下颌下腺移位预防鼻咽癌放疗后口干燥症

目的 研究下颌下腺移位预防鼻咽癌放疗后口干燥症的可行性.方法 对23例符合入选标准的鼻咽癌患者,在放疗前将下颌下腺移位至颏下区,术后2周内接受常规放疗,放疗时颏下区设置挡块,放疗后3个月、6个月、12个月进行口干程度问卷调查.结果 23例患者放疗后12个月行口干程度问卷调查时无口干症状(G1)6例(26.1%),轻度口干(G2)13例(56.5%),中度口干(G3)3例(13.0%),重度口干(G4)1例(4.4%).结论 下颌下腺移位是预防鼻咽癌放疗后口干燥症行之有效的治疗方法,有利于提高鼻咽癌患者的生存质量.     

颌下腺移位术预防鼻咽癌放疗后口咽干燥症临床观察

目的 观察颌下腺移位术预防鼻咽癌放疗后口咽干燥症的临床效果.方法 2006年9月～2008年10月连续诊治的20例鼻咽癌患者中,选择符合入选标准的8例患者(试验组),于放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗中颏下区设置挡块以保护移位之颌下腺;其余12例(对照组)接受常规放疗.系统观察比较放疗中的急性口腔黏膜反应,并干放疗后3个月进行口干程度调查.结果 试验组病例中,4例患者疗后无口咽干燥症状,4例患者疗后有轻微13干感觉;对照组12例皆口干症状.试验组和对照组放疗后唾液分泌量平均值分别为1.39g和0.68g,差异有统计学意义(P<0.01).结论 颌下腺移位术预防鼻咽癌放疗后口咽干燥症的近期疗效好,有利于改善患者放疗后的生活质量.     

颌下腺移位术预防鼻咽癌放疗后口呕干燥症临床观察

目的观察颌下腺移位术预防鼻咽癌放疗后口咽干燥症的临床效果。方法2006年9月-2008年10月连续诊治的20例鼻咽癌患者中，选择符合入选标准的8例患者（试验组），于放疗前将颌下腺移位至颏下区，术后接受常规放疗，放疗中颏下区设置挡块以保护移位之颌下腺；其余12例（对照组）接受常规放疗。系统观察比较放疗中的急性口腔黏膜反应，并于放疗后3个月进行口干程度调查。结果试验组病例中，4例患者疗后无口咽干燥症状，4例患者疗后有轻微口干感觉；对照组12例皆口干症状。试验组和对照组放疗后唾液分泌量平均值分别为1．3和0．68g，差异有统计学意义（P〈0．01）。结论颌下腺移位术预防鼻咽癌放疗后口咽干燥症的近期疗效好，有利于改善患者放疗后的生活质量。     

鼻咽癌放疗后口干燥症及其对生活质量的影响

目的观察鼻咽癌患者放疗后口干燥症的情况及其对日常生活的影响,探讨影响口干燥症的相关因素,以期提高鼻咽癌患者的生活质量。方法选择放疗后满1年复查的鼻咽癌患者79例,复查时进行面对面访谈方式的口干问卷调查,根据调查结果分析口干燥症的严重程度及其对生活质量的影响。结果全组口干燥症的发生率为100%,中重度发生率为74.7%,其中13.9%的患者夜晚经常喝水,74.7%的患者吃饭时需饮水,59.5%的患者感到说话困难,91.1%的患者认为日常生活明显受影响。结论鼻咽癌放疗后口干燥症的发生率较高,因此需要一种安全、简便、廉价、有效的方法治疗放疗后口干燥症,以提高患者的生活质量。     

