助听器验配的临床实践模式探讨

助听器验配师面临着新的挑战和机遇,如何提升自身的专业水平,成为亟待探讨的问题。本文从循证验配和以人为本验配2个角度分析助听器验配师的发展方向,比较两种主流的验配模式,并提出以循证为纲,以人为本的最佳实践模式,该模式能够兼顾科学性和人性化,更好地满足听障者的个性化需求和期望,提高助听器验配的效果和满意度。本文探讨了两种验配模式与听力康复的关系,以及如何实现最佳的实践效果。     

应用原位逆转录PCR技术检测Captopril对动脉粥样斑块中c-myc和c-fos mRNA表达的影响

目的　了解卡托普利对动脉粥样斑块中原癌基因 c- m yc和 c- fos m RNA表达的影响及原位逆转录 - PCR(IS-RT- PCR)技术在检测中的应用效果。方法　将 40只雄性日本大耳白兔随机分为对照组、胆固醇组及用药组 ,采用ISRT- PCR技术观察三组原癌基因 c- myc和 c- fos m RNA的表达及分布。结果　 (1)胆固醇组的 c- m yc和 c- fosm RNA阳性率明显高于对照组 ,用药组则显著低于胆固醇组 ;(2 )主动脉粥样斑块中 c- m yc、c- fos m RNA呈强阳性反应 ,广泛分布于内膜层 ,阳性信号为核阳性 ;而用药组呈弱阳性反应 ,散在性分布。结论　提示卡托普利能显著抑制 AS斑块中原癌基因 c- m yc和 c- fos m RNA的表达 ,同时亦体现了 ISRT- PCR技术将细胞类型与扩增结果相联系的良好实验效果     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

全民食盐加碘对山东省碘缺乏地区8～10岁儿童碘营养状况的影响分析

目的 了解全民食盐加碘后山东省碘缺乏地区8～10岁儿童碘营养状况,为今后碘缺乏病防治提供科学依据.方法 分别于1995、1997、1999、2002、2005年在山东省碘缺乏地区,按人口比例概率法或单纯随机抽样法对8～10岁儿童进行抽样,采用触诊法和B超法检查儿童甲状腺肿大情况,直接滴定法检测食用盐碘、砷铈氧化还原法检测儿童尿碘.结果 实施全民食盐加碘10年,山东省碘缺乏地区儿童食用盐碘中位数、尿碘基本呈逐年升高趋势,而甲状腺肿大率呈逐年降低趋势,到2005年碘缺乏地区碘盐覆盖率为97.2%,碘盐合格率为97.1%,合格碘盐食用率为94.3%;尿碘中位数为227.7μg/L,≥100μg/L者占89.7%(323/360);甲状腺肿大率(触诊法)由1995年的22.3%(282/1267)降至2005年的4.4%(53/1200).结论 实施全民食盐加碘10年,山东省碘缺乏地区人群碘营养状况得到显著改善,处于适宜碘营养状态.     

多发骨质疏松性椎体的急性或亚急性 骨折的MRI表现

目的探讨多发骨质疏松性椎体骨折中,急性或亚急性椎体骨折的MRI表现。方法回顾性 分析74例经我院诊治的多发骨质疏松性椎体骨折的临床资料与MR图像,在MR图像上,把骨折椎 体按形态分为5型：正常,楔形变、双凹变形、单凹变形和挤压变形（即椎体后缘压缩骨折）;按椎体高 度压缩严重程度分为4度：正常,轻度、中度和重度;根据急性或亚急性骨折椎体的分布情况分为：单 发骨折,多发连续骨折和多发不连续骨折。MR图像评价由两位有多年诊断经验的骨骼肌肉系统放 射医生完成,当有异议时,通过协商达成一致。应用Fisher''精确概率法进行统计学分析。结果在 74例患者中,共有592个椎体纳入研究,骨折椎体有280个,占47.3%.。其中101个椎体为急性或亚 急性骨折,占椎体骨折的36. 1%。椎体形态改变：楔形变23个（22. 8% ),双凹变形60个（59.4% ), 单凹变形16个（15.8% ),挤压变形2个（2. 0% )。椎体高度压缩程度：轻度压缩20个（19.8%.),中 度压缩44个（43.6%.),重度压缩37个（36.6%.)。急性或亚急性骨折椎体的分布：单发54例 (73.0% ),多发连续11例（14. 9% ),多发不连续9例（12.2% )。结论在多发骨质疏松性椎体骨折 中,MRI特点有助于急性或亚急性椎体骨折的诊断。     

慢型克山病死亡病例的有关资料分析

目的 调查研究慢型克山病死亡病例的有关资料，为克山病防治研究提供有价值的信息。方法 设计慢型克山病死亡病例有关资料的统一调查表，由专业人员查阅有关病例资料填写。结果 慢型克山病的死亡女性明显多于男性。发病时的年龄多集中在5～11岁的年龄。发病在1年内的高达30％以上，发病在3年内死亡的高达50％以上。结论 慢型克山病致短年限内死亡的主要病理改变是心室劳损合并各种早搏和传导阻滞。     

山东省全民食盐加碘防治碘缺乏病措施现状评价

目的　监测山东省居民户食用盐现状以评价全民食盐加碘防治碘缺乏病措施。方法　采用横断面调查方法 ,在随机抽取的乡 (镇 )和村庄采集居民户食用盐样本进行碘含量检测。结果　调查了 97个县 (市、区 )、85 7个乡 (镇 )的 2 742 3个居民户 ,采集并检测食用盐 2 742 3份。加碘盐 2 6189份占 95 .5 % ,合格碘盐 2 4996份占 91.2 % ,非碘盐 12 3 4份占 4.5 % ;人口加权后的全省碘盐覆盖率为 95 .9%、碘盐合格率 94.9%、合格碘盐食用率 91.1%、非碘盐率 4.1%。81.4% (79/97)县 (市、区 )的碘盐覆盖率≥ 95 % ,88.7% (86/97)县 (市、区 )的碘盐覆盖率≥ 90 % ;76.3 % (74/97)县 (市、区 )的合格碘盐食用率≥ 90 % ;11.3 % (11/97)县 (市、区 )的非碘盐率 >10 %。非碘盐问题主要存在于沿海产盐地区。结论　山东省落实全民食盐加碘措施良好 ,居民户碘盐覆盖率在省级水平上已达到消除碘缺乏病目标 ,但在市级和县级水平还未达到标准。应加强综合性干预措施以期在县级水平实现目标。     

干细胞与心肌细胞移植

扩张型心肌病、心肌梗死及晚期心衰目前并无理想的临床治疗手段 ,晚期患者常需要进行心脏移植。而供体难以获得、免疫排斥反应、费用的昂贵及手术的高风险使心脏移植治疗受到很大的限制。随着对干细胞研究的深入及细胞培养水平的提高、分子生物学技术的发展 ,干细胞的分离纯化及体外定向分化技术逐步提高 ,干细胞定向分化为心肌细胞并进行细胞移植有可能为心脏病提供一种新的有希望的细胞治疗方法。1　干细胞概述1.1　干细胞的概念干细胞是机体组织中的未分化细胞 ,它是一种多功能的原始细胞 ,具有自我更新、增殖并进一步分化为成熟细胞的能…