FTA的应用-耳声发射检测系统的风险分析

在临床上，耳声发射是一种快速、无损、客观的听力检测方法，特别是可以反映出听外周系统以及内耳耳蜗的感音性能，因而在耳蜗功能检查和新生儿的听力筛查等方面有广泛的应用。国家药品监督管理局发布的《医疗器械-风险管理-第一部分风险分析的应用》标准已开始实施，在此标准中，将“故障树分析“（FTA）与“失效模式与效应分析“（FMEA）和“危害和可运行性研究“（HAZOP）同列为推荐的风险分析的方法资料。本文将故障树分析的方法运用于耳声发射检测系统的风险分析之中，通过剖析耳声发射系统的构造及其工作原理，分析可能存在的危害，并提出了降低风险的方法。最后，对医疗器械的安全设计进行了探讨。     

电离辐射对大鼠耳蜗外毛细胞Prestin蛋白表达影响的实验研究

目的探讨电离辐射下大鼠耳蜗外毛细胞Prestin蛋白表达的改变及意义。方法建立大鼠耳放射损伤模型,检测其听力复合动作电位（CAP）阈值及畸变产物耳声发射（DPOAEs）幅值,验证其电离辐射晚期感音神经性耳聋（SNHL）的发生。提取大鼠耳蜗组织mRNA及蛋白,荧光实时定量PCR检测耳蜗Prestin蛋白mRNA水平的表达,以及Western杂交检测Prestin蛋白水平的表达。结果成功建立了电离辐射晚期SNHL大鼠模型,其耳蜗Prestin蛋白无论是mRNA表达水平还是蛋白表达水平均较未照射组明显降低。结论放疗晚期感音神经性耳聋的发生机制可能与电离辐射导致内耳外毛细胞Prestin蛋白的表达异常有关。     

感音神经性耳聋分子机制的研究进展

感音神经性耳聋主要表现为声波感受障碍引起的听力损失,与耳蜗感觉上皮和螺旋神经元的结构及功能受 损密切相关,但具体的病理机制尚不确切。细胞、分子水平的研究证明细胞凋亡、氧化应激损伤、免疫炎症、代 谢障碍、基因突变可能参与多种因素引起的内耳细胞损伤或死亡,引起听力损失。本文将围绕上述细胞、分子过 程在多种因素引起的感音神经性耳聋内耳细胞损伤和存活中的调控机制进行综述,以帮助研究人员识别关键分子 靶点,为干预、治疗感音神经性耳聋新策略提供参考。     

耳声发射的研究进展——基础研究与临床应用

耳声发射是一种产生地耳蜗经听骨链及鼓膜传导释放入外耳道的音应能量。它快速，无损，客观地反映了耳蜗外毛细胞的功能状态，一经发现便受到了人们广泛的关注，并可望成为临床诊断和听力筛查的新方法。     

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.     

强直性脊柱炎患者的听力表现

目的强直性脊柱炎患者的听力表现鲜有报道,本文参与探讨"强直性脊柱炎是否有传导性聋"存在的争议。方法通过横断面临床研究观察24例强直性脊柱炎患者的纯音测听、鼓室压曲线、畸变产物耳声发射、听性脑干反应,并与25例年龄性别匹配的正常对照进行比较。结果强直性脊柱炎患者听力下降发生率29%,其中感音神经性聋21%,传导性聋8%,明显高于正常对照组(P0.05)。鼓室压曲线"As"型明显高于对照组(P0.05)。传导性聋可能由听骨链受累引起。感音神经性聋为耳蜗受累,未发现蜗后病变。女性听力下降发生率高。结论强直性脊柱炎患者听力下降发生率较高,听力下降可能是强直性脊柱炎关节外表现之一;强直性脊柱炎存在传导性聋,传导性聋发生率低于感音神经性聋;强直性脊柱炎患者听力下降以耳蜗和听骨链受累为主。     

耳蜗植入术的发展和展望

耳蚋植入术又称电子耳蜗或人工耳蜗,是目前唯一可以使全聋患者恢复听力的装置。本文首先介绍了耳蜗植入术的概况和基本结构与原理,然后介绍了其关键技术及今后的研究方向,最后对我国耳蜗植入的发展作了展望。     

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。     

一种实用的汉语言语听力测试系统及临床应用

本文描述了一种基于计算机音频技术的汉语言语听力测试系统.在临床听力计的基础上,计算机将所选取言语材料的普通话数字音频波形,经声卡的音频接口输出至听力计的音频接口输入端,再由听力计放大至不同强度的声音作为言语听力的测试信号.耳科正常人、听神经病患者和极重度感音神经性聋人工耳蜗植入者使用和未使用人工耳蜗的测试结果与各自的临床症状相符.这表明此开发系统能够评估受试者的言语接受和理解能力,是一种方便、性能稳定、可供临床应用的实用汉语言语听力测试系统.     

48例职业性噪声聋诊断体会

职业性噪声聋是人们在工作过程中,由于长期接触噪声而发生的一种进行性的感音性听觉损伤[1]。职业性噪声聋病因明确,即由长期接触噪声而引起的感音性听力损失,可伴有听力下降、耳鸣等症状,以耳蜗病变为主。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.