广州市黄埔地区听力损失患者助听器使用状况及影响因素调查

目的探讨广东省黄埔地区听力损失患者的助听器使用率及其影响因素。方法采用横断面研究方法对2012年3月至6月广州市黄埔区红会医院耳鼻喉科的164例听力损失的门诊病例进行一对一问卷调查，调查内容包括一般人口学特征、助听器使用相关行为、助听器使用效果评价。结果调查的152例听力损失患者中男性85例（55．9％），女性67例（44．1％），平均年龄（66．8±11．4）岁；152例听力损失患者助听器使用者为34例（22．4％），助听器使用类型最多为耳背式（50％），72．7％的助听器使用者表示满意使用效果。logistic回归分析表明，性别、年龄以及受教育程度等一般人口学信息与助听器的使用率间无统计学关联。结论广东省黄埔地区听力损失患者助听器的使用率较低，提醒有关部门应采取相应措施改善弱听人士的听力状况。     

The design and screening of drugs to prevent acquired sensorineural hearing loss

Introduction: Sensorineural hearing loss affects a high percentage of the population. Ototoxicity is a serious and pervasive problem in patients treated with cisplatin. Strategies to ameliorate ototoxicity without compromising on antitumor activity of treatments are urgently needed. Similar problems occur with aminoglycoside antibiotic therapy for infections. Noise-induced hearing loss affects a large number of people. The use of ear protection is not always possible or effective. The prevention of hearing loss with drug therapy would have a huge impact in reducing the number of people with hearing loss from these major causes. Areas covered: This review discusses significant research findings dealing with the use of protective agents against hearing loss caused by cisplatin, aminoglycoside antibiotics and noise trauma. The efficacy in animal studies and the application of these protective agents in clinical trials that are ongoing are presented. Expert opinion: The reader will gain new insights into current and projected future strategies to prevent sensorineural hearing loss from cisplatin chemotherapy, aminoglycoside antibiotic therapy and noise exposure. The future appears to offer numerous agents to prevent hearing loss caused by cisplatin, aminoglycoside antibiotics and noise. Novel delivery systems will provide ways to guide these protective agents to the desired target areas in the inner ear and circumvent problems with therapeutic interference of antitumor and antibiotics agents as well as minimize undesired side effects.     

老年人听力与高尿酸血症的相关性分析

目的：探讨高尿酸血症对老年人听力的影响。方法：选择2013年9月—2016年3月高尿酸血症患者100例（199耳）与100例（199耳）同年龄组相对健康老年人,分为疾病组和对照组,对两组进行纯音听力和高刺激率听觉脑干反应（ABR）测试,并对结果统计分析。结果：疾病组纯音听力各频率均显著高于对照组（P＜0.01）;疾病组ABR测试I、III、V波潜伏期和I–III、I–V波间期均较对照组显著延长（P＜0.01）,III–V波间期较对照组比较无显著差异（P＞0.05）,疾病组V波阈值较对照组显著增加（P＜0.05）。结论：高尿酸血症对老年人的外周和脑干听觉中枢均可造成损害,使患者听阈增加,导致听力下降,预防和治疗高尿酸血症是防止和延缓老年性耳聋的重要措施之一。     

安徽某热电厂职工健康状况调查分析

目的 了解热电厂职土在噪声、粉尘环境下的健康状况,以减少职业病的发生.方法 根据<职业健康监护管理办法>规定的接触职业病危害的不同,确定不同职业健康检查项目进行体检.结果 90名作业工人中,41人异常,检出率为45.6%;听力损失11人,检出率为14.3%.常见病及单项指标异常32人,检出率为35.6%.结论 应重视对噪声危害的控制,采用有效的听力防护措施,加强监督监测,做好职业病预防工作.     

