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1.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 296-300, 2020.
Article in Chinese | WPRIM | ID: wpr-871619

ABSTRACT

Objective:To investigate the effect and mechanism of obstructive sleep apnea hypopnea syndrome(OSAHS) on nocturnal angina in patients who undergo coronary artery bypass grafting(CABG).Methods:According to the inclusion criteria and exclusion criteria, this prospective observational study included 76 patients who underwent CABG at Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to December 2018. Patients included 60 males and 16 females, mean aged(61.4±7.3) years, BMI(25.7±2.3) kg/m 2. Portable sleep respiration monitoring and bedside ECG monitoring were performed before surgery. According to the apnea index(AHI), patients were divided into mild or no OSAHS group(AHI<15, 35 patients) and moderate to severe OSAHS group(AHI≥15, 41 patients). Baseline data, hematologic examination, degree of coronary stenosis, sleep breathing examination, night time heart rate and incidence of atrial fibrillation, and nocturnal angina were compared between the two group. Results:Combined with mild or no OSAHS group, moderate to severe OSAHS group had a significantly higher syntax-score(47.3±10.6 vs 35.1±6.8), a significantly higher proportion of coronary diffuse lesions(53.7% vs 31.4%), a significantly faster heart rate[(94.3±21.5)times/min vs(74.8±10.0) times/min], a significantly higher proportion of nocturnal angina(29.2% vs 2.9%). The differences were statistically significant( P<0.05). Binary logistic regression analysis showed that the fastest heart rate at night significantly affected the occurrence of nocturnal angina in CABG patients( OR=1.320, 95% CI: 1.084-1.607, P=0.006), the syntax-score, the fastest heart rate at night significantly affected the degree of OSAHS in CABG patients( OR=1.269, 95% CI: 1.094-1.473, P=0.002; OR=1.066, 95% CI: 1.004-1.131, P=0.036). Two linear regression showed a significant linear correlation between AHI with the fastest heart rate and syntax-score at night( R2=0.576, P<0.001; R2=0.658, P<0.001). Conclusion:OSAHS can significantly aggravate the degree of coronary artery stenosis in CABG patients, and further increase the incidence of nocturnal angina by significantly increasing nighttime heart rate.

2.
Allergy, Asthma & Immunology Research ; : 176-237, 2020.
Article in English | WPRIM | ID: wpr-785344

ABSTRACT

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.


Subject(s)
Adult , Humans , Asian People , Biomarkers , China , Consensus , Diagnosis , Diagnosis, Differential , Drug Therapy , Eosinophils , Epidemiology , Epigenomics , Genetics , Hypersensitivity , Inflammation , International Agencies , Medical Staff , Neck , Phenotype , Precision Medicine
3.
Chinese Journal of Emergency Medicine ; (12): 825-830, 2019.
Article in Chinese | WPRIM | ID: wpr-751859