鼻咽癌放疗后分泌性中耳炎的防治

目的探讨鼻咽癌患者放疗后分泌性中耳炎(SOM)的发生机制及防治方法。方法将56例放疗前无SOM的鼻咽癌患者分为试验组和对照组各28例,放疗开始后,试验组采用丙酸氟替卡松喷鼻剂喷鼻,善邦通鼻腔洗剂冲洗鼻腔和鼻咽部,口服桉柠蒎肠溶软胶囊及罗红霉素,加强鼻腔、鼻咽局部清理等综合治疗措施,对照组不采取任何措施。放疗结束后3月观察两组患者耳鸣、耳闷塞感及听力下降等症状。结果对照组18例32耳、试验组10例16耳出现耳鸣;对照组20例35耳、试验组9例14耳出现耳闷塞感,两组比较差异均有统计学意义(P<0.01)。两组放疗前气导听阈均值比较差异无统计学意义(P>0.05),放疗后试验组气导听阈均值为25.5±3.0dB HL,与对照组(40.3±5.0dB HL)相比,差异有统计学意义(P<0.01)。对照组发生分泌性中耳炎16例(占57.14%,16/28),试验组6例(21.42%,6/28),前者显著高于后者,差异有统计学意义(P<0.01)。结论鼻咽癌患者放疗中运用丙酸氟替卡松喷鼻剂喷鼻,善邦通鼻腔洗剂冲洗鼻腔和鼻咽部,口服桉柠蒎肠溶软胶囊及罗红霉素,加强鼻腔、鼻咽局部清理等综合治疗措施能有效降低放疗后分泌性中耳炎的发生率。     

康莱特联合放射治疗老年鼻咽癌的临床观察

目的探讨康莱特注射液(KLT)联合放疗治疗老年鼻咽癌患者的疗效及其对放疗毒副反应、免疫反应和生活质量的影响.方法收治老年鼻咽癌患者75例,分为治疗组(KLT 放疗)39例和对照组(单纯放疗)36例.对两组的疗效、放疗反应和生活质量予以观察对比.结果两组总有效率和1年生存率分别为94.9%、97.4%和91.7%、94.4%,P>0.05;两组3年生存率分别为79.5%和69.4%,P<0.05;放射性口腔炎对照组明显重于治疗组,P<0.05;生活质量(Karnofsky评分)治疗组好于对照组,P<0.05;T淋巴细胞免疫活性(Ag-NORs)治疗组高于对照组.结论康莱特注射液联合放射治疗老年鼻咽癌,不但能提高患者的生活质量,增强机体的免疫功能,减轻患者的放疗反应,而且能提高生存率,延长生存期,确为配合放疗的一种理想药物,值得在临床上积极应用.     

颌下腺移位术:一种预防放射性口腔干燥症的新方法探讨

放射性口腔干燥症是头颈肿瘤患者放射治疗时的常见问题 ,严重影响患者生活质量。该作者报告采用将颌下腺移位到颏下间隙的手术方法 ,有效地避免了严重的颌下腺放射性损伤。手术操作方法 :沿下颌骨下缘2 cm处自乳突尖到颏部作手术切口 ,自颈阔肌以下平面翻起皮瓣 ;游离、切除颌下腺周围组织 ,保留面动脉、面静脉、下颌下神经节及颌下腺导管 ,选择性颈清扫 , 区淋巴结 ,解剖并切除 区全部淋巴结 ,将 、 区任何可疑的淋巴结及 区 (颏下区及颌下区 )全部淋巴结送冰冻 ,如果淋巴结有肿瘤侵犯 ,则放弃颌下腺移位手术 ;结扎面动脉近心端 ,部分切…     

转移兴奋灶针灸法为主治疗鼻咽癌放疗后口咽黏膜放射性损伤的临床观察

目的 观察转移兴奋灶针灸法为主治疗鼻咽癌放疗后口、咽黏膜放射性损伤的疗效.方法 接受放射治疗的鼻咽癌患者94例,随机分为试验组和对照组,每组各47例.治疗组采用转移兴奋灶针灸法结合自拟中药方生津利咽饮含漱,对照组以生津利咽饮含漱并内服,疗程1个月.结果 试验组总有效率为89.4%,对照组为70.2%,组间差异比较,统计学意义显著(P<0.01).结论 转移兴奋灶针灸疗法对鼻咽癌放疗后口,咽黏膜的放射性损伤治疗效果良好.     