Multidrug-resistant Gram-negative bacterial infections: the emerging threat and potential novel treatment options

Gram-negative bacterial infections constitute an emerging threat because of the development of multidrug-resistant organisms. There is a relative shortage of new drugs in the antimicrobial development pipeline that have been tested in vitro and evaluated in clinical studies. Antibiotics that are in the pipeline for the treatment of serious Gram-negative bacterial infections include the cephalosporins, ceftobiprole, ceftarolin and FR-264205. Tigecycline is the first drug approved from a new class of antibiotics called glycylcyclines, and there has been renewed interest in this drug for the treatment of some multidrug-resistant Gram-negative organisms. Carbapenems in the pipeline include tomopenem, with the approved drugs doripenem and faropenem, an oral agent, under evaluation for activity against multidrug-resistant Gram-negative bacterial infections. Polymyxins are old antibiotics traditionally considered to be toxic, but which are being used because of their activity against resistant Gram-negative organisms. New pharmacokinetic and pharmacodynamic data are available regarding the use of these agents. Finally, antimicrobial peptides and efflux pump inhibitors are two new classes of agents under development. This review of investigational antibiotics shows that several new agents will become available in the coming years, even though the pace of antimicrobial research is far from ideal.     

新疆维吾尔族耳鸣耳聋中医辨证分型的研究

目的进行新疆维吾尔族耳鸣耳聋疾病的分子流行病学调查,观察总结肾虚血瘀型在耳鸣耳聋疾病中的比例,为耳鸣耳聋的辨证分型提供理论依据。方法对137例耳聋患者进行临床资料采集,采用调查问卷形式,并全面的体格检查、耳鼻咽喉专科检查以及听力学评估（包括纯音听阈和声导抗多频率测定）。按照严格的纳入和排除标准分别筛选,然后对其进行肾虚血瘀、非肾虚血瘀辨证分型,比较肾虚血瘀型和非肾虚血瘀型之间的构成比有无差异。结果耳聋组137例中肾虚血瘀型105例（76.6%）,非肾虚血瘀型32例（23.4%）,即耳聋组分型构成比有差异,耳聋组肾虚血瘀型发生率高于非肾虚血瘀组。结论对新疆维吾尔族耳聋患者区分肾虚血瘀型和非肾虚血瘀型有临床意义,区分肾虚血瘀型和非肾虚血瘀型可以指导临床诊断,为耳聋耳鸣的分型论治提供理论依据。     

Regeneration and replacement in the vertebrate inner ear

Deafness affects more than 40 million people in the UK and the USA, and many more world-wide. The primary cause of hearing loss is damage to or death of the sensory receptor cells in the inner ear, the hair cells. Birds can readily regenerate their cochlear hair cells but the mammalian cochlea has shown no ability to regenerate after damage. Current research efforts are focusing on gene manipulation, gene therapy and stem cell transplantation for repairing or replacing damaged mammalian cochlear hair cells, which could lead to therapies for treating deafness in humans.     

Polymeric hearing protectors in sport shooting

Using hearing protectors during exposition to noise is fundamental to hearing loss prevention. The optimal choice of hearing protectors should take into consideration not only the physical characteristics of the acoustic environment which imply the traumatic action of noise, but also some individual preferences of the user. All contemporary produced hearing protectors both earmuffs as well as earplugs are made of synthetic polymers e.g. ABS, polyvinylchloride, polyethylene, polyurethathane, silicone rubbers. The type of the material used determines hardness, incompressibility and plasticity of the hear protector and may cause some discomfort. A special group of individuals exposed to noise are sport shooters in which (whose) case the exposition to impact noise is several times higher above standards. The aim of this work was an appraisal of the individual preferences in the choice of hearing protectors. The properties of polymers used for the production of hearing protectors were also taken into consideration. 104 females and 93 males representing master class were interviewed in this study. The analysis of the answers indicated that abandoning of hearing protectors by some shooters is due to the frequent skin irritations, overheating in the ear canal and allergy. Shooters linked these problems with the materials used for the production of hearing protectors. Earplugs were preferred by females, whereas males indicated earmuffs as their preferred choice. Females preferred earplugs made of soft materials which can be easily fitted to ear canal. Those males who used earplugs preferred protectors made of hard plastics as they thought this make better insulation. It can be concluded that the choice of the hearing protectors should not be done on the basis acoustic signal characteristics only, but also should reduce some discomforts resulting from properties of the materials used for their production.     

