ABSTRACT
Objectives To investigate the methods of protecting external branch of the superior laryngeal nerve (EBSLN)in carotid endarterectomy and to observe the effect of using these methods in clinical surgery. Methods EBSLN (20 sides)of 10 heads of corpse were studied by using microanatomy from January 2013 to December 2013. The occurrence probability of EBSLN on the lower edge of posterior belly of digastric muscle,medial edge of external carotid artery and upper edge of superior thyroid artery in anatomy triangle was analyzed. The distances from the midpoint of the EBSLN to carotid bifurcation, mandibular angle and mastoid tip were measured. Sixty-five patients with carotid endarterectomy in Tianjin Huanhu Hospital from December 2013 to November 2014 were treated with the protective methods of the relevant EBSLN by using anatomy triangle as a mark. Whether the patients had injury symptoms of EBSLN were followed up after procedure. Results (1)The occurrence probability of 20-side EBSLN in anatomy triangle was 95%(19 sides). The midpoint of EBSLN in the anatomy triangle at the posterior mandibular angle was median 0. 34 (-1. 62 to 2. 43)cm,at the inferior mandibular angle was 1. 28 (-1. 33 to 3. 42) cm,at anterior mastoid tip was 2. 84 (0. 51 to 5. 14)cm,at inferior was 4. 51 (2. 82 to 6. 39)cm,and at anterior superior of the carotid bifurcation was 1. 64 (0. 57 to 3. 78)cm. (2)65 patients who underwent carotid endarterectomy used the protective methods of intraoperative EBSLN. There was no manifestation of EBSLN injury at 3 weeks to 9 months after procedure. Conclusion In carotid endarterectomy,taking an anatomic triangle as a symbol,it is no more than 2 cm of the anterior superior of carotid bifurcation during the separation process. As for the patients with higher or lower position of carotid bifurcation,in the range of crossing rear mandibular angle 0. 50 cm or below the mastoid tip 4. 50 cm for arterial separation should be avoided,and this can effectively protect EBSLN.
ABSTRACT
Objective To analyze the occurrence features of the active surveillance of adverse events following immu?nization (AEFI) in Tianjin, and evaluate the sensitivity of passive surveillance systems over the same period. Methods The layered eight vaccination clinics of four counties were selected as active surveillance points. The data of active surveillance AEFI were collected through telephone investigation in 2011-2013. The data of passive surveillance was collected through the national AEFI information management system. The descriptive methodology and chi square test were used. Results A total of 235 cases were collected through active surveillance in 2011-2013. The AEFI incidence rate was 718.70 per 100 000 doses,no difference in the incidence between three years(χ2=5.07). A total of 4164 cases were collected through passive sur?veillance. The incidence rate was 34.09 per 100 000 doses,the incidence increased year by year(χ2=572.02,P<0.05). In ac?tive surveillance cases, 95.32%was the common vaccine reaction, 3.83%was the rare vaccine reaction, no serious vaccinereaction. In passive surveillance cases, the common vaccine reaction, the rare vaccine reaction were 85.09%and 13.32%. The serious vaccine reaction was found in 44 cases. Conclusion The more slightly common vaccine reaction can be found by active surveillance. The sensitivity of Tianjin passive surveillance system is increasing year by year, which can meet the requirements for job. The classification and diagnostic criteria of the serious vaccine reaction need to be established.
ABSTRACT
To observe the incidence of varicella vaccine after breaking through the case of varicella vaccine , immunization strategy ,popularized in the city.Inoculation Population living in the Binhai New Area of full age to 12 years old children in December,has been vaccinated or who have had chickenpox varicella vaccine except .Controls were four districts around the city girls without varicella in children.Methods: Implementation of vaccination for the target population.All vaccinees was observed from 42 days to 2 and a half years later ,the incidence of varicella break cases.In the observation group and the control group was observed in two groups of varicella vaccine protection rate calculation.Results: The gelatin free attenuated varicella vaccine breakthrough in 134 cases,the incidence rate was 0.35%;no gelatin attenuated varicella vaccine protection rate of 80.92%, with domestic and foreign reports consistent.Conclusion:After vaccination from 42 to 2 and a half years ,varicella vaccine can effectively protect children from the onset, while reducing the prevalence of children 's pain and the economic burden of the family.Varicella vaccine is still a breakthrough occurred ,therefore to consider two inoculations ,with further observation of two times after inoculation the body to produce antibody level and epidemiological protection effect.