Background:Acute suppurative terminal cholangitis(ASTC)is rarer than acute obstructive cholangitis and is not well studied.To explore this subtype of acute cholangitis,we described our clinical experience with ASTC.Me...Background:Acute suppurative terminal cholangitis(ASTC)is rarer than acute obstructive cholangitis and is not well studied.To explore this subtype of acute cholangitis,we described our clinical experience with ASTC.Methods:We performed a retrospective review of patients with ASTC admitted to our center from September 2014 to August 2020.We analyzed their clinical characteristics,including etiology,clinical manifestations,imaging features,treatment and prognosis.Results:A total of 32 ASTC patients were included in the analysis.The majority of the patients had a history of biliary operations,and clinical manifestations were occult and atypical.The positive rate of bacterial culture was 46.9%.All the patients had typical imaging features on computed tomography and magnetic resonance imaging.Treatment with effective antibiotics was provided as soon as diagnosis was established.After treatment,most patients had a good outcome.Elevated levels of total bilirubin,aspartate aminotransferase,procalcitonin and gamma-glutamyltransferase were the characteristics of critically ill patients and were associated with relatively poor prognosis.Conclusions:Our results demonstrated that ASTC should be recognized as a new subtype of acute cholangitis,and that earlier diagnosis and more personalized treatments are needed.展开更多
Objective: To explore the clinical value of surgical treatment and postoperative anti-infection treatment for acute suppurative appendicitis. Methods: A total of 116 patients with acute suppurative appendicitis were e...Objective: To explore the clinical value of surgical treatment and postoperative anti-infection treatment for acute suppurative appendicitis. Methods: A total of 116 patients with acute suppurative appendicitis were enrolled in this study. The collection period was from December 2021 to December 2023. The patients were randomly grouped into a control group (surgical treatment) and an observation group (surgical treatment and postoperative anti-infection treatment), of 58 patients each. At the end of the treatment, the results of each index of the two groups were compared. Results: The length of hospitalization time, exhaust time, and incidence of complications in the observation group were shorter than those of the control group (P < 0.05). The total effective rate of the observation group was higher than that of the control group (P < 0.05). Conclusion: It is crucial to perform anti-infective treatment promptly after surgical treatment in patients with acute suppurative appendicitis. It can effectively prevent the occurrence of complications and improve the clinical efficacy. Hence, it is worthy of research and promotion.展开更多
Acute obstructive suppurative cholangitis(AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography(ERCP) with s...Acute obstructive suppurative cholangitis(AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography(ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy(EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.展开更多
BACKGROUND Suppurative oesophagitis is a diffuse inflammation of the oesophagus characterized by suppurative exudate or pus formation.Suppurative infections can affect any part of the gastrointestinal tract,most commo...BACKGROUND Suppurative oesophagitis is a diffuse inflammation of the oesophagus characterized by suppurative exudate or pus formation.Suppurative infections can affect any part of the gastrointestinal tract,most commonly the stomach,with inflammation involving the entire gastric cavity.However,cases extending beyond the cardia or pylorus and involving the oesophagus,small intestine,and colon are rare.Usually such cases are discovered during surgery or autopsy.CASE SUMMARY We report a rare case of acute suppurative oesophagitis.A 57-year-old man presented at the Emergency Department of our hospital with fever and productive cough.The patient had a significant history of lower oesophageal mucosal frostbite.He was successfully diagnosed and treated with repeated gastroscopy,appropriate antibiotics,and innovative symptomatic treatment.CONCLUSION Early diagnosis and appropriate treatment of acute suppurative oesophagitis are critical.Nutritional support,postural drainage,and other symptomatic treatments must be considered.展开更多
