Common Medical Ethical Problems in the Diagnosis and Treatment of Otorhinolaryngology Diseases / 中国医学伦理学

Otorhinolaryngology is a high-risk department of a hospital, where there are many emergency critical diseases, common multiple diseases and major malignant diseases. Therefore, it is easy to cause many medical ethical problems. This paper analyzed the clinical status and characteristics of various otolaryngology diseases systematically, and expounded the related medical ethical issues in the diagnosis and treatment of otorhinolaryngology, including doctor-patient trust, safety and informed consent. Finally, the paper put forward a number of measures to do well the psychological evaluation and nursing care of patients, improve the professional skills of medical and nursing care, formulate the treatment plan of diseases, enhance the supervision and management of the network, and promote the social support of patients. The aim was to alleviate the "doctor-patient conflict" and create a harmonious medical environment.

The therapeutic effect of proton pump inhibitor on alleviation of hoarseness symptoms in patients with laryngopharyngeal reflux / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the therapeutic effect of proton pump inhibitor(PPI) on alleviation of hoarseness symptoms in patients with laryngopharyngeal reflux(LPR).@*METHOD@#The LPR outpatients in ENT department of our hospital(60 cases)complained of hoarseness were enrolled in the study from August of 2013 to October of 2014. All of them were randomly divided into group A and B. The individuals in group A (30 cases) taked golden voice capsule to treat for 3 months, while the individuals in group B (30 cases) taked golden voice capsule and omeprazole to treat for 3 months. The data about reflux symptom index (RSI), reflux finding score (RFS) and voice handicap index (VHI)from the first month to the third month after treatment were recorded and compared group A with group B.@*RESULT@#The scores of RSI and RFS in patients (60 cases) before treatment were significantly correlated with their VHI (r=0. 823, P0. 05; t=0. 376, P> 0. 05).@*CONCLUSION@#PPI therapy could significantly alleviate the hoarseness symptom in LPR patients.

The expression and clinical significance of pepsin and pepsinogen in patients with otitis media with effusion / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the role and significance of pepsin and pepsinogen in the pathogenesis of OME in children.@*METHOD@#Pediatric patients with otitis media aged 2-8 years who enrolled in our department of the hospital from May of 2012 to December of 2012 were set as experimental group (38 cases, 48 ears) which should be underwent tympanic membrane puncture/tube insertion. Meanwhile, pediatric patients waiting for cochlear implant without otitis media (10 ears), were set as control group. Middle ear lavage fluid and plasma samples from the two groups were collected and detected using enzyme-linked immune method for pepsin and pepsinogen.@*RESULT@#The concentrations of pepsin and pepsinogen in the middle ear lavage fluid of OME group [(48.8 ± 415.99) ng/ml and 676.32 ± 336.71)ng/ml] were significantly higher than those in the control group [(8.20 ± 4.59)ng/ml and (77.27 ± 50.33) ng/ml] (P 0.05).@*CONCLUSION@#Pepsin and pepsinogen in the middle ear cavity of OME patients maybe originated from laryngopharyngeal reflux (LPR), indicating that LPR is associated with the pathogenesis of OME in children.

Expression and significance of Toll-like receptors in fungal rhinosinusitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the expression of Toll-like recptor2(TLR2)and Toll-like receptor4(TLR4) in the fungal rhinosinusitis tissues,and to explore the role of TLR2 and TLR4 in the pathogenesis of fungal rhinosinusitis.METHODS The mRNA and protein expression of TLR2 and TLR4 were detected by reverse transcription polymerase chain reaction(RT- PCR)and immunohistochemistry(IHC)in 24 fungal rhinosinusitis tissues,24 chronic rhinosinusitis tissues,and 15 normal mucosa of inferior turbinate. RESULTS The mRNA expression of TLR2 and TLR4 in fungal rhinosinusitis tissues(0.208?0.063,0.159?0.059)was significantly decreased compared with that in chronic rhinosinusitis(0.505?0.097,0.406?0.102)and normal inferior turbinate tissues(0.327?0.047;0.232?0.088).The protein expression rates of TLR2 and TLR4 in fungal rhinosinusitis tissues (3/24,4/24)were significantly lower than that in chronic rhinosinusitis(20/24,21/24)and normal inferior turbinate tissues(7/15,8/15)by IHC study. CONCLUSION The lower expression of TLR2 and TLR4 in fungal rhinosinusitis tissues indicates that the declined role of TLR-mediated innate immune responses in the defensive reaction of anti-fungal in sinonasal mucosa,which may be one of the reasons for dropped clearance rate and increased susceptibility to fungi.