Progress in clinical application of topical anesthesia / 中国临床药理学与治疗学

Topical anesthesia are being widely used in clinical diagnostic or therapeutic fields such as ophthalmology, ENT, dermatology, urology. It is defined as superficial loss of sensation in mucous membranes or skin, produced by direct application of penetrating local anesthetics. Topical anesthesia has the advantages of simple performance, high safety, quick recovery, which can effectively improve patient's satisfaction. In recent years, more and more attention has been paid to the concept of comfortable diagnosis and treatment. The new drugs and application methods of topical anesthesia are emerging constantly, special attention must be paid to their pharmacological characteristics and possible adverse reactions when using them. This article reviews the research progress of topical anesthesia in clinical application in order to provide reference for clinical practice.

The influence of subjective comfort of working environment on occupational stress of railway station workers / 中华劳动卫生职业病杂志

Objective: To explore the influential factors of job stress suffered by workers in railway stations, the level of job stress of were measured and subjective comfort of employees targeting to working environment were reported. Methods: In March 2019, a cluster sampling study was designed to collect the personal characteristics, job characteristics and subjective comfort degree of working environment of 432 employees in Chongqing railway stations. Meanwhile, job stress was assessed using the effort-reward imbalance scale. Chi-square test was used to compare the difference of occupational stress detection rate among different stratified factors such as occupational characteristics. Logistic regression was applied to analyze the influential factors of occupational stress. Results: The detection rate of job stress of workers in the railway stations was 31.02% (134/432) . The detection rate of job stress was higher among the divorced workers in railway stations, those earning less than 5, 000 yuan per month, those with 10-20 years' length of service, those who worked as a conductor and other workers including baggageman, station master on duty and assistant engineer (χ(2)=9.61, 14.76, 23.28, 11.06, P=0.008, 0.002, 0.000, 0.011) . The detection rate of job stress was higher among those whose working environment subjective feelings were uncomfortable, the differences were statistically significant (P<0.001) . The results showed that the occupational stress of the staff in the railway stations was influenced by their subjective feeling of air quality, noise and Space Layout (P<0.05) . The risk factors of occupational stress were air quality, noise and uncomfortable space layout (OR=0.571, 0.068, 0.441, P=0.051, 0.054, 0.007) . Conductor, other (Bellboy, Duty Station Master, assistant engineer) were the risk factors of occupational stress (OR=1.884, 2.703, P=0.065, 0.019) . The employees of station A and station B were the risk factors of occupational stress (OR=4.681, 1.811, P=0.002, 0.067) . Conclusion: The higher detection rate of job stress of workers in the railway stations is correlated with the subjective comfort degree of the working environment of the workers.

Effects of Loose Housing Designs on Expressions of Milking Parlour Behaviours and Milk Yield of Crossbred Jersey Cows

Milking behaviour of dairy cows has serious impacts on their production efficiency. A number of genetic and environmental factors controls and influences milking behaviour of dairy cow. The aim of present study was to investigate the influence of housing comfort on expressivity of milking behaviours of cows in parlour, milk yield and compositions. Forty Jersey crossbred cows of similar production levels were selected and divided into 2 groups based on age, production and parity. Subsequently, cows were kept in two different types of loose house; each containing 20 animals. Two types of housing patterns were compared - (i) Traditional shed (T0) and (ii) Thermo-comfortable shed (T1). Impact of housing comfort significantly transformed the expressions of dairy cows behaviour even in milking parlour. Milking temperament scores and stepping during milking were significantly lower in cows kept in T1 compared to that of T0. Cows of thermo-comfortable shed showed more docile, calm and less nervous behaviour than those kept in traditional shed. Housing patterns significantly influenced daily milk yield (kg) being 2.86% more in T1 as compared to T0. Similarly milk compositions were better and significantly higher in T1 group of cows than that of T0. It was concluded that staying comfort of living by resignificantly modulated the expression of dairy cows behaviours even in milking parlour, demonstrated favourable milking temperament, reduced nervousness, enhanced milk yield and showed better milk compositions in Jersey crossbred cows

Utilidad de mediciones objetivas para la programación en implantes cocleares / Use of objective measures for cochlear implant programming