BACKGROUND： At present, suppurative meningitis is mainly treated through anti-infection with antibiotics, depressing encephalic pressure with mannitol , lowering body temperature with drugs , supporting treatment, et...BACKGROUND： At present, suppurative meningitis is mainly treated through anti-infection with antibiotics, depressing encephalic pressure with mannitol , lowering body temperature with drugs , supporting treatment, etc. However, Jt takes a long course of treatment and has poor therapeutic effect. Successive irrigation of subarachnoid cavity maybe have better effect on suppurative meningitis.OBJECTIVE： We compared the successive irrigation of subbarachnoid cavity with routine therapeutic methods to observe the effect of successive irrigation of subarachnoid cavity on the body temperature, cerebrospinal fluid pressure, the number of white blood cell and the level of protein of suppurative meningitis dogs. DESIGN： A randomized and controlled animal experiment SETTING： Institute of Neuroscience, Taihe Hospital Affiliated to Yunyang Medical College MATERIALS： Totally 17 healthy adult male Beagle dogs, of common grade, weighing 9 to 10 kg, were involved in the experiment, and raised in the 20 ℃ temperature with relative humidity of 50% for 1 week. They were randomized into 3 groups： normal group （n=5）, control group （n=5） and irrigation group （n=6）. Artificial cerebrospinal fluid was prepared according to the level of glucose and chloride of cerebrospinal fluid of normal dogs, and then it was sterilized with high pressure. METHODS ： This experiment was carried out in the experimental animal center of Yunyang Medical College from April to August 2001. ① After the dogs were anesthetized,1 mL fresh staphylococcus aureus liquid [（1.5-1.6）× 10^9 L 1] was injected into medullary cistern to establish suppurative meningitis models. ② After models were successfully established, intravenous drip infusion of 1.2 ×10^6 U/（kg.d）, muscular injection of sulfadiazine sodium of 100 mg/（kg.d ）and intravenous injection of 200 g/L mannitol of 5 g/（kg .time） for 3 times a day were performed in the control group. The irrigation of subarachnoid meningitis was conducted in the irrigation group besides the routine treatments in the control group： Artificial cerebrospinal fluid was successively injected into the epidural catheter in the waist part. The mixtures of artificial cerebrospinal fluid and inflammatory cerebrospinal fluid flowed out incessantly from epidural catheter of medullary cistern. Irrigation was ended 48 hours later. Dogs were routinely raised in the control group. ③ From the first day after being modeled to the 14^th day after treatment, the rectal temperatures were daily measured in the morning, at noon and in the evening respectively, then the mean temperatures were calculated. From the 2^nd day after being modeled to the 14^th day after treatment, puncture at waist was given once, and the cerebrospinal fluid pressure, the number of white blood cells and the level of protein were measured. MAIN OUTCOME MEASURES ： The body temperature, cerebrospinal fluid pressure, the number of white blood cells and the level of protein were measured on suppurative meningitis model dogs. RESULTS＂ Totally 17 Beagle dogs were involved in this study.①The body temperatures of dogs were significantly reduced in the control group and in irrigation group on the 1^st day after treatment and lower than suppurative meningitis model dogs on the 2^nd day after being modeled （P 〈 0.05）. The body temperatures were gradually decreased in control group from the 2^nd day after being modeled to the 14^th day after treatment （P 〈 0.01）, but were significantly higher than those of dogs in normal group on the 14^th day after treatment （P 〈 0.05）. The body temperatures of dogs were gradually decreased in irrigation group on the 2^nd day or 3^rd day after treatment （P 〈 0.01） and then were close to the normal body temperature on the 14^th day after treatment. ②There was the same cerebrospinal fluid pressure in control group as in irrigation group on the 2^nd day after being modeled （P 〉 0.05）, but significantly decreased in two groups from the 1s＇ day or 2^nd day after treatment （P 〈 0.01）, and cerebrospinal fluid pressure was close to the normal level in irrigation group. Although the cerebrospinal fluid pressure raised a little on the 3^rd day or 4^th day after treatment in the irrigation group （P〈 0.05）, but recovered to the normal level on the 9^th day after treatment again. It decreased slowly in the control group and still was sig- nificantly higher than normal group on the 14^hd day after treatment （P〈 0.01 ）. ③No significant difference existed in number of white blood cell and the level of protein between control group and irrigation group on the 2^nd day following modeled. Both of them began to significantly decrease on the 1^st and 2^nd day after treatment （P 〈 0.01 ）. Although the number of white blood cell and the level of protein rebounded a little in irrigation group 3 or 4 days after treatment （P〈 0.05）, they were gradually decreased and recovered to normal levels on the 13^th day after treatment. The number of white blood cell and the level of protein slowly decreased in the control group compared with irrigation group and were still significantly higher than normal group on the 14^th day （P〈 0.01 ）. EONELUSEON ： Irrigation of subarachnoid cavity can decrease the body temperature, cerebrospinal fluid pressure, the number of white blood cells and the level of protein at early stage of suppurative meningitis, and the therapeutic effect is better than that of routine treatment.展开更多