血红蛋白浓度与鼻咽癌放疗疗效的分析

目的探讨鼻咽癌患者血红蛋白浓度与其放射治疗近期疗效及5年生存率的相关性。方法回顾性分析1991年12月至1992年12月经本院病理确诊并进行系统治疗的鼻咽癌患者314例。全部病人予Co60常规分割根治性放疗,鼻咽病灶放疗剂量65～80/Gy/6～8W,颈部转移淋巴结放疗剂量60～70Gy/6～7W。放疗前及放疗过程中定期检测血红蛋白浓度。结果鼻咽癌患者放疗后的近期效果与其血红蛋白浓度无明显相关性。当血红蛋白浓度在80g～、90g～、100g～、110g～、120g～/L时,患者5年生存率分别为11.1%、36.4%、37.4%、37.9%、60.0%,组间差异有高度统计学意义(P0.001)。结论血红蛋白浓度水平与鼻咽癌患者放疗后的远期疗效明显相关,5年生存率随着血红蛋白浓度的增高而升高。     

介入动脉化疗栓塞治疗鼻咽癌的临床研究

目的:探讨介入动脉化疗栓塞治疗鼻咽癌的效果。方法:将87例鼻咽癌随机分成3组。A组:行介入化疗加放疗,26例。B组:放疗加化疗,29例。C组:单纯放疗,32例。结果:随访38～72个月,近期疗效CR分别为A组92.3％,B组72.4％,C组68.8％,A组与B、C组分别比较均有统计学意义(P<0.05);3年生存率分别为A组88.5％,B组69.0％,C组62.5％,A组与B、C组分别比较均有统计学意义(P<0.05)。结论:采用放疗结合介入化疗栓塞对鼻咽癌治疗有协同作用。     

Normal threshold of hearing for cat for free-field listening

Summary A new normal threshold of hearing of cat (monoaural) for free field listening was determined by behavioural audiometry and this was compared with cat's hearing thresholds obtained by other techniques of behavioural audiometry. The absolute hearing thresholds obtained in the present study are slightly lower than those of other authors at many test frequencies. This appears to be due to different conditioning techniques and testing methods which are used to determine hearing thresholds. Any large interindividual variability in absolute hearing threshold at any test frequency resulted from differences in the technique and method of obtaining the thresholds and not from differences in hearing ability of the animals.

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Zusammenfassung An einseitig labyrinthektomierten Katzen wurde nach push-pull Konditionierung verhaltensaudiometrisch die normale Hörschwelle im freien Schallfeld bestimmt und mit den durch andere Methoden der Verhaltensaudiometrie ermittelten Katzenhörschwellen verglichen. Die in den vorliegenden Untersuchungen gefundenen absoluten Hörschwellen sind in vielen Prüffrequenzen geringgradig niedriger als die. von- anderen Autoren bestimmten. Das dürfte eine Folge der verschiedenen Konditionierungstechniken und Prufmethoden sein, die bei der Restimmung der Hörschwelle benutzt wurden. Die hier verwendete Technik der Verhaltensaudiometrie ermöglicht es, daß die Katze auf den schwächsten Schallreiz reagiert. Nach einem ausreichenden Konditionierungstraining lag bei den Audiogrammen aller Katzen eine auffallende Übereinstimmung vor (interindividuelle Übereinstimmung). Größere interindividuelle Abweichungen der absoluten Hörschwelle dürften also auf unterschiedliche Prüfmethoden und Konditionierungstechnik der Hörschwellenbestimmung und nicht auf Unterschiede in der Hörfähigkeit der Katzen zurückzuführen sein.

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Part of a Thesis approved by the University of London for the Ph. D. Degree in Medicine, 1969.     