Beyond the genome--SMi Conference 27-28 January 2003, London,UK

Over a decade of astonishing developments, genomics and proteomics have promised a fundamentally new approach to drug discovery. Although there has been an undeniable increase in the range of potential targets available, this has not led to an increased output of the drug discovery pipeline into the clinic. With tighter markets and increasing competition, the major pharmaceutical companies are under intense pressure to achieve rapid, concrete delivery of those early promises, but there remain acute problems in the genes-to-drugs pipeline. This meeting showcased a range of novel approaches from proteomics and bioinformatics to address these problems. A common theme in the range of proteomics offerings was the prioritization of potential novel targets on the basis of their accessibility to drugs and their functional link to disease phenotypes. Informatics and in silico offerings also concentrated on fast, accurate, drug-focused workflows built on large integrative databases and novel data-mined algorithms.     

The measurement of substance use among adolescents: when is the 'bogus pipeline' method needed?

The use of objective measures to assess cigarette smoking among adolescents has become commonplace in research studies in recent years. This trend is based on evidence that this so called pipeline methodology can increase the disclosure of socially proscribed behaviors in a setting where adolescents might otherwise feel pressure to deny that they smoke. This paper examines the effects of the pipeline methodology alone and in combination with procedures designed to ensure anonymity on the disclosure of tobacco, alcohol, and marijuana use by young adolescents. The data indicate that the pipeline procedures significantly increase disclosure of tobacco and marijuana use when students are promised confidentiality but not anonymity. However, when anonymity was assured, disclosure of cigarette use was just as high without the pipeline; for marijuana use, disclosure was higher without the pipeline. No effects were observed for alcohol disclosure. These data are interpreted for their implications for prospective and cross sectional studies.     

Ototoxicity of a new glycopeptide, norvancomycin with multiple intravenous administrations in guinea pigs

Time courses of plasma concentration of a new glycopeptide, norvancomycin (NVCM) after single intravenous (iv) and intraperitoneal (ip) injection, and the peak plasma concentrations (Cmax's) of this drug at various doses after single iv injection were determined in guinea pigs. There were significant differences in pharmacokinetic parameters between the two routes of administration and the Cmax linearly increased with the dose used increasing. Guinea pigs with normal hearing were then used to investigate ototoxic liability of NVCM after multiple intravenous administrations (54, 108, 216mg/kg, qd for 14 days). Postrotatory vestibular nystagmus (PRN), auditory brainstem response (ABR) and electron microscopy (SEM TEM) results showed that, similarly to vancomycin, there was no functional or morphological evidence of ototoxicity of NVCM at the dose of 54, 108 mg/kg. In the high dose group (216 mg/kg), there was a 0 approximately 4 dB elevation of hearing threshold but no morphological changes. The results suggested that the ototoxicity of NVCM is absent or minimal after multiple iv administrations within this dose range.     

Auditory and vestibular sequelae to traumatic brain injury: a pilot study

AIM: To investigate the incidence of persisting auditory and vestibular sequelae in a group of 30 young adults recovering from Traumatic Brain Injury (TBI). METHODS: 30 participants, aged 21-45 years, with TBI suffered 19 months to 27 years previously, underwent a semi-structured interview and pure-tone hearing test in their home. Participants who failed the hearing screen then undertook a more comprehensive audiological evaluation. RESULTS: A variety of sequelae to TBI were reported. These were interpreted as tinnitus (53%), vestibular dysfunction (83%), abnormal facial sensory symptoms (27%) and intolerance to loud/sudden noises (87%). Ten (33%) participants demonstrated significant sensorineural hearing impairment in addition to speech recognition performance significantly worse than would have been predicted from their hearing impairment. CONCLUSIONS: Findings from this study will be of benefit to health professionals working in this area of rehabilitation as they seek to provide functional assessments and devise programmes to treat the often devastating auditory processing problems of people recovering from TBI.     

