鼻渊舒口服液与西药治疗慢性鼻窦炎的临床疗效及安全性对比分析

目的研究并对比鼻渊舒口服液与西药治疗慢性鼻窦炎的临床疗效及安全性。方法 2013年1~12月该院门诊就诊的慢性鼻窦炎患者共186例。以数字法随机分成观察组(93例)和对照组(93例)。观察组患者使用鼻渊舒口服液进行治疗;对照组患者则使用西药进行治疗。对两组患者进行为期40d的治疗后,通过患者的治疗效果、用药后并发症以及治疗后的复发情况来比较两组患者的治疗情况。结果通过40d的治疗后发现观察组和对照组的临床疗效都比较好,两组的治疗效果差异无统计学意义(P0.05)。在治疗中因为用药导致全身多个系统出现并发症,观察组的总并发症发生率为4.3%,对照组30.11%,两组恶心呕吐、头晕目眩、全身乏力及总并发症发生率差异均有统计学意义(均P0.05)。在治疗结束后两组患者均出现不同程度上的病情复发,观察组有8例(8.60%)患者出现复发,而对照组中则有32例(34.41%)患者出现复发,两组复发率差异有统计学意义(P0.05)。结论使用鼻渊舒口服液对慢性鼻窦炎进行治疗后发现治疗结果良好,并发症少,值得在临床上广泛推广。     

The Quality of Health Information on Allergic Rhinitis,Rhinitis, and Sinusitis Available on the Internet

PurposeThe internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago.MethodsThe terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update.ResultsA total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information.ConclusionsThe quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required.     

慢性鼻窦炎患者鼻腔(脓性)分泌物的细菌谱及其药敏分析

目的:探讨慢性化脓性鼻窦炎的菌种分布情况及药物敏感性。方法:收集89例慢性化脓性鼻窦炎患者的鼻腔脓性分泌物,进行培养基培养,采用纸片扩散法(Kirby-Bauer,KB法)进行药物敏感性监测,分析这些菌株对头孢唑啉、头孢他啶、头孢吡肟、亚胺培南、美罗培南、头孢哌酮舒巴坦、环丙沙星等抗菌药物的敏感性,万古霉素用MIC法进行定量分析。结果:89例慢性化脓性鼻窦炎患者的鼻道黏脓性分泌物标本经送检分析发现,80例患者检出细菌,阳性检出率为89.89%(80/89);80例患者中共检出82株细菌,共计15种细菌,其中1例患者的鼻道黏脓性分泌物标本检出2株细菌。排除院内感染,在检出的15种细菌中金黄色葡萄球菌、大肠埃希杆菌、表皮葡萄球菌、铜绿假单胞菌、产气肠杆菌等5种细菌占据前5位,分别占18.29%、14.63%、14.63%、13.41%、10.98%。金黄色葡萄球菌的药敏检查结果显示所有的金黄色葡萄球菌对万古霉素敏感,敏感率为100.00%;而对头孢唑啉、头孢他啶、头孢吡肟、亚胺培南、美罗培南、头孢哌酮舒巴坦、环丙沙星等抗菌的敏感率均为0.00%。所有的表皮葡萄球菌对亚胺培南、美罗培南、万古霉素、头孢哌酮舒巴坦均敏感,敏感率为100.00%;其次是头孢唑啉,敏感率为83.33%,而对头孢他啶、头孢吡肟、环丙沙星的敏感率较差,均在30.00%以下。大肠埃希杆菌、铜绿假单胞菌及产气肠杆菌等革兰氏阴性菌均对亚胺培南、美罗培南敏感,敏感率为100.00%。结论:慢性化脓性鼻窦炎患者多伴有细菌感染,主要致病菌包括表金黄色葡萄球菌、大肠埃希杆菌、表皮葡萄球菌、铜绿假单胞菌、产气肠杆菌等,细菌培养阳性对万古霉素、亚胺培南、美罗培南、头孢哌酮舒巴坦、头孢唑啉等抗菌药物敏感,在进行抗菌治疗前应密切监测抗菌谱的改变,以便及时调整用药。     

Frontal EEG asymmetry as predictor of physiological responses to aversive memories

Evidence suggests that asymmetry in frontal electrical activity predicts responses to aversive experiences, such that higher left‐sided activity might dampen responses to trauma reminders. We measured frontal asymmetry at rest and during viewing of a trauma film, and assessed startle responses to film‐reminder images. To explore potential moderators, we compared two films (Study 1; N = 64) and modulated reappraisal (Study 2; N = 72). As expected, left frontal activation during film viewing predicted dampened responses in individuals who viewed a staged road accident. However, this effect tended to be reversed when a genocide documentary was used. In Study 2, all participants viewed the genocide film. Left frontal activity at rest again predicted higher startle responses, while reappraisal did not moderate the effects. Thus, the type of trauma film plays a crucial role in the effects of frontal asymmetry, which warrants further critical investigation.     

Frontal sinus augmentation: Preliminary results of a new approach in prosthetic orbital reconstruction

PurposeReliable application of endosseous implants for prosthetic facial reconstruction depends on the bone volume available at the defect site. Regarding the orbit, sufficient bone presentation in the medial superior orbital rim is limited due to the frontal sinus. The aim of this article is to report for the first time on the augmentation of the frontal sinus for gaining bone volume for supraorbital implant placement.Materials and methodsBetween 2007 and 2014, five patients with orbital exenteration were treated by frontal sinus augmentation using autogenous cancellous bone graft from the ilium. Extraoral implants for prosthetic orbit reconstruction were placed 4–7 months later. In advance, cadaver surgery was performed to prove the feasibility of the method. Surgical technique is described, and intraoperative images are provided.ResultsThe frontal sinus was successfully augmented in all five patients. No major complications related to the procedure were observed. A total of nine orbital implants were inserted in the augmented bone, thereof one sleeping implant. Six implants were restored prosthetically, two implants were lost at exposure. The observation period ranged from 6 to 97 months (mean: 52.8 months). Mean time for patient rehabilitation was 13 months. High patient satisfaction was achieved with the implant-retained orbital prosthesis.ConclusionThe augmentation of the frontal sinus allows implant placement by providing sufficient bone volume in the medial supraorbital rim. Considering the surgical success of this method and patient satisfaction, this new approach is concluded to be a viable option in a unique subset of patients.