兰州地区言语测听中几个常用数据的测算

对兰州地区言语测听的几个常用数据进行了测算。供临床言语测听中参考。正常人言语接受阈(SRT):27.5±7.2dB;最大识别率(PBmax):正常听力(181耳)90.8±3.7％,传导性聋(85耳)87.0±5.6％,感音神经性聋(86耳)80.2±11.5％;校正值正常听力为17.5±5.5dB,传导性聋17.7±7.0dB,感音神经性聋18.6±8.9dB。感音神经性聋校正值受纯音听力图形的影响,陡降型听力校正值明显偏低。为提高测试的准确性,主张要求患者机械模仿,必须对每个测词应答。     

直升机飞行员与歼击机飞行员听力比较

目的比较陆军直升机飞行员与空军歼击机飞行员的听力资料,观察不同机种飞行员的听力差别。方法收集处于飞行合格状态的陆航部队157例直升机飞行员听力资料和空军105例歼击机飞行员听力资料,分别比较纯音测听在0.25、0.5、1、2、3、4、8 k Hz时和言语频率、全频左右耳听阈差别,及两组噪声性聋的发生率。结果 0.25 k Hz,直升机飞行员平均听阈(左耳9.78±5.50,右耳9.27±4.49)小于歼击机飞行员(左耳11.52±3.41,右耳10.86±2.54),差异有统计学意义(t=2.903、t=3.648,P<0.01)。0.5 k Hz,直升机飞行员平均听阈(左耳9.59±4.12,右耳8.89±3.95)小于歼击机飞行员(左耳10.71±2.34,右耳10.43±1.98),差异有统计学意义(t=2.817、t=4.179,P<0.01)。言语频率,直升机飞行员右耳平均听阈(9.85±3.79)小于歼击机飞行员(10.75±2.39),差异有统计学意义(t=2.356,P<0.05)。全频,直升机飞行员右耳平均听阈(10.66±4.09)小于歼击机飞行员(11.60±2.98),差异有统计学意义(t=2.027,P<0.05)。其他频率,两组噪声性聋的发生率,差异无统计学意义。全部飞行员均达到飞行人员体格检查标准对纯音听阈的要求。结论直升机飞行员听力状况整体优于歼击机飞行员,与直升机飞行员的防护意识强有关。     

言语测听体系评价中医药治疗耳聋耳鸣疗效研究

【目的】通过比较言语测听及现有的纯音听阈测听与患者主观听力、耳鸣之间的相关程度,研究言语测听的特点,以期寻找中医自身规律和特点的耳聋耳鸣临床疗效评价模式。【方法】收集20例耳聋患者(40耳)治疗前后主观自觉听力损失程度、耳鸣致残量表(THI)的评分情况,并进行言语识别阈(SRT)、言语平均纯音听阈(PTA)等的主客观测试,评价主观自觉听力损失程度、THI量表评分情况与SRT、PTA的关联程度。【结果】患耳治疗前后主观听力损失与SRT、PTA的Spearman相关系数较高(P0.05),而治疗前后THI量表评分与两种测试的Spearman相关系数均较低(P0.05)。就言语测听的SRT而言,其与治疗前后主观听力损失的Spearman相关系数比PTA更高(P0.01)。说明两种测试方式均可较好地评定患者的听力损失情况,但是对耳鸣情况的变化不能较好地评定。可见言语测听与患者主观的听力损失程度的相关性更好,高于PTA及纯音听阈听力损失程度,更能评定患者主观的听力损失程度的变化。【结论】言语测听检测本身比现有纯音听阈测听更符合中医的思维模式,符合中医自身规律和特点的耳聋耳鸣临床疗效评价模式,可为治疗耳聋耳鸣提供一套中西医认可的评价临床疗效的新手段和工具。     

噪声性耳聋语言测听的初步探讨

噪声对听觉影响的研究利用主观测听最普通的方法是纯音听阈测听术、纯音阈上测听法及强度辨差阈试验(DL)。语言测听法属阈上测听法。语言测听项目甚多,最常用的项目是语言接受阈又称可懂阈(SRT),语言最大识别率又称最大清晰度(DS)。我们于1985年3月～5月对某纺织厂织布车间氏期接触高频稳态噪     