RESUMEN Introducción: La programación adecuada de los implantes cocleares permiten lograr niveles de estimulación auditivos óptimos. Se realiza de forma individualizada, siendo la detección del umbral de confort ideal un desafío. Se ha descrito la utilidad de los potenciales auditivos del tronco encefálico eléctrico (ePEATC) y el reflejo eléctrico estapedial (eREE) para este propósito. Objetivo: Determinar la posibilidad de realizar ePEATC y eREE en pacientes adultos y pediátricos con implantes cocleares, y evaluar cambios en la programación de los implantes cocleares luego de las mediciones objetivas. Material y método: Se realizó un estudio prospectivo, descriptivo, de pacientes con implante coclear marca MED-EL®, separando los pacientes en dos grupos: el grupo adulto (n =5) y el grupo pediátrico (n =5). Todos los pacientes incluidos presentaron más de 6 meses de encendido del implante. Se evaluaron variables epidemiológicas y tiempo de encendido del implante. Se realizó una otoscopía, prueba básica de funcionamiento del implante, y las mediciones objetivas eléctricas (ePEATC, eREE). Con estos resultados se ajustó el umbral de confort. Resultados: El tiempo promedio de encendido del implante en el grupo adulto fue de 27 meses, y 30 meses en el grupo pediátrico. El ePEATC requiere más tiempo y cooperación al compararlo con eREE. Luego de estas evaluaciones objetivas, fue necesario el ajuste del umbral de confort en tres pacientes adultos, y en dos pacientes pediátricos. Fue necesario realizar una audiometría de campo libre para estimar el umbral de confort en dos pacientes pediátricos que no presentaron respuesta en eREE. Conclusión: Fue posible realizar estas mediciones objetivas en pacientes adultos y pediátricos, siendo mejor tolerado y requiriendo menos tiempo, el eREE.

ABSTRACT Introduction: Mapping a cochlear implant allows for adjusting ideal electrical stimulation limits. It is an individualized process and detecting the most comfortable loudness level can be challenging. The use of electrically evoked auditory brainstem response (ePEATC) and electrically evoked stapedius reflex thresholds (eREE) have been considered for this purpose. Aim: To determine the feasibility of performing ePEATC and eREE on adult and pediatric patients with a cochlear implant, and to evaluate changes in programming following these objective measures. Material and method: A prospective, descriptive study was completed, of patients with MED-EL® cochlear implants, separating patients into two groups: adults (n=5) and children (n=5). All of the patients included had their implants activated for 6 months or longer. Epidemiological variables and duration of implant activation were evaluated. Otoscopy, a basic implant functioning evaluation, and objective measures (ePEATC, eREE) were performed. With these results, comfortable loudness levels were adjusted. Results: Average duration of implant activation was 27 months and 30 months, for adults and children respectively. Performing ePEATC required more time and cooperation as compared to eREE. Following the objective measures, adjustment of the comfortable loudness levels was required for three adult and two pediatric patients. Sound field audiometry was necessary for two pediatric patients in order to estimate the comfortable loudness levels because the eREE responses were absent. Conclusions: It is feasible to perform these objective measures for both adult and pediatric patients, with eREE requiring less time and being better tolerated by patients.

Effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance / 重庆医学

Objective To investigate the effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance.Methods Two hundreds and thirteen children cases undergoing elective operation under general anesthesia were selected,aged 2-12 years old,ASA grade Ⅰ-Ⅱ,developmental normal,without mental system and cognitive dysfunction,and randomly divided into the experimental group 1,2 and control group.The children cases in the experimental group 1 conducted the anesthesia induction by their parents accompany on the operation day,while those in the experimental 2 conducted the anesthesia induction on the operation day after conducting the comfort anesthesia technique guidance.The control group was performed the conventional follow up before operation,the anesthesia induction was performed by the operation nurses and anesthesia doctor accompany on the operation day.Results There were statistically significant differences between the cases of slightly large age,with surgical experience,parents non-anxiety and psychological internal control type with the control group(P＜0.05).The difference between conducting the anesthesia induction guidance and non-conducting the anesthesia induction guidance was not statistically significant(P＞0.05).Conclusion The parents accompany comfort anesthesia induction technique can effectively increase the compliance during the anesthesia induction period in the children patients with slightly large age,operation experience,parents non-anxiety and psychological internal control type.

Effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance / 重庆医学

Objective To investigate the effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance.Methods Two hundreds and thirteen children cases undergoing elective operation under general anesthesia were selected,aged 2-12 years old,ASA grade Ⅰ-Ⅱ,developmental normal,without mental system and cognitive dysfunction,and randomly divided into the experimental group 1,2 and control group.The children cases in the experimental group 1 conducted the anesthesia induction by their parents accompany on the operation day,while those in the experimental 2 conducted the anesthesia induction on the operation day after conducting the comfort anesthesia technique guidance.The control group was performed the conventional follow up before operation,the anesthesia induction was performed by the operation nurses and anesthesia doctor accompany on the operation day.Results There were statistically significant differences between the cases of slightly large age,with surgical experience,parents non-anxiety and psychological internal control type with the control group(P＜0.05).The difference between conducting the anesthesia induction guidance and non-conducting the anesthesia induction guidance was not statistically significant(P＞0.05).Conclusion The parents accompany comfort anesthesia induction technique can effectively increase the compliance during the anesthesia induction period in the children patients with slightly large age,operation experience,parents non-anxiety and psychological internal control type.

Comparison of Acceptable Noise Levels Using Korean and Non-Semantic Speech Signals in Normal Hearing Subjects / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The acceptable noise level (ANL) test measures the maximum noise level that a subject can tolerate while following speech. Given the limited investigation of ANL across different languages, this study aimed to compare ANLs using both Korean semantic speech and non-semantic speech signals (reversed Korean speech and international speech test signal, ISTS) in normal-hearing subjects. SUBJECTS AND METHOD: Twenty-five subjects with normal hearing (9 males, 16 females, with the mean age of 28.5±3.15 years) were included in the study. ANLs were obtained using three speech materials (Korean speech, reversed Korean speech, and ISTS) as the target speech material and an eight-talker babble noise as the competing background noise. RESULTS: Generally, the inter-subject variability was large. The ANLs did not differ statistically regardless of the type of speech signal. CONCLUSION: The ANLs seemed to be unaffected by the meaningfulness or semantic contents of the target speech, at least in normal-hearing adults. Thus, non-meaningful speech signals or non-semantic material can be considered as the target signal for the implementation of ANL test.

The Use of Acceptable Noise Level on Monaural and Binaural Amplification in Hearing Aids Fitting / 听力学及言语疾病杂志

Objective To compare the relationship of acceptable noise level (ANL) between monaural and binaural hearing aid in patients with bilateral moderate-to-severe hearing loss, and to investigate the clinical significance of the ANL in binaural hearing aid fitting and the predictive role in the hearing aid effect assessment.Methods A total of 15 patients with bilateral moderate-to-severe hearing loss were selected, and the most comfortable levels (MCL), background noise level (BNL) and calculate ANL were tested, respectively, in 4 conditions: without hearing aids, fitted only left ears, fitted only right ears and binaural fitting.Results The ANL in 15 subjects measured at 4 conditions were 18.87±5.26, 12.60±2.47, 12.00±2.90, and 5.13±1.25 dB S/N, respectively.The MCLs were 80.40±9.28, 63.73±5.15, 62.27±5.36, and 61.80±6.05 dB HL, respectively.The BNLs were 61.67±6.14, 51.13±3.94, 50.27±4.50, and 56.67±5.16 dB HL.The ANL difference between the only left and right fitting groups was not statistically significant(P>0.05).The ANL difference between the monaural or the binaural hearing aid group and without hearing aids group were statistically significant (P<0.05), respectively.Compared with the monaural hearing aid group, the binaural hearing aid group had significantly lower ANL(P<0.05).Conclusion For people with bilateral hearing loss, hearing aids can improve their ability to manage the background noise, and binaural hearing aid fitting is better than monaural.

