Otolaryngology Consultation for Peritonsillar Abscess in the Pediatric Population

Objective To assess clinical outcomes of children seen in consultation for peritonsillar abscess treated without the routine use of computed tomography or needle aspiration. Study Design Retrospective review of patients evaluated in the emergency department for possible peritonsillar abscess. Patient outcomes are reviewed with a statistical analysis of children grouped according to age. Methods A series of 102 patients, ages 8 months to 19 years, who were evaluated by the emergency department with otolaryngology consultation for possible peritonsillar abscess. All patients were admitted and given intravenous fluid replacement, antibiotics, and analgesia. Patients who responded to 24 hours of medical treatment were discharged, whereas patients who did not respond underwent elective tonsillectomy. Main Outcome Measure Outcome of patients evaluated for peritonsillar abscess treated without immediate surgery, needle aspiration, or computed tomography. Outcomes are correlated with age and clinical findings. Results Fifty‐two patients were discharged after initial medical therapy. Fifty patients underwent elective tonsillectomy; 40 of these patients were found to have abscesses at the time of surgery. When analyzed according to age, patients ages 8 months to 6 years were more likely to respond to medical treatment than children ages 7 to 12 and 12 to 19 (P = .023). Significant differences in the mean age of children requiring surgery (11.0 y) compared with those who responded to medical treatment (7.9 y) were observed (P = .003). Younger children who underwent tonsillectomy had a lower incidence of surgically confirmed abscess. Conclusions A significant number of children presenting with odynophagia, malaise, pharyngotonsillar bulge, and decreased oral intake respond to medical therapy without radiological evaluation or surgical intervention. Additionally, younger children (1–6 y) are more likely to respond to medical treatment than older children. Pertinent clinical data, as well as advantages and disadvantages of this approach, are discussed.     

侧颅底肿瘤手术入路(附44例报告)

目的:探讨切除侧颅底肿瘤的最佳入路.方法:44例患者中,采用下颌外旋入路17例,耳后C形切口入路16例,上颌外旋入路7例,颞额入路4例.结果:25例良性肿瘤术后无复发;19例恶性肿瘤中,术后生存不足1年2例,1年以上4例,2年以上7例,3年以上6例.结论:下颌外旋入路适用于切除咽旁间隙、颞下窝、鼻咽部、口咽部、蝶骨、斜坡及上颈椎肿瘤;耳后C形切口入路适用于切除颞骨肿瘤.     

The acceptance of SARS-CoV-2 rapid antigen self-testing: A cross-sectional study in China

Compared with the nucleic acid amplification test (NATT), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen self-testing (RAST) has advantages in speed and convenience. However, little is known about people's acceptance and influencing factors for SARS-CoV-2 RAST. A cross-sectional study was conducted from April 21 to 30, 2022 in China. The χ² test and multivariate logistic regressions were used to identify the influencing factors. The structural equation model was used to test the extended protective motivation theory (PMT) model hypotheses. Among the total of 5107 participants, 62.5% were willing to accept the SARS-CoV-2 RAST. There were significant differences in acceptance among different residences (p < 0.001), educational level (p < 0.001), occupation (p < 0.001), monthly income (p < 0.001), travel frequency (p < 0.05), and feelings about NATT (p < 0.001). Response efficacy (β = 0.05; p = 0.025) and self-efficacy (β = 0.84; p < 0.001) had a positive effect, while response cost showed a negative effect (β = −0.07; p < 0.001). The public's major concerns about SARS-CoV-2 RAST are its reliability, testing method, price, and authority. Overall, a moderate intention to use SARS-CoV-2 RAST was found among the Chinese population. The extended PMT can be used for the prediction of intention to accept the RAST. We need to take measures to increase people's acceptance of SARS-CoV-2 RAST.     

脑缺血再灌注期间海马CA1区微管运动蛋白活性变化

研究脑缺血再灌注期间海马ＣＡ１区锥体细胞微管运动蛋白活性的变化。方法沙土鼠前脑缺血再灌注,脑缺血１０ｍｉｎ。将２０只土鼠随机分为４组：假手术组、再灌注Ⅰ组（再灌注６ｈ）、再灌注Ⅱ组（再灌注４８ｈ）、再灌注Ⅲ组（再灌注９６ｈ）。采用免疫组织化学方法结合计算机图像分析测定脑缺血再灌注期间海马神经元微管运动蛋白活性。结果脑缺血再灌注期海马ＣＡ１区微管运动蛋白活性明显下降,在再灌注６ｈ,４８ｈ,９６ｈ时期     

