弱智儿童听觉中潜伏期反应和40Hz相关电位

目的：对弱智儿童４０Ｈｚ听觉相关电位（４０ＨｚＡＥＲＰ）、听觉中潜伏期反应（ＭＬＲ）和听性脑干反应（ＡＢＲ）检测结果进行比较和评估。方法：在作过ＡＢＲ测试的基础上，对６５例（１３０耳）弱智儿童和３０例（６０耳）正常儿童记录４０ＨｚＡＥＲＰ和ＭＬＲ，对两组各项结果进行比较。结果：弱智组４０ＨｚＡＥＲＰ和ＭＬＲ波形出现率在２０ｄＢ（ｎＨＬ）声强刺激时明显低于正常组（Ｐ＜０．００１）；４０ＨｚＡＥＲＰ反应阈较正常儿童增高（Ｐ＜０．０１）；弱智组ＭＬＲ波潜伏期较正常儿稍延长；ＭＬＲ各波振幅较正常组明显降低（Ｐ＜０．０５）。４０ＨｚＡＥＲＰ检测弱智组的波形出现率、反应阈值等与正常组儿童的差异小于ＡＢＲ。结论：弱智组平均听力较正常儿童差；４０ＨｚＡＥＲＰ在评价弱智儿童听力时敏感性比ＡＢＲ高，更能检测出患者存在的低频残余听力     

阈值强度刺激BAEP检测在梅尼埃病的应用

目的：探讨阈值强度刺激在梅尼埃病（ＭＤ）ＢＡＥＰ检测中的应用价值。方法：对３６例ＭＤ患者４６只耳同时进行阈上强度刺激ＢＡＥＰ检测和阈值强度刺激检测,并和２５例正常人５０只耳检测结果进行比较。结果：ＭＤ组４６只耳阈上强度刺激ＢＡＥＰ检测２只耳Ⅰ波潜伏期延长,１３只耳Ⅰ波缺失,异常率３３％。而阈值强度刺激时ＢＡＥＰ反应阈增高者３６只耳,异常率７２％,两者差异显著（Ｐ＜００１）。与正常对照组Ｖｔ波潜伏期（均值７９５ｍｓ）比较,ＭＤ组Ｖｔ波潜伏期（均值６６５ｍｓ）缩短,有显著差异Ｐ＜００１）。结论：阈值强度刺激可显著提高ＭＤＢＡＥＰ检测阳性率,Ｖｔ波潜伏期＜７０ｍｓ可作为判断蜗性损害的一项客观指标     

A NONLINEAR DISTRIBUTED-LUMPED HYBRID PARAMETER MODEL OF THE ARTERIAL SYSTEM

ＡＮＯＮＬＩＮＥＡＲＤＩＳＴＲＩＢＵＴＥＤ－ＬＵＭＰＥＤＨＹＢＲＩＤＰＡＲＡＭＥＴＥＲＭＯＤＥＬＯＦＴＨＥＡＲＴＥＲＩＡＬＳＹＳＴＥＭＦａｎＹｕｂｏ，ＣｈｅｎＪｕｎｋａｉ，ＫａｎｇＺｈｅｎｈｕａｎｇ，ＹｕａｎＺｈｉｒｕｎ（ＤｅｐａｒｔｍｅｎｔｏｆＥｎ...     

ELECTRON MICROSCOPE ANALYSIS OF MITOCHONDRIA ON RENAL TUBULE CELL SUFFERED WARM ISCHEMIC AND REPER FUSIVE DAMAGE IN RABBITS

ＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＥＡＮＡＬＹＳＩＳＯＦＭＩＴＯＣＨＯＮＤＲＩＡＯＮＲＥＮＡＬＴＵＢＵＬＥＣＥＬＬＳＵＦＦＥＲＥＤＷＡＲＭＩＳＣＨＥＭＩＣＡＮＤＲＥＰＥＲＦＵＳＩＶＥＤＡＭＡＧＥＩＮＲＡＢＢＩＴＳＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＥＡ...     

