Endoscopic Ho laser interstitial therapy for pharyngolaryngeal venous malformations in adults.

Many methods have been used to treat venous malformations, including sclerotherapy, laser therapy, and surgery. Nowadays, endoscopic laser surgery has become a popular therapeutic modality for most of pharyngolaryngeal venous malformations. There are various kinds of lasers that have been applied, but Holmium:YAG laser (Ho laser) has not been reported yet. Ho laser is produced by a kind of iraser which is made of yttrium aluminum garnet mixed with holmium, chromium and thulium. Aim of the current work is to evaluate the efficacy and safety of Ho laser interstitial therapy in pharyngolaryngeal venous malformations in adults. The clinical data of 42 patients with pharyngolaryngeal venous malformation treated with endoscopic Ho laser interstitial therapy over a 12-year period were retrospectively reviewed and analyzed. The wave length of Ho laser was 2.1 µm and the diameter of optical fiber was 550 µm. The pulse energy was 0.5 J and the time of duration was 600 µs. The highest output power was 100 W. Outcomes were graded as cure (complete resolution), considerable reduction (>60-80 % reduction), and no obvious change (<50 % reduction). The lesions were well controlled without severe complications. Complete resolution of the lesion was observed in 95.1 % of the patients, while 4.9 % patients showed considerable reduction of the swelling. Complications occurred in 4.8 % of patients. No respiratory troubles or other severe complications occurred. Endoscopic Ho laser interstitial therapy is an effective and safe treatment modality for pharyngolaryngeal venous malformations in adults.

A cross-sectional study on health management service for hypertension and diabetes, Sichuan province, 2014 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province.</p><p><b>METHODS</b>44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't.</p><p><b>RESULTS</b>33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087).</p><p><b>CONCLUSION</b>The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.</p>