目的观察鼻内镜下咽鼓管置管联合鼓室中药液冲洗治疗慢性分泌性中耳炎（CSOM）的治疗效果。方法将2012年9月-2014年3月期间就诊的80例CSOM患者随机分成2组。实验组40例（61耳）行经鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗,每次2 m L,4~7 ...目的观察鼻内镜下咽鼓管置管联合鼓室中药液冲洗治疗慢性分泌性中耳炎（CSOM）的治疗效果。方法将2012年9月-2014年3月期间就诊的80例CSOM患者随机分成2组。实验组40例（61耳）行经鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗,每次2 m L,4~7 d。对照组40例（59耳）行鼓膜切开置管,置入管通常6~8周后取出或自行掉落。术后随访6月,观察2组疗效。结果实验组治愈率为81.97%,总有效率为95.08%,优于对照组（64.41%、83.05%）,P〈0.05。实验组并发症发生率为9.84%,低于对照组（28.81%）,P〈0.05。实验组复发率为6.56%,低于对照组（20.34%）,P〈0.05。结论鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎,创伤小、疗效确切、副反应少、复发率低,值得临床推广。展开更多
Objective： To study the bacteriological profile in a healing mastoid cavity. Methods： This study was a single centre prospective study. Culture swabs from granulations in the mastoid cavity were sent in 40 consecuti...Objective： To study the bacteriological profile in a healing mastoid cavity. Methods： This study was a single centre prospective study. Culture swabs from granulations in the mastoid cavity were sent in 40 consecutive patients with squamosal chronic otitis media undergoing mastoidectomy. Cultures were processed for both aerobic and anaerobic bacteria. Results： Preoperatively： specimens from 26 out of 40 （60.5%） had growth on culture, with 22 （55%） showing only one organism while 4 showing multiple organisms. The commonest organism isolated was pseudomonas aeruginosa （n=15）. At 1 month after mastoidctomy, 11 patients had sterile culture while 29 had growth, of which 26 had aerobic growth and 3 had anaerobic growth. Pseudomonas was seen in 22 patients and staphylococcus aureus in 2 patients. The mean Merchant score was 2. At 3 months： 29 patients （72.5%） had sterile culture from mastoid cavity while 11 patients （27.5%） had growth on culture. All positive cultures were aerobic, including pseudomonas （n=9） and proteus （n= 2）. The mean Merchant score was 1.03. Of the 40 patients, 16 （40%） had a different organism cultured postoperatively compared to preoperative swabs. Conclusion： Pseudomonas and proteus seem to be the most common organisms responsible for persistent otorrhea after mastoidectomy. Persistent sterile otorrhea was seen in 4 patients （10%） in this group at the end of 3 months. Sterile cultures of preoperative swab are more likely to remain sterile in the postoperative period.展开更多
Aural polyps are a common clinical entity encountered by otorhinolaryngologist in daily practice. Polyps are frequently seen in paediatric patients, usually inflammatory in nature. In children rhabdomyosarcomas (RMS) ...Aural polyps are a common clinical entity encountered by otorhinolaryngologist in daily practice. Polyps are frequently seen in paediatric patients, usually inflammatory in nature. In children rhabdomyosarcomas (RMS) can mimic all the cinical features of chronic suppurative otitis media which usually present as external auditory canal mass or polyp. Here we present a case where a male child presented with recurrence of polyp in left ear which was finally diagnosed as embryonal rhabdomyosarcoma which is a rare and invariably fatal disease in children. Through this article we intend to highlight the failures and delay committed in attaining diagnosis in this patient in spite of multispecialty evaluation involving repeated imaging and histopathological correlation. Our experience with embryonal rhabdomyosarcoma throws light on the high vigilance required in handling the aural polyps in pediatric population as early diagnosis and treatment are the key elements for successful outcomes.展开更多
Aim: This study was carried out to assess association between Sensorineural hearing loss (SNHL) and Chronic Suppurative Otitis Media (CSOM), to identify possible risk factors and determine correlation of duration of C...Aim: This study was carried out to assess association between Sensorineural hearing loss (SNHL) and Chronic Suppurative Otitis Media (CSOM), to identify possible risk factors and determine correlation of duration of CSOM and incidence of SNHL. Material and Method: The study consisted of 100 patients of either sex between 15 and 40 years of age, suffering from unilateral CSOM for the past three months or more, the normal ear served as control. Results: This study showed duration of symptoms is 18% patients for 5 - 10 years and below 5 years in 73% patients. It was found that mean BC thresholds were significantly higher in the diseased ears as compared to the control ears. Though the higher frequencies are more affected than the lower frequencies, in subtotal and attic perforations the speech frequencies seemed to be maximally affected. Conclusion: CSOM should be diagnosed early and should be managed effectively so as to prevent the chances of developing SNHL.展开更多
