畸变产物耳声发射在糖尿病前期患者听功能检测中的应用

目的通过对糖尿病前期(pre-diabetes)患者畸变产物耳声发射(DPOAE)的筛查,了解糖尿病前期患者是否存在早期听力损失。方法通过口服葡萄糖耐量试验入选60岁的糖尿病前期患者40例,同时选取年龄、性别匹配的血糖正常者40例为对照组,对入选人群进行纯音测听、DPOAE检查。结果糖尿病前期组40例中17例存在纯音测听异常,对照组40例中仅3例纯音测听异常(x~2=13.067,P0.001)。糖尿病前期组DPOAE幅值在各频率点均较对照组降低,其中在1.5,2,3,4,6 kHz差异有统计学意义(P0.05)。在1,2,4 kHz相同频率下DPOAE较纯音测听异常检出率升高(P0.001)。结论糖尿病前期存在听力损失,DPOAE检测可在纯音测听出现异常之前发现耳蜗外毛细胞功能状态的改变,敏感性较纯音测听高,临床上可作为糖尿病前期患者耳蜗功能早期变化的有效客观检测方法 。     

386例老年人耳疾与听力障碍状况

目的 调查来我院以耳部疾患就诊的386例老年人的听力残疾状况与耳疾的病因分布,为本地区老年人群耳聋、耳疾的防治提供科学依据. 方法 对来我院以耳部疾患就诊的386例65岁以上的老年人分别进行电耳镜、声导抗、纯音测听、畸变产物耳声发射检查,根据听力检查及诊断结果对386例老年人进行听力损失评定及病因分析.结果 386例(772耳)老年人中,无听力损失为67耳,占8.68%;轻度听力损失为228耳,占29.53%;中度听力损失为288耳,占37.31%;重度听力损失为117耳,占15.16%;极重度听力损失为72耳,占9.33%.就诊患者听力损失的发生率为91.32%,其中以中耳炎和老年性聋为主要病因.结论 以耳部疾患就诊的老年人中都有不同程度地听力损失,其中中耳炎和老年性聋致残占相当大的比例,有效防治中耳炎和老年性聋是防聋治聋的关键.     

扬州地区老年人、中年人及青年人听力情况调查分析

目的 调查分析目前扬州地区老年人群（≥60岁）、中年人群（≥45岁且＜60岁）和青年人群（≥30岁且＜45岁）听力状况,着重了解老年性聋的分布和严重程度的相关情况,为老年性聋的预防、治疗提供科学可靠的依据。方法 用随机抽样的方法调查扬州市区、江都、仪征、宝应、高邮、安徽天长的听力情况。总共选取2 116人,运用纯音测听、声导抗、听力筛选等方法进行统计分析。结果 首先进行耳部检查,去除耵聍及异物等,确诊传导性听力损失人群（外耳或中耳疾病患者）,给予治疗指导意见,并在研究中予以排除,老年组人群听力减退比例为65.57%,其中轻度听力损失为46.78%,中度听力损失为13.31%,中重度听力损失为4.25%,重度听力损失为1.23%。中年组人群听力减退比例为48.12%,其中轻度、中度、中重度和重度听力损失分别为41.76%、4.34%、1.45%和0.58%。青年组人群听力减退比例为47.05%,其中各度听力损失分别为37.12%、6.76%、2.73%和0.43%,老年人、中年人及青年人听力损失的差异有统计学意义。结论 随着年龄增长,听力损失情况逐步加重。听阈随着年龄的增长而提高,并且在高频处,听力损失尤为明显。重视老年性疾病（如高血压、糖尿病、冠心病、脑供血不足等）的预防与治疗,避免噪声环境,拒绝烟酒等,对于防治老年患者的听力损失,有积极作用。     

短声诱发听性脑干反应阈与不同听力构型纯音听阈相关性探讨

目的探讨短声诱发听性脑干反应阈与不同听力损失构型人群2～4kHz纯音听阈均值的相关性。方法听力正常组选择正常听力成人10名（20耳）。62例感音神经性聋患者分为平坦型听力损失24耳及陡降型听力损失38耳。陡降型听力损失组38耳再分为四个亚组：1kHz陡降型5耳、2kHz陡降型11耳、4kHz陡降型19耳、6kHz陡降型3耳,均采用短声诱发听性脑干反应记录反应阈及纯音测听记录0．25、0．5、1…246、8kHz反应阈,记录数据通过SPSSV13．0软件进行分析。结果听力正常组、平坦型听力损失组、1kHz陡降型听力损失组、2kHz陡降型听力损失组2～4kHz纯音听阈均值及click-ABR的反应阈的直线相关系数分别为0．83（P〈0．01）、0．94（P〈0．01）、0．97（P〈0．01）、0．80（P〈0．01）。4kHz陡降型听力损失组2～4kHz纯音听阈均值及click—ABR的反应阈的直线相关系数为0．16（P〉0．05）,6kHz陡降组由于病例较少,差异无统计学意义。结论click-ABR的反应阈与2—4kHz纯音听阈均值相关性好,但是不能理解为能够用click—ABR的反应阈较精确评估2～4kHz纯音听阈均值。click—ABR的反应阈与2～4kHz纯音听阚均值之差的修正值为36dB,对于正常听力人群和平坦型听力损失人群可较精确评估听阈;对陡降型听力损失人群的听阈评估,ABR的反应阈与2—4kHz纯音听阈均值之差从10dB到70dB。尽管如此,在临床应用中click-ABR的反应阈作为听阈评估仍有其参考价值。     