ABSTRACT

Objective To examine the prevalence of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS),and to evaluate the relationship of OSA with inflammatory biomarkers in ACS patients.Methods Patients with ACS treated at Beijing Anzhen Hopital from June 2015 to May 2017 were enrolled.Subjects were evaluated for OSA by sleep study,and were divided into a normal-mild OSA group (Apnea Hypopnea Index,AHI < 15 times/h) and a moderate-severe OSA group (AHI ≥ 15 times/h).Laboratory examination and sleep study were monitored to analyze the effects of OSA on biomarkers by LSD-t test,Mann-whitney U test,or Chi-square test.Correlation analysis was performed to analyze the association of OSA with high sensitivity C-reactive protein (hs-CRP) by Spearman correlation anaylsis.Results A cohort of 836 patients with ACS were enrolled including 408 patients in the normal-mild OSA group and 428 patients in the moderate-severe OSA group.The levels of leukocyte(x 109L) [7.78 (6.33,9.86) vs 7.29 (6.01,9.16),P=0.006],neutrophils(× 109L) [5.05 (3.84,7.23)vs 4.80 (3.74,6.66),P=0.044],monocytes(x 109L) [0.42 (0.33,0.54) vs 0.39 (0.31,0.51),P=0.033],hsCRP(mg/L) [3.18 (1.10,11.52) vs 1.78 (0.65,6.46),P<0.01],fibrinogen(g/L) [3.17 (2.87,3.74) vs 2.97 (2.59,3.50),P=0.002],and uric acid(μmol/L) [360 (302,422) vs 341(283,407),P=0.006] in the moderatesevere OSA group were significant higher than those in the normal-mild OSA group.AHI (correlation coefficient=0.171,R2=0.020,P<0.01),ODI (correlation coefficient =0.201,R2=0.027,P<0.01),and TSaO2 < 90% (correlation coefficient =0.105,R2=0.005,P<0.01) were positively correlated with hs-CRP;minimal SaO2 (correlation coefficient=-0.100,R2=0.001,P=0.008) and mean SaO2 (correlation coefficient =-0.127,R2=0.006,P<0.01) were negatively correlated with hs-CRP.Conclusions For patients with ACS,the level of inflammatory markers in the moderate-severe OSA group is significantly higher than that in the normal-mild OSA group.Hs-CRP is significantly associated with the severity of OSA.Diagnosis and monitoring of OSA should be considered in ACS management in the future.

4.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 815-819, 2018.
Article in Chinese | WPRIM | ID: wpr-807650

ABSTRACT

Objective@#To explore the clinical effects and the influence factors of olfactory training in the treatment of olfactory dysfunction.@*Methods@#A total of 86 patients with olfactory dysfunction (49 post-infectious and 37 post-traumatic) in Beijing Anzhen Hospital during Dec 2016 to May 2017 were recruited in this prospective study. The clinical data of patients were analyzed, including gender, age, body mass index (BMI), course of disease, smoking history, drinking history, diabetes history, hypertension history, hyperlipidemia history, and anxiety visual analogue score (VAS). All patients were treated with olfactory training for 16 weeks, and all of them underwent Sniffin′ Sticks olfactory test before and after treatment, which was evaluated by composite threshold-discrimination-identification score (TDI). SPSS 23.0 software, paired t test and univariate and multivariate Logistic regression analysis were used to analyze the data.@*Results@#Eighty patients received treatment, including 46 post-infectious olfactory dysfunction and 34 post-traumatic olfactory dysfunction. After olfactory training, the total scores of TDI increased with statistically significant (18.3±8.6 vs 13.6±7.4, t=-6.158, P<0.05). The overall efficacy was 40% (32/80). The effective rate were 45.7% (21/46) in post-infectious olfactory dysfunction and 32.4% (11/34) in post-traumatic olfactory dysfunction respectively, with no statistically significant difference (χ2=1.441, P=0.230). Logistic regression analysis showed that the course of disease was an influence factor in the clinical curative effect (OR=0.881, 95%CI: 0.799-0.973, P=0.012). In patients with less than a year of olfactory dysfunction, the olfactory function improved obviously with the efficiency of 50.9% (29/57).@*Conclusion@#Sixteen weeks of olfactory training provides a significant therapeutic effect on the post-infectious and post-traumatic olfactory dysfunction, and the olfactory training can achieve better therapeutic effects at the early stage.