Analysis of Debugging Results in Congenital Deaf Children after Cochlear Implantation / 中国医科大学学报

Objective To investigate the changes of electrode impedance,threshold(THR),maximum comfortable level(MCL),and dynamic range(DR),providing the basis for debugging after operation in congenital deaf children. Methods A respective study was carried out on 20 cases of congenital deaf children who were implanted with cochlear Med?EL SONATAti100. The measurements and changing ranges of electrode imped?ances,THR,MCL and dynamic range during the operation and at postoperative one month,three months,and six months were statistically analyzed. Results Electrode impedances were the lowest during the operation and the highest at one month after operation(P0.05). Conclusion The electrode impedances varied due to different electrode posi?tion. The vales of THR,MCL and DR were unrelated with electrode impedance. DR was gradually increasing,MCL reached steady state earlier than THR. It is important that THR should be debugged at three months after operation and MCL should be debugged at six months.

Application of Comfortable Nursing for Body Position in Endoscopic Thyroidectomy / 中国微创外科杂志

[Summary] A total of 108 cases of endoscopic thyroidectomy via thoracic approach were conducted in our department between January 2012 and January 2015.The comfortable nursing was applied during the operation.The patients’ body position was adjusted properly according to requirements of the operation at different periods of pre-operation, intra-operation and post operation.No complications due to nursing mistakes or improper position occurred in the 108 patients. Follow-up checkups on the second postoperative day found 2 patients with vomiting.According to the Wong-Banker Faces Pain Scale to evaluate the head and back pain, there were 46 cases of 0 point, 51 cases of 1 point, 11 cases of 2 points.We got the conclusion that the application of comfortable nursing for proper position of patient not only reflects the nursing principle of Patients First, but also improves the entire quality of nursing services.

Effects of Mandarin Speech Rate on Mandarin AcceptabIe Noise LeveI Test in NormaI Hearing AduIts / 听力学及言语疾病杂志

Objective To investigate the effects of Mandarin speech rate on Mandarin acceptable noise level test in normal hearing adults.Methods Using the national Putonghua proficiency test material to produce 0.8 times,1.0 times and 1.2 times speed rate of ANL test materials.ANL tests were measured for 58 normal hearing a-dults using different peed matetrials.For each case,the most comfortable loudness(MCL)and background noise lev-el(BNL)were found.The ANL was then computed by subtracting the mean BNL from MCL.ResuIts Statistic anal-ysis indicated that there were no significant differences of the ANL(P>0.05)among the differenct speed materials, there were no correlation between MCL-ANL (P>0.05),negatively correlation between BNL-ANL(P<0.05)a-mong the differenct speed materials.ConcIusion Mandarin speech speed does not effect ANL test,the more the in-dividual’s ability to accept the background noise,the smaller the value of ANL.

A Study of Clinical Feasibility of Acceptable Noise Level Test / 听力学及言语疾病杂志

Objective To observe the clinical feasibility of the acceptable noise level (ANL) test ,analyze the effect of different test instructions to the result of Mandarin acceptable noise level test .Methods Twelve young peo-ple (24 ears) with normal pure-tone test and acoustic immittance test (threshold≤15 dB HL) were included in this study .They were randomly divided into two groups with 12 ears in each group .Group A received the same test in-struction firstly and then received different instructions depended on the different translation of English instruction by tester .Group B received the reverse test order .The acceptable noise level(ANL) ,most comfortable level(MCL) and back groud noise level(BNL) were analyzed .Results The average value of ANL was 7 .5 ± 6 .61 and 8 .29 ± 6 .54 dB SPL ;the average value of most comfortable level (MCL) was 83 .58 ± 8 .57 and 85 .41 ± 8 .89 dB SPL ;the average value of background noise level (BNL) were 78 .92 ± 10 .56 and 77 .13 ± 7 .91 dB SPL respectivoly .The difference of MCL ,BNL ,ANL in these two groups were not statistically significant (P>0 .05) .Test method 1 re-sulted in great individual differences in ANL ,which it ranged from -6 .4 to 20 .12 dB S/N .While ANL from test method 2 ranged from 2 .50~20 .12 dB S/N .Conclusion Different test instruction do not correlated to the results of acceptable noise level ,testers can translate the English instruction by different ways so that it is convenient to the application and clinical research of ANL test .

