OBJECTIVE：To p rovide policy suggestions for the development and supervision of online drugstores in China. METHODS：By literature review ，the relevant literatures and policy documents about the development of online drugstores were searched，screened and sorted out to summarize the development process of China ’s internet drug trading mode and policy ，analyze the development status of China ’s online drugstores ；on the basis of the development experience of some developed countries ，the suggestions were put forward for China ’s relevant policies. RESULTS & CONCLUSIONS ：China’s medical e-commerce started relatively late ，and the policies related to online drug trading were basically released during last 20 years. The number of online drugstores showed a growing trend. The online drugstores were geographically allocated widely but unevenly. They sold many varieties，and policies on selling prescription medicines were gradually liberalized. These online drugstores provided diverse payment and delivery choices ，but their pharmaceutical service needed to be improved. The development models of online drugstores in the United Kingdom ，the United States and Germany could be referred. According to the current situation of online drugstores in China ， combined with the development mode and operation strategy in foreign countries ，it is suggested to improve relevant laws and regulations，and strengthen legal support ；strengthen the government supervision to ensure drug safety ；use the industrial power to standardize medicine operation behavior ；set up the third part trading platform to promote medical insurance payment.

Packing the nose after septoplasty is common practice. The use of postoperative packing has been proposed to reduce the dead space between the subperichondrial flaps and minimize postoperative complications such as hemorrhage, septal hematoma, and formation of synechiae. Additionally, postoperative packing is thought to stabilize the remaining cartilaginous septum and minimize persistence or recurrence of septal deviation. Despite these theoretic advantages, evidence to support the use of postoperative packing is lacking. Additionally, nasal packing is not an innocuous procedure. The use of nasal packing actually cause these complications such as postop- erative pain, mucosal injury, bleeding, worsening of breathing due to sleep disorders, and postoperative infections. Routine use of anterior nasal packing after septoplasty should be challenged for not presenting proven benefit. As alternatives to traditional packing, septal suturing, septal stapler and fibrin glue have been used recently. The purpose of this article is to summarize the progress of traditional packing to no packing after septoplasty.
Bandages ; Epistaxis ; Humans ; Nasal Cartilages ; surgery ; Nasal Septum ; abnormalities ; surgery ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Rhinoplasty ; methods ; Surgical Flaps ; Sutures ; Tampons, Surgical ; statistics & numerical data

OBJECTIVE: To observe the effect of nasal endoscope negative pressure cleaning and sinupret drops to treat radiation nasosinusitis (RNS). METHOD: One hundred and fifty-three patients with nasopharyngeal carcinoma were randomly divided into treatment group A, B, C . Group A using nasal endoscope negative pressure cleaning and sinupret drops, group B using nasal endoscope negative pressure cleaning and normal saline spray washing, group C using saline nasal irrigation through nasal catheter. All patients with sinusitis condition were evaluated at the end of radiotherapy, three months and six months after radiotherapy. RESULT: Comparison between groups, three periods of RNS incidence, moderate to severe RNS incidence are A < B < C. Six months after radiotherapy, group A compared with group C, there are significant difference (P < 0.01), group A and group C compared with group B respectively, the difference was statistically significant (P < 0.05). CONCLUSION Nasal endoscope negative pressure cleaning and sinupret drops can significantly reduce the long-term incidence of RNS, especially obviously reduce the incidence of moderate to severe RNS,which is a practical and effective method to treat RNS.
Carcinoma ; Endoscopy ; Humans ; Incidence ; Nasal Cavity ; Nasal Lavage ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Plant Extracts ; administration & dosage ; therapeutic use ; Radiotherapy ; adverse effects ; Sinusitis ; therapy ; Sodium Chloride

OBJECTIVE: To Summary the experience of surgical treatment for many times in 1 case of maxillofacial huge dermatofibrosarcoma protuberans. METHOD: The patient was diagnosed with dermatofibrosarcoma protuberans according to the pathological examination. From 2004 to 2011, the patient underwent extensive surgical resection, Mohs micrographic surgery(MMS) and free flap grafting method as surgical treatment for many times, and was closely followed-up after operation. RESULT: The tumor was completely removed in each operation, with wound skin graft survived. But relapse occured repeatedly, recurrence interval was from 7 months up to five years and eight months,recurrence interval gradually extended, all of the recurrence occurred at Mohs microsurgery cut edge. CONCLUSION Eexpanded resection is the preferred treatment for the early stage maxillofacial huge dermatofibrosarcoma protuberans. For advanced stage tumor, expanded resection should be combined with Mohs microsurgery. Free flap grafting was suggested in primary repair insteading of myocutaneous flap. At the same time, postoperative assistant radiotherapy, strengthen follow-up and early intervention were suggested.
Dermatofibrosarcoma ; surgery ; Facial Neoplasms ; surgery ; Free Tissue Flaps ; Humans ; Mohs Surgery ; Myocutaneous Flap ; Neoplasm Recurrence, Local ; surgery ; Reoperation ; Skin Neoplasms ; Skin Transplantation

Humans ; Male ; Myocutaneous Flap ; Neck Injuries ; etiology ; surgery ; Pectoralis Muscles ; transplantation ; Radiation Injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Ulcer ; etiology ; surgery ; Tissue Transplantation ; methods

