An evaluation of the gum elastic bougie

This study was designed to evaluate the routine use of a gum elastic bougie for tracheal intubation. The median time to intubation with the gum elastic bougie while simulating an 'epiglottis only' view was only 10 s longer than the time taken during conventional intubation with an optimum view. Three of the patients required a gum elastic bougie-assisted intubation after attempts at conventional visual intubation had failed. There was no significant difference in the incidence of postoperative sore throat and hoarseness between the two groups. We recommend that anaesthetists should use the gum elastic bougie whenever a good view of the glottis is not immediately obtained.     

纤维支气管镜与间接喉钳手术治疗声带疾病

目的进一步研究声带小结与息肉的治疗手段。方法采用日本OlimpusBFp20型纤支镜和国产FF-99光电子内窥镜显示仪，配合间接万向喉钳治疗声带小结和息肉57例。结果治愈率92％，病人痛苦小。结论纤支镜配合间接喉钳手术治疗声带小结和息肉效果良好。     

Prevalence of hepatitis-C virus RNA in serum and throat washings of children with chronic hepatitis

Serum samples from 46 children with chronic and probably transfusion acquired hepatitis were tested for the presence of hepatitis C virus (HCV) RNA by a “nested” polymerase chain reaction (PCR) assay, to judge a possible risk of HCV transmission from these patients. In 73% of the samples, viral RNA was detected, indicating a high virus prevalence in this patient group. High titers of HCV-RNA were observed in some sera as shown by the detection of virus in some samples even at dilutions of 10^?3. Comparison of simultaneously obtained PCR results and ALT values revealed no significant correlation between virus presence in serum and higher ALT levels. It was, however, shown that unusually high ALT values may reflect a high titer of viral RNA in serum. To investigate the prevalence of viral RNA in saliva, which could be a vehicle of virus transmission, 35 throat washing samples from the HCV-infected children were screened by PCR. Using three different sample preparation procedures, 20% of the throat washings were found to be positive for HCV-RNA. This indicates a prevalence of virus in this fluid lower than that reported previously. © 1994 Wiley-Liss, Inc.     

探针ASPCR检测肺炎支原体 微量耐药突变A2063G方法的建立

[摘要]　目的　 建立能够特异性检测微量肺炎支原体（Mycoplasma pneumoniae, MP）A2063G耐药突变基因的特异性扩增等位基因的探针法实时定量PCR（probe-based allele-specific real-time PCR, 探针ASPCR）方法。方法?建立特异性检测A2063G耐药突变位点的探针ASPCR方法,并验证其灵敏度、特异度及准确度等性能。结果?特异性扩增2063G和非特异性扩增2063A/G的引物/探针组合分别扩增105拷贝野生基因型（2063A）模板的Ct值的差(△Ct)高达10.93,能够特异性检测A2063G突变。探针ASPCR方法检测2063G基因型占总MP的比例的准确度可低至1％;检测MP的灵敏度低至10拷贝,检测A2063G耐药突变比例的灵敏度低至0.01％。探针ASPCR方法与前期建立的染料ASPCR方法检测临床样本的MP感染结果一致,MP阳性检出率均为94.83%（55/58）,高于传统巣式PCR联合测序方法的检测结果（75.86%,44/58）;探针ASPCR和染料ASPCR 2种方法检测MP耐药率分别为63.64%（35/55）、70.91%（39/55）,高于传统巣式PCR联合测序方法检测结果59.09%（26/44）。结论?新建探针ASPCR方法是一种具有高特异度、准确度和灵敏度的快速检测MP微量A2063G耐药突变的方法;与染料ASPCR方法相比,探针ASPCR方法检测耐药MP的灵敏度略低,但其临床样本检测复查率也低于染料ASPCR方法,且其结果判读简单,更适合在临床中应用推广,能够为临床制定MP及耐药MP感染的治疗方案提供理论依据。     

低温等离子刀结合支撑喉镜对临床早期喉癌治疗的研究进展

耳鼻喉科较为常见的一种恶性肿瘤就是喉癌,该疾病男性发病率较女性更高,通常是女性总发病例数的7~10倍。临床上较为常见的肉瘤、腺癌等鳞癌在进行治疗时可根据患者病情的分期以及病变范围选择不同的术式。目前常见的几种术式为全部切除术、部分切除术和喉微创手术等。就治疗彻底性来说,全喉切除术最为彻底,但术后创伤极大,留有永久性的经气管造瘘,患者术后交流、发音以及呼吸功能均会受到极大的损伤,即便是进行部分切除,患者喉部整体功能也会受到影响。近些年来,喉部微创手术技术得以不断的更新和进步,对于早期喉癌患者来说,可以考虑采用微创手术进行治疗,该术式不但能将患者喉部的正常功能和组织有效保留,还能避免进行气管切开,术后没有颈部切口,患者接受度更高。文章对低温等离子刀结合支撑喉镜这一维持术式的研究进展作一综述。     

