Evaluation on the hearing, speech and quality of life for cases received cochlear implant / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the use of the categories of auditory performance (CAP-II), the speech, spatial and qualities of hearing scale-parents' version (SSQ-P), children using hearing implants quality of life (CuHI-QoL) in patients with prelingual hearing impairment to compare the rehabilitation effect between preoperative and postoperative auditory performance, speech behavior and quality of life and at the same time to figure out dose rehabilitation effect connected to age.@*METHOD@#Mainly used classification method to compare the audotory performance, speech behavior and quality of life of 50 patients before and after 2.5 years after the implantation. At the same time these 50 patients are divided on the basis of the age received the surgery, A group received the surgery before 6(1.0-5.9) years old and group B received the therapy after this age (6.0-10.9). Their auditory performance, speech behavior and quality of life were all evaluated.@*RESULT@#There were statistical difference between two kinds of classification method of CAP-II. In the study of SSQ-P and CuHI-QoL, there was no statistical difference in well-being and happiness before and 3 years after the implant, also there was no statistical difference in parental stress between two age groups. In addition to the above two, the rest all have statistical significance.@*CONCLUSION@#After the implant, postoperative auditory performance, speech behavior and quality of life all had improved and the smaller the age, the better the performance.

Middle ear cancer recurrence after operation+radiotherapy with adjacent tissue necrosis: two cases report / 临床耳鼻咽喉头颈外科杂志

Retrospective analysis of two cases of advanced carcinoma of the middle ear. Two patients underwent operation and radiotherapy. A case developed extensive necrosis in ear and neck, which finally led to lethal hemorrhage. Multiple relapse with cranial fossa invasion and extensive necrosis was found in the other case.

A questionnaires study on cochlear implantation in patients with white matter changes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This article evaluates the auditory and speech perception outcomes of sensorneural hearing loss with cerebral white matter abnormalities after cochlear implantation.@*METHOD@#A retrospective analysis was performed on the cochlear implantatees with cerebral white matter abnormalities by using the categories of auditory performance and speech intelligibility rating, and compared with the non-syndrome patients with sensorineural hearing loss. Paired t-test was used for statistical analysis.@*RESULT@#There was statistical difference between normal group and white matter changes group with sensorineural hearing loss after 6 month. No statistical difference was found after 12 month and 24 month.@*CONCLUSION@#In the short term, the cochlear implant can be performed safely in patients with white matter changes. After a formal rehabilitation training,no significant difference in auditory or language ability was found between normal group and white matter changes group with sensorineural hearing loss.

Identification method of Stephania tetrandra and its adulterants / 国际中医中药杂志

Aiming at the confused situation of Stephania tetrandra and its adulterants in the production,supply and sale market,the author had overviewed information on Stephania tetrandra and its adulterants in source,character identification,microscopic identification,physical and chemical identification at home and abroad in recent years,so thus for scientific identify of species,distinguishing between the families and genera and correcting medication for clinical use.

Insight on breakthroughs expected for public hospitals reform / 中华医院管理杂志

In view of the two acute problems of excessive medical service and over-fast increase of medical expenditure as currently complained by the Chinese people, the author proposed that public hospitals take the 3 + 1 pattern in their reform. This pattern calls for reform in the payment mode,coordinated implementation of clinical pathways and standardization of outpatient prescriptions, as well as intensification of medical supervision and reform of hospital' s internal incentives and operation mechanism. All these measures should proceed in an interconnected and mutual-improvement manner,while internal incentives should ensure effective implementation of external obligatory reform measures,in an effort to control costs, ensure quality of care, mechanism change and a win-win outcome. The paper also proposed the key points and cautions for the reform.

Diagnostic diagnosis of thyroid microcarcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate how to improve the rate of clinically diagnosis of thyroid microcarcinoma.@*METHOD@#Clinically diagnostic data of 73 cases with TMC, operated and confirmed by pathology from Jan. 2000 to Dec. 2009 were retrospective analyzed, the data were divided into A, B groups, A group (21 cases) can touch the regional lymph nodes and/or thyroid nodule with hard quality; B group(52 cases) can't touch the regional lymph nodes and/or thyroid nodule with hard quality, and the data was analyzed by statistical software.@*RESULT@#Fifty-three cases diagnosed preoperatively and intraoperatively, the diagnosis rate was 73% (53/73). A group including 18 ca ses, diagnostic rate was 86% (18/21); B group including 35 cases, diagnostic rate was 67% (35/52); A variety of auxiliary examination and intraoperative exploration, etc, was statistically significant for improving the diagnostic rate of TMC.@*CONCLUSION@#The clinically missed diagnostic rate of TMC was high, but the physicians adequate attention, careful palpation before surgery, the corresponding auxiliary inspection measures will help improve the clinically diagnostic rate of TMC.