Background: Otitis media is one of the most common childhood infections, the leading cause of doctor’s visit by children in ENT clinic. The acute form if not recognized early is commonly characterized by suppuration ...Background: Otitis media is one of the most common childhood infections, the leading cause of doctor’s visit by children in ENT clinic. The acute form if not recognized early is commonly characterized by suppuration from the middle ear following perforation of the tympanic membrane otherwise referred to as acute suppurative otitis media (ASOM). If not adequately treated, it progresses to chronic suppurative otitis media with attendant challenges in management. Ceasation of ear discharge is an indication of resolution of disease. The objective of this study is to appraise the value of local ear suction toileting and dressing in the ceasation of ear discharge in acute suppurative otitis media. Materials and Method: Consecutive new cases of acute suppurative otitis media seen at the Ear, Nose and Throat clinic of a tertiary health centre in north western Nigeria were assessed for efficacy of aural toileting and dressing with antibioctic impregnated guaze in the treatment of acute suppurative otitis media and compared with patients with similar disease without aural toileting and dressing or dressing with normal saline soaked guaze in addition to systemic antibiotic and antihistamine medications. Ear toileting was done by suctioning the discharge with suction machine, and cleaning the external auditory canal with hydrogen peroxide and methylated spirit. They were then dressed with gauze impregnated with antibiotic ear drops daily until there was no more ear discharge. The period of ceasation of ear discharge in each group was assessed. Results: There were 39 patients with acute suppurative otitis media (ASOM). Eighteen were females (46.2%) while 21 were males (53.8%), giving M:F ratio 1:2.1. Their ages ranged between 1 month and 45 years. About 36 (92.3%) were children and out of this, 28 (77.8%) were less than 5 years old. The average period of ceasation of discharge was 24 - 48 hours with those undergoing ear toileting and dressing but varied between 7 and 10 days with those without ear dressing or dressing with normal saline soaked guaze. This finding compelled us to stop the study on ethical grounds when this was carried out in the first 5 patients on each side of the study groups necessitating reversals of other groups to aural toileting and dressing with antibiotic impregnated guaze. Conclusion: Local ear toileting and dressing appear to show significant contribution to the early ceasation of ear discharge and are highly recommended not only for acute suppurative otitis media but also for all suppurative ear diseases.展开更多
Research of 1960’s show that treating asthma with suppurative moxibustion has obvious effectiveness and can improve immune function of asthmatic patients. But, making a comprehensive survey of the research situation,...Research of 1960’s show that treating asthma with suppurative moxibustion has obvious effectiveness and can improve immune function of asthmatic patients. But, making a comprehensive survey of the research situation, effectiveness of asthma treated by suppurative moxibustion needs to be heightened, two defects of suppuration and scar of suppurative moxibustion are worth notice, and we must explore the mechanism of asthma treated by suppurative moxibustion above all, which should be setted about from "supperative effect" and from preventing and treating air passage inflammation of asthmatic patient, so as to progressively promote and promote the research going deep into molecule and gene levels.展开更多
Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharg...Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharge which is collected with sterile swabs is subjected to Gram’s staining and culture of the causative organism. Antibiotic sensitivity test of cultured bacterial growth is undertaken to know the susceptibility of the causative organism. Of the 100 samples, 62 were culture positive where Pseudomonas aeruginosa was the most common pathogen followed by Staphylococcus aureus. Most of the cultured organisms in our study were sensitive to drug Ciprofloxacin. The outcome of our study enabled us to set an empirical medical treatment for an early resolution of ear discharge and inflammation in our patients with CSOM as we could understand the aetiological pathogens and their susceptibility pattern. Effective medical treatment in obtaining a discharge free ear prior to surgical treatment led us to improve the surgical outcome in our patients with CSOM.展开更多