随着医学生物学模式向生物-心理-社会医学模式的转变,生活质量（quality of life,QOL）这一指标越来越多地得到人们的关注。在评价医学结局时,中、西医使用的评价方法会有较大差别,而生活质量评价可能是中、西医之间达到疗效评定统一的...随着医学生物学模式向生物-心理-社会医学模式的转变,生活质量（quality of life,QOL）这一指标越来越多地得到人们的关注。在评价医学结局时,中、西医使用的评价方法会有较大差别,而生活质量评价可能是中、西医之间达到疗效评定统一的较好方法。展开更多
In this paper, we report organic carbon isotopic characterizations from two loess sequences （JY and GL）, spanning the last 20 ka, from the northwest Chinese Loess Plateau （CLP）. The results indicate that the veget...In this paper, we report organic carbon isotopic characterizations from two loess sequences （JY and GL）, spanning the last 20 ka, from the northwest Chinese Loess Plateau （CLP）. The results indicate that the vegetation type is nearly pure C3 plants in the studied region during the Holocene. In contrast to other reported loess sequences in the central-southeast CLP, the relative abundance of the C4 plants decreases from southeast to northwest, with the vegetation types changing from pure C3 to a C4/C3 mixture should near 36°N in the Holocene. From the perspective of the modem temperature and precipitation distribution, the summer temperature has no obvious change at the same latitude, but there are differences in the summer precipi- tation, which exhibit an obvious increase from west to east. Further analysis indicated that the C4 plant abundance decreases with the decreasing summer season precipitation from the southeast to the northwest CLP during the Holocene. We suggest that with the absence of favorable precipitation condition, increasing temperature and decreasing atmospheric CO2 concentration are insufficient to drive an expansion of the C4 plants on the CLP in the Holocene. According to a Holocene precipitation recon- struction, a ＂threshold value＂ of summer precipitation existed, which mainly controlled the expansion of C4 plants. Compared with the modern δ13Csom and climate data on the CLP, both the Holocene and the present ＂threshold value＂ are near the 360-mm summer precipitation line, although the present precipitation line turned slightly southwestward. Our results provide new insights for further research on the C4/C3 variations with precipi- tation and the relationship to global C4/C3 change.展开更多
文摘目的观察鼻内镜下咽鼓管置管联合鼓室中药液冲洗治疗慢性分泌性中耳炎（CSOM）的治疗效果。方法将2012年9月-2014年3月期间就诊的80例CSOM患者随机分成2组。实验组40例（61耳）行经鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗,每次2 m L,4~7 d。对照组40例（59耳）行鼓膜切开置管,置入管通常6~8周后取出或自行掉落。术后随访6月,观察2组疗效。结果实验组治愈率为81.97%,总有效率为95.08%,优于对照组（64.41%、83.05%）,P〈0.05。实验组并发症发生率为9.84%,低于对照组（28.81%）,P〈0.05。实验组复发率为6.56%,低于对照组（20.34%）,P〈0.05。结论鼻内镜下咽鼓管置管联合鼓室清窍汤冲洗治疗慢性分泌性中耳炎,创伤小、疗效确切、副反应少、复发率低,值得临床推广。
文摘Objective： To study the bacteriological profile in a healing mastoid cavity. Methods： This study was a single centre prospective study. Culture swabs from granulations in the mastoid cavity were sent in 40 consecutive patients with squamosal chronic otitis media undergoing mastoidectomy. Cultures were processed for both aerobic and anaerobic bacteria. Results： Preoperatively： specimens from 26 out of 40 （60.5%） had growth on culture, with 22 （55%） showing only one organism while 4 showing multiple organisms. The commonest organism isolated was pseudomonas aeruginosa （n=15）. At 1 month after mastoidctomy, 11 patients had sterile culture while 29 had growth, of which 26 had aerobic growth and 3 had anaerobic growth. Pseudomonas was seen in 22 patients and staphylococcus aureus in 2 patients. The mean Merchant score was 2. At 3 months： 29 patients （72.5%） had sterile culture from mastoid cavity while 11 patients （27.5%） had growth on culture. All positive cultures were aerobic, including pseudomonas （n=9） and proteus （n= 2）. The mean Merchant score was 1.03. Of the 40 patients, 16 （40%） had a different organism cultured postoperatively compared to preoperative swabs. Conclusion： Pseudomonas and proteus seem to be the most common organisms responsible for persistent otorrhea after mastoidectomy. Persistent sterile otorrhea was seen in 4 patients （10%） in this group at the end of 3 months. Sterile cultures of preoperative swab are more likely to remain sterile in the postoperative period.