5.
Chinese Journal of Cardiology ; (12): 622-628, 2018.
Article in Chinese | WPRIM | ID: wpr-807118

ABSTRACT

Objective@#To investigate the impact of moderate/severe obstructive sleep apnea (OSA) on the prognosis of acute myocardial infarction.@*Methods@#We prospectively selected patients with acute myocardial infarction (AMI) who were hospitalized at the Emergency Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. Patients who met the inclusion criteria were examined with portable sleep respiration monitoring. Patients were divided into moderate/severe OSA group (apnea-hypopnea index (AHI)≥15 beats/hour) and no/mild OSA group (AHI<15 beats/hour) according to sleep AHI. The incidence of major adverse cerebrovascular events (MACCE) after discharge was compared between the two groups, and the independent risk factors of MACCE were analyzed.@*Results@#A total of 432 patients were enrolled in this study, including 211 moderate/severe OSA patients (48.8%). Compared with no/mild OSA group,patients with moderate/severe OSA had higher body mass index ((27.17±3.22) kg/m2 vs. (25.55±3.44) kg/m2, t=-5.033,P<0.001), higher proportion of history of percutaneous coronary intervention (PCI) (18.5%(39/211) vs. 8.6%(19/221), χ2=9.076,P=0.003), and higher proportion of 3-vessel disease (31.3%(66/211) vs. 24.9%(55/221), χ2=10.196,P=0.017). The median follow-up time was 1.0 (0.7, 1.7) years. The incidence of MACCE in the moderate/severe OSA and no/mild group was 19.9%(42/211) and 11.3%(25/221), respectively. Kaplan-Meier analysis showed a higher cumulative risk of MACCE in patients with moderate/severe OSA (log-rank test,χ2=5.467, P=0.019). Multivariate Cox regression analysis showed that moderate/severe OSA (HR=1.915, 95%CI 1.016-3.611, P=0.045) and diabetes mellitus (HR=1.819, 95%CI 1.022-3.238, P=0.042) were independent risk factors for MACCE at 1 year post discharge in patients with AMI.@*Conclusions@#Nearly half of AMI patients are complicated with moderate/severe OSA in this patient cohort. Coronary artery disease is more severe in AMI patients complicating with moderate/severe OSA. Moderate/severe OSA is an independent risk factor for MACCE at 1 year after discharge in patients with AMI. Whether the prognosis of AMI can be improved by intervention of OSA remains to be investigated.@*Trial Registration@#Clinical Trial.gov, NCT03362385.

6.
Chinese Journal of Internal Medicine ; (12): 571-575, 2018.
Article in Chinese | WPRIM | ID: wpr-807037

ABSTRACT

Objective@#To explore the association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease (CHD).@*Methods@#A total of 784 patients with CHD were consecutively enrolled at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. According to thyroid function test results, patients were divided into hypothyroidism group (79 cases) and non-hypothyroidism group (705 cases). All patients had undergone sleep monitoring. The sleep apnea status was compared between the two groups. Multivariate logistic regression and linear regression models were used to analyze the association between hypothyroidism and sleep breathing disorders in patients with CHD.@*Results@#The proportion of females, mean body weight and body mass index in the hypothyroidism group were higher than those in the non-hypothyroidism group [26.6% vs.16.2%, (78.6±11.6) kg vs. (75.7±12.0) kg, (27.7±3.2) kg/m2 vs. (26.6±3.5) kg/m2, all P<0.05]. Patients in hypothyroidism group had a decreased average oxygen saturation (SaO2) compared with patients in non-hypothyroidism group [ (93.2±2.9) % vs. (93.9±2.0) %, P=0.030]. In addition, events of hypoventilation in hypothyroidism group were significantly higher than those in non-hypothyroidism group[92.5 (45.8, 758.3) times vs. 68.0 (33.0, 125.0) times, P=0.013]. There were no significant differences in apnea hypopnea index, diagnosis of obstructive sleep apnea and other sleep breathing parameters between the two groups (P>0.05). A multiple linear regression analysis found that in patients with CHD, the correlation between hypothyroidism and average sleep SaO2 was significant (β=-0.508, 95%CI -0.989--0.026, P=0.039).@*Conclusions@#CHD patients with hypothyroidism had a lower sleep average SaO2, and a higher sleep hypopnea events. There is a correlation between hypothyroidism and sleep hypoxia in patients with CHD.@*Clinical trial registration@#clinicalTrials.gov, NCT03362385.