Parotid mass causing facial nerve palsy is rare, and is associated with malignant tumours. Acute infection or abscess leading to facial nerve palsy is an extremely rare complication. A literature review revealed only ...Parotid mass causing facial nerve palsy is rare, and is associated with malignant tumours. Acute infection or abscess leading to facial nerve palsy is an extremely rare complication. A literature review revealed only 16 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We present a case of deep parotid abscess which is complicated by facial nerve dysfunction.展开更多
BACKGROUND Paraganglioma occurring at the lateral skull base is a rare tumor.Surgery is the primary treatment of benign paragangliomas.Postoperative infection of the surgical site at the lateral skull base is very dan...BACKGROUND Paraganglioma occurring at the lateral skull base is a rare tumor.Surgery is the primary treatment of benign paragangliomas.Postoperative infection of the surgical site at the lateral skull base is very dangerous and hard to manage.CASE SUMMARY A 30-year-old man with a 1-year history of left-side progressive hearing loss,tinnitus,facial palsy,and choking failed conventional treatment and is the focus of this case report.Imaging revealed a mass around the left jugular foramen that was approximately 47 mm×38 mm×34 mm in size and had eroded the bone of the vertebral and horizontal segments of the internal carotid artery.The tumor breached the meninges and occupied the cerebella pontine region.A two-stage surgery was designed for the resection of the mass.In the first-stage,the epidural portion of the mass was removed.The abdominal fat and the temporal muscle flap were transposed within the surgical site.The surgery was successful;however,25 d after surgery,he developed suppurative parotitis,and the infection spread to the surgical site at the skull base.Broad-spectrum antibiotics were used,and debridement was deployed.After that,the wound was cleaned daily.Five months after the first-stage surgery,the wound was still unclosed,and there was intermittent purulent exudation within the surgical site.vacuum sealing drainage(VSD)was used,and the wound healed in a month.One year after the first surgery,the second-stage of the operation was performed to remove the intracranial portion of the tumor.Recurrence of the tumor was not detected after a 6-month follow-up.CONCLUSION After a lateral skull base surgery,suppurative parotitis can spread into the operative cavity leading to infection of the surgical site.VSD can help to effectively heal the infected wound.A two-stage surgical approach offers a safer option for removing the lateral skull base paraganglioma that involves the meninges.展开更多
目的探讨内镜下逆行胰胆管造影术(ERCP)治疗急性梗阻性化脓性胆管炎(AOSC)患者的疗效。方法2020年1月~2023年1月我院收治的AOSC患者103例,其中观察组58例接受ERCP治疗,对照组45例接受开腹手术治疗。采用视觉模拟评分法(VAS)评估疼痛程度...目的探讨内镜下逆行胰胆管造影术(ERCP)治疗急性梗阻性化脓性胆管炎(AOSC)患者的疗效。方法2020年1月~2023年1月我院收治的AOSC患者103例,其中观察组58例接受ERCP治疗,对照组45例接受开腹手术治疗。采用视觉模拟评分法(VAS)评估疼痛程度,采用ELISA法检测血清白细胞介素(IL)-6、IL-1、肿瘤坏死因子(TNF)-α和C反应蛋白(CRP)水平。结果观察组术中出血量、手术时间、术后3 d VAS评分和术后住院日分别为(30.7±4.6)mL、(74.3±8.8)min、(3.1±0.8)分和(7.2±1.4)d,均显著短于或少于对照组【分别为(85.4±10.2)mL、(117.6±12.5)min、(4.9±1.1)分和(13.3±3.7)d,P<0.05】;在术后5 d,观察组血清ALT和GGT水平分别为(48.2±4.1)U/L和(163.9±17.2)U/L,均显著低于对照组【分别为(66.9±5.3)U/L和(189.6±21.5)U/L,P<0.05】;观察组血清IL-6、IL-1、TNF-α和CRP水平分别为(82.6±8.3)ng/L、(20.9±4.0)ng/L、(16.2±3.5)ng/L和(18.1±2.2)mg/L,均显著低于对照组【分别为(100.7±11.2)ng/L、(32.7±5.3)ng/L、(23.6±4.3)ng/L和(32.9±4.8)mg/L,P<0.05】;观察组并发症发生率为5.1%,显著低于对照组的17.8%(P<0.05)。结论采用ERCP治疗AOSC患者效果好,术后恢复快,并发症发生率低,值得临床应用。展开更多
Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and...Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and an MRI to evaluate soft tissue involvement, depth of invasion, and perineural invasion, followed by a biopsy, are indispensable for diagnosis and treatment. There is no standard treatment for squamous cell carcinoma of the middle ear, however, most reported cases are treated with surgical resection followed by postoperative radiotherapy. Given the challenges of achieving complete surgical excision, radiotherapy plays a crucial role in controlling middle ear cancers, as demonstrated in our case. We present a case of squamous cell carcinoma of the middle ear in a 63-year-old female with a history of chronic suppurative otitis media. The patient underwent a right subtotal petrosectomy without lymph node dissection followed by concurrent chemoradiotherapy. At the one-year follow visit, no recurrence or metastasis was detected.展开更多
基金This study was supported by a grant from the National Natural Science Foundation of China(81870457).