Considerations for the design of clinical trials for tinnitus

CONCLUSION: There are many possible control conditions to consider in designing research on tinnitus treatments. Some of the counseling procedures involve more than simply 'talking' or providing information, and it is important to make this distinction. Several good handicap scales are available, but we believe that 100-point interval scales have some superior attributes. Both primary and secondary measures of benefit should be used. Open trials have some merit, but should only be used cautiously. Several recent guidelines have been suggested for improving the design and reporting of clinical trials. OBJECTIVES: This paper reviews some basic considerations in the design of research to evaluate tinnitus treatments, particularly counseling and sound therapies. METHODS: We have reviewed some of the basic issues, referenced some relevant work, and provided some data supporting some of our assertions. RESULTS: We provide some recommendations for consideration for the design of clinical trials.     

Assessment of subjective scales for selection of patients for nasal septal surgery

Objective: To investigate the use of subjective measures to assist the surgeon in patient selection for septal surgery. Study design: Prospective, observational. Approved by local ethics committee. Setting: ENT outpatient department, University Hospital of Wales. Participants: Forty‐six participants on the waiting list for septal surgery for nasal obstruction. Main outcome measure: Measurement of nasal partitioning of airflow by rhinospirometer (GM Instruments, Scotland), subjective scales, and investigator's assessment of septal deviation. Results: The subjective scores, and investigator's assessment of septal deviation, were compared with the rhinospirometer objective measurements for correlation, sensitivity and specificity. The rhinospirometry results showed that 20% of the patients on the waiting list had objective measures of partitioning of nasal airflow within a normal range for healthy subjects. The ordinal scale proved to be more useful than the visual analogue scale for patient selection. The subjective scores of airflow partitioning from the double ordinal scale correlated well with the rhinospirometry measurements (r = 0.8). The ordinal scale also had a sensitivity of 81% and a specificity of 60%. The investigator's subjective assessment of septal deviation had a high sensitivity at around 100% but had a lower specificity (30%). Conclusions: The use of a subjective ordinal scale to measure partitioning of airflow greatly increased the specificity of patient selection and it is proposed that this scale may be useful to the surgeon when assessing patients for septal surgery.     

错(牙合)畸形患者的心理状况分析

目的研究错     

听障儿童言语识别能力评估标准的修订

目的通过评估健听儿童的言语识别能力,修订听障儿童单音节词、双音节词和短句识别能力的评估标准。方法采用听觉语言识别能力评估词表分别对300名健听儿童进行单音节词、双音节词和短句识别能力评估,采用描述性统计方法对单音节词、双音节词和短句识别能力评估标准进行修订。结果单音节词、双音节词和短句识别率随年龄的增长而提高。2岁1个月～2岁12个月健听儿童的单音节词、双音节词和短句识别率都低于90％,3岁以上健听儿童的单音节词、双音节词和短句识别率均≥90％。结论①制定了2岁听障儿童单音节词、双音节词和短句识别能力评估标准。②对于3岁及以上各年龄段听障儿童可以用实际测试得分代表单音节词、双音节词和短句识别能力。     

Indications for the use of ventilating tubes for secretory otitis media

Seventy-seven children (147 ears) with secretory otitis media (S.O.M.) were surgically treated by myringotomy with aspiration, insertion of ventilating tubes, and adenoidectomy, if indicated. The results of treatment for S.O.M. were analyzed according to the degree of mastoid pneumatization and complications with or without ipsilateral sinusitis.The present study was performed in order to establish indications for the use of ventilating tubes.The results of treatment for S.O.M. in poorly developed mastoids were poor. With an ipsilateral sinusitis the prognosis of S.O.M. was also poor.In some cases of S.O.M., particularly those in well-developed mastoids, either adenoidectomy alone or myringotomy with aspiration alone proved effective for recovery from middle ear effusions.Ventilating tubes are most suitable for the following conditions: (1) in cases of sclerotic or poorly developed mastoids; (2) in cases with ipsilateral sinusitis; and (3) in cases with recurrent effusions after a first myringotomy with aspiration.