2型糖尿病患者听力损伤的早发现研究

目的验证纯音测听和畸变产物耳声发射可以作为2型糖尿病患者听力损伤的早发现检测手段。方法收集2018年4—10月就诊于天坛社区卫生服务中心的39例(78耳)2型糖尿病患者及15名(30耳)健康体检者。先对观察组和对照组的受试者分别进行纯音测听(PTA)。计算观察组中主诉听力正常及下降的糖尿病患者纯音测听异常的比例,再比较观察组中主诉与纯音测听间的差异。然后,选取观察组与对照组中纯音测听正常的受试者,分别进行畸变产物耳声发射(DPOAE)检测,比较不同频率的幅值差异。结果观察组中,主诉听力正常的54耳中经纯音测听检查发现仍有32耳(59.26%)听力有不同程度的损伤,主诉听力下降的24耳中有23耳(95.83%)存在听力障碍。主诉与纯音测听间的差异有统计学意义(χ²=24.645,P<0.05)。接受DPOAE检测的两组幅值,各频点差异有统计学意义(P<0.05)。结论证实纯音测听和畸变产物耳声发射可以作为2型糖尿病患者听力损伤的早发现检测手段。     

耳声发射在老年聋早期监测中的应用

目的 探索老年聋的听力学特征,研究畸变产物耳声发射(DPOAE)在监测和早期发现老年聋方面的价值.方法 将受试者分为青年组(健康青年人,22名)、准老年组(纯音听阈正常的老年前期受试者,29名)、老年A组(纯音听阈正常老年人,30名)、老年B组(纯音听阈异常老年人,42名).对所有受试者进行DPOAE等听力学测试,分析检测结果.结果 准老年组各频率点的DPOAE幅值较青年组明显下降,阈值明显升高(P＜0.05).与准老年组相比较,老年A组在2 kHz以上频率点的DPOAE幅值明显下降(P＜0.05),在0.5、0.7、1、2、3、4、6、8 kHz频率点的阈值升高(P＜0.05).老年B组各频率点DPOAE幅值较老年A组明显下降,阈值明显升高(P＜0.05).结论 DPOAE可以客观监测和早期发现老年人听功能衰退,为早期诊断和防治老年聋提供有价值的资料.     

老年血微循环障致耳聋的临床观察

目的 从微循环障碍的角度对老年性耳聋的病因进行探讨。方法 对30例正常人，平均年龄62岁，50例老年性耳聋患者（平均年龄64岁）进行纯音测听及甲襞微循环观察。结果 血液微循环的状态与老年性耳聋的病情，病变程度呈正相关。结论 血液微循环改变与老年耳聋的发生，发展有着密切的关系，因此，改善微循环，增加血氧饱和度是预防和治疗老年性耳聋的一个重要方面。     

中老年突发性耳聋患者的临床特征、转归及预后

目的探讨老年突发性耳聋(SD)患者的临床特征、转归及影响预后的相关因素。方法通过对158例老年性SD患者和同期治疗的142例非老年性SD患者的临床资料进行回顾性分析,分析其临床特征、转归及影响预后相关因素。结果老年性SD患者具有不同的临床特征;老年组158例中治愈者8例,显效22例,有效50例,无效78例,总有效率为50.63%(80/158);非老年对照组142例中治愈16例,显效44例,有效40例,无效42例,总有效率为70.42%(100/142)。老年组治疗有效率明显低于非老年对照组(P<0.05)。单因素分析筛选出年龄、有无糖尿病、是否伴有眩晕、有无高血压、听力损失程度、病程、听力曲线类型、畸变产物耳声发射、听性脑干反应因素与预后有关(P<0.05)。多因素Logistic回归统计分析发现,病程长、全聋型曲线、重度及重度以上的听力损失是影响SD患者预后的独立危险因素。结论老年性SD患者具有其独特的临床特征,预后与多种因素有关,病程长、全聋型曲线、重度及重度以上的听力损失是影响SD患者预后的独立危险因素,临床上要注意SD患者的临床特征和注意各种可能的影响因素。     

抗氧化剂防治老年性聋的研究进展

正衰老是一种普遍的生理现象,以生物体时间依赖的功能衰退为特征~[1]。此过程常伴随着与年龄相关的听力损失,也称老年性聋。老年性聋是老年人中最常见的感觉障碍,调查显示,在65岁以上的人群中,老年性聋的发病率为25%～40%,大于75岁的老年人中,其发病率为48%～66%,而85岁以上的老年人发病率则超过80%~[2]。老年性聋还会导致社交孤独、抑郁和认知能力障碍等疾病。据2016年的全球疾病负担(GBD)报告显示,听力丧失     

畸变产物耳声发射在外伤后听力评估中的应用

目的探讨畸变产物耳声发射（DPOAE）在外伤后听力评估中的应用价值。方法对30例外伤后述有耳鸣、听力下降者行DPOAE和常规听力检测。结果 DPOAE正常者18例,其中伪聋12例;DPOAE异常者12例,其中无听力障碍者5例、中耳受累者2例、其他耳蜗损伤者5例。结论 DPOAE可鉴别伪聋、发现无听力障碍耳鸣者的耳蜗功能异常,是外伤后听力学检查的重要手段。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.