Evaluation on effect of comfortable nursing in percutaneous coronary intervention for patients with acute myocardium infarction / 中国实用护理杂志

Objective To observe the application effect of comfortable nursing in percutaneous coronary intervention for patients with acute myocardium infarction.Methods 112 patients with acute myocardium infarction receiving the treatment of percutaneous coronary intervention were randomly divided into the observation group and the control group,each group including 56 cases.The control group was given conventional nursing,and the observation group was given comfortable nursing.Hospitalization time,nursing satisfaction degree,psychological status before and after treatment and life quality for patients in two groups were evaluated.Results The nursing satisfaction degree,nursing effect and life quality for 56 patients in the observation group were higher evidently than those in the control group.And the average hospitalization time of the observation group was lower than that of the control group.The comparison between two groups had statistical significance.Conclusions Comfortable nursing in percutaneous coronary intervention for patients with acute myocardium infarction can evidently improve medical quality,and can provide strong guarantee for the life and safety of patients.

An investigation of the temperature and heat stimulation sense with ginger-partitioned moxibustion / 全日本鍼灸学会雑誌

[Purpose]Ginger-partitioned moxibustion is indirect moxibustion of putting sliced ginger between the skin and the moxa. It can give mild stimulation with damp heat. The characteristic of the temperature by the thickness of the ginger was investigated with a temperature sensor without changing the weight of the moxa. Moreover, the relation between the result of a questionnaire on thermal sense and maximum temperature was investigated by applying different thicknesses of ginger-partitioned moxibustion to participants.<BR>[Method]A thermometer was fixed on a wood board 3mm thick. Ginger was cut in a 2 cm square, in three kinds of thickness; 3mm, 5mm, and 7 mm. The temperature change was measured every 30 seconds when the cone-shaped moxa (weight: 200 mg, diameter: 2cm, height: 2cm) was burnt on the ginger for each thickness. Next, the thermal sense of the human body was investigated for ginger-partitioned moxibustion. The maximum temperature of ginger-partitioned moxibustion to the forearm of participants was measured by the thermometer set between the sliced ginger and skin. After moxibustion, we did a questionnaire survey about thermal sense and comfort sense.<BR>[Result]As a result of measuring the temperature on the wood board, the maximum temperature decreased and the time to reach the maximum temperature took a long time according to ginger thickness. Ginger-partitioned moxibustion applied to the human body resulted in a correlation between thermal sense and the maximum temperature. The thinner sliced ginger had the stronger thermal sense. Participants who answered little comfort, comfortable or very comfortable were 5/10 people in the 3mm thickness sliced ginger, 9/12 people in the 5 mm ginger group, and 5/9 persons in the7 mm ginger group.<BR>[Discussion and Conclusion]The thickness of ginger can be an important factor that influences the quantity of stimulus of ginger-partitioned moxibustion. In investigating the comfort sense, the stimulation of ginger-partitioned moxibustion was expected to give the comfort. But four of ten participants who received ginger-partitioned moxibustion with a 3mm thickness felt uncomfortable. If we apply ginger-partitioned moxibustion of 200 mg to patients without discomfort, it is undesirable that the ginger thickness be 5 mm or less.

Influence of comfortable nursing on life quality and satisfaction degree of patients with malignant tumor undergoing chemotherapy / 中国实用护理杂志

Objective To explore the role of comfortable nursing in patients with malignant tumor undergoing chemotherapy and the quality of life and satisfaction degree in patients after chemotherapy. Methods 100 patients with malignant tumor undergoing chemotherapy were divided randomly into the observation group and the control group(each had 50 cases). The observation group took the comfortable nursing, the control group was applied with the traditional nursing method, their comfort degree,satisfaction degree and life quality after chemotherapy were observed and compared. Results Comparing the results of two groups of patients, the satisfaction degree of the observation group was significantly higher than the control group, the scores of life quality for the observation group and the control group were (45.2±5.1 ) and (34.1 ±4.6) respectively. Conclusions Comfortable nursing for patients with malignant tumor undergoing chemotherapy may improve their comfort degree, satisfaction degree and life quality, and hence is worthy of being recommended in clinical practice.