7.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 512-518, 2018.
Article in Chinese | WPRIM | ID: wpr-810047

ABSTRACT

Objective@#To investigate the indication, feasibility, and safety of da Vinci robotic surgical system in pharyngolaryngeal tumor resection. @*Methods@#Thirty patients were diagnosed with pharyngolaryngeal tumors and treated with a transoral robotic surgery (TORS) in Beijing Anzhen Hospital from June 1, 2016 through November 30, 2017. Inclusion criteria included lesions of the oropharynx (n=13), parapharyngeal space (n=7), larynx (n=6) and hypopharynx (n=4). Twenty cases were males and ten cases were females. The median age was 56 years old (ranging from 30 to 81 years). @*Results@#The robotic surgeries were performed successfully on 30 patients. One patient (3.3%) underwent TORS combined with a neck incision. The mean operative time was 40.7 min. The mean blood loss was 15.8 ml. The mean recovery time for oral intake was 5.3 days. The mean hospital stay was 9 days. None of the patients underwent tracheotomy or mandible split. Postoperative pathological examination showed that 18 cases (60.0%) were malignant and 1 case (5.6%) had positive surgical margin. Sixteen cases received neck dissection. No serious complications occurred during or after the operation. There was no local recurrence, metastasis or death except for regional recurrences in 2 cases (11.1%) with a follow-up of 1 to 18 months(median 13 months). @*Conclusion@#Transoral robotic surgery is a feasible, safe and effective surgical procedure with clear operation field, rapid surgical access, minimally invasive surgery, lesser hemorrhage, good cosmetic effect and fast recovery.

8.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 507-511, 2018.
Article in Chinese | WPRIM | ID: wpr-810046

ABSTRACT

Objective@#Using 18F-fluorodeoxyglucose (18F-FDG) and microPET-CT to test the feasibility of 18F-FDG PET-CT for validation of olfactory function of rats with standard phenethyl alcohol (PEA) and isovaleric acid (IVA) odors stimulation. To verify the possibility of 18F-FDG PET-CT as a new objective examination method for olfactory function. @*Methods@#Six healthy Sprague-Dawley (SD) male rats were selected with a weight of 250-300 g. First of all, buried food pellet test (BFT) was used to confirm the normal olfactory function of rats. Then in the next 3 days, after the intravenous injection of 18F-FDG (18 MBq/100 g), awaken rats were placed in a ventilated plexiglas cage for 30 min. Subsequently, pure air (the first day), PEA (the second day) and IVA (the third day) were delivered. After odor stimulation for 30 min, rats were performed by a static PET-CT under anesthesia. Images reconstructed were assessed by SPM method and analyzed by VBM method. Data was analysied by paired t test.@*Results@#Activation regions of rat′s brain after PEA stimulation included bed nucleus and insula. Activation regions of rat′s brain after IVA stimulation included olfactory bulb, anterior olfactory nucleus, amygdala, entorhinal cortex, olfactory cortex, piriform cortex, insula, prefrontal cortex, cingulate cortex and bed nucleus (P<0.005, Ke>20 voxels). @*Conclusions@#Through microPET-CT, we can observe that olfactory stimulation with different odors can induce metabolic activation in different regions of rat′s brain, which was in concordance with olfactory regions. The olfactory related brain regions of rats have strong responses to odor stimulation of IVA.

9.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 495-499, 2018.
Article in Chinese | WPRIM | ID: wpr-810044

