSAHS was dominated by mild to moderate ,while the middle‐aged group ,was dominated by moderate to severe ,but the differ‐ence was not statistically significant (P>0 .05);REM AHI was more than the middle‐aged group ,the difference was statistically significant (P< 0 .05) ,AHI was less in old age group than in the middle‐aged group ,the difference was statistically significant (P<0 .05);NREMⅠ + Ⅱ stage in the aged group was more than that in the middle‐aged group(P<0 .05) ,and NREM Ⅲ + Ⅳstage ,REM period ,the average SaO2 (% ) ,MAI clear were less than those in the young group;LSAT (% ) was greater than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05) .Conclusion The incidence of typical clinical manifestations of aged OSAHS patients was lower than that in the middle‐aged group ,but high blood pressure ,diabetes and other complications prevalence were significantly higher than those in the middle‐aged group ,with similar severity of OSAHS in both groups ,there were differences PSG monitoring results with the middle‐aged group ,and the difference of REM AHI was significant .

Objective To analyze the pathological voice ,normal voice range chart crowd voice characteristics through tests and analyze the differences between the two groups of test‐related parameters chart range between indicators ,so as to explore the value of the test range map in the polyp of vocal cord .Methods One hundred and twenty patients with vocal polyps according to in‐clusion and exclusion criteria were selected .Sixty cases of normal voice were randomly selected .Germany XION DIVAS system dia‐gram test mode range were recorded for both groups ,with the strongest voice of the bass were measured at different frequencies , first obtain low VRP intensity curve ,then get high‐intensity curve VRP .The maximum frequency of the vocal cord polyp group and normal control group ,the minimum frequency ,maximum intensity ,most quietly strong ,maximum phonation time ,fundamental fre‐quency perturbation and dysphonia index of the data were compared statistically .Results Compared with the control one ,the mean maximum frequency of vocal cord polyp group were lower (P= 0 .029 6) ,the average minimum frequency were significantly higher ( P= 0 .000 3) ,frequency range reduced(P= 0 .022 9) ;vocal cord polyp average loudest group was stronger(P= 0 .003 9) ,the whis‐pered strength values were significantly higher (P = 0 .000 0) ,significantly limited the average sound intensity range than normal voice group group (P= 0 .006 9) .Classification index based on objective voice disorders ,in terms of frequency ,mild voice disorders at the maximum frequency .There was no significant difference in the minimum frequency ,frequency range with a normal voice group ;and in severe voice disorders average maximum frequency lower than the normal voice group ,the smallest than normal voice frequency was significantly higher frequency range than the normal group was significantly limited .In terms of strength ,mild im‐pairment in the loudest voice is strong ,most quietly strong .There was no significant difference with the normal voice group intensi‐ty range ;and in severe voice disorders average maximum sound intensity ,most quietly strong values were higher than normal voice group .However ,the average sound intensity narrow range than normal voice group .Conclusion The range map test can be quanti‐fied assessment of voice ,and can distinguish normal voice ,clinical pathological voice and the severity of damage ,which is an impor‐tant means of voice feature detection to provide an objective basis .

Objective To observe the therapeutic efficacy of different treatment programs on the acute subjective tinnitus . Methods 327 patients with acute subjectivity tinnitus were randomly divide into physical ,medication and comprehensive treatment group .The 97 cases in physical group were treated with hyperbaric oxygen ,acupuncture and sound therapy ;the 103 cases in medica‐tion group were treated with microcirculation and oral steroids ;the 127 cases in comprehensive treatment groups were treated with combination the therapy of above what have mentioned .THI was used to evaluate three groups before the treatment ,two and four weeks after treatment .Results After two week′s treatment ,the efficiency rate for physical group is 60 .82% ,64 .78% in medica‐tion group and 70 .08% in comprehensive group .After four weeks of treatment ,the efficiency rate of each group is 70 .10% , 72 .81% and 80 .31% .At two‐week time point ,there was no significant difference between drug and physics group (P> 0 .05) , there was statistically significant difference between medication group and comprehensive group (P< 0 .05) .At four‐week time point ,the difference of physics group and drug group had no statistically significance compared with the two‐week in each group (P>0 .05) ,but there was a statistically significant difference in comprehensive group (P<0 .05) ,meanwhile ,there was statistically significant differences between comprehensive group and the physical group and drug group (P<0 .05) .Conclusion Physical and medication therapy have quite effects on acute subjective tinnitus ,but the effect was worse than the comprehensive therapy group . After four weeks of treatment ,the efficiency of purely physical and drug therapy have not been significantly improved compared with two weeks time ,but still improved of comprehensive treatment .

OBJECTIVE: To analyze the clinical features & variation features of cervical tuberculous lymphadenitis and to discuss its effective surgical treatment. METHOD: Retrospective analysis of 27 cases of cervical tuberculous lymphadenitis patients admitted to the hospital from January 2008 to December 2013. The cervical tuberculous lymphadenitis is classified based on the enhanced CT scanning conducted before operation and the preoperative evaluation of clinical characters of patients. The lymphaden ncisional biopsy was conducted on the type I patients with cervical tuberculous lymphadenitis. The lesion resection was performed on the type II and mixed type I + II patients. The regional cervical lymph node dissection was carried on the type III, the type IV and other mixed type patients. The negative pressure drainage ball was placed after operation, and the cavity was flushed with 5% povidone iodine solution. The antituberculosis therapy was performed after wound healing. RESULT: The analysis of the clinical features for 27 patients: the incidence rate on the left side, right side, both sides and middle-line is 63.0%, 25.9%, 7.4% and 3.7% respectively. The majority of patients whose lesion involving more than one region account for 62.1%; the patients whose lesion involving one region account for 37.9%. The most common is level V involved lesion (69.0%), then level IV (62.1%), level III (51.7%), level II (34.5%), level I (10.3%) and level VI (3.4%) in order. The analysis of the CT imageology features for 27 patients: the simple type is the majority (65.5%), and the most common is type III (24.1%), then the type I (17.2%), type II (13.8%) and type IV (10.3%) in order. The mixed type is minority (34.5%), but the two mixed is often (31.0%). The three mixed is only located on one side (3.4%). The recurrence never happened on the patients with resection and standard antituberculosis therapy. CONCLUSION For the cervical tuberculous lymphadenitis, the suitable surgical treatments shall be selected according to the lesion characteristics & location and CT imaging manifestations presurgical evaluation. The effective way to treat cervical tuberculous lymphadenitis is to conduct negative pressure drainage after operation, to flush the cavity with 5% povidone iodine solution and to perform antituberculosis therapy.
Antitubercular Agents ; therapeutic use ; Drainage ; Humans ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; classification ; drug therapy ; surgery