The Effects of Cochlear Implantation on Children with Large vestibular Aqueduct Syndrome / 听力学及言语疾病杂志

Objective The purpose of this study is to compare the most comfortable levels and neural re-sponse imaging threshold between children of cochlear implants with large vestibular aqueduct syndrome and normal inner ears. Methods Thirty-eight implanted children participated in this study and were divided into two groups. Group A consisted of 32 patients with normal inner ears and group B 6 patients with radiographically proven large vestibular aqueduct syndrome. All of the patients were the recipients of the cochlear implants by Advanced Bionics. The initial time for the first programming session was approximately one month after surgery. The psychophysical tests included M- level tests. Programming techniques used in the test were suitable for the age of patients. Sound-Wave 1.4 software was used to test tNRI. Results Using the rank sum test, M-level and tNRI of electrode 3,7,11 and 15 did not differ significantly between group A and B(P>0. 05). Conclusion The parameters of mapping are not significantly different between the implanted children with large vestibular aqueduct syndrome and normal inner ear. The management and procedures of mapping used to the subjects with normal inner ear can be applied to the children with large vestibular aqueduct syndrome.

Research about using comfortable nurisng for patients with malignant tumor to promote their qual-ity of life / 中国实用护理杂志

Objective To know the influence of comfortable nursing for paitnets with malignant tumor on promoting their quality of life. Methods Selected 995 patients with malignant tumor who had diagnosed by pathology and coured by chemotherapy or radioehemotherapy. Divided them into the experimental group (498 cases) and the control group (497 cases) randomly. Routine nursing cares were used in the control group,while the comfortable nursing cares were used in the experimental group in addition. QLQ-C30 was used to evaluate the level of patients'quality of life at the time of beginning, ending and the midpoint of the treatment. Results There was no significant difference between the two groups about the QLQ-C30 values at the beginning of the treatment, while the differences were signifi-cant at the other two time points, the level of quality of life in the experimental group was better than in the control group. Conclusions Comfortable nursing can promote quality of life of patients with malignant tumor, which should be developed in the clinical field.

Long Term Changes of Electrical Stimulation Levels in Children with Cochlear Implant / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The goal of mapping after cochlear implantation (CI) is to find a proper range of acoustic signals for the implantees. In young children or infants, however, it is more difficult to obtain reliable responses during mapping procedure. The purpose of this study was to observe the changes of the proper electrical stimulation levels (threshold levels, comfortable levels and dynamic range) in children with the Nucleus 24 cochlear implant system by analyzing postoperative mapping results. SUBJECTS AND METHOD: The maps of 23 children with normal inner ear who received CI were examined at 7 time intervals (1, 6, 12, 24, 36, 48 and 60 months post-connection). RESULTS: The mean value of C levels and DR of 23 children gradually increased according to time from 1 month to 60 months post-connection. The value of T level increased up to 6 months post-connection and then stabilized. CONCLUSION: This study emphasized the need for frequent mapping in the first 6 months of implant use in children. Protocol for regular mapping schedule from 1 year to 5 year post-connection would be necessary.

Application study of comfortable nursing in patients with skin flap transplantation after hand injury / 中国实用护理杂志

Objective To explore the application effect of comfortable nursing in patients with skin flap transplantation.Methods 140 patients with skin flap transplantation after hand injury were divided into the observation group and the control group with 70 cases in each group.The control group received routine numing while the observation group was given comfortable numing.The numing effect of the two groups was compared.Results The rehabilitation effect of the observation group was beuer than that of the control group(P＜0.01).Conclusion Comfortable nursing had evident promoting effect for the rehabilitation of patients with skin flap transplantation after hand injury.

Effect observation of comfortable care in reducing insomnia for cerebral infarction patients / 中国实用护理杂志

Objective To explore the effect of comfortable care in alleviating insomnia for cerebral infarction patients and improve the health of the patients. Methods Selecting 231 conscious and hospitalized cerebral infarction patients randomly from January to December,2005.Giving apprpfi-ate comfortable care measures in acute period,stable period and recovery period.Insomnia WaS evaluated at admission and after two weeks of hospitalization.Results Insomnia of cerebral infaretion patients allevi-ated after two weeks,which was statistically different from that at admission.P<0.01. Conclusions Comfortable care is significant to alhviate insomnia of cerebral infarction patients.reduce the com-plication and improve the quality of nursing service.We should emphasize it and put it into practice widely.