The maintenance and utilisation of government fitted hearing aids

This study is aimed to examine the maintenance and utilisation of hearing aids given to clients attending government hospitals in Tshwane and to probe factors that impacted on the hearing aid fitting process, in order to contribute to the formation of service delivery guidelines. As most participants were embarrassed to wear their devices, results showed that there was a general consensus about the self-image and wearing of hearing aids. Furthermore, it was found that most government fitted hearing aids and accessories were poorly cared for and maintained. One of the factors which negatively influenced the utilisation and maintenance of hearing aids was finance. Participants could not afford to properly maintain and service their hearing instruments. Multilingualism also presented an obstacle in terms of utilising hearing aids correctly and to their full benefit, as most participants were not instructed on hearing aid care and use in their first language. Furthermore, distance to and from the provincial hospitals also posed a problem for clients living in rural and outlying areas.     

Cochlear stem cells/progenitors and degenerative hearing disorders

Hearing loss (deafness) affects approximately 250 million people globally. The major cause of deafness is loss of hair cells and spiral ganglion neurons due to aging, antibiotic use, noise exposure, and genetic defects. At the present time, there is no effective method for restoration of hearing biologically. Cochlear stem cells/progenitors (CSCs), quiescent in the organ of Corti, are excellent candidates for restoration of cell types in the organ of Corti biologically. However, little is known about the biology of CSCs and developmental cues for CSCs to differentiate into hair cells and neurons at the present time. In this article, we briefly reviewed the isolation of CSCs from the postnatal organ of Corti in mice and their capability to differentiate into hair cells and neurons in vitro under the guidance of a group of growth factors: sonic hedgehog (SHH), epidermal growth factor (EGF), retinoic acid (RA), and brain-derived neurotrophic factor (BDNF), herein termed SERB. The identification of CSCs and their differentiation signals is potentially of clinical importance.     

Irreversible atorvastatin-associated hearing loss

Drug-associated ototoxicity is a potentially irreversible adverse event. Among the several 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) available in the United States, only atorvastatin is associated with tinnitus, but none are associated with any forms of hearing loss. A search of the published literature (1950-August 2011) revealed no published case reports of ototoxicity associated with statins. To our knowledge, we describe the first case of progressive, irreversible hearing loss in a 32-year-old man 18?months after starting atorvastatin therapy. He began taking atorvastatin 20?mg every evening for treatment of hypercholesterolemia. Six months later, he complained of occasional episodes of tinnitus, which resolved spontaneously. An audiogram was obtained and was normal. By 18?months, the tinnitus became continuous. Another audiogram revealed bilateral "cookie-bite" middle-frequency hearing loss. Atorvastatin was immediately discontinued, and the patient was fitted with hearing aids. Four years after drug discontinuation, his hearing loss had neither progressed nor regressed. Use of the Naranjo adverse drug reaction probability scale indicated a possible (score of 2) temporal and causal relationship between the patient's hearing loss and atorvastatin. Causes of "cookie-bite" hearing loss include chronic exposure to loud noises, presbycusis, genetic predisposition, and drugs. The manufacturer of atorvastatin has received three unpublished cases of deafness, but claims that causal relationships were not established. Despite these claims by the manufacturer, based on this case report, we recommend that clinicians and patients be aware of the risk of atorvastatin-associated tinnitus and permanent hearing loss. Further research is needed to better understand the mechanism and frequency of this adverse event.     

迟发性显性遗传性感音神经性聋的听力和言语表现及其对策

目的：探讨2家系迟发性显性遗传性感音神经性聋的听力和言语情况。方法：对2家系进行耳聋遗传调查和系统的听力学调查。结果：2家系6例听阈检查示全频程听阈重度升高，听阈曲线呈缓降型，其中2例3耳仅低频听力残存。2家系耳聋发生年龄有逐代提前、代代相传、病程缩短、耳聋程度加重的特征。发生耳聋的年龄愈小，言语功能愈差。结论：应加强对遗传性聋的咨询，指导以及宣传工作。尽力减少或控制遗传性耳聋的发生率，对有家族遗传史者应定期进行听力学监测，对已发生耳聋者应及早配戴助听器并进行适当的言语训练。     