ABSTRACT

Objective@#To investigate the white matter integrity in patients with olfactory dysfunction using diffusion tensor imaging (DTI). @*Methods@#Twenty-one patients with olfactory dysfunction and sixteen age, sex and level of education matched normal subjects were recruited in this study. Sniffin′ Sticks olfactory test was performed to evaluate the olfactory function of all subjects. We acquired diffusion tensor images with a echo planar imaging (EPI) sequence from all subjects on a 3T scanner. The fractional anisotropy (FA) images were performed using DTI-studio, and bilateral piriform cortex, orbitofrontal cortex, hippocampus and insula cortex adjacent white matter as well as capsula interna were delineated from the FA images as the region of interest associated with olfactory (ROIawo) manually. Independent sample t test analysis was used to compare the FA value of all ROIawo between the controls and patients. @*Results@#In olfactory dysfunction group, the FA value of adjacent white matter of right piriform cortex and orbitofrontal cortex were significantly lower than those of control group (0.42±0.05 (±s) vs 0.45±0.05, 0.43±0.06 vs 0.49±0.07, t value was 2.32, 2.79, respectively, all P<0.05). The FA value of adjacent white matter of left piriform cortex and orbitofrontal cortex had no significant difference compared with those of control group (0.43±0.05 vs 0.45±0.04, 0.44±0.04 vs 0.47±0.06, t value was 1.65, 1.37, respectively, all P>0.05). The FA value of the adjacent white matter of bilateral hippocampus, insula cortex and capsula interna had no significant difference compared with those of control group, neither (0.45±0.08 vs 0.44±0.08, 0.45±0.09 vs 0.44±0.10, 0.41±0.08 vs 0.39±0.07, 0.41±0.07 vs 0.38±0.05, 0.64±0.08 vs 0.63±0.08, 0.64±0.07 vs 0.63±0.07, t value was 0.30, 0.15, 0.88, 1.34, 0.14, 0.35, respectively, all P>0.05). @*Conclusions@#The patients with olfactory dysfunction showed abnormal white matter connection in the major primary and secondary olfactory cortex. The reduced white matter integrity in ROIawo might contribute to the pathogenesis of olfactory dysfunction.

10.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 414-418, 2018.
Article in Chinese | WPRIM | ID: wpr-810024

ABSTRACT

Objective@#To investigate the brain volume alterations in patients with hyposmia using voxel-based morphometry (VBM) and to correlate these alterations with the degree and duration of hyposmia.@*Methods@#Forty patients with hyposmia from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital since 2013 to 2016 and forty age and sex matched normal subjects were recruited in this study. Sniffin′ Sticks olfactory test was performed to evaluate the olfactory function of all subjects. We acquired T1-weighted magnetic resonance images from all subject on a 3T scanner. VBM was performed using VBM8 toolbox and SPM8 in a Matlab environment. Independent sample t test analysis was used to compare the volume of gray and white matter between the controls and patients. In addition, the Pearson or Spearman correlation analysis was used for the correlation between the voxel value of cerebral volume alterations area and the degree and duration of hyposmia on patients (threshold discrimination identification, TDI). @*Results@#Compared with the controls, patients showed significantly decreased volume in the gray matter of right orbitofrontal cortex (number of voxel in clusters was 226, t=-4.46, P<0.001, uncorrected). There was negative correlation between decreased gray matter volume of the right orbitofrontal cortex with significantly decreased area and the TDI results (r=-0.40, P=0.01), but positive correlation with duration of hyposmia (r=0.37, P=0.02). @*Conclusions@#The patients with hyposmia show gray matter atrophy of the right orbitofrontal cortex. The duration may be an important risk factor for decreased gray matter in patients with hyposmia.

11.
Chinese Archives of Otolaryngology-Head and Neck Surgery ; (12): 90-94, 2017.
Article in Chinese | WPRIM | ID: wpr-692153

