Objective To analyze the results of the quality inspection of the content of terminal medical records in a tertia-ry hospital,summarize the causes of common problems,and propose corrective measures to provide a basis for the efficient imple-mentation of medical record quality management work.Methods Based on Zhejiang Province medical record quality scoring crite-ria,a medical record quality inspection scoring form was developed for the hospital.A total of 7,140 terminal medical records dis-charged from the hospital between January 1,2023,and December 31,2023,were randomly selected for content quality inspection.The discharge rate and major defect occurrence rate of medical records before and after quality improvement were compared.Results After the implementation of corrective measures,the overall qualification rate of discharged medical records increased from 84.76%to 91.38%,and the rate of individual vetoed medical records decreased from 6.07%to 2.32%,with statistically signifi-cant differences(P<0.05).The frequency of major defect issues and major individual veto issues in discharged medical records decreased after the improvement,with statistically significant differences in the two groups(P<0.05).The frequencies of issues regarding the lack of a 72-hour conversation record and the lack of the first postoperative course did not show significant changes before and after the improvement,with no statistically significant differences(P>0.05).After the improvement,the number of medical teams with a twelve-point deduction score≥6 decreased from 28 to 8,with statistically significant differences(P<0.05).Conclusion Many factors can affect the quality of medical record writing.By implementing a series of corrective meas-ures such as strengthening medical record writing training,enhancing the four-level quality monitoring system of medical record management,improving the reward and punishment system,establishing a convenient and efficient communication platform,and strengthening quality management in various stages,the quality of medical record writing can be effectively improved.

Objective To utilize AI technology to achieve quality control of all medical records,further standardize the medical record writing process,and address the shortcomings of the manual quality control model,such as the inability to cover all medical records.Methods Based on the paperless electronic medical record system,an electronic medical record quality control system based on AI technology was constructed.The system achieves automatic monitoring,reminders,and feedback functions for all electronic medical records by running quality control rules.Results The AI quality control system has achieved real-time quality control of 100％of electronic medical records,significantly improving the timeliness and completeness of medi-cal record writing.Conclusion The medical record quality control system based on AI technology can effectively enhance the ef-ficiency of hospital medical record quality control,significantly improve the quality of electronic medical record writing,and solve the shortcomings of manual quality control.

This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.

OBJECTIVE To invest igate the therapeutic effects of music combined cognitive behavioral therapy on subjective tinnitus and the changes in spectral characteristics of resting electroencephalogram(EEG) before and after treatment under eyes closed condition. METHODS 8 patients with subjective tinnitus were enrolled as experimental group including 4 males and 4 females, with a mean age of 33.57±8.52 years from 18 to 40 years, 6.00±3.63 months of illness and right-handedness. Music combined cognitive behavioral therapy included a total of 6 sessions of treatment. The initial session of the treatment aimed to establish basic trust with the patient and understand the patient's personality, tinnitus symptoms, medical history, and other basic conditions. The light music which was specially processed by mactching the frequency and intensity to the patient's tinnitus were selected as combined audio of cognitive behavioral therapy. 7 minutes of closed-eye resting state EEG, THI scale, VAS scale, and SAS scale of the patients with subjective tinnitus were collected. The last 5 sessions was a tailored relaxation therapy including training and counseling patients to understand the treatment feedback after each meeting. After 3 months of the therapy, 7 minutes of EEG, THI, VAS and SAS scales of the 8 patients were asessed. The results of 7min-EEG, THI, VAS, and SAS scales were compared in patients with tinnitus before and after treatment. In addition, 8 patients with normal hearing and without tinnitus were enrolled as control group including 4 males and 4 females, with a mean age of 21.26±7.56 years from 20 to 45 years and right-handedness. The control group underwent 7 minutes of EEG examination. RESULTS The difference between the two groups before treatment was statistically significant(t =4.404, P <0.05). The full-band(0.5-44 Hz) energy of EEG before and after treatment in 8 patients with subjective tinnitus was statistically significant(t =3.705, P <0.05), and the average power of EEG after treatment in the experimental group and the control group was similar. The THI scale(t =3.664, P <0.05) and VAS scale(t =3.265, P <0.05) were compared before and after treatment and the difference was statistically significant. The difference of SAS scales between the two groups was not statistically significant(P >0.05). CONCLUSION Music combined with cognitive behavioral therapy has a significant effect on subjective tinnitusand the closed-eye resting state of brain power can show the recovery of subjective tinnitus of patients objectively which has significance for rehabilitation.