两种新冠病毒核酸检测系统检测结果的比对分析

目的 对不同新型冠状病毒(SARS-CoV-2)核酸检测方法进行比较和分析,探讨核酸提取扩增检测一体化的实时荧光定量PCR系统的应用价值。方法 2020年1月—10月于新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)复核样本库中随机抽取确诊病例和排除病例的灭活咽拭子标本,共计10份。采用盲法随机编号,同时使用全自动医用PCR分析系统GeneXpert DX system和ABI QuantStudio Dx实时定量PCR检测系统进行检测,每组均进行平行检测,利用四格表法对结果进行一致性分析。结果 检测结束后揭盲,所有样本纳入统计分析,无剔除数据。经检测,两种方法对8例新冠病毒确诊病例咽拭子检测结果均为阳性,2例排除病例咽拭子检测结果均为阴性;两种方法检测结果一致性好(Kappa系数=1,P值=0.002);使用方法A检测前处理时间为30秒,结果报告时间为48分钟;在核酸检测过程中检测人员与样本接触时间短,气溶胶危险较低,试剂盒全程密封,实验完成后标本处理安全性高。结论 方法A与方法B在新型冠状病毒核酸检测中结果一致,方法A具备操作环节简单、生物安全风险系数小、检测更为快速等优点。     

Postoperative sore throat: cause, prevention and treatment

Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown to be important causative factors. Routine tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may also account for postoperative throat symptoms. Sore throat following the use of a laryngeal mask appears to be related to the technique of insertion but the contribution of intracuff pressure remains to be clarified. It would appear, however, that high intracuff pressure is associated with nerve palsies due to neuropraxia and nerve compression. Careful insertion techniques for both the tracheal tube and laryngeal mask are of paramount importance in the prevention of airway trauma and postoperative sore throat.     

润嗓冲剂的临床研究与体会

[目的]观察应用润嗓冲剂预防和治疗喉部疾患的临床疗效。[方法]随机设治疗组(润嗓冲剂治疗 )和对照组 (四季润喉片治疗) ,30d为1个疗程 ,1个疗程后统计疗效 ;对健康人群进行润嗓冲剂预防治疗 ,随访观察1a。[结果]润嗓冲剂治疗咽喉部疾患的治愈率及显效率为64 98% ,明显高于对照组的16 34% ,有非常显著性差异(P<0.01);健康人群服用润嗓冲剂后 ,咽喉疾患发病率为4 13% ,较对照组36 42%有非常显著性差异(P<0.01)。[结论]润嗓冲剂对慢性咽炎、扁桃体炎、喉炎等喉部疾患有良好的预防和治疗作用。     

An exploratory study of the factors related to mouth breathing syndrome in primary school children

ObjectiveMouth breathing syndrome (MBS) is defined as a set of signs and symptoms that may be completely or incompletely present in subjects who, for various reasons, replace the correct pattern of nasal breathing with an oral or mixed pattern. It is important to identify the relevant factors affecting MBS in order to diagnose its cause since breathing obstructions can result from multiple factors. The purpose of this study is to clarify the relevant factors and the interrelationships between factors affecting MBS among children.DesignWe surveyed 380 elementary school children from 6 to 12 years in age. The questionnaire consisted of 44 questions regarding their daily health conditions and lifestyle habits and was completed by the children’s guardians. A factor analysis was performed to classify closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors.ResultsTwenty-six out of the 44 questions were selected, and they were classified into seven factors. Factors 1–7 were defined as “Incompetent lip seal”, “Diseases of the nose and throat”, “Eating and drinking habits”, “Bad breath”, “Problems with swallowing and chewing”, “Condition of teeth and gums”, and “Dry lips”, respectively. There were also correlations between these factors themselves.ConclusionMBS was categorized according to 7 major factors. Because Factor 1 was defined as “Incompetent lip seal”, which was representative of the physical appearance of mouth breathers and correlated with other factors, we suggested that MBS should consist of 7 factors in total.