Ethical Problems Existing in the Application of Mobile Phone Application Software in Pre - Hospital Emergency Volunteers and Its Countermeasures / 中国医学伦理学

China's pre - hospital emergency resources are shortage, city traffic is congestion, and the arrival of ambulance takes some time. For this reason, the emergency center designed and manufactured a pre - hospital e-mergency volunteer mobile application software. This paper analyzed some ethical problems encountering in the practical application of the software in the 120 emergency alarm of Hangzhou area, such as volunteer identification, patient information confidentiality, volunteer rescue whether to cause a dispute and other issues, and gave the rele-vant solution countermeasures, including setting access threshold for the emergency volunteer, adopting various technical measures to protect the information of patient and formulating and perfecting the relevant legal regulations.

Iron and zinc levels in tonsil of the patients with tonsillar hypertrophy or chronic tonsillitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the roles of iron and zinc in the pathogenesis of recurrent tonsillitis and tonsillar hypertrophy.METHODS In total,40 patients who underwent a tonsillectomy to treat chronic tonsillitis or tonsillar hypertrophy were included in the study.Patients were divided into 2 groups,chronic tonsillitis or tonsillar hypertrophy group.The levels of iron and zinc elements were measured for each tonsillar tissue sample.RESULTS There was a significant difference in the iron and zinc level (P＜0.001) between the tonsillar hypertrophy and chronic tonsillitis groups.The levels of iron and zinc were significantly lower in the chronic tonsillitis group.CONCLUSION The results suggest that low tissue concentration of iron and zinc may lead to chronic tonsillitis.

OSAHS patient gas up-take cross-sectional area nasopharynx sound reflection examination and significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore a simple and accurate method for localization of upper airway obstruction in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and provide instructions for surgical treatment.@*METHOD@#Fifty OSAHS patients confirmed by PSG underwent acoustic rhinometric and pharyngometric assessment by Eccovision. The parameters were recorded, including nasal minimal cross-sectional area (NMCA), distance of MCA from the nostril (DCAN), minimum cross-sectional area at the nasal valve(MCA), nasal resistance (NR) and nasal volume from 0 to 6 cm from the nostril (NCV), as well as pharyngeal cross-sectional area (CSA) and volume from 4.8 to 15.0 cm. The sensitivity and specificity of acoustic rhinometry and pharyngometry on localization of airway obstruction was determined by a comprehensive imaging and endoscopic study.@*RESULT@#In 50 cases with severe OSAHS, NMCA, DCAN, MCA, NCV, NR were (0.61 +/- 0.35) cm2, (2.06 +/- 0.12) cm, (0.87 +/- 0.12) cm2, (9.24 +/- 2.31)cm3 and (0.51 +/- 0.32)kPa/(L x min), respectively. Pharyngeal CSA and volume were statistically significantly lower than that in control group (P < 0.01). The value of DCAN was (2.06 +/- 0.12) cm, (9.50 +/- 4.08) cm, (13.10 +/- 2.52) cm in type I II, III patient, respectively. Compared with the control group, the difference was statistically significant.@*CONCLUSION@#Acoustic rhinometry and pharyngometry is a simple and safe method in localization of airway obstruction in patients with OSAHS.

The applied anatomical study for transethmoidal-sphenoid optic nerve decompression under endoscopy / 中华显微外科杂志

Objective To explore the anatomy for transethmoidal-sphenoid optic nerve decompression under endoscopy and its significance in operation. Methods Fifteen cases (30 sides) of formalin-fixed adult optic canal specimens were dissected under the microscope. The anatomic characteristics of the optic canal and its adjacent were observed, and the relative parameters were evaluated according to nasal endoscopic approach. Results ①The relationship between the optic carotid triangle(OCT)with the optic canal, the ophthalmic artery, the cavernous sinus and the internal carotid artery were invariable, its present ratio were in 66.7%. ②The mean distance from the front margin of nasal columella floor to medial wall of the orbital opening, middle portion and the cranial opening in the optic canal were (72.79 ± 5.40)mm, (75.85 ± 5.10)mm and (79.34 ± 4.95)mm, respectively, and the elevation angles were (39.45 ± 3.68)°, (37.30±4.24)°and (35.45 ± 4.16)°, respectively. ③The mean thickness of sheath in the medial wall of the orbital opening,middle portion and the cranial opening were (0.70 ± 0. 18)mm, (0.51 ± 0.15)mm and (0.49-0.22)mm,respectively. The difference in thickness between the orbital opening and middle portion, the cranial opening were very remarkable(P ＜ 0.01 ). ④The lateral deviate distance from medial wall of the orbital opening, middle portion and cranial opening to sagittal median plane of cadaveric were 1/2 (12.69 ± 2.73)mm、1/2( 19.61± 3.47)mm and 1/2 (25.79 ± 3.23)mm, respectively. Conclusion OCT is the most reliable anatomic landmark to locate the optic canal, and the key point is at the orbital opening of the optic nerve in the optic nerve decompression. It is secure and feasible to cut the sheath from the place where the medial wall crosses the superior wall of the optic nerve.

Applied anatomy study of optic canal by transnasal endoscopy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To provide transnasal endoscopic optic canal decompression with the anatomic reference.@*METHOD@#15 samples of the adult corpse wet specimen (30 sides for the optic canal) were examined under the endoscope to scrutinize the regional anatomy of the optic canal.@*RESULT@#distance between the spina nasalis anterior and the midpoint of optic canal medial wall is (61.02 +/- 5.83) mm, and the angle between spina nasalis anterior and the midpoint of optic canal medial wall is (45.1 +/- 4.81) degrees. The medial wall of optic canal is longest, with an average length of (11.61 +/- 1.58) mm; the lateral wall of optic canal is thickest, and the medial wall thinnest. 10 traumatic blind patient underwent endoscopic optic canal decompression with satisfactory outcome.@*CONCLUSION@#The regional anatomy of the optic canal under endoscope is of importance to endoscopic optic canal decompression. Which is microinvasive with direct approach and clear view thus is widely used in clinical practice.