OBJECTIVE Disturbance of K+ ion balance in inner ear is associated in age-related hearing loss. Our study is to investigate the role of NKCC1 and Na-K-ATPase in cochlea and auditory function regulated by with different expression of NKCC1 and Na-K-ATPase. METHODS Auditory threshold of young or old C57BL/6J mice was measured by auditory brainstem response(ABR). The expression of NKCC1 and Na-K-ATPase in mice cochlea were evaluated by reverse transcription polymerase chain reaction(RT-PCR) and western blotting. Furosemide and Ouabain were applied in vivo to inhibit NKCC1 and Na-K-ATPase in C57BL/6J mice. RESULTS C57BL/6J mice developed hearing loss at 12M by ABR threshold shifting to (75±10), (78±26) and (81±14)dB SPL at frequencies of 8, 16 and 32 kHz; PCR showed that the relative expression of NKCC1 and Na-K-ATPase mRNA in the aged group decreased, which were 0.52±0.06 and 0.35±0.04 times higher than those in the young control group, the difference was statistically significant(t =7.466 and 16.11, all P＜0.05). WB showed that relative expression of NKCC1 and Na-K-ATPase protein level in the aged group decreased by 0.79±0.02 and 0.68±0.05 times as much as that of the young control group, the difference was statistically significant(t =8.857 and 6.771, P all＜0.05). After applied with Furosemide and Ouabain to suppress the two ion transporters, the ABR threshold increased to (50±17), (53±21), (55±17)dB SPL and (56±6), (70±17), (73±6)dB SPL at frequencies of 8, 16 and 32 kHz. CONCLUSION In vivo experiment of C57BL/6J suggested that NKCC1 and Na-K-ATPase might be related to age related hearing loss.

Objective To understand the characteristics of the hearing loss in patients with small acoustic neuroma .Methods A retrospective analysis was used to analyze the results of pure tone audiometry (PTA) and au-ditory brainstem response (ABR) in 35 patients (35 ears) diagnosed with small acoustic neuroma .The types of au-diometric curves ,degrees and frequencies of hearing loss and latent periods of ABR were analyzed .Results Moder-ate deafness was the most common type in this study ,with a total of 13 ears (37 .14％ ,13/35) .In addition ,8 ears were profound deafness (22 .86％ ,8/35) ,7 ears of binaural severe deafness (20 .00％ ,7/35) ,6 ears of mild deafness (17 .14％ ,6/35) ,and 1 normal ear (2 .86％ .1/35) ,respectively .The types of audiometric curves were mainly U -shaped and sloping .15 audiometric curves were U -shaped (42 .86％ ,15/35) ,15 sloping (42 .86％ ,15/35) ,3 flat (8 .57％ ,3/35) ,and 1 tent-shaped (2 .86％ .1/35％ ) .The main frequencies of hearing loss were 1 kHz ,2 kHz ,4 kHz ,and 8 kHz .The mean thresholds had statistically significant differences (P<0 .05) compared with the other frequencies by S -N -K test .ABR was abnormal in 32 ears(91 .43％ ,32/35) .20 of the ears'I - V waves were prolonged or the inter-aural latency difference of V wave was>0 .4 ms .Five ears failed to show any ABR wave , but their 4 kHz pure tone threshold was < 80 dB HL .25 (71 .43％ ,25/35)ears'ABR results indicated a retroco-chlear nature of ear disease .Conclusion Moderate deafness is the most common type of hearing loss in small acous-tic neuroma patients ,but only 71 .43％ of the patients'ABR indicate a retrocochlear disease ,so an analysis of PTA together with ABR will help to diagnose .

