住院医师规范化培训是毕业后医学教育的重要组成部分.承担培训任务的住院医师规范化培训专业基地的建设质量直接影响培训结果.本文总结了在中国医师协会组织开展的耳鼻咽喉科专业基地评估过程中暴露的共性问题,并尝试提出持续改进的对策,以期更好地促进住院医师规范化培训事业的发展,提高全国耳鼻咽喉科基地建设的水平和培训质量.

Objective To examine the prevalence and risk factors of allergic rhinitis in Beijing region. Methods A total of 2 215 residents were selected with stratified cluster sampling and surveyed with a questionnaire,physical examination and skin prick test on allergic rhinitis. Results The prevalence of allergic rhinitis was 25. 72% and there was no significant between-gender difference in the prevalence(P 0. 05). The partiapants of 21-30 years old had the highest prevalence rate and there were statistical between-age group difference(P 0. 05). Occupation,living environmental pollution,cockroaches and other insects in house,with parental allergic rhinitis history,pollen allergies,asthma history,and occupational exposure to dust were influencing factors of allergic rhinitis(all P 0. 05). The results of multi-factor logistic regression show ed that living environmental pollution(odds ratio[OR]= 2. 437),parental history of allergic rhinitis(OR = 8. 546),pollen allergies(OR = 3. 752),history of asthma(OR = 1. 873),and occupational dust exposure(OR = 3. 182) were the risk factors of allergic rhinitis. Conclusion The prevalence of allergic rhinits is higher in young adults but then decreases with the increment of age among the residents in Beijing region.

OBJECTIVE To investigate the correlation factors of the immunotherapeutic efficiency of perennial allergic rhinitis (PAR). METHOD One hundred and sixty-four patients with PAR were treated with specific immunotherapy (IT) in our department between 1990 and 2000. Specific allergens were selected through the history and skin test or nasal provocation test. The patients were given subcutaneous injections with allergen extract which was produced by Xiehe Hospital. The individual initiative dose was determined by the skin test reaction or the end point concentration. The doses were gradually increased until the maintenance dose (10(2) w/v, 0.5 ml once time), then the interval between injections was gradually increased up to one month. The clinical effectiveness evaluation based on the symptoms and signs before and after IT was judged as marked, moderated and poor response. The possible factors which affected the efficacy of IT were selected. These factors included sex, age, illness duration, disease condition, asthma, duration of IT, reaction condition of the skin test, accompanying itch of eye, ear and oral cavity, eosinophilia in nasal smears and family history of atopy. The correlation factors with efficacy were sifted with multifactorial stepwise regression analysis. RESULT The marked, moderated and poor response were 14.4%, 54.3% and 31.3% respectively. The efficacy of IT correlated well with the duration of IT (P < 0.01), but not with sex, illness duration, disease condition, reaction condition of the skin test, accompanying itch of eye, ear and oral cavity, eosinophilia in nasal smears and family history of atopy. Asthma and age maybe influenced the effect of IT (P = 0.081, P = 0.063). CONCLUSION This study demonstrates that the immunotherapy is effective in the treatment of perennial allergic rhinitis. The duration is the factor significantly influences the efficacy of IT. The efficacy of long-IT was superior to that of the short-IT.

Objective To evaluate the efficacy and safety of azelastine hydrochloride tablet in allergic rhinitis in compare with loratadine. Methods A multicenter randomized doubl-blind and parallel-controlled clinical trail was conducted. Patients with mild to moderate allergic rhinitis received either azelastine hydrochloride tablet 1 mg twice daily or placebo tablet and loratadine tablet 10 mg each once daily for consecutive 14 days. Nasal symptom score, consisting of sneezing, runny nose, itchy nose, nasal congestion and nasal cavity condition scores was recored before, during and after the treatment. Results The total effective rate was 87.93% for azelastine group and 82.54% for loratadine group, and the adverse event rate was 8.62% and 14.06%, respectively. There was no statistical significant between the two groups. Conclusion Azelastine hydrochloride tablet was effective and safe for the treatment of allergic rhinitis.

急性会厌炎是以会厌及杓会厌皱襞为主要病变部位的急性炎症,其病情发展常难以预测,可突发喉梗阻甚至会窒息死亡.因此对该病充分认识与恰当处理可减轻病人痛苦,缩短住院日,降低死亡率.本文回顾性分析了我科自1988年10月至1996年10月收治的100例成人急性会厌炎病例.特别讨论重症急性会厌炎的发生、发展及治疗.

> 患者女,36岁。因咽痛、声嘶4个月,渐进性吸气性呼吸困难1个月于1991年7月25日入院。检查:发育正常,神清,急性面容。Ⅲ度吸气性呼吸困难,会厌正常,双声带运动好,吸气时声门下偏右可见红色肿物。X线喉部断层摄片显示声门下右侧有一