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.     

后半规管阻塞前后豚鼠前庭及耳蜗功能的动态变化

目的 探讨机械性后半规管阻塞前后豚鼠前庭和耳蜗功能的动态变化。方法 采用２０只豚鼠建立单侧后半规管阻塞的动物模型,观察手术前后眼震电图,听性脑干反应,耳声发射等变化。结果 术后第１天,第３天豚鼠正弦摆动刺激术侧眼震反应,明显减术,术后第５天起双侧眼震恢复正常。术后早期ＡＢＲ阈值一度升高,第５天达高峰,ＡＢＲ阈值平均升高４．５ｄＢ。ＤＰＯＡＥ反应幅度无明显改变。结论 后半规管阻塞能选择性地消除后半规     

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.     

四倍体菘蓝毛状根的抗内毒素作用

目的：从菘蓝的同源四倍体植物诱导出毛状根,并探讨用毛状根代替自然根作为药用的可能性。方法;利用发根农杆菌Ａ４菌株感染四倍体菘蓝,采用细菌内毒素检查法考察诱导所得毛状根的抗内毒素作用。结果：Ａ４菌株能诱导四倍体菘蓝产生毛状根,毛状根具有较强的抗内毒素作用。结论：发根农杆菌诱导四倍体植物产生的毛状根有可能成为传统中药材的一种代用品。     

盐酸维拉帕米脉冲控释片人体内的药代动力学及生物利用度研究

目的：比较盐酸维拉帕米脉冲释放片与其片芯在人体的药代动力学特征及生物利用度。方法：采用拉丁方设计,将志愿者８人随机分为３组,交叉口服Ⅲ,Ⅳ型脉冲片和片芯,以片芯为对照制剂,考察体内脉冲控释效果。结果：Ⅲ型脉冲片在体内的时滞为４ｈ,而ｃｍａｘ,ＡＵＣ等与片芯无明显差异,达到设计要求。结论：该研究制备的脉冲释放制剂为防治心血管疾病的凌晨发作提供了一个良好的剂型选择。     

苏州市职工医疗保健制度改革后3家三级医院门诊费用的调查分析

目的　调查苏州市医改后门诊费用状况。方法　采用计算机SPSS软件系统分析 30 5 4张三家三级医院的门诊处方。结果　公费次均费 183.2 9± 175 .89元 ,自费 87.85± 95 .6 1元 ,而医保则为 71.36± 49.5 5元 ,三者差别有非常显著意义 (P =0 .0 0 0 0 )。变异系数分别为 96 .0 % ,10 8.8% ,6 9.6 %。医保病人个体差异最小 ,超定额率为 72 .0 % ,36 .4%和 37.3% (P <0 .0 1)。结论　医保门诊定额偏紧 ,门诊主要表现为负面效应 ,应调动医院积极性 ,采取有效控制门诊费用的措施。     

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     

哑铃形椎管肿瘤29例临床分析

回顾性分析我院从１９９０年３月～１９９８年１１月２９例哑铃形椎管肿瘤的诊治。所有病例经ＣＴ、ＭＲＩ确诊。ＭＲＩ能提供多时向、多空间图像,故可视为诊断哑铃形椎管肿瘤最有价值的方法。除２例拒绝手术治疗外,２７例采用后正中或后外侧入路作１期显微手术切除,疗效较满意。本文重点讨论了该肿瘤的临床表现特征,ＣＴ,ＭＲＩ检查和手术治疗的特点。     

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。