BEAP对氨基甙类抗生素耳毒性反应的监测随访

本研究利用ＢＡＥＰ检测对２７例应用常规剂量氨基甙类抗生素（链霉素、庆大霉素、卡那霉素）的患儿进行门诊随访研究，以了解此类药物的耳毒性及远期影响。２７例中，男１７例，女１０例。用药时平均年龄２岁零４个月（２个月～８岁）。用药前均无听力障碍。随访时平均年龄１２岁（５岁～１９岁），随访时间最长１５年。最短３年。结果发现：２７例患儿中，１例听力稍差，１７例２２只耳ＢＡＥＰ异常，即Ⅰ、Ⅱ波潜伏期延长；Ⅰ－Ⅴ波峰间潜伏期缩短；耳间差＞０．４ｍｓ。随访中有４例患儿，治疗前ＢＡＥＰ正常，治疗后４天复查，ＢＡＥＰ异常３例。说明氨基甙类抗生素耳毒性副作用相当多见，而且出现较早；ＢＡＥＰ异常是其耳毒性的早期表现之一，可作为停药的指征。     

A STUDY ON THE PARAWALKER CONTROLLED BY EMG

ＡＳＴＵＤＹＯＮＴＨＥＰＡＲＡＷＡＬＫＥＲＣＯＮＴＲＯＬＬＥＤＢＹＥＭＧＡＳＴＵＤＹＯＮＴＨＥＰＡＲＡＷＡＬＫＥＲＣＯＮＴＲＯＬＬＥＤＢＹＥＭＧＷａｎｇＲｅｎｃｈｅｎｇ；ＺｈａｎｇＰｅｉｙｕ；ＺｈａｎｇＪｉｃｈｕａｎ；ＪｉｎＤｅｗｅｎ（Ｄｅｐｔ．ｏｆ...     

瞬目反射、脑干听觉诱发电位、经颅多普勒超声对椎基底动脉供血不足的诊断价值

目的：观察瞬目反射（ＢＲ）、脑干听觉诱发电位（ＢＡＥＰ）、经颅多普勒超声（ＴＣＤ）对椎基底动脉供血不足（ＶＢＩ）的诊断意义。方法：对４１例已经临床确诊的ＶＢＩ病人在间歇期进行ＢＲ、ＢＡＥＰ及ＴＣＤ检查。结果：ＴＣＤ、ＢＲ、ＢＡＥＰ异常率分别为８３％、８０％、６８％。ＢＲ提示脑桥损害１例、延髓损害１５例、广泛性脑干损害１７例；ＢＡＥＰ发现内耳听力减退２０例、脑干病变１３例；ＴＣＤ发现多血管流速异常１４例、一支流速改变１６例，有或伴有血管张力异常１３例。结论：由于ＢＲ、ＢＡＥＰ反射路径不同，检测结果不尽一致。联合检查有助于对病损部位进行定位。ＴＣＤ则有助于定性诊断     

脑干听觉诱发电位测试参量重要性的探讨

对国内外各家ＢＡＥＰ资料进行统计分析，以及对４１例健康人（１５～５６岁，男１９例，女２２例）８１只听力正常耳分别用短声和滤波短声进行ＢＡＥＰ测试，结果表明，在ＢＡＥＰ正常值检测中，刺激声是影响其结果的最重要参量之一。因此，各实验室应有自己的正常值，如果测试条件及仪器符合规格。那么在测试方法学和测试参量统一的条件下，各实验室的ＢＡＦＰ正常值应该是可以相互参考的。     

电阻抗法测定心排血量的非线性公式

电阻抗法测定心排血量的非线性公式况明星，彭录生（江西医学院，南昌）关键词：电阻抗，非线性，心搏出量ＮＯＮ－ＬＩＮＥＡＲＦＯＲＭＵＬＡＦＯＲＤＥＴＥＲＭＩＮＡＴＩＮＧＣＡＲＤＩＡＣＯＵＴＰＵＴＢＹＥＬＥＣＴＲＩＣＡＬＩＭＰＥＤＡＮＣＥＭＥＴＨＯＤ￥Ｋｕ...     

