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Background Tuberculosis (TB) remains a significant global public health problem. China has the second highest TB burden in the world. With a growing TB population with diabetes mellitus (DM), the TB control system faces mounting challenges. To date, evidence remains inconclusive regarding the association between TB-DM co-morbidity and delayed diagnosis of TB patients. This study aims to assess the diagnostic delay of TB patients with known DM and identify the factors associated with this delay. Methods Data was collected from China’s Tuberculosis information management system in two counties of Zhejiang province, China. Patient delay, health system delay and total diagnostic delay are defined as follows: 1) the interval between the onset of TB symptoms and first visit to any health facility; 2) from the first visit to the health facility to the confirmed TB diagnosis in the designated hospital; 3) the sum of patient and health system’s respective delays. Comparison of these delays was made between TB patients with and without DM using Mann-Whitney U test and Chi-square test. Univariate and multivariate regression analysis was used to identify factors influencing delays among TB patients with DM. Results Of 969 TB patients, 67 (7%) TB patients had DM co-morbidity. Compared with TB patients without DM, TB patients with DM experienced significantly shorter health system delays (p 14 days (7.0% vs. 18%, p p p 14 days. Conclusions Our study suggests that DM does not contribute to further diagnostic delay as expected. Instead, we observed significantly improved health system delay among TB patients with DM. The findings indicate the importance of early screening and diagnosis for TB among diabetic patients and of strengthening the integrated control and management of TB and diabetic programs.

BACKGROUND Sensorineural hearing loss is caused by defects in the inner ear. In the present study, associations between chronic rhinosinusitis, outer hair cell injury, and sensorineural hearing loss were investigated. MATERIAL AND METHODS A total of 103 patients who met the inclusion criteria were recruited and allocated into a chronic rhinosinusitis group (n=82) and a simple deviated nasal septum group (n=21). Degree and type of hearing loss, including distortion product otoacoustic emissions, were used to assess the status of cochlear outer hair cells. RESULTS The rate of hearing loss in the simple deviated nasal septum group was significantly lower than in the chronic rhinosinusitis group (4.76%, 1/21 vs. 24.39%, 20/82, P

Background: External auditory canal (EAC) cholesteatoma (EACC) is rare and its treatment for different lesions has not yet been standardized.Objective: This study aimed to explore the clinical feat...

Objectives To describe a clear and simplified classification system for juvenile nasopharyngeal angiofibroma (JNA), and to describe suitable management options. Study design Retrospective medical record review. Methods The clinical and imaging materials of 51 cases of JNA diagnosed at our hospital between 1981 and 2011 were collected and studied. Based on our experiences, we prefer to divide JNAs into three types. Type I includes JNAs fundamentally localized to the nasal cavity, paranasal sinus, nasopharynx, or pterygopalatine fossa. Type II is a JNA extending into the infratemporal fossa, cheek region, or orbital cavity, with anterior and/or minimal middle cranial fossa extension but intact dura mater. Type III is a calabash-like massive tumor lobe in the middle cranial fossa. The management and prognosis for the three types of JNA were compared and evaluated. Results Among cases of type I JNA (n = 16), the entire mass was removed by the initial operation in 15 cases and by a repeat operation in 1 case. Among cases of type II JNA (n = 29), the entire mass was removed by the first operation in 24 cases and by repeat operation in 5 cases. In cases of type III JNA (n = 6), the huge calabash-like lobe in the middle cranial fossa could not be completely excised; 4 cases underwent radiotherapy and 2 cases were lost to follow-up. Conclusions 1) The transnasal cavity approach with endoscopic guidance is suitable for type I JNA resection. 2) The transantral–infratemporal fossa–nasal cavity combined approach is reliable for resection of a type II JNA, which extends into the deep anterior cranial fossa and/or minimally into the middle cranial fossa, with intact dura mater. 3) The complete removal of a type III JNA is difficult, even through a combined extracranial and intracranial approach. Radiotherapy is useful for treating the residual intracranial tumor. The successful or failed experiences of 6 typical cases prove that this revised classification system is reasonable and reliable.

To evaluate the treatment of advanced squamous cell carcinoma of the tonsil.Eight patients with advanced tonsillar carcinoma underwent resections combining mandibular ramus and oral cavity approaches, neck dissection and one-stage repair of the defect with pectoralis major myocutaneous flap (PM). The managements were supplemented with preoperative chemotherapy and postoperative radiotherapy.Following up 3 to 9 years, 6 of 8 cases(75%) survived for more than 3 years. Two of 8 cases (25%) died of different causes postoperatively. One case died of serious hemorrhage resulted from radio-mandibulomyelitis 3 months after operation, and the other case died of esophageal carcinoma 2 years after operation. Two cases complicated radio-mandibulomyelitis. Two cases suffered from temporary regurgitation of food to the nasal chamber.Through this combined approach, the advanced tonsillar carcinoma could be resected en bloc under direct visual field and keeping 1-1.5 cm safe margin to the tumor. Neck dissection, preoperative chemotherapy and postoperative radiotherapy were supplemental measures. Combined therapy was of great significance in reducing recurrence of the tumor. PM was usually survived and easily obtained, hence, suitable for repairing the pharyngeal defect.