文摘Aural polyps are a common clinical entity encountered by otorhinolaryngologist in daily practice. Polyps are frequently seen in paediatric patients, usually inflammatory in nature. In children rhabdomyosarcomas (RMS) can mimic all the cinical features of chronic suppurative otitis media which usually present as external auditory canal mass or polyp. Here we present a case where a male child presented with recurrence of polyp in left ear which was finally diagnosed as embryonal rhabdomyosarcoma which is a rare and invariably fatal disease in children. Through this article we intend to highlight the failures and delay committed in attaining diagnosis in this patient in spite of multispecialty evaluation involving repeated imaging and histopathological correlation. Our experience with embryonal rhabdomyosarcoma throws light on the high vigilance required in handling the aural polyps in pediatric population as early diagnosis and treatment are the key elements for successful outcomes.
文摘Aim: This study was carried out to assess association between Sensorineural hearing loss (SNHL) and Chronic Suppurative Otitis Media (CSOM), to identify possible risk factors and determine correlation of duration of CSOM and incidence of SNHL. Material and Method: The study consisted of 100 patients of either sex between 15 and 40 years of age, suffering from unilateral CSOM for the past three months or more, the normal ear served as control. Results: This study showed duration of symptoms is 18% patients for 5 - 10 years and below 5 years in 73% patients. It was found that mean BC thresholds were significantly higher in the diseased ears as compared to the control ears. Though the higher frequencies are more affected than the lower frequencies, in subtotal and attic perforations the speech frequencies seemed to be maximally affected. Conclusion: CSOM should be diagnosed early and should be managed effectively so as to prevent the chances of developing SNHL.
基金supported by the Strategic Leading Science and Technology Special Project(XDA05120402)the Open Fund for the State Key Laboratory of Loess and Quaternary Geology(SKLLQG1119)
文摘In this paper, we report organic carbon isotopic characterizations from two loess sequences （JY and GL）, spanning the last 20 ka, from the northwest Chinese Loess Plateau （CLP）. The results indicate that the vegetation type is nearly pure C3 plants in the studied region during the Holocene. In contrast to other reported loess sequences in the central-southeast CLP, the relative abundance of the C4 plants decreases from southeast to northwest, with the vegetation types changing from pure C3 to a C4/C3 mixture should near 36°N in the Holocene. From the perspective of the modem temperature and precipitation distribution, the summer temperature has no obvious change at the same latitude, but there are differences in the summer precipi- tation, which exhibit an obvious increase from west to east. Further analysis indicated that the C4 plant abundance decreases with the decreasing summer season precipitation from the southeast to the northwest CLP during the Holocene. We suggest that with the absence of favorable precipitation condition, increasing temperature and decreasing atmospheric CO2 concentration are insufficient to drive an expansion of the C4 plants on the CLP in the Holocene. According to a Holocene precipitation recon- struction, a ＂threshold value＂ of summer precipitation existed, which mainly controlled the expansion of C4 plants. Compared with the modern δ13Csom and climate data on the CLP, both the Holocene and the present ＂threshold value＂ are near the 360-mm summer precipitation line, although the present precipitation line turned slightly southwestward. Our results provide new insights for further research on the C4/C3 variations with precipi- tation and the relationship to global C4/C3 change.
