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OBJECTIVE@#To evaluate the clinical characteristics of tinnitus complaint.@*METHOD@#The information of 628 patients with subjective tinnitus was collected using questionnaires from October, 2013 to June, 2014. Among them, 453 cases were included in this study, whose quality of life and sleep were significantly affected. Then we elucidated the features of tinnitus, tinnitus incentives and systemic diseases and analyzed their relationship.@*RESULT@#The proportion of the patients complaint was highest in gruop ≤ 30 y. The patients with tinnitus complaint were more likely to have persistent tinnitus with higher loudness VAS scores than their counterparts. 65.4% of the total patients had at least one treatment (52.2% of patients can tolerate, and only 13. 2% can not tolerate). More patients had cranial Ming on the left than on the right ear. The proportion of patients with polyphony in bilateral tinnitus was higher than those with unilateral tinnitus (P < 0.05). Moreover, 59% patients had tinnitus inducing factors, and 44% patients had systemic comorbidities (The three most frequently involved systems were otolaryngologic, cardiovascular and digestive system). There was no significantly statistical difference of the tinnitus severity between patients with other systematic diseases and those without.@*CONCLUSION@#Patients with tinnitus complaint were younger in age (≤ 30 y) and more likely to have persistent tinnitus with higher loudness VAS scores Predisposing factors are closely associated with mental or physical trauma. The accompanied diseases can be classified by organ system.
Subject(s)
Humans , Quality of Life , Surveys and Questionnaires , Tinnitus , DiagnosisABSTRACT
OBJECTIVE@#To explore the risk factors of the newborns who failed initial hearing screening by analysing the distortion production otoacoustic emission (DPOAE) results of 1021 newborns with potential risk factors of hearing loss.@*METHOD@#All newborns, who were born in obstetrical department and admitted in the neonatal department of the Nanfang Hospital during June 2009 to January 2012 and underwent initial hearing screening, were included in this study. Their clinical data and DPOAE results were analyzed retrospectively in order to identify the risk factors for failure of initial hearing screening in infants; cases who failed the DPOAE test were followed up by telephone interviews.@*RESULT@#(1) One hundred and thirty-seven cases (13.42%) of the 1021 newborns did not pass the hearing screening. 51 cases (5.00%) did not pass the test in both ears. Meanwhile, left ear in 47 cases (4.60%) and right ear in another 39 cases (3.82%) failed the test respectively. (2) Univariate analysis showed that 14 factors had significant influence on the hearing screening results, such as birth weight, small for gestational age, multiple pregnancy, gestational age, delivery mode, oligohydramnion, oxytocin, blood sugar level of newborn, Apgar scores at 1 min, exposed prenatally to glucocorticoid, maxillofacial deformity, hypoxic-ischemic encephalopathy, neonatal respiratory distress syndrome and neonatal asphyxia (P < 0.01). (3) Multivariate Logistic regression analysis suggested that birthweight less than 1500 g, multiple pregnancy, Apgar scores of 0-4 at 1 min, exposed prenatally to glucocorticoid and maxillofacial deformity were risk factors for failure of initial hearing screening (OR were 3.132, 1.808, 2.615, 1.827 and 12.174 respectively; 95% CI were 1.466-6.691, 1.120-2.917, 1.317-5.336, 1.130-2.953 and 1.986-74.632 respectively). (4) Results of telephone interviews revealed that Apgar scores of 0-4 at 1 min would be a risk factor of language development.@*CONCLUSION@#Birthweight less than 1500 g, multiple pregnancy, Apgar scores of 0-4 at 1 min, exposed prenatally to glucocorticoid and maxillofacial deformity are risk factors of failure of initial hearing screening among newborns with potential hearing loss. Monitoring of the hearing condition of the infants at risk should be strengthened.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Deafness , Diagnosis , Hearing Disorders , Diagnosis , Hearing Tests , Neonatal Screening , Otoacoustic Emissions, Spontaneous , Risk FactorsABSTRACT
This paper identified misunderstandings of the measures taken in China to overcome the problems incurred by off-label uses (namely reliance on drug makers to modify their medicine specifications,on medical institutions to enhance their regulation and management of off-label uses,and on informed consent to avoid risks).Based on such findings,the paper named defects found with such measures,and puts forward feasible ideas and methods to make such off-label uses legitimate and reasonable.These include clarification of the legal status of the medicine specifications,encouraging authoritative guidance for off-label uses,and determining the subject of evaluation to approve the off-label uses as reasonable.Such efforts aim at helping off-label uses out of the legal difficulties.
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A variety of views and approaches were found in the appraisal and judgments of the people's courts in various provinces and cities,on medical disputes involving absence of a hand or foot of newborns,which result in different or event contradictory court decisions.This study made an analysis of the characteristics,nature,and classification of such cases as well as countermeasures of medical institutions,with recommendations on rational and appropriate handling of such cases,for the purposes of legitimate rights maintenance of both doctors and patients,and promotion of mutual understanding between the two parities,and establishment of a harmonious doctor-patient relationship.
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In the macrocosmic perspective,the development trend of the rights and obligations of doctors and patients is regarded as changes in the healthcare mode.In the microcosmic perspective,it is regarded as a clarification and emphasis of the informed consent of the patients as required by laws and regulations.However,medical workers tend to neglect their obligation of informing the patients of the medical expenses to be paid out of their own pocket.In this consideration,informing the patients in writing of their self-payment in medical expenses is obligatory and important,i.e,the self-payment agreement is highly important in clinical work.This paper analyzed the legal at-tributes of self-payment agreement in the aspects of both the informed consent and the signing of the medical service contract,with discussions of the tining of signature,in the hope of inspiring and helping medical workers in their clinical practice.
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Upon the situation that the scale of international students studying clinic medicine is enlarging,we adopted the questionnaire designed by International Affairs'Office of Ministry of Education to investigate the general information as the reason why international students come to study in China,the entrance standard,the evaluation on teaching,the occupation selecting and the tuition fee etc.The essay aims to provide information for normalizing the education and constituting concerned policy.
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In allusion to the constant development of degree students majoring in medicine recent years,the essay discusses the future development trend of medicine degree student on analysis of education demand of the neighboring countries and the contrast of different cultivate model and the quality standardization.