感染性疾病患者外周血淋巴细胞性激素受体和性激素的改变？…

应用放射配体结合分析检测感染性疾病患者１１５例的外周血淋巴细胞雄激素受体（ＡＲ）及雌激素受体（ＥＲ）。商时应用放免分析检测血浆雌二醇（Ｅ２）和睾酮（Ｔ）。结果为：１．各感染组血浆Ｅ２和Ｔ与对照组差异不显著；２．各感染组ＥＲ的Ｂｍａｘ均明显低于对照组（均Ｐ〈０．０５）；Ｋｄ值无明显改变；３．各感染组ＡＲ的Ｂｍａｘ和Ｋｄ值与对照组相比，差异不显著。表明患者血浆Ｅ２水平虽然正常，但由于ＥＲ降低，Ｅ２的增     

中耳功能异常对畸变产物耳声发射测试的影响

目的 探讨中耳传音功能异常对畸变产物耳声发射（DPOAE）测试结果的影响程度并在临床应用中加以识别和剔除。方法 将年龄2月－11岁56例（107耳）小儿依听力损失类型分为感音性聋组 和传导性聋组，并设置正常听力对照组，应用GSI 60耳声发射仪分别观察其DPOAE的DP检出率、DP幅值、DP与NF幅值差及相同参数条件下DPOAE测试时间。结果 耳蜗功能严重受损和渗出性中耳炎所记录到的DPOAE各测量参数之间的差异无统计学意义（P＞0．05）。结论 中耳积液导致的中耳传音功能障碍对DPOAE测试结果的影响，与耳蜗功能严重损害时所记录到的DPOAE参数变化，在临床检测中难以区分。因此，临床上在应用DPOAE进行听力评估之前，首先要检测受检者的中耳功能，剔除其对DPOAE检测结果的影响，确保结果的可靠性。     

2623例新生儿听力筛查和GJB2基因检测结果分析

目的探讨常规听力筛查的同时进行GJB2基因检测的可行性。方法采取知情同意、自愿选择的原则,对2623例新生儿出生后2-3天采集足跟血,利用飞行时间质谱技术对GJB2耳聋基因进行检测,包括5个热点突变位点235delC、299-300delAT、35delG、l76-191dell6、167delT突变,并采用GSI耳声发射仪（DPOAE）进行新生儿听力筛查。结果2623例新生儿中GJB2基因检测阳性率3．20％,其中听力初筛通过婴儿中基因阳性率2．50％,听力初筛未通过婴儿中基因阳性率5．21％,听力初筛未通过GJB2耳聋基因阳性率高于听力初筛通过婴儿,差异性显著（P〈0．01）。l例GJB2235del纯合突变经ABR检查确诊为双耳中重度听力损失。结论 将JB2基因筛查和常规听力筛查联合对早期发现新生儿语前听力损失或迟发的听力损失,及婚育指导具有重要意义。     

脑干听觉诱发电位(BAEP)在新生儿及婴儿听力检测中的应用价值

目的:探讨BAEP在新生儿及婴儿听力检测中的应用价值。方法:对60例出生后利用耳声发射仪做听力筛查"未通过"的新生儿及婴儿进行BAEP检测。结果:BAEP异常52例(占86.7%),作BAEP听阈测定有耳聋的48例(占80%),其中轻度耳聋27只(占60例的22.5%),中度耳聋20只(占60例的16.7%),重度耳聋33只(占60例的27.5%)。结论:对耳声发射仪做听力筛查"未通过"的新生儿及婴儿做BAEP检查,能够了解听力障碍的程度以及类型,为临床的早期诊断和早期干预提供可靠的依据。     

儿童感音神经性聋听觉稳态诱发反应阈与听性脑干反应阈比较

目的研究听觉稳态诱发反应(ASSR)和听性脑干反应(ABR)阈与纯音听阈的差别和相关性。方法选择74例儿童感音神经性聋患者(118耳)分别进行ASSR、ABR和电测听检查,比较ASSR、ABR反应阈及纯音听阈,同时就ASSR、ABR反应阈与纯音听阈进行相关性分析。结果 ASSR和ABR反应阈与纯音听阈均有良好的相关性。ABR的反应阈与纯音听阈阈值接近,而ASSR反应阈与纯音听阈间差值较大。ASSR反应阈与纯音听阈间的相关性要优于ABR反应阈与纯音听阈间的相关性。结论 ASSR和ABR均为较好的评估行为听阈的客观测听方法。     