文摘Background:Acute suppurative terminal cholangitis(ASTC)is rarer than acute obstructive cholangitis and is not well studied.To explore this subtype of acute cholangitis,we described our clinical experience with ASTC.Methods:We performed a retrospective review of patients with ASTC admitted to our center from September 2014 to August 2020.We analyzed their clinical characteristics,including etiology,clinical manifestations,imaging features,treatment and prognosis.Results:A total of 32 ASTC patients were included in the analysis.The majority of the patients had a history of biliary operations,and clinical manifestations were occult and atypical.The positive rate of bacterial culture was 46.9%.All the patients had typical imaging features on computed tomography and magnetic resonance imaging.Treatment with effective antibiotics was provided as soon as diagnosis was established.After treatment,most patients had a good outcome.Elevated levels of total bilirubin,aspartate aminotransferase,procalcitonin and gamma-glutamyltransferase were the characteristics of critically ill patients and were associated with relatively poor prognosis.Conclusions:Our results demonstrated that ASTC should be recognized as a new subtype of acute cholangitis,and that earlier diagnosis and more personalized treatments are needed.
文摘Objective: To explore the clinical value of surgical treatment and postoperative anti-infection treatment for acute suppurative appendicitis. Methods: A total of 116 patients with acute suppurative appendicitis were enrolled in this study. The collection period was from December 2021 to December 2023. The patients were randomly grouped into a control group (surgical treatment) and an observation group (surgical treatment and postoperative anti-infection treatment), of 58 patients each. At the end of the treatment, the results of each index of the two groups were compared. Results: The length of hospitalization time, exhaust time, and incidence of complications in the observation group were shorter than those of the control group (P < 0.05). The total effective rate of the observation group was higher than that of the control group (P < 0.05). Conclusion: It is crucial to perform anti-infective treatment promptly after surgical treatment in patients with acute suppurative appendicitis. It can effectively prevent the occurrence of complications and improve the clinical efficacy. Hence, it is worthy of research and promotion.
基金Supported by The Japan Society for the Promotion of Science and the Japanese Foundation for the Research and Promotion of Endoscopy,No.22590764 and 25461035
文摘Acute obstructive suppurative cholangitis(AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography(ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy(EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.
基金Supported by the Fund of Spring Wind Plan of Tianjin First Central Hospital,No.TFCHCF201814.
文摘BACKGROUND Suppurative oesophagitis is a diffuse inflammation of the oesophagus characterized by suppurative exudate or pus formation.Suppurative infections can affect any part of the gastrointestinal tract,most commonly the stomach,with inflammation involving the entire gastric cavity.However,cases extending beyond the cardia or pylorus and involving the oesophagus,small intestine,and colon are rare.Usually such cases are discovered during surgery or autopsy.CASE SUMMARY We report a rare case of acute suppurative oesophagitis.A 57-year-old man presented at the Emergency Department of our hospital with fever and productive cough.The patient had a significant history of lower oesophageal mucosal frostbite.He was successfully diagnosed and treated with repeated gastroscopy,appropriate antibiotics,and innovative symptomatic treatment.CONCLUSION Early diagnosis and appropriate treatment of acute suppurative oesophagitis are critical.Nutritional support,postural drainage,and other symptomatic treatments must be considered.