ABSTRACT

OBJECTIVE To explore and evaluate the value of CT in diagnosis of malignant tumor of maxillary sinus and the accuracy of the involved bone wall by comparing the preoperative CT imaging with the pathologic examination.METHODS 11 patients without maxillary sinus squamous cell carcinoma and lymph node metastasis received pathological examination and enhanced CT scan before operation,partial or total maxillary resection were implemented according to the CT features and scope.The position and azimuth of the cut bone tissue samples were marked.The specimens were routinely fixed,decalcified,embedded,sliced and HE stained to observe the bone tissue pathological changes on the bone wall under light microscope.RESULTS Nasal sinus enhancement CT scan showed that the medial wall of maxillary sinus were all resorped and invaded(4 cases lack inner wall).Anterior wall was invaded in 6 cases,superior wall in 7 cases and bottom wall in 3 cases,posterior and exterior wall in 9 cases;After ruling out the cases without internal wall of maxillary sinus,the inner wall of the maxillary sinus was invaded by cancer cells,so was the front wall and the bottom wall.Those showed bone wall erosion on preoperative CT with continuous change but without interruption and accompanied by bone wall thickening and hardening were found without tumor invasion by postoperative pathological verification.CONCLUSION Bone wall damage on preoperative CT does not mean tumor invasion,and the probability of each maxillary sinus wall invasion is different;the comprehensive analysis found that for wormhole like change of bone wallon preoperative CT with continuous bone wall thickening and hardening of the 'reconstruction of bone destruction',there was no tumor invasion by postoperative pathological validation;Routine selection analysis of bone tissue pathology can supplement the extent diagnosis of malignant tumor of maxillary sinus on preoperative CT scan,so it can accurately estimate the T staging of tumor.It may provide a more effective basis for selection of minimally invasive surgery,postoperative evaluation of surgical effect and formulating more comprehensive treatment protocol.

12.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 27-30, 2016.
Article in Chinese | WPRIM | ID: wpr-749735

ABSTRACT

OBJECTIVE@#Evaluation and analyze the characteristics of balance function in patients with type 2 diabetes, and to find out the importance of proprioception, vision and vestibular in postural control.@*METHOD@#All subjects were divided into two groups, 37 normal individuals, 33 patients with type 2 diabetes mellitus. All were assessed by computerized posturography under six upright stance.conditions: including standing on the firm surface and foam with eyes open and closed.@*RESULT@#(1) On anteroposterior,the scores of proprioception, vision and vestibular were 93.96 ± 7.95, 80.22 ± 16.24, 70.87 ± 20.99, the normal were 98.00 ± 2.18, 91.44 ± 6.01, 80.44 ± 7.81. There were significances between diabetes mellitus group and normal control group (P 0.05.@*CONCLUSION@#The balance function of patients with type 2 diabetes decreased. It is the main characteristic that the vision and vestibular decreased more significantly in the postural control.


Subject(s)
Humans , Case-Control Studies , Diabetes Mellitus, Type 2 , Dizziness , Postural Balance , Proprioception , Vertigo , Vestibule, Labyrinth , Vision, Ocular
13.
Chinese Archives of Otolaryngology-Head and Neck Surgery ; (12): 81-83, 2016.
Article in Chinese | WPRIM | ID: wpr-493954

ABSTRACT

[ABSTRACT]OBJECTIVETo investigate the change of fibrinogen, soluable intercellular adhesion molecules-1 (sICAM-1), soluable vascular cell adhesion molecule-1 (sVCAM-1) in the blood of elderly patients with sudden sensorineural hearing loss (SSHL) and the difference between different type of SSHL.METHODS40 elderly patients with SSHL were subdivided into different types according to the newest guideline of diagnosis and treatment of Chinese medical association.They were subdivided into two groups with or without comorbidities.The control group were made of 40 healthy elderly people.The expression of fibrinogen, sICAM-1 and sVCAM-1 in the blood serum were detected and statistically analysed.RESULTSThe expression of fibrinogen, sICAM-1 and sVCAM-1 in SSHL patients were higher than that of the control group with statistical significance.There is no significant difference between different types of SSHL,though significant difference were found between groups with and without comorbidities. CONCLUSIONThere is increased expression of fibrinogen, sICAM-1 and sVCAM-1 in elderly SSHL patients;microcirculation dysfunction may play an dominant role in the pathogenesis of elderly patients with SSHL.

