Low-Frequency Hearing Loss: Auditory Brainstem Response-Derived Band Analysis

Conventional (0.125-8 kHz) and high-frequency (8-20kHz) audiometry, together with brainstem response audiometry supplemented with derived-band studies have been performed in 6 patients with sensorineural hearing loss: 1 with narrow-band, 3-4 kHz, and 5 with low-frequency threshold elevations. The derived-band results in the latter indicate that the low-frequency audiometric thresholds are spurious, and represent the low-frequency tails of viable high-frequency neurons. Threshold preservation in the 4- to 8-kHz frequency band proved necessary for generation of a normal auditory brainstem response at suprathreshold stimulus levels.

On a étudié sur 6 patients présentant une surdité de perception l'audiogramme conventionnel (0.125-8 kHz) et haute-fréquence (8-20 kHz), ainsi que les potentiels précoces dérivés: l'élévation de seuil était limitée à une bande étroite, 3-4 kHz, chez 1 patient, et intéressait les basses fréquences pour les 5 autres. La technique des potentiels dérivés sur ces derniers sujets montre que les seuils audiométriques sur les graves sont faux et représentent en fait les extrémités basse-frequence de neurones haute-fréquence demeurés sains. La préservation de l'audition au niveau de la bande 4-8 kHz est nécessaire à l'obtention de potentiels précoces normaux aux niveaux supraliminaires.     

Potentiels évoqués auditifs rapides «dérivés»

Brain stem auditory-evoked responses to a 70 dB SL click masked by high-passed noises were recorded in 12 normal hearing subjects. By applying the technique of derived potentials, the contributions of one-octave-wide frequency bands are assessed. Summation of these derived potentials gives a pattern similar to the unmasked-response waveform. Waves I and III show a strong predominance of high-frequency responses, whereas wave V is discernible down to low-frequency responses.

Les potentiels évoqués de la cochlée et du tronc cérébral sont enregistrés chez 12 sujets conjointement stimulés par un clic de 70 dB SL et des bruits passe-haut. En utilisant la technique des potentiels dérivés, les contributions de bandes de fréquence d'une octave sont analysées. La sommation de ces différents potentiels dérivés donne naissance à une courbe voisine de la réponse au clic non masqué. Les ondes I et III présentent principalement des contributions de fréquence aiguë, tandis que l'onde V est également générée par les bandes de fréquence grave.     

The Role of Grammar Instruction in Language Teaching

The role of grammar instruction in foreign orsecond language acquisition is one of the mostcon-troversial issues in foreign/ second language teach-ing and learning research.The advocators of gram-mar instruction argue that grammar should be thecore of language instruction and formal instructionenhances formal accuracy.On the otherhand,crit-ics maintain that the grammar knowledge has lim-ited uses and may hinder the students from acquir-ing the communicative competence and efficiency.Undoubtedl…     

Psychiatric symptomatologies and disorders related to epilepsy and antiepileptic medications

Introduction: Psychiatric comorbidities (such as depression, anxiety, psychosis, inattention, obsession, personality traits, aggression and suicide) are frequent in patients with epilepsy and have a significant impact on medical management and quality of life.

Areas covered: A literature search was performed in MEDLINE for epidemiological, longitudinal, prospective, double-blind clinical trial studies published between 1990 and 2011 using the following words: epilepsy, antiepileptic drugs (AEDs), behavioral/emotional/psychiatric comorbidities, suicide and aggression. In this review, the author discusses: i) the characterization and prevalence of behavioral disturbances associated with epilepsy, ii) variables correlated with behavioral comorbidities which include: psychosocial-, clinical- and treatment-related variables, iii) the complex mechanisms of behavioral comorbidities associated with epilepsy, which include both psychosocial (functional) and organic; the process of epileptogenesis, neuronal plasticity, abnormalities in hypothalamic-pituitary axis and neurotransmitters and pathways are fundamental determinants, iv) the negative psychotropic effects of AEDs and their mechanisms and v) the suggested biopsychosocial model of management (pharmacological and non-pharmacological).

Expert opinion: The relationship between psychiatric disorders and epilepsy has relevant therapeutic implications which should be directed towards a comprehensive biopsychosocial approach that focuses on the whole person rather than simply on the disease process.     

Notch信号通路介导血小板源生长因子AA诱导的血管平滑肌细胞增殖和迁移

目的探讨Notch信号通路在血小板源生长因子AA(PDGF-AA)诱导血管平滑肌细胞(VSMC)增殖和迁移中的作用及机制。方法脱臼处死1~2月龄雄性SD大鼠,无菌取腹主动脉,剥弃外膜及去除内皮后,贴块法培养VSMC,α-SM-actin染色鉴定。实验分为四组:对照组、γ-secretase抑制剂组(DAPT组)、PDGF-AA组和PDGFAA+γ-secretase抑制剂组(PDGF-AA+DAPT组)。实时荧光定量PCR(Real-time q PCR)检测Notch信号分子mRNA表达;Cell Titer96 Aqueous One Solution试剂盒检测细胞增殖活性;采用细胞划痕实验检测VSMC的迁移能力。结果腹主动脉VSMC表达Notch信号通路Jagged1、Jagged2、Notch1~3等几种主要的配体及受体;PDGF-AA刺激24h和48 h后分别导致Jagged2和Jagged1 mRNA表达显著增强(P0.01,n=4);与0 h相比,PDGF-AA刺激72 h后,Notch1、Notch3 mRNA表达显著增高(P0.01,n=4),而刺激24 h后Notch2 mRNA表达显著降低。PDGF-AA显著促进HES1(P0.05,n=4)、HEY2(P0.05,n=4)和转录因子Rbp-jКmRNA(P0.05,n=4)表达,DAPT抑制PDGF-AA介导的HES1、HEY2 mRNA表达增强(P0.01,n=4),但是进一步促进PDGF-AA诱导的Rbp-jКmRNA表达(P0.05,n=4);PDGF-AA刺激促进VSMC增殖(P0.01,n=5)和减少划痕余留面积(P0.01,n=4),两种效应均可被DAPT显著阻抑(P0.01,n=4)。结论 PDGF-AA调节了VSMC Notch信号分子表达,PDGF-AA部分通过激活Notch信号通路调节VSMC的增殖和迁移。     