Ototoxicity of Toluene and Styrene: State of Current Knowledge

Noise is the most common preventable cause of irreversible sensorineural hearing loss. During recent years, the results of experimental and human investigations have raised the level of concern about the potential ototoxicity of chemical agents and their interaction with noise. European Directive 2003/10/EC on the minimum health and safety requirements regarding the exposure of workers to the risks arising from noise specifies that the employer shall give particular attention, when carrying out the risk assessment, to, among others, any effects on workers' health and safety resulting from interactions between noise and work-related ototoxic substances. There is, however, currently very little awareness in the occupational health community of the chemical hazards to hearing. The main objective of this review was to analyze the available scientific literature on the ototoxic effects of styrene and toluene, in order to examine dose-response/effect relationships and the relevance of the prevention strategy for people exposed to these solvents. While both solvents appear clearly ototoxic in rats, human data are less straightforward and the existing evidence does not allow characterization of the dose-response/effect relationships; further research is needed. However, once hearing loss is incurred, it is irreversible, and one should be alert to the possible hearing loss induced by toluene and styrene and to the possible additive, potentiating, or synergistic ototoxic effects in case of combined exposure to several chemicals and in case of combined exposure to noise and chemical substances.     

Evaluating children's hearing by DPOAEs at 1-10 kHz

The efficacy of application of DPOAE (distortion product otoacoustic emission) in the evaluation of hearing in children was assessed. 106 children were checked by both DPOAE and ABR. The results show that DPOAE is highly effective in discriminating between hearing disorders and normal hearing. The correct classification rate of normal ears varied between 86.8-96.8% and ears with hearing loss (ABR threshold equal or above 20 dB HL) 87-100%. At the lower frequencies (1-2 kHz) the hit rate was lower. The results of this study suggest that the DPOAE can be used as a rapid hearing screening test for infants and children providing frequency specific information, mostly in the 3-10 kHz frequency range. The effectiveness of DPOAE at 1-10 kHz was evident in children with middle ear dysfunction and in detecting infants with possible high frequency hearing loss. In addition, high frequency DPOAE broadens the range typically available from click-evoked ABR measurements. This information is of increased clinical value not only in terms of speech and language development but also for detecting children who are at high-risk for possible hearing deterioration and who require early intervention.     

Recoverable hearing loss with amphetamines and other drugs

Prolonged and sustained consumption of alcohol, heroin and volatiles had been reported to impair hearing. Amphetamine related hearing loss is clinically different from the hearing loss seen with other agents. It seems that illicit drug use could result in two clinically different types of hearing losses. In May and June of 2001, 183 men aged 18 and above who met DSM-IV criteria for substance dependence were studied in a hospital in Saudia Arabia. The purpose of the study was to ascertain the prevalence of amphetamine-related recoverable hearing loss, establish whether similar hearing loss also occurred with other drugs of abuse and determine if drug-related psychosis was more prevalent in those amphetamine users who developed this type of hearing loss. Recoverable type of hearing loss was not just seen in amphetamine users but also occurred with cannabis, heroin, alcohol, dextromethorphan and glue use. Drug-induced psychosis was three and a half times more common in those amphetamine users who developed a hearing loss. Major depression and suicidality was also more common in these individuals. This association of major depression and subsequent development of hearing loss was also found in those using other type of drugs. It was concluded that a history of major depression was a good predictor of later development of both drug-induced psychosis and hearing loss in amphetamine users, and hypoperfusion was proposed as the possible explanation.     

新生儿听力筛查的临床分析

目的通过对新生儿进行听力筛查,使其达到早期发现、早期诊断、早期干预、早期治疗和即时康复的目的 ,保护和增进新生儿童的健康。方法对2010年在我院生产的2123例活产新生儿在出生24～72h进行听力筛查。结果 2013例通过,占94.81%;110例未通过者,占5.18%。结论对新生儿进行听力筛查,可以早期发现听力障碍,及早干预,减少聋哑人口,控制致残率,提高人口素质。