文摘BACKGROUND： At present, suppurative meningitis is mainly treated through anti-infection with antibiotics, depressing encephalic pressure with mannitol , lowering body temperature with drugs , supporting treatment, etc. However, Jt takes a long course of treatment and has poor therapeutic effect. Successive irrigation of subarachnoid cavity maybe have better effect on suppurative meningitis.OBJECTIVE： We compared the successive irrigation of subbarachnoid cavity with routine therapeutic methods to observe the effect of successive irrigation of subarachnoid cavity on the body temperature, cerebrospinal fluid pressure, the number of white blood cell and the level of protein of suppurative meningitis dogs. DESIGN： A randomized and controlled animal experiment SETTING： Institute of Neuroscience, Taihe Hospital Affiliated to Yunyang Medical College MATERIALS： Totally 17 healthy adult male Beagle dogs, of common grade, weighing 9 to 10 kg, were involved in the experiment, and raised in the 20 ℃ temperature with relative humidity of 50% for 1 week. They were randomized into 3 groups： normal group （n=5）, control group （n=5） and irrigation group （n=6）. Artificial cerebrospinal fluid was prepared according to the level of glucose and chloride of cerebrospinal fluid of normal dogs, and then it was sterilized with high pressure. METHODS ： This experiment was carried out in the experimental animal center of Yunyang Medical College from April to August 2001. ① After the dogs were anesthetized,1 mL fresh staphylococcus aureus liquid [（1.5-1.6）× 10^9 L 1] was injected into medullary cistern to establish suppurative meningitis models. ② After models were successfully established, intravenous drip infusion of 1.2 ×10^6 U/（kg.d）, muscular injection of sulfadiazine sodium of 100 mg/（kg.d ）and intravenous injection of 200 g/L mannitol of 5 g/（kg .time） for 3 times a day were performed in the control group. The irrigation of subarachnoid meningitis was conducted in the irrigation group besides the routine treatments in the control group： Artificial cerebrospinal fluid was successively injected into the epidural catheter in the waist part. The mixtures of artificial cerebrospinal fluid and inflammatory cerebrospinal fluid flowed out incessantly from epidural catheter of medullary cistern. Irrigation was ended 48 hours later. Dogs were routinely raised in the control group. ③ From the first day after being modeled to the 14^th day after treatment, the rectal temperatures were daily measured in the morning, at noon and in the evening respectively, then the mean temperatures were calculated. From the 2^nd day after being modeled to the 14^th day after treatment, puncture at waist was given once, and the cerebrospinal fluid pressure, the number of white blood cells and the level of protein were measured. MAIN OUTCOME MEASURES ： The body temperature, cerebrospinal fluid pressure, the number of white blood cells and the level of protein were measured on suppurative meningitis model dogs. RESULTS＂ Totally 17 Beagle dogs were involved in this study.①The body temperatures of dogs were significantly reduced in the control group and in irrigation group on the 1^st day after treatment and lower than suppurative meningitis model dogs on the 2^nd day after being modeled （P 〈 0.05）. The body temperatures were gradually decreased in control group from the 2^nd day after being modeled to the 14^th day after treatment （P 〈 0.01）, but were significantly higher than those of dogs in normal group on the 14^th day after treatment （P 〈 0.05）. The body temperatures of dogs were gradually decreased in irrigation group on the 2^nd day or 3^rd day after treatment （P 〈 0.01） and then were close to the normal body temperature on the 14^th day after treatment. ②There was the same cerebrospinal fluid pressure in control group as in irrigation group on the 2^nd day after being modeled （P 〉 0.05）, but significantly decreased in two groups from the 1s＇ day or 2^nd day after treatment （P 〈 0.01）, and cerebrospinal fluid pressure was close to the normal level in irrigation group. Although the cerebrospinal fluid pressure raised a little on the 3^rd day or 4^th day after treatment in the irrigation group （P〈 0.05）, but recovered to the normal level on the 9^th day after treatment again. It decreased slowly in the control group and still was sig- nificantly higher than normal group on the 14^hd day after treatment （P〈 0.01 ）. ③No significant difference existed in number of white blood cell and the level of protein between control group and irrigation group on the 2^nd day following modeled. Both of them began to significantly decrease on the 1^st and 2^nd day after treatment （P 〈 0.01 ）. Although the number of white blood cell and the level of protein rebounded a little in irrigation group 3 or 4 days after treatment （P〈 0.05）, they were gradually decreased and recovered to normal levels on the 13^th day after treatment. The number of white blood cell and the level of protein slowly decreased in the control group compared with irrigation group and were still significantly higher than normal group on the 14^th day （P〈 0.01 ）. EONELUSEON ： Irrigation of subarachnoid cavity can decrease the body temperature, cerebrospinal fluid pressure, the number of white blood cells and the level of protein at early stage of suppurative meningitis, and the therapeutic effect is better than that of routine treatment.