男性膀胱颈挛缩32例临床分析

目的：总结对男性膀胱颈挛缩的诊治体会,方法：分析32例男性膀胱颈挛缩的临床特征及诊断要点,评价经膀胱切除颈部狭窄纤维环及前列腺的手术疗效,结果：术后平均尿流率及最大尿流率与术前比较均有显著性提高（P＜0．01）,随访3－12个月,临床症状消失,排尿满意,结论：男性膀胱颈挛缩要注意与前列腺增生症相鉴别,其中行膛胱镜检查是重要的鉴别手段。经膀胱切除颈部狭窄纤维环及前列腺是疗效可靠的治疗方法。     

基于应用软件平台的医疗保险信息系统的分析与实现

介绍了应用软件平台的应用背景--管理信息系统的模型,在此基础上推导出了应用软件平台的定义,描述了应用软件平台的结构.提出了应用软件平台的具体应用项目--医疗保险信息系统,阐述了医疗保险的基本概念,用管理信息系统的4元组描述法提出了医疗保险信息系统的模型.概述了该应用系统中的应用软件平台的组成和结构,以及系统的特点和实施结果.     

The effects of obesity on pulmonary function.

AIMS: (1) To determine the predominant pulmonary function abnormality in our population of obese children; and (2) to assess the correlation between the severity of lung function impairment and the degree of obesity as assessed by dual energy x ray absorptiometry (DEXA). METHODS: Sixty four obese patients underwent physical examination, standardised pulmonary function tests (spirometry, lung volumes, and single breath diffusion capacity for carbon monoxide), and DEXA scan measurements. The trunk and subtotal (total - head) body fat mass were used as surrogate index of body adiposity. RESULTS: Sixteen girls and 48 boys with median age and body mass index (BMI) of 12 years (interquartile range (IQR): 10-14) and 30.1 kg/m2 (IQR: 27.2-32.8) respectively were studied. None of the patients had clinical evidence of cardiopulmonary disease. Reduction in functional residual capacity (median FRC 93% predicted, IQR: 68.5-116.5%) and impairment of diffusion capacity (median DLco 83.5% predicted, IQR: 70.0-100.7%) were the most common abnormalities in our cohort, being observed in 30 (46%) and 21 (33%) patients respectively. Obstructive ventilatory impairment was found in three patients. There was significant negative correlation between the degree of reduction of FRC but not DLco with DEXA scan measurements, but such a relation was not found when BMI was used as the indicator of obesity. CONCLUSION: Reduction in FRC and diffusion impairment were the commonest abnormalities found in our cohort of obese patients. Reduction in static lung volume was correlated with the degree of obesity.     

氯氮平在体内代谢与细胞色素P450 1A2-2964位点多态性的关系

目的：探讨氯氮平在精神分裂症患者体内代谢和细胞色素P450 1A2－2964位点多态性关系，指导临床对不同患者合理使用氯氮平。方法：采用固定剂量给药，用高效液相色谱法（HPLC）测定血药浓度，用限制性片段长度多态性（RFLPs）分析基因型。结果：吸烟组和非吸烟组之间比较，吸烟组血浆氯氮平浓度低，去甲氯氮平／氯氮平比值高（P＜0．05，P＜0．01），P450 1A2-2964位点等位基因G的频率为0．75，A的频率为0．25，在非吸烟患者中，去甲氯氮平／氯氮平在w/w基因型与非w/w基因型(w/m m/m)之间无显著的统计学意义（P＞0．05），在吸烟患者中，w/w基因型去甲氯氮平／氯氮平要高于非w/w基因型（P＜0．05），在吸烟患者和非吸烟患者中w/w基因型之间比较，吸烟患者的去氯氮平／氯氮平明显高于非吸烟患者（P＜0．01）；而非w/w基因型之间无显著的统计学意义（P＞0．05），结论：吸烟能诱导P450 1A2的活性。P450 12-2964位点等位基因均为G（w/w)时诱导能力最强，发生G→A突变时，诱导能力降低，分析患者P450 1A2 G－2964A的多态性，对合理使用氯氮平有意义。     

288例老年呼吸道感染患者病原菌分布特性及药敏分析

目的: 了解老年呼吸道感染患者病原菌的分布特点及药敏特性.方法: 对288例老年呼吸道感染患者痰样本(NCCLS法)进行细菌培养,K-B纸片法进行药敏测定.结果: 患者痰中共检出病原菌400株,细菌280株,其中G-杆菌147株,占36.75%, G 球菌133株,占33.25%.肺炎克雷伯菌及铜绿假单胞菌最敏感药的是头孢他啶,敏感率均为40%以上,肺炎链球菌和金黄色葡萄球菌最敏感药的是万古霉素;检出真菌120株,占30%,以白色念珠菌为主.结论: 进行病原菌跟踪监测及时的药敏试验,对及时控制老年呼吸道感染,是不可缺少的重要环节.