Sensorineural hearing loss in children and adults with Williams syndrome

Williams syndrome (WS) is a genetic neurodevelopmental disorder, most often accompanied by mild-to-moderate mental retardation. Individuals with WS show unique communication strengths and impairments that are challenging to treat in community, educational, and vocational settings. Many issues regarding characteristics of auditory sensitivity in WS remain to be resolved. Our purpose was to obtain behavioral (screening and pure-tone audiometry) and objective (distortion product otoacoustic emission-DPOAE) measures of auditory system function from a group of 27 individuals with WS, 6-48 years of age. These measures were gathered both at an international professional conference (n = 19) and in a clinic setting (n = 8). In the behavioral screening conditions, 16/19 (84%) of the individuals failed the hearing screening; and in the behavioral diagnostic hearing condition, 6/8 (75%) demonstrated sensorineural hearing loss (SNHL) and 1/8 demonstrated a hearing loss of undetermined type. In the objective DPOAE testing, 19/25 (76%) had DPOAE absolute amplitudes below the 5th percentile for ears with normal hearing [Gorga et al. (1997); Ear Hear 18(6):440-455]. We report SNHL in 14/18 (78%) of school-age children with WS. Post hoc analyses revealed a significant effect for age, suggesting a pattern of progressive hearing loss. An effect size analysis indicated a clinically meaningful difference in the hearing sensitivity between school-aged children and adults in the high frequencies (4,000 and 8,000 Hz). Similar hearing loss phenotype was observed in patients with familial nonsyndromic supravalvular aortic stenosis (SVAS), suggesting that molecular defects in the elastin gene in the pathogenesis of SNHL in WS. This study highlights the importance of early and regular hearing testing for WS patients and suggests that elastin may have a previously unappreciated function in maintaining hearing sensitivity.     

Limitation of Conventional Audiometry in Identifying Hidden Hearing Loss in Acute Noise Exposure

PurposeThe concept of hidden hearing loss can explain the discrepancy between a listener''s perception of hearing ability and hearing evaluation using pure tone audiograms. This study investigated the utility of the suprathreshold auditory brainstem response (ABR) for the evaluation of hidden hearing loss in noise-exposed ear with normal audiograms.Materials and MethodsA total of 15 patients (24 ears) with normal auditory thresholds and normal distortion product otoacoustic emissions were included in a retrospective analysis of medical records of 80 patients presenting with histories of acute noise exposure. The control group included 12 subjects (24 ears) with normal audiograms and no history of noise exposure. Pure tone audiometry and suprathreshold ABR testing at 90 dB peSPL were performed. The amplitudes and latencies of ABR waves I and V were compared between the noise-exposed and control groups.ResultsWe found no significant difference in the wave I or V amplitude, or the wave I/V ratio, between the two groups. The latencies of ABR wave I, V, and I-V interpeak interval were compared, and no significant intergroup difference was observed.ConclusionThe results suggest that either hidden hearing loss may not be significant in this cohort of patients with acute noise exposure history, or the possible damage by noise exposure is not reflected in the ABRs. Further studies are needed to inquire about the role of ABR in identification of hidden hearing loss.     

Esketamine may be an ideal substitute for ketamine during cochlear function measurement

The mixture of ketamine and xylazine is widely used for the auditory brainstem response (ABR) measurement. Esketamine is twice as potent as ketamine. Our objective was to assess the influence of esketamine in mice undergoing cochlear function measurement including ABR and distortion product otoacoustic emission (DPOAE) measurement. C57Bl/6J mice were treated with an equivalent dose of analgesia and received either a single intraperitoneal (ip) injection of 100 mg/kg ketamine and 25 mg/kg xylazine or 50 mg/kg esketamine and 25 mg/kg xylazine. Hearing thresholds, peak latencies of waves I and V, and DPOAE thresholds were recorded. Time to loss of righting and time to regain righting were also assessed. We found that hearing thresholds, the peak latencies of waves I and V, and DPOAE thresholds were similar between the two groups (all P>0.05). Time to regain righting was significantly shorter in the esketamine group (P<0.001) than in the ketamine group. We concluded that when using equivalent doses of analgesia, esketamine may be an ideal substitute for ketamine during cochlear function test.     