职业紧张与生存质量关系的结构方程模型

目的通过构建结构方程模型,分析中小学教师职业紧张对生存质量的影响。方法采用职业紧张量表修订版(OSI-R)和健康调查简表(SF-36)对924名市区中小学教师进行问卷调查,应用SPSS14.0和结构方程模型分析软件(AMOS6.0)对数据进行分析处理。结果除任务模糊外职业任务和应对资源各子项对教师生理健康和心理健康均有不同程度的作用,任务界限和社会支持对教师生存质量的综合作用效应较强。结论个体紧张反应是职业紧张对生存质量作用效应上的中介变量,应用结构方程模型能更好地处理此类问题。     

Bayesian methods for meta‐analysis of causal relationships estimated using genetic instrumental variables

Genetic markers can be used as instrumental variables, in an analogous way to randomization in a clinical trial, to estimate the causal relationship between a phenotype and an outcome variable. Our purpose is to extend the existing methods for such Mendelian randomization studies to the context of multiple genetic markers measured in multiple studies, based on the analysis of individual participant data. First, for a single genetic marker in one study, we show that the usual ratio of coefficients approach can be reformulated as a regression with heterogeneous error in the explanatory variable. This can be implemented using a Bayesian approach, which is next extended to include multiple genetic markers. We then propose a hierarchical model for undertaking a meta‐analysis of multiple studies, in which it is not necessary that the same genetic markers are measured in each study. This provides an overall estimate of the causal relationship between the phenotype and the outcome, and an assessment of its heterogeneity across studies. As an example, we estimate the causal relationship of blood concentrations of C‐reactive protein on fibrinogen levels using data from 11 studies. These methods provide a flexible framework for efficient estimation of causal relationships derived from multiple studies. Issues discussed include weak instrument bias, analysis of binary outcome data such as disease risk, missing genetic data, and the use of haplotypes. Copyright © 2010 John Wiley & Sons, Ltd.     

3548例产妇焦虑状况与社会人口学特征的相关性分析

目的探讨产妇焦虑状况与社会人口学特征的关系。方法采用便利取样的方法,选择2008年1月-2009年8月本院住院产妇3548例,采用焦虑自评量表(self-rating anxiety scale,SAS)对分娩后1w内的产妇进行调查。结果 3548例产妇焦虑发生率为13.21%,SAS总分为(33.72±6.41)分,高于国内常模(P0.01);焦虑得分及阳性检出率与婚姻状况及文化程度有关,与年龄无关;多重线性回归分析显示,未婚、离异产妇较已婚产妇焦虑程度重,文化程度越高,焦虑程度越重(均P0.05)。结论产妇焦虑状况不容乐观,尤其是未婚或离异、高学历人群,医务人员应给予更多的关注,避免和减少产后焦虑的发生,从而减少及避免产后抑郁症,保障母婴安全。     

Risks of suicidality in adult patients with epilepsy

AIM: To determine the prevalence and risks of suicidality in a group of patients with epilepsy. METHODS: Included were 200 adult patients and 100 matched healthy subjects. The clinical interview using The Diagnostic and Statistical Manual of Mental Disorders (4th edition), Beck Depression Inventory (2nd edition) (BDI-II), Hamilton Anxiety Rating Scale (HAM-A), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Eysenck Personality Questionnaire-Revised Rating Scale testings were used for diagnosis and assessment of severity of psychiatric symptoms. Blood concentrations of serotonin, catecholamines and dopamine were also measured. RESULTS: Suicidality was reported in 35% (compared to 9% for controls), of them 80%, 72.86%, 55.71% and 52.9% had depression, anxiety, obsession and aggression respectively. Patients with suicidality had higher scores of BDI-II (P = 0.0001), HAM-A (P = 0.0001), and Y-BOCS (P = 0.037) and lower scores of psychotic (P = 0.0001) and extroversion (P = 0.025) personality traits. Regardless the presence or absence of suicidality, patients with epilepsy had low serotonin (P = 0.006), noradrenaline (P = 0.019) and adrenaline (P = 0.0001) levels. With suicidality, significant correlations were identified between: (1) age and scores of BDI-II (r = 0.235, P = 0.0001) and HAM-A (r = 0.241, P = 0.046); (2) age at onset and concentrations of noradrenaline (r = -0.502, P = 0.024); (3) duration of illness and scores of BDI-II (r = 0.247, P = 0.041), Y-BOCS (r = 0.270, P = 0.025) and neurotic personality trait (r = -0.284, P = 0.018); and (4) doses of antiepileptic drugs and scores of psychotic personality traits (r = -0.495, P = 0.006 for carbamazepine; r = -0.508, P = 0.0001 for valproate). CONCLUSION: This is the first study which systematically estimated the prevalence and risks of suicidality in a homogenous group of patients with epilepsy. This study emphasizes the importance of epilepsy itself as a risk for suicidality and not its treatment.