文摘Background: Otitis media is one of the most common childhood infections, the leading cause of doctor’s visit by children in ENT clinic. The acute form if not recognized early is commonly characterized by suppuration from the middle ear following perforation of the tympanic membrane otherwise referred to as acute suppurative otitis media (ASOM). If not adequately treated, it progresses to chronic suppurative otitis media with attendant challenges in management. Ceasation of ear discharge is an indication of resolution of disease. The objective of this study is to appraise the value of local ear suction toileting and dressing in the ceasation of ear discharge in acute suppurative otitis media. Materials and Method: Consecutive new cases of acute suppurative otitis media seen at the Ear, Nose and Throat clinic of a tertiary health centre in north western Nigeria were assessed for efficacy of aural toileting and dressing with antibioctic impregnated guaze in the treatment of acute suppurative otitis media and compared with patients with similar disease without aural toileting and dressing or dressing with normal saline soaked guaze in addition to systemic antibiotic and antihistamine medications. Ear toileting was done by suctioning the discharge with suction machine, and cleaning the external auditory canal with hydrogen peroxide and methylated spirit. They were then dressed with gauze impregnated with antibiotic ear drops daily until there was no more ear discharge. The period of ceasation of ear discharge in each group was assessed. Results: There were 39 patients with acute suppurative otitis media (ASOM). Eighteen were females (46.2%) while 21 were males (53.8%), giving M:F ratio 1:2.1. Their ages ranged between 1 month and 45 years. About 36 (92.3%) were children and out of this, 28 (77.8%) were less than 5 years old. The average period of ceasation of discharge was 24 - 48 hours with those undergoing ear toileting and dressing but varied between 7 and 10 days with those without ear dressing or dressing with normal saline soaked guaze. This finding compelled us to stop the study on ethical grounds when this was carried out in the first 5 patients on each side of the study groups necessitating reversals of other groups to aural toileting and dressing with antibiotic impregnated guaze. Conclusion: Local ear toileting and dressing appear to show significant contribution to the early ceasation of ear discharge and are highly recommended not only for acute suppurative otitis media but also for all suppurative ear diseases.
文摘Research of 1960’s show that treating asthma with suppurative moxibustion has obvious effectiveness and can improve immune function of asthmatic patients. But, making a comprehensive survey of the research situation, effectiveness of asthma treated by suppurative moxibustion needs to be heightened, two defects of suppuration and scar of suppurative moxibustion are worth notice, and we must explore the mechanism of asthma treated by suppurative moxibustion above all, which should be setted about from "supperative effect" and from preventing and treating air passage inflammation of asthmatic patient, so as to progressively promote and promote the research going deep into molecule and gene levels.
文摘Our prospective study conducted over a period of 9 months includes 100 samples of ear discharge collected from 90 patients suffering from tubo-tympanic type of chronic suppurative otitis media (CSOM). The ear discharge which is collected with sterile swabs is subjected to Gram’s staining and culture of the causative organism. Antibiotic sensitivity test of cultured bacterial growth is undertaken to know the susceptibility of the causative organism. Of the 100 samples, 62 were culture positive where Pseudomonas aeruginosa was the most common pathogen followed by Staphylococcus aureus. Most of the cultured organisms in our study were sensitive to drug Ciprofloxacin. The outcome of our study enabled us to set an empirical medical treatment for an early resolution of ear discharge and inflammation in our patients with CSOM as we could understand the aetiological pathogens and their susceptibility pattern. Effective medical treatment in obtaining a discharge free ear prior to surgical treatment led us to improve the surgical outcome in our patients with CSOM.
文摘Parotid mass causing facial nerve palsy is rare, and is associated with malignant tumours. Acute infection or abscess leading to facial nerve palsy is an extremely rare complication. A literature review revealed only 16 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We present a case of deep parotid abscess which is complicated by facial nerve dysfunction.