OBJECTIVE To explor e the characteristics of spectral oscillatory power of resting-state electroencephalography(EEG) in subjective tinnitus patients and to lay the foundation for study of central mechanism of tinnitus.METHODS 31 subjects(15 subjects with subjective tinnitus and 16 age matching healthy subjects) underwent a 128-channel resting-state EEG analyses. After a series of preprocessing, data were segmented into 8 frequency bands, including δ(0.5～3.5 Hz), θ(4～7.5 Hz), α1(8～10 Hz), α2(10～12 Hz), β1(13～18 Hz), β2(18.5～21 Hz), β3(21.5～30 Hz) and γ(30.5～44 Hz). The group differences of spectral power were analyzed by independent t test. Correlation between spectral power of each frequency band and tinnitus subjective symptoms were also analyzed. RESULTS Significant higher spectral power of the α1, β and γ bandwere found in the left and right temporal areas of tinnitus group compared with that of normal group.Tinnitus subjects also had higher spectral powerof the δ and θ band in temporo-parietal areas than that of the normal group. There was no significant difference of spectral power in other frequency bands. Moreover, signif icant positive cor relation were found between tinnitus loudness and spectralpower of right anterior lateral(R=0.66, P =0.007) and right anterior medial(R=0.58, P =0.031) areas. CONCLUSION Tinnitus subjects have higher spectral oscillatory power on right and left temporal lobe and temporo-parietal area. A positive correlation exsit between tinnitus loudness andspectral power of right anterior lateral and medial areas in tinnitus subjects, whichindicate that central reorganizationexsit in tinnitus reorganization andγ band maybe considered as a possible biomarkerforthe tinnitus subjective symptom.

OBJECTIVE To explore the efficacy of autologous fat injection of eustachian tube pharyngeal orifice in the treatment of Patulous eustachian tube (PET). METHODS We selected 18 patients who had no obvious improvement after medical treatment of PET over 1 months. They were treated with autologous fat injections to narrow the pharyngeal ostium of the eustachian tube. The treatment results were documented, including the patient's supervisory feeling and visual analogue scale (VAS). RESULTS The total effective rate was 83.3％ after 12 months of follow-up (symptoms significantly reduced in 27.8％ of patients and partial improvement is 55.6％), 16.7％ the symptoms remain unchanged, no one worsened. No patients had any complications. CONCLUSION Autologous fat injection of the eustachian tube is a effective and safe treatment for PET with the percentage of significant or partial relief of 83.3％, It is easy to conduct in clinical practice which could potentially serve as an alternative treatment for PET.

OBJECTIVE To evaluate the short-term efficacy of ear molding in the treatment of congenital auricular deformation. METHODS Twenty-four infants(twenty-eight ears) were treated with ear molding devices(EarWell Infant Ear Correction System). Doctors and parents were surveyed 1 months after treatment. RESULTS All cases were treated successfully without severe complications. 25 ears(89％) and 26(92％) were rated as very satisfied or satisfied by doctors and parents, respectively. CONCLUSION Ear molding is a noninvasive treatment, and effectively corrects congenital auricular deformation.

Objective To evaluate and characterize tinnitus patients, and provide profiles for further studying tinnitus.Methods This study included 2 171 tinnitus patients seeking treatment between Janurary 2014 and December 2015 from department of head and neck surgery,Sun Yixian Memorial Hospital,Zhongshan University.Tinnitus measurements consisted of pure tone audiometry and tinnitus matching procedures.The characteristics of tinnitus were analyzed by the essential information and auditory checks of the patients.Results Average age was 44.08±15.37 years old.Tinnitus frequently occurred between 41 to 50 years old(491 cases,22.60%).Unilateral tinnitus was more than bilateral tinnitus, while the cranial tinnitus was rare.The patients with mild or moderate tinnitus had the largest population,with higher average hearing threshold at 8 000 Hz in tinnitus ear than non tinnitus ear.The highest frequency of tinnitus matching frequency was high frequency(4~8 kHz).The first three causes for tinnitus were unknown reasons,sudden deafness and middle ear disease.Conclusion Larger population was subjective tinnitus.Tinnitus was closely related with hearing loss.The causes for tinnitus were complex.Tinnitus retraining therapy is a treatment that is worth to be popularized.