14.
Chinese Journal of Hospital Administration ; (12): 910-912, 2014.
Article in Chinese | WPRIM | ID: wpr-474698

ABSTRACT

2013 witnessed the full coverage of the medical insurance lump-sum prepayment management at all hospitals above secondary level in Beijing.As a result,medical insurance management of the hospital turned its focus from“ expense settlement” to“ expense management”,with a multidimensional,multi-method,multi-sectoral and multi-index lump-sum prepayment of medical insurance management system set up.Methods and concepts introduced included diagnosis related groups (DRGs) management tools in hospitalization service management; equivalent hospital departments comparison in outpatient service for post management; the concept of total budget management concept,and the “market-operations-finance-performance” linkage mechanism for priority control of drug expenses; and focused management on key patient groups and drug/consumable suppliers.

15.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 625-628, 2012.
Article in Chinese | WPRIM | ID: wpr-746732

ABSTRACT

OBJECTIVE@#To explore changes of olfactory and gustatory functions in patients with olfactory dysfunction.@*METHOD@#The 284 study subjects included 92 healthy volunteers, 92 with hyposmia and 100 with functional anosmia. Their olfactory and gustatory functions were examined using T&T olfactometer, olfactory event-related potentials (OERPs) and triple drop method, respectively.@*RESULT@#The T&T results showed that the difference between patients with hyposmia and functional anosmia and healthy subjects had statistical significance. The OERPs results showed that patients with olfactory dysfunction had N1 and P2 waves of prolonged latency and reduced amplitude when compared to healthy subjects with the difference of statistical significance. When compared to healthy subjects, patients with olfactory dysfunction had clear hypogeusia and the difference had statistical significance. There was no significant difference between female and male groups.@*CONCLUSION@#It is suggested that the apparently concomitant hypogeusia is in patients with olfactory dysfunction. Decreased of olfactory and gustatory function exhibited little or no relationship with gender. Combined examinations of OERPs, T&T and triple drop method, could make it possible to reflect the overall chemical sensory functions in subjects systematically and provide scientific evidence for clinical diagnosis and treatment early.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Ageusia , Diagnosis , Case-Control Studies , Evoked Potentials , Olfaction Disorders , Diagnosis , Smell , Taste
16.
Chinese Journal of Medical Science Research Management ; (4): 241-243, 2009.
Article in Chinese | WPRIM | ID: wpr-380567

ABSTRACT

The scientific research fund is an important resource for carrying out the scientific re-search projects effectively. Whether it can be reasonable used not only relates to the fulfilled quality, bene-fit, using direction and quantity, but also makes the reformation of management methods inevitable with the increase of quantities of the projects and funds. By summarizing the previously practical experiences, this paper explored the network managements of scientific research funds based on workflow in the hospital. By means of computer and network, the concept of workflow was further introduced to the application of platform of scientific research funds management. It embodies the charactor of approval flow in workflow management system. Finally the data of scientific research funds can be shared and integrated into multi-departments, so it is beneficial to improve the fund's benefit and strengthens the supervision in the whole process manage-ment.

17.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 454-455, 2008.
Article in Chinese | WPRIM | ID: wpr-749048

ABSTRACT

OBJECTIVE@#To evaluate the expression of eosinophil major basic protein (MBP) in chronic rhinosinusitis (CRS) and discuss the role of MBP in the pathogenesis in CRS.@*METHOD@#Thirty-eight nasal mucus obtained from CRS patients were used to detect the expression of MBP by Elisa assay. Thirty nasal mucus samples from health people were used as control.@*RESULT@#The expression of MBP of nasal mucus obtained from CRS patients was obviously higher than that of nasal mucus obtained from control. There was significant statistical difference (P < 0.01).@*CONCLUSION@#MBP was involved in the formation of CRS.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Blood Proteins , Metabolism , Case-Control Studies , Chronic Disease , Eosinophil Major Basic Protein , Mucus , Metabolism , Nasal Mucosa , Metabolism , Proteoglycans , Metabolism , Sinusitis , Metabolism , Pathology
18.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 219-221, 2007.
Article in Chinese | WPRIM | ID: wpr-748837

