Clinical value of procalcitonin detection and blood culture in early diagnosis of blood stream infection / 国际检验医学杂志

Objective To explore the clinical value of procalcitonin (PCT ) and blood culture in the united diagnosis of early blood stream infection .Methods The blood specimens of 625 patients were collected ,the serum level of PCT was detected by EL‐FA ,and the blood culture was accessed at the same time .23 cases of blood culture positive samples were received continuous detec‐tion of PCT ,and the results were analyzed .Results Positive rate of PCT was 41 .01% (0 .05 -2 .58 μg/L)in patients with blood culture negative results (negative group) ,and that in patients with blood culture positive results (positive group) was 80 .77%(0 .05-200 .00 μg/L) .The positive rate of PCT in positive group was significantly higher than negative group (χ2 =65 .12 ,P<0 .01) .Positive rates of PCT in patients with infection of Candida tropicalis ,kinds of bacteria ,Gram‐negative bacilli and Gram‐posi‐tive cocci were 100 .00% ,100 .00% ,92 .11% and 56 .81% ,respectively .Continuous detection of PCT in 23 patients with blood cul‐ture positive results showed that patients with gradually decreased PCT level suggested a good prognosis ,and patients whose PCT levels were higher than 10 μg/L and were maintained at high levels had poor prognosis .Conclusion Simultaneously blood culture and PCT detection was important to the early diagnosis and treatment of blood stream infection .

Application of double-cavity balloon urinary catheter in the treatment of epistaxis / 中国基层医药

ObjectiveTo explore the applied methods and the effect of double-cavity balloon urinary catheter in the treatment of epistaxis.MethodsClinical data of 96 epistaxis patients who were operated with postnasal packing applied double-cavity balloon urinary catheter at our unit were analyzed retrospectively.ResultsAll patients ( 100％ ) were successfully healed.One patient suffered from anterior nostril stenosis because of the constriction by urinary catheter.The rest was no significant complications.ConclusionPostnasal packingl applied double-cavity balloon urinary catheter had a safe and effective method for treatment of severe epistaxis.Attention to detail in the operation could prevent the occurrence of complications.

Observation of the efficacy of endoscopic myringoplasty with homoplastic amniotic membrane / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical effectiveness of endoscopic myringoplasty with homoplastic amniotic membrane.@*METHOD@#A retrospective study in 43 patients underwent endoscopic myringoplasty with homoplastic amniotic membrane was observed at the wound healing of tympanic membrane perforation and the hearing improve-threshold audiometry in 43 patients after surgery.@*RESULT@#The tympanic membrane's perforation healing rate was 95.3% (41/43), and air conduction threshold audiometry in language frequency improved average 10 dB. The follow up was 1--4 years, and no recurrence or complications had occurred.@*CONCLUSION@#The endoscopic myringoplasty could be able to simple myringoplasty whose air conduction threshold audiometry in language frequency was less than 40 dB. It could be used to repair not only the central perforation in tympanic membrane, but also the marginal perforation which has residual tympanic membrane in most of the regional. Human amniotic membrane is an ideal materials for repair of tympanic membrane.

Clinical study of 26 patients with osteoma in the external / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To summarize the experience of diagnosis and treatment on osteoma in the external auditory canal.@*METHOD@#Retrospective study were undertaken in 26 patients with osteoma in the external auditory canal operated in author's unit.@*RESULT@#Osteomas were removed through interauricular approach in all patients and confirmed by histopathological examination. The hearing of 22 patients with conductive hearing loss became normal after operation. The air conduction hearing threshold in 2 patients with mixed hearing loss improved average 15 dB and 20 dB respectively after operation. The follow up was more than 1 year, and no recurrence or complications had occurred.@*CONCLUSION@#Osteoma in the external auditory canal is an uncommon benign lesion. The method of choice in diagnosis is temporal bone CT scan. Osteoma must be distinguished from exostosis in the external auditory canal. Osteoma is confirmed by pathological diagnosis and surgery is the only method for treatment.

Use of silicon T-tube in laryngotracheal reconstruction / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the function and operative method of silicon T tube in laryngotracheal reconstruction.@*METHOD@#Two hundred and ninety-seven patients of laryngotracheal stenosis were operated with laryngotracheal reconstruction in our department. All of patients were tracheostomy dependent before reconstruction and were placed a silicon T-tube stenting for 3 to 6 months after reconstruction.@*RESULT@#Two hundred and eighty-nine patients (97.3%) were successfully decannulated with good airway patency and effective phonation. They were followed up from 1 to 10 years, and no recurrence was found.@*CONCLUSION@#Silicon T-tube is an effective and safe stent for laryngotracheal reconstruction. Paying attention to some application details may avoid the complication and obtain a satisfactory effect.

Reconstruction of laryngotracheal defect using the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect of the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum on the reconstruction of extensiveness laryngotracheal defect.@*METHOD@#Retrospectively studied 49 patients, who admitted in our department from 1996 to 2005 years for severe laryngotracheal defect. There were 28 males and 21 females aged from 15 to 69 years old (mean age was 47 years old). The causes of laryngotracheal defect were laryngotracheal stenosis (31 cases) and surgery for thyroid carcinoma invading trachea (18 cases). All of 49 cases were treated with the graft of musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum and placed a silicon T-tube stenting for 3 to 6 months.@*RESULT@#All of 49 cases were successfully decannulated with recuperative normal airway patency and effective phonation. The follow up ranged from 2 to 10 years, and the effect of operation was steady.@*CONCLUSION@#The musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum is an ideal graft for the reconstruction of cervical extensiveness tracheal defect.

Reconstruction of laryngotracheal defect using the musculo-periosteum flapof the sternocleidomastoideus with clavicular periosteum / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the effect of the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum on the reconstruction of extensiveness laryngotracheal defect. Method: Retrospectively studied 49 patients, who admited in our department from 1996 to 2005 years for severe laryngotracheal defect. There were 28 males and 21 females aged from 15 to 69 years old (mean age was 47 years old). The causes of laryngotracheal defect were laryngotracheal stenosis(31 cases) and surgery for thyroid carcinoma invading trachea (18 cases). All of 49 cases were treated with the graft of musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum and placed a silicon T-tube stenting for 3 to 6 months. Result; All of 49 cases were successfully decannulated with recuperative normal airway patency and effective phonation. The follow up ranged from 2 to 10 years, and the effect of operation was steady. Conclusion:The musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum is an ideal graft for the reconstruction of cervical extensiveness tracheal defect.