铁缺乏大鼠耳蜗肌动蛋白的检测及其意义

目的 检测铁缺乏大鼠耳蜗肌动蛋白的变化。探讨铁缺乏引起耳蜗毛细胞损伤的发生机制。方法 应用免疫组织化学染色法，SDS-PAGE和Western blot，检测正常及以缺铁饮食饲养8wk大鼠的耳蜗肌动蛋白水平的变化并进行比较。结果 出现感音神经性耳聋的铁缺乏组大鼠耳蜗肌动蛋白的相对含量降低，免疫组化的反应性明显减弱；听力正常的铁缺乏大鼠组中两者无明显变化。结论 耳蜗肌动蛋白含量及免疫组化染色反应性的变化。可能是铁缺乏引起的耳蜗毛细胞损伤的重要病理基础。     

Hearing loss in skeletal dysplasia patients

A hearing screening program was performed to determine the prevalence of hearing loss and abnormal tympanometry in individuals with short-stature skeletal dysplasias attending a national meeting. Behavioral audiometry, otoacoustic emission testing, and tympanometry were used to assess hearing. Failed hearing screen was defined as hearing ≥ 35 dB at one or more frequencies or by "fail" on otoacoustic emissions. One hundred ten of 112 subjects completed the screening. 58 (51.8%) were children. Seventy-three (65.2%) had achondroplasia, 34 (30.4%) had one of 11 other diagnoses, and 5(4.4%) were undiagnosed. 25.8% of children failed hearing screening in one or both ears, while 46.3% of adults failed in one or both ears. 55.1% of adults and 25.0% of children with achondroplasia failed screening. Abnormal hearing was also found in the some patients with spondyloepiphyseal dysplasia congenital (SEDC; 75%), diastrophic dysplasia (66%), and Morquio (66%). Hearing was normal in those with hypochondroplasia, pseudoachondroplasia, and microcephalic osteodysplastic primordial dwarfism. Tympanometry was abnormal in at least one ear in 53.3% of children and 38.5% of adults. Abnormal tympanometry in the absence of functioning tympanostomy tubes was associated with 9.5 greater odds of hearing loss in children and 2.8 greater odds of hearing loss in the total cohort. Only 3 (2.7%) respondents reported the use of hearing aids. Hearing loss and middle ear disease are common in both children and adults with skeletal dysplasia. Adults were more likely to fail hearing screening than children. Abnormal tympanometry is associated with hearing loss. Hearing screening with appropriate intervention is recommended for these patients.     

Newborn hearing screening in Kuwait

OBJECTIVES: The purpose of the study was to detect permanent hearing loss in a universal newborn hearing screening (UNHS) program that included 200 normal ("well baby") newborn children and 15 children at high risk for hearing loss at Ahmadi Hospital in Kuwait. PATIENTS AND METHODS: Distortion product oto-acoustic emissions (DPOAEs) were conducted in the ward on newborns at the age of 2 days. Newborns who did not pass the DPOAE the second time (at the age of 1 month) were evaluated by a brainstem evoked response audiometry (BERA) test within the age of 3 months. If the infant failed the BERA test, the test was repeated at the age of 6 months to confirm any permanent hearing loss. RESULTS: The peak latencies and interpeak intervals of BERA were established for newborns (5-90 days) at our clinic (ms), I: 1.58 + 0.11, III: 4.16 + 0.22, V: 6.70 + 0.24, I-III: 2.57 + 0.19, III-V: 2.59 + 0.24, I-V: 5.12 + 0.26. The incidence of permanent hearing loss was different across nursery levels. In the "well baby" group, 1% had profound sensorineural hearing loss, 1% had severe (70 dBnHL) sensorineural hearing loss, and 98% had normal hearing level. In the "high-risk" group, 26.67% had profound sensorineural hearing loss, 20% had moderate (60 dBnHL) sensorineural hearing loss, and 53.33% had normal hearing level. CONCLUSIONS: The newborn hearing screening program revealed that hearing loss in the "well baby" group is 2%, while in the "high risk" group it is 46.67%. The results warrant the establishment of UNHS programs in Kuwait and other countries in the Middle East to detect permanent hearing loss very early in life and provide appropriate medical treatment.