临床咽拭子标本反复冻融对肺炎支原体分离效果的影响

目的了解临床呼吸道标本反复冻融对肺炎支原体分离培养的影响,促进肺炎支原体临床标本分离培养工作的开展。方法选取2008-2009年北京临床医院150份肺炎病例咽拭子标本,使用液体培养并通过颜色变化单位(CCU)测定法检测标本中活菌,对1～4次冻融样本的阳性培养率和/或活菌量进行分析。结果临床咽拭子标本(200μl)中肺炎支原体携带量主要在0～103CCU之间。带菌量≤10 CCU的标本占培养阳性标本的40%左右,此类标本带菌量为临界培养检测限,经每次冻融会造成约1/4的阳性标本培养转阴。带菌量10 CCU的标本,经3次反复冻融后均培养阳性,且CCU计数无明显变化,但培养阳性时间平均每次延长14 h左右。结论鉴于反复冻融对低病原体含量样品分离率的明显影响和对样品培养所需时间的明显延长,可能是影响临床样本支原体分离率的重要因素,应在样品分离培养前避免样品的反复冻融。     

眼耳鼻喉科专科护理技术管理多终端信息系统的开发与应用

目的开发眼耳鼻喉科专科护理技术管理多终端信息系统,探讨其应用效果,提升眼耳鼻喉科专科护理技术管理水平。方法整合眼耳鼻喉科专科护理技术操作标准及流程等资源,基于现有护理信息系统平台进行功能升级,构建多终端(PC端、PAD端、手机App端)信息管理系统,形成"护理部-护理技术管理小组-护士长"三级专科护理技术管理模式。于2018年6月至2019年5月应用于临床护理实践(护士261名),与2017年6月至2018年5月采用传统管理模式(护士264名)进行效果比较。结果实施三级专科护理技术管理模式后,护士的护理技术实践考核达标率、能级进阶成功率和满意度显著提高(均P<0.01)。结论实施眼耳鼻喉科专科护理技术多终端信息管理,能有效提高护士的临床护理技术理论与实践能力,实现护士培训与考核多样化,提高护士对系统使用的满意度,提升临床专科护理技术管理水平。     

“Atypical Suicidal” cut throat injury – A case report

Suicide is one of the leading causes of death in the world. The incidence and pattern of suicide vary from country to country. Cultural, religious and social value plays a vital role. Hanging, poisoning, drowning are the common methods of committing suicide. Suicide by incising one’s own throat without hesitation marks remains a rare, and only few cases have been reported in the forensic literature. We present here an unusual and rare case of self-inflicted cut throat injury of a 45-year old ex-military man without tentative cuts over the neck, which has resulted from a curved sharp weapon.     

咽部标本16s rDNA序列分析方法的建立及应用

目的建立一种非培养的、以16s rDNA序列分析为基础的咽喉标本细菌筛查技术。方法提取标本中的总DNA,针对细菌16s rDNA保守区设计通用引物进行PCR扩增、克隆、测序,将获得的16s rDNA序列与数据库中的发表序列进行比对,分析克隆群中细菌的种类和比例。结果16s rDNA序列分析方法,能够对正常成人的咽部标本进行分析;在咽部标本中发现了不动杆菌、真杆菌、流感嗜血杆菌等;在这些细菌中,既有能够常规分离培养的细菌,也有常规难以分离培养的细菌。结论成功建立了咽部标本的16s rDNA序列分析方法;通过分析正常成人咽部标本,得到正常人体咽部菌群的种类和比例,发现了多种不能常规分离培养的细菌。     

水泥粉尘对从业人员鼻和咽部危害的调查

目的 了解水泥粉尘对从业人员鼻和咽部疾病发病的影响。方法 调查1a产20万tR型硅酸盐水泥厂,统计分析3a粉尘监测资料,对960名水泥生产工人与非接尘组进行体验,对比分析名水泥生产工人鼻和咽部疾病的发病情况。结果 接触水泥尘的人员比不接触水泥尘的工人鼻和咽部疾病发病率高（P＜0．005）,其中接触生料尘比熟料尘者更甚（P＜0．005）。工龄对发病无明显影响（P＞0．05）。结论 建议采取有效收尘除尘。加强个人防护及劳动保护知识教育,以综合措施控制水泥粉尘对从业人员的危害。     

功能性鼻腔扩大术的护理

目的:总结功能性鼻腔扩大术的护理经验.方法:完成功能性鼻腔扩大术50例,术后着重做好肿胀期、结痂期及恢复期的观察及护理,防止术后大出血,保持适宜的温度及湿度.结果:术后随访2～20个月,近期和远期效果满意.结论:功能性鼻腔扩大术保留和恢复了鼻腔的生理功能.     

张伯礼教授治疗小儿慢性扁桃体炎所致反复发热验案1则

小儿慢性扁桃体炎为儿科常见病、多发病,病情反复,迁延难愈,反复发作易累及机体多脏器。宗“咽喉诸病皆属于火”之说,张伯礼教授采用标本兼治、治病求本的治疗原则,治以疏风解表、清热解毒、凉血消肿、养阴润燥之法,临床效果显著,体现中医药优势。     

The Effect of Cold Vapor and Ice Cube Absorption in the Early Postoperative Period on Sore Throat and Hoarseness Induced by Intubation

PurposeThis study aimed to determine the effect of cold vapor and ice cube absorption in the early postoperative period on sore throat and hoarseness induced by intubation.DesignThis is a randomized controlled experimental study.MethodsFour groups (n = 30) were involved in the study: cold vapor application (group 1), ice cube absorption (group 2), ice cube absorption along with cold vapor application (group 3), and a control group (group 4). The sample consisted of 120 participants. The data were collected using the visual analog scale (VAS) and Stout's hoarseness scale postextubation (zeroth hour) and at the second, sixth, and 24th hours.FindingsAfter the interventions, the mean VAS scores for sore throat at the sixth postoperative hour were found to be 1.50 ± 1.71, 1.16 ± 1.08, and 1.30 ± 1.62 in group 1, group 2, and group 3, respectively. The mean VAS score for sore throat of group 4 was found to be 3.70 ± 1.89. The decrease in the VAS score for the sixth postoperative hour was ranked from highest to lowest as follows: ice cube absorption group, ice cube absorption along with cold vapor application group, and cold vapor application group. There was no significant difference between application groups in terms of mean VAS scores; however, it was found that mean VAS scores of all application groups were lower than that of control group, and there was a significant difference between them (P < .05). We found that at the sixth postoperative hour after intervention, 33.3% of group 1, 36.7% of group 2, 30% of group 3, and 46.7% of group 4 had hoarseness. No significant difference was found between groups, in terms of hoarseness scores of patients in the sixth postoperative hour after intervention (P > .05).ConclusionsCold vapor application, ice cube absorption, and ice cube absorption along with cold vapor application were effective in reducing sore throat but were ineffective as treatment for hoarseness.