One-stage tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy / 临床耳鼻咽喉头颈外科杂志

Objective:To research the clinical application of tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy. Method:There were 52 patients with otitis media received canal wall down tympanomastoidectomy. We placed ventilation tube in posterior hypotympanum during the surgery. After surgery, all patients were followed up in 12 days, 1 month, 2 months, 6 months, and 1 year. The ventilation tubes were withdrew 6 months later, and then the hearing level and tympanic cavity status was evaluated after another half year. Result:All cases were followed up at least 1 year after surgery. Forty-four patients' tubes were removed 6 months later, but other 8 tubes had been extruded within 1 to 3 months. After 1 year, all 52 cases of ears were dry; 39 patients' tympanic membranes were stable, the postoperative complications included tympanic membrane retraction in 7 cases, middle ear effusion in 4 cases, and tympanic membrane perforation at anterior-inferior quadrant in 2 cases; CT examination indicated that 39 patients' aeration between tympanic cavity and Eustachian tube bony portion was normal, 9 patients' tympanic cavity aeration was smaller, and 4 patients' cavity was obstructed; 52 patients' average air conduction thresholds were 12.5 dB lower than that of preoperation. Conclusion:One-stage tympanic cavity ventilation tube placement is a simple, safe and effective method in canal wall down tympanomastoidectomy for middle ear diseases with Eustachian tube severe stenosis or obstruction in bony portion.

The anatomic study of tragal cartilage and its clinical application in ear surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Dissecting adult cadaver's tragal cartilage and researching its clinical application in ear surgery.@*METHOD@#Dissect the bilateral tragal cartilage of 22 adult cadavers immersed in formalin (both of male and female are 11). Measure and compute the average value of the length, width, thickness and area. Summarize autologous tragal cartilage's clinical application in ear surgery.@*RESULT@#The statistic values of male tragal cartilage were: length (22.55 ± 0.89) mm, width (19.00 ± 1.09) mm, thickness (1.04 ± 0.09) mm, and area (315.70 ± 32.57) mm2. The statistic values of female respectively were (19.36 ± 0.86) mm, (15.73 ± 0.69) mm, (0.93 ± 0.06) mm, and (229.64 ± 13.97) mm2. Tragal cartilages were utilized in 419 middle ear surgeries in my department, including tympanoplasty(type I 189 cases, type II and III 116 cases), atticotomy (65 cases), and the repair of the lateral skull base (3 cases). The postoperative effect was satisfactory.@*CONCLUSION@#Tragal cartilage is in the operation region, which is convenient to be harvested and shaped. Hence, the donor can satisfy the requirement of general ear surgery and it is suitable for widely application in ear surgery.

The lateral attic wall reconstruction with tragal cartilage and temporalis fascia graft / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the reconstruction method of lateral attic wall with tragal cartilage and temporalis fascia graft. And analyze the postoperative result of its clinical application.@*METHOD@#From Jan 2005 to Jul 2014, 45 patients whose middle ear disease were limited to attic received this surgery in our department. Among 31 cases of cholesteatoma otitis media and 14 cases of external auditory canal cholesteatoma were included. In order to expose the attic fully, we operated epitympanotomy through retroauricular incision and then removed the scutum and lateral attic bone wall. After eliminating the lesions, we reconstructed the lateral attic bone wall with tragal cartilage, covered the cartilage with temporalis fascia and then repaired the tympanic membrane and external ear canal skin. After surgery, all patients were followed up at 10 days, 1 month, 2 months, 6 months and 1 year.@*RESULT@#Two months after surgery, 45 patients' achieved one-stage wound healing. Six months later, all of the patients' operation area had epithelized completely. After 1 year, 37 patients had recovered the normal shapes and stable audition; 7 cases patients have different level tympanic membrane retraction; 1 patient suffered from tympanic membrane retraction and recurrent cholesteatoma.@*CONCLUSION@#With regard to the lesion limited to the attic, we can remove it by operating epitympanotomy through retroauricular incision, and then reconstruct the lateral attic wall with tragal cartilage and temporalis fascia. By the support of the cartilage, we can keep the epitympanic aeration, reduce the retraction of pars flaccida membrana tympani, and maintain the fundamental shape of lateral attic wall.

Research in status of community nursing among migrant infants of 0～6 months / 中国实用护理杂志

Objective This paper aimed to analyze the health situation and its influencing factors of the migrant infants in Gongshu district Hangzhou city,and discuss the best children's health care community management mode.Methods A random sampling method was taken to select the children's health management files who had took physical examinations in the community health service center in Gongshu district,the total migrant infants were 71 cases and local infants were 439 cases.Indicators such as rate of anemia,suffering from a disease,timely adding of vitamin D,and breast feeding were analyzed.Results The teething rate was 18.3％,anemia rate was 7.0％,obesity rate was 4.2％,overweight rate was 8.5％ in migrant infants.Compared with the local infants,the teething rate,anemia prevalence,overweight rate of migrant infants were lower than the local infants,and obesity rate was higher than the local infants,but there were no statistically significant differences between them.As a whole outdoor activities time of migrant infants was shorter than local infants.They both did not go out within 42 days primarily,outdoor activities time primarily were 1～2 h/d on the third month,more than 2 h/d on the 6th month.Conclusions To carry out health education for migrant parents actively,strengthen migrant infants care,timely addition of assist food,to combine vaccination information and children's health care information effectively are effective measures to improve the infants health service quality.

Clinical study of colon dialysis in 60 Cases with chronic renal failure / 中国综合临床

Objective To investigate the effects of colon dialysis on chronic renal failure(CRF).Methods 120 patients with CRF were randomly divided into two groups and they were given the same conventional therapy including alimentary control,blood pressure control,etc.The A group (colon dialysis group,n=60) was given colon dialysis,the B group (conventional therapy group,n=60) was given conventional therapy for 4 weeks.The serum creatinine(SCr),urea nitrogen,24 h proteinuria were observed in two groups.The therapeutic effects of colon dialysis were assessed by the changes of SCr.Results The colon dialysis and conventional therapy can decrease the SCr from (363.97±82.34) μmol/L to (280.87±87.52) μmol/L and (371.73±87.46) μmol/L to (339.90±68.59) μmol/L respectively.The former was more effective than the latter.The effects of colon dialysis in the renal function compensation stage and decompensation stage were more effective than in renal failure stage but no difference was detected between the former stages.Conclusions The colon dialysis has certain effects to CRF,especially to those with serum creatinine ＜443 μmol/L can get more benefit.