ABSTRACT

OBJECTIVE@#To observe the olfactory bulb's morphological change after ischemic injury in rats, and explore the role of vascular factor in olfactory disorders.@*METHOD@#Forty adult SD rats (weighting 250-300 g) were used, 30 of which were treated with permanent bilateral occlusion of both common carotid arteries, and the others were served as the control. The olfactory bulbs were carefully taken out on the 1st week, 4th week, 2nd month post operation, respectively, then observed the morphological changes by light microscopy. The ultra structure of cells in olfactory bulbs were also observed by transmission electron microscope.@*RESULT@#In rats with permanent bilateral occlusion of both common carotid arteries, the vascular pattern changed and the cell number decreased in olfactory bulbs by light microscopy. In the 1st week group, the mitral cells' mitochondria injury and metamorphism were found. In the 4th week group, the microvascular paramorphia, lipofuscin in mitral cells and metamorphic nerve fibers were found by transmission electron microscope.@*CONCLUSION@#Ischemia could injure the neuron and nerve fiber. This may be one of the reasons of olfactory disorders.


Subject(s)
Animals , Rats , Ischemia , Pathology , Microscopy, Electron, Transmission , Neurons , Pathology , Olfactory Bulb , Cell Biology , Pathology , Rats, Sprague-Dawley
19.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 771-774, 2007.
Article in Chinese | WPRIM | ID: wpr-748356

ABSTRACT

OBJECTIVE@#To analyze the correlation between olfactory disorders and the morphology of nasal cavity in chronic rhinosinusitis (CRS).@*METHOD@#One hundred and seventy-six patients with chronic rhinosinusitis and/or polyps were included. Olfactory function, the morphology of nasal cavity and nasal sinus, especially the morphology of olfactory cleft, were surveyed by T&T Olfactometer, nasal endoscope and computed tomography (coronal and horizontal position). All patients were divided into 5 groups by different olfaction level. Data was achieved by the scoring endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey and analyzed by SPSS 11.5.@*RESULT@#(1) Among all patients, 61.9% accompanied with hyposmia, 21% with anosmia , the other 17.1% with normal olfaction; (2) There was positive correlation between the scores of staging system of Lund-Mackey and the olfactory function level (P < 0.01) (3) There was positive correlation between the scores of endoscopic appearances of Kennedy and the olfactory function level (P < 0.05).@*CONCLUSION@#(1) Olfactory function were correlated with the severity of CRS; (2) As the determining methods of CRS, staging system of Lund-Mackey can be used to estimate the olfactory function generally and initially; (3) There was not significant difference between the scores of endoscopic appearances of Kennedy and the olfactory function level.


Subject(s)
Adult , Female , Humans , Male , Chronic Disease , Endoscopy , Nasal Cavity , Diagnostic Imaging , Pathology , Olfaction Disorders , Diagnostic Imaging , Pathology , Paranasal Sinuses , Diagnostic Imaging , Pathology , Sinusitis , Diagnostic Imaging , Pathology , Tomography, X-Ray Computed
20.
Chinese Archives of Otolaryngology-Head and Neck Surgery ; (12)2006.
Article in Chinese | WPRIM | ID: wpr-526692

ABSTRACT

OBJECTIVE To study how to properly evaluate the curative effect of chronic sinusitis and nasal polyps management with endoscopic sinus surgery(ESS). METHODS Nasal airway resistance, olfactory function, the morphological character of mucosa in nasal and sinus cavity after ESS were surveyed by anterior rhinomanometry,T&T olfactometer standard odors for measuring olfactory sense,acoustic rhinometry and scoring measure of mucosa. RESULTS After ESS, nasal airway resistance decreased and olfactory functions improved obviously. The morphological characters of mucosa in nasal and sinus cavity affect the surgical result directly. CONCLUSION As the determining methods of nasal function after/before ESS,anterior rhinomanometry,T&T olfactometer standard odors,acoustic rhinometry and scoring measure of mucosa can be used to comprehensive estimate the curative effect of ESS objectively.

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