文摘BACKGROUND Paraganglioma occurring at the lateral skull base is a rare tumor.Surgery is the primary treatment of benign paragangliomas.Postoperative infection of the surgical site at the lateral skull base is very dangerous and hard to manage.CASE SUMMARY A 30-year-old man with a 1-year history of left-side progressive hearing loss,tinnitus,facial palsy,and choking failed conventional treatment and is the focus of this case report.Imaging revealed a mass around the left jugular foramen that was approximately 47 mm×38 mm×34 mm in size and had eroded the bone of the vertebral and horizontal segments of the internal carotid artery.The tumor breached the meninges and occupied the cerebella pontine region.A two-stage surgery was designed for the resection of the mass.In the first-stage,the epidural portion of the mass was removed.The abdominal fat and the temporal muscle flap were transposed within the surgical site.The surgery was successful;however,25 d after surgery,he developed suppurative parotitis,and the infection spread to the surgical site at the skull base.Broad-spectrum antibiotics were used,and debridement was deployed.After that,the wound was cleaned daily.Five months after the first-stage surgery,the wound was still unclosed,and there was intermittent purulent exudation within the surgical site.vacuum sealing drainage(VSD)was used,and the wound healed in a month.One year after the first surgery,the second-stage of the operation was performed to remove the intracranial portion of the tumor.Recurrence of the tumor was not detected after a 6-month follow-up.CONCLUSION After a lateral skull base surgery,suppurative parotitis can spread into the operative cavity leading to infection of the surgical site.VSD can help to effectively heal the infected wound.A two-stage surgical approach offers a safer option for removing the lateral skull base paraganglioma that involves the meninges.
文摘目的探讨内镜下逆行胰胆管造影术(ERCP)治疗急性梗阻性化脓性胆管炎(AOSC)患者的疗效。方法2020年1月~2023年1月我院收治的AOSC患者103例,其中观察组58例接受ERCP治疗,对照组45例接受开腹手术治疗。采用视觉模拟评分法(VAS)评估疼痛程度,采用ELISA法检测血清白细胞介素(IL)-6、IL-1、肿瘤坏死因子(TNF)-α和C反应蛋白(CRP)水平。结果观察组术中出血量、手术时间、术后3 d VAS评分和术后住院日分别为(30.7±4.6)mL、(74.3±8.8)min、(3.1±0.8)分和(7.2±1.4)d,均显著短于或少于对照组【分别为(85.4±10.2)mL、(117.6±12.5)min、(4.9±1.1)分和(13.3±3.7)d,P<0.05】;在术后5 d,观察组血清ALT和GGT水平分别为(48.2±4.1)U/L和(163.9±17.2)U/L,均显著低于对照组【分别为(66.9±5.3)U/L和(189.6±21.5)U/L,P<0.05】;观察组血清IL-6、IL-1、TNF-α和CRP水平分别为(82.6±8.3)ng/L、(20.9±4.0)ng/L、(16.2±3.5)ng/L和(18.1±2.2)mg/L,均显著低于对照组【分别为(100.7±11.2)ng/L、(32.7±5.3)ng/L、(23.6±4.3)ng/L和(32.9±4.8)mg/L,P<0.05】;观察组并发症发生率为5.1%,显著低于对照组的17.8%(P<0.05)。结论采用ERCP治疗AOSC患者效果好,术后恢复快,并发症发生率低,值得临床应用。
文摘Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and an MRI to evaluate soft tissue involvement, depth of invasion, and perineural invasion, followed by a biopsy, are indispensable for diagnosis and treatment. There is no standard treatment for squamous cell carcinoma of the middle ear, however, most reported cases are treated with surgical resection followed by postoperative radiotherapy. Given the challenges of achieving complete surgical excision, radiotherapy plays a crucial role in controlling middle ear cancers, as demonstrated in our case. We present a case of squamous cell carcinoma of the middle ear in a 63-year-old female with a history of chronic suppurative otitis media. The patient underwent a right subtotal petrosectomy without lymph node dissection followed by concurrent chemoradiotherapy. At the one-year follow visit, no recurrence or metastasis was detected.