Clinical anatomical study of the adult lateral skull base / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Through the observation and the measurements of the significant anatomical landmark the lateral skull base, to provide anatomical data of clinical location and navigation for surgery at the lateral skull base.@*METHOD@#Significant anatomical landmarks of twenty adult cadaveric heads (40 sides) fixed in 10% formaldehyde and 20 operation cases (20 sides) had been observed and measured. Lateral skull bases of cadaveric heads were numbered from 1st to 40th, while the operation cases were numbered from 1st to 20th.@*RESULT@#The anatomical data was achieved by measuring related anatomical landmark as follows: the distances between the significant landmark of the lateral skull base and the pars neuraxis, vein of the jugular foramen; the areas of trautmann triangle; post labyrinths triangle and the superficial triangle of processus mastoideus; the maximal distance of initiative displacement of facial nerve in the lateral skull base operations.@*CONCLUSION@#The data measured at lateral skull base could effectively help operators not only to enlarge the field of vision in operations with security and to avoid the damagement of the important blood vessel and nerves, but also to retain the function of the facial nerve to the utmost.

A clinical study of the influence on the drying of the ear canal by cleaning the focus of infection in the posterior tympanum / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the influence of drying the ear canal by cleaning the focus of infection in the posterior tympanum in middle ear operations.@*METHOD@#Retrospectively analyze 168 cases of middle ear operations, which were divided into two groups by whether the posterior tympanum was open or not in the operation process. Then comparing the drying ear rate.@*RESULT@#The drying ear rate (DEC) were 81.7% (67/82) and 91.9% (79/86) in the posterior tympanum unopened and opened group, respectively. In the posterior tympanum unopened group, the DEC rate were 78.9% (30/38) and 84.1% (37/44) in 38 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum opened group, the DEC rate were 88.2% (37/42) and 94.7% (42/44) in 42 cases of chronic otitis media and mastoiditis with cholesteatoma and in 44 cases of chronic otitis media and mastoiditis with granulation tissue, respectively. In the posterior tympanum unopened group, the DEC rate were 81.7% (36/44) and 84.6% (34/38) in 44 cases of radical mastoidectomy and in 38 cases of tympanoplasty; compared with the posterior tympanum opened group, the DEC rate were 91.3% (42/46) and 92.5% (37/40) correspondingly.@*CONCLUSION@#In the middle ear operation, open the posterior tympanum in convention can not only have profits to clear the insidious focus of infection, but also have profits to skeletonized to lower facial ridge to the utmost limits and make the drainage of the ear canal easy and smooth. At last, the rate of DEC was raised.

Diagnosis and management of epistaxis caused by traumatic pseudoaneurysm / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the diagnosis and management of epistaxis caused by traumatic pseudoaneurysm.METHODS The clinical data of 16 cases with epistaxis caused by traumatic pseudoaneurysm were retrospectively studied.There were 12 males and 4 females.Their ages ranged from 16 to 41 years with an average of 25.4 years.RESULTS All the patients were cured via digital subtraction angiogrophy(DSA) and embolization except one died.The time between the hospitalization and the DSA examinat ion was 3 to15 days.Interestingly,every patient had received anterior and posterior nasal packing one to 5 times.CONCLUSION If the anterior and posterior nasal packing were not effective to the patients with repeated and vast nasal bleeding,who had trauma history before nasal bleeding,the DSA examination should be carried out immediately to identify whether the pseudoaneurysm exists.

Perfecting the medical security system: the fundamental solution to the issue of inadequate and overly expensive medical services / 中华医院管理杂志

In light of the connotations of inadequate and overly expensive medical services,the paper analyzes solutions to the issue and their features under different circumstances.Then based on data about studies and establishment of medical security systems at home and abroad,it concludes that the establishment of a medical security system,with joint sharing of risks in bearing the burden of medical expenses,is the fundamental solution to the issue.It also puts forward suggestions for perfecting the medical security system in China.

A comparative study on the types and prices of drugs in outpatient pharmacies and retail pharmacies / 中华医院管理杂志

Objective To understand the types and prices of drugs in outpatient pharmacies and retail pharmacies, study their differences and provide corresponding suggestions on policies. Methods The types and prices of drugs in 7 pharmacies and 8 hospital outpatient pharmacies in 4 provinces were studied and compared. Results Significant differences were found in the types and prices of drugs in these outpatient pharmacies and retail pharmacies. Retail pharmacies might fail to fill 60% of the physician prescriptions. The quality and price control of drugs in outpatient pharmacies was different from that in retail pharmacies. The types and prices of drugs in outpatient pharmacies were different from those in retail pharmacies. Many drugs independently-priced were extremely high. Pharmaceutical departments of hospitals had abundant senior and qualified pharmaceutical personnel whose pharmaceutical expertise was far superior to that of retail pharmacies. Conclusion There was a significant difference between outpatient pharmacies and retail pharmacies. Under the circumstances, it is not yet feasible to release policies and regulations that would separate pharmacies from hospitals or encourage outpatients to fill their prescriptions in retail pharmacies. Medical institutions should further standardize their purchases of drugs as well as prescriptions by physicians.