非化脓性中耳炎80例纯音听力计检查分析

本文主要将非化脓性中耳炎80例分为鼓室积液组(A组)和鼓室无积液组(B组)各40例进行纯音听力测听。两组经初步观察,治疗前后听力曲线,语言频率平均数(500HZ、1KHZ、2KHZ)提高最大值A组31dB,B组30dB,两组近似相等。在听力计测听80例当中,作者将听力曲线分为四类;此四形听力曲线与非化脓性中耳炎发病过程一致。     

自觉听力正常耳鸣患者的纯音测听特征及意义

目的探讨自觉听力正常耳鸣患者的纯音测听特征及意义。方法随机抽取于2016年6月至2017年8月在我院进行就诊的80例自觉听力正常的耳鸣患者的临床资料进行分析,另外选取40例健康人士,将其分为双侧组(双侧耳鸣40例)和单侧组(单侧耳鸣40例),分别将两组患者与对照组(健康人士40例)相比较,比较三组之间高频、低频以及语言频率。结果双侧组患者的高频(27.0±15.6)dB、低频(13.7±9.5)dB、语言频率(19.5±9.6)dB,显著高于对照组(15.2±14.3)dB、(11.4±8.5)dB、(12.3±7.5)dB,对比具有统计学意义(P0.05);单侧组与对照组之间差异不大,但单侧组高频、低频、语言频率略高于对照组,对比具有统计学意义(P0.05)。结论自觉听力正常的耳鸣患者存在一定的听力隐患,应及早对其进行干预~([1-2])。     

听觉脑干诱发电位与噪声性聋易感性的相关性研究

目的探讨听觉脑干诱发电位（BAEP）与噪声性聋易感性的相关性。方法使用纯音测听计和听觉脑干诱发电位仪检测50例职业性噪声聋患者和50例听力正常者,比较纯音测听与BAEP反应阈检测结果。结果轻度、中度噪声聋组的纯音测听结果与BAEP反应阈值均较对照组明显升高,三者比较差异有统计学意义（P〈0.01）;BAEP反应阈与纯音测听差值三组间差异无统计学意义（P〉0.05）,两两比较显示,中度噪声聋组差值高于轻度噪声聋和对照组,差异有统计学意义（P〈0.01）。100例被检查者BAEP反应阈与纯音测听值的差值为（14.58±7.46）dB,经相关分析发现,BAEP反应阈与纯音测听值呈正相关（r=0.755）。结论 BAEP检测能为职业性听力损伤的诊断提供客观、公正的依据,但与主观语频听阈仍不能完全符合。     

健康飞行人员坐位下体负压耐力试验测检方法的改进

对50名健康男性军事飞打人员进行了坐位LBNP耐力试验。受检者在递增性负压(-35、-40、-50mmHg)的作用下各5min,同时记录其血压、心电图、心阻抗血流图和耐受时间。其平均耐受时间为13.37±1.81min。不同年龄组和各类飞行人员LBNP的耐受时间,相差均不显著(P>0.05)。各机种飞行员的耐受时间,直升机和运输机与歼击机飞行员比较,相差显著(P<0.05);轰炸机与歼击机飞行员比较,虽有降低趋势,但相差不显著(P>0.05)。     

听力正常的噪声暴露者1/24倍频程精细化纯音测听结果分析

目的 用1/24倍频程精细化纯音测听对听力正常的噪声暴露者进行听力测试,了解听力正常的噪声暴露者的隐性听力损伤,为职业病的早期精准防护提供客观依据。方法 选取2023年1月至10月我院228例听力正常的噪声暴露者和216例非噪声暴露者为研究对象,用1/24倍频程精细化纯音测听对其进行测试。结果 结果显示,听力正常的噪声暴露者1/24倍频程精细化纯音测听异常率高于非噪声暴露者,并伴有焦虑、抑郁及睡眠障碍。结论 听力正常的噪声暴露者存在隐性听力损失,建议对常规纯音测听检测听力正常的噪声暴露者加做1/24倍频程精细化纯音测听,以早期发现可能存在隐性听力损失的人群,为职业病的早期精准防护提供一种新的客观依据。     

歼击机飞行员尿液中过氧化脂质水平

本文以硫代巴比妥酸(TBA)法分析了98例歼击机健康飞行员和91例健康成人的尿液过氧化脂质(U-LP0)水平。结果表明,歼击机飞行员组的U-LPO平均水平显著高于健康成人组之值(P<0.001),歼击机飞行员的飞行时间与U-LPO水平呈直线正相关(P<0.005)。提示飞行活动很可能是导致飞行员体内脂质过氧化反应增长的一个重要因素。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.