BACKGROUND:The auditory ossicle chain reconstruction is stil an important method to treat conductive deafness. Although a great variety of materials have been applied, the blood supply of otosteon after the implantation is ignored. Moreover, there is no real bone formed.
OBJECTIVE:To observe the angiogenesis of vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold which is implanted into the otocyst of guinea pig.
METHODS:Total y 60 guinea pigs were randomly divided into experimental group (vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold), col agen I control group (col agen I modifiedβ-tricalcium phosphate porous scaffold) and blank control group (β-tricalcium phosphate porous scaffold). The guinea pigs were executed under anesthesia at weeks 1, 2, 3, 4 respectively. The surface of scaffolds was observed by scanning electron microscopy. The angiogenesis of scaffolds were observed by hematoxylin-eosin staining and CD34 immunohistochemistry staining, and then the microvascular density was counted. The osteogenesis of the scaffolds was observed by toluidine blue staining.
RESULTS AND CONCLUSION:Endothelial cel proliferation and lumen formation could be observed after 1 week in the experimental group, and the angiogenesis reach the peak after 3 weeks with traffic branches formedbetween micropores. In the other two groups, the lumen formed at 2 weeks but no traffic branches were visible. The sprouting of new blood vessels in the pores were observed more in the experimental group than the other two groups (P<0.05). The adherence and proliferation of cel s could be examined in the surface and pores of the scaffold by scanning electron microscope. After 4 weeks, the osteogenesis could be observed by toluidine blue staining, especial y in the experimental group. These findings suggest that the vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold can realize an effective vascularization in the environment of guinea pigs’ middle ear. What’s more, the scaffold also can promote bone formation.

OBJECTIVE: To explore the value of computer-aided design/computeraided manufacturing (CAD/CAM) technology for individual reconstruction of the thyroid cartilage defects. METHOD: Select the 20 New Zealand white rabbits (male or female). Randomly divided into two groups. Group A in the pre-operative CT scan of the throat, three-dimensional reconstruction of the thyroid cartilage imaging, surgical removal of either side of the thyroid cartilage, defect implanted in the use of CAD/CAM technology and mirror technology to produce personalized restorative materials; Group B surgical resection either side of the thyroid cartilage, defect implanted production of non-personalized probably according to the experimental animals unilateral thyroid cartilage repair materials. After surgery by gross observation, electronic laryngoscopy observed experimental animals throat. RESULT: General check and electronic laryngoscopy show: the use of CAD/CAM technology to prepare the individual repair materials throat plays better supporting role than the non personalized materials. CONCLUSION CAD/CAM technology before surgery designed to provide a personalized solid model to improve the accuracy of the surgery, time saving surgery to reduce surgical complications.
Animals ; Computer-Aided Design ; Female ; Image Processing, Computer-Assisted ; Male ; Prostheses and Implants ; Rabbits ; Reconstructive Surgical Procedures ; Thyroid Cartilage ; surgery ; Tomography, X-Ray Computed

Objective To explore the effect of objective management for indwelling catheter associated urinary tract infection ( CAUTI) in ICU.Methods Patients with urinary catheter in ICU for more than ten days were selected into the study .Totals of 108 ICU patients , as the control group , received routine nursing care during January to December 2012 .And 122 ICU patients , as the objectives management group , received intervention nursing care during January to December 2013 .The CAUTI rate on day three , day seven and day ten of catheter indwelling were compared between two groups .Results The CAUTI infection rate of day three , day seven and day ten in the objectives management group were 4.09%, 22.95%and 36.07%.Those rates in the control group were 11.11%, 51.85% and 75.00%.The differences were statistically significant (χ2 =10.12, 20.44, 59.26, respectively;P<0.01).Conclusions Objective management can reduce the rate of CAUTI and improve the quality of nursing care .

OBJECTIVE: To investigate the clinical features and treatment options of ossifying fibroma of paranasal sinuses. METHOD: A retrospective evaluation of twenty-three patients with ossifying fibroma of paranasal sinuses was presented. The choice of surgical operations on ossifying fibroma of paranasal sinuses was mainly decided by the location and area of ossifying fibroma. Radical operations were performed in twenty-one patients, ten of them through a lateral rhinotomy approach, eight through nasal endoscopic approach, four through Caldwell-Luc approach, one through coronal approach. RESULT: Two patients were performed partial resection by nasal endoscopic surgery. Diagnoses of all cases were confirmed by pathology. All patients outcomes were successful, no serious complication from the surgical technique occurred. Twenty cases were followed-up for six months to nineteen years. Two patients recurred. CONCLUSION Earlier diagnosis, CT scan, proper surgery, and radical resection are the keys to the treatment of ossifying fibroma of paranasal sinuses.
Adolescent ; Adult ; Child ; Female ; Fibroma, Ossifying ; diagnosis ; surgery ; Humans ; Male ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Retrospective Studies ; Young Adult

A male patient of 71 years old was admitted due to repeated hoarseness for two years which got worse accompanied with dyspnea so that to receive tracheotomy in another hospital more than one month ago. The two vocal cord biopsies carried out in the other hospital before showed vocal keratosis and squamous cell hyperplasia. Electronic laryngoscopy result showed normal epiglottis. a lot of saliva at hypopharynx, and rough arytenoid mucosa. The supraglottic area was remarkably swollen and the glottal area can not be observed clearly. The biopsy of throat was unable to conduct. Barium swallow examination revealed no obvious space-occupying lesion in piri form fossa or esophagus. Larynx CT scan showed a space-occupying lesion in the laryngeal cavity on the right side of the neck involving the thyroid cartilage. The patient was finally treated by total laryngectomy. cervical infected tissue resection. grafting transposition with pectoralis major flap and tracheostomy. The postoperative pathology showed laryngeal verrucous carcinoma.
Aged ; Carcinoma, Verrucous ; Humans ; Laryngeal Neoplasms ; Male