感音神经性聋儿多频稳态诱发电位及短纯音听性脑干反应与行为测听的相关性

目的 比较多频稳态诱发电位（MASSR）、短纯音听性脑干反应（Tb—ABR）与感音神经性聋儿行为测试听阈的差值．研究MASSR和Tb—ABR反应阈与行为听阈之间是否存在相关性以及在不同听力损失聋儿、不同的频率之间的差异。方法 对60名感音神经性聋儿分别测试MASSR和Tb—ABR反应阈和行为听阈，评价MASSR反应阈、Tb—ABR反应阈与行为听阈的相关性。结果 MASSR反应阈、Tb—ABR反应阈和行为听阈之间均有较高的相关性。二者在频率为2、4kHz时，对行为听阈的预测具有相似的、较高的准确性；但在频率为0．5、1kHz时，MASSR的准确性较Tb—ABR高。结论 MASSR和Tb—ABR均可用作感音神经性聋儿言语频率客观听阈的预测，为低龄儿童及难以检测行为听力的患儿提供诊断依据。     

谈带教过程中的"八动"管理方略

护生带教工作是教学医院日常工作之一,有着非常重要的意义。本文主要探讨了带教各个环节和过程中的组织管理技法。提出从目标、内容、考核、道德、情感、教学组织等方面加强对带教工作的管理。     

Correlation between hair selenium concentration and gastric cancer

Objective: To investigate the correlation between hair selenium (Se) level and gastric cancer. Methods: Atomic fluorescence spectrophotometer(AFS) was used to detect the Se level in hair. Results: The Se concentration in patients with gastric cancer ranged from 0.25 to 2.33μg/g(0.825±0.51μg/g), and that of health individuals ranged from 4.23 to 9.21μg/g(6.29±1.68μg/g). The results showed that the Se concentration in the patients' hair was significantly lower than that in controls (P＜0.01).Conclusion: There is a correlation between hair concentration and gastric cancer.     

不同听力检测方法对早期发现噪声性隐性听力损失的意义

目的探讨扩展高频纯音测听、畸变产物耳声发射(DPOAE)及噪声下言语识别能力测试对早期发现噪声性隐性听力损失的意义。方法选取20例常频纯音听阈正常、有噪声接触史的工人(接噪组,年龄20~41岁)与20例无噪声接触史、常频听阈正常的青年人(对照组,年龄19~35岁),分别行扩展高频纯音测听、扩展高频DPOAE及噪声下言语识别能力测试(汉化版噪声下BKB语句测试),记录并比较两组各项测试结果。结果接噪组扩展高频纯音听阈检出率低于对照组,在16 kHz差异有统计学意义(P<0.05),在18、20 kHz差异有显著统计学意义(P<0.01);接噪组8~20 kHz扩展高频纯音听阈平均值高于对照组,在9、18 kHz差异有统计学意义(P<0.05),在14 kHz差异有显著统计学意义(P<0.01);接噪组扩展高频DPOAE的信噪比及幅值均较对照组降低,在10 kHz差异有统计学意义(P<0.05),在8、9 kHz差异均有显著统计学意义(P<0.01);噪声下言语识别能力测试显示接噪组信噪比损失平均值为4.6±2.19 dB,高于对照组(3.00±2.08 dB)(P<0.01)。结论接噪组相较对照组,扩展高频纯音听阈值升高或引不出,扩展高频DPOAE信噪比及幅值降低,噪声下言语识别能力显著下降,以上三种检测方法对早期发现噪声性隐性听力损失有一定的参考价值。     

应用纯音测听诊断职业性噪声聋的可靠性和有效性

对6年以上工龄的青年织布女工108人(216耳)连续二次纯音测听的资料表明:第一次和第二次的听阈均值差除个别频率(8KHz左耳为3.5dB)外,其余各频率都在-0.3～0.5dB范围内;最大标准差于2KHz处为17.4dB,在3KHz和8KHz处分别为18.5dB、20.1dB。据此认为一次纯音测听的记录可作为职业性噪声聋诊断和评价听力损失程度的初步依据,必要时可用阻抗计测试镫骨肌反射阈和听觉脑干诱发反应测听以排除中耳疾患和非器质性聋。2例女工脱离噪声环境疗养2周,每隔一周复查听力一次,结果三次测听的语频均值出现21.7和13.3dB的差值,考虑系暂时性阈移的恢复。作者们对1980年卫生部门颁发的“噪声性聋调查方法”提出了改进意见。     

Transient hearing loss following spinal anaesthesia

Audiograms were performed pre-operatively in 14 patients scheduled for transurethral resection of the prostate under spinal anaesthesia and again 2 days postoperatively. Six of the 14 patients showed a minor reduction of hearing in the low frequency range. Follow-up audiograms showed full recovery after 1-7 months. No significant hearing loss was found in 12 patients who underwent the same procedure with epidural anaesthesia.     

The use of the OSCE in postgraduate education

Background: The Objective Structured Clinical Examination (OSCE) is a method of assessing the clinical skills of undergraduates in medicine, dentistry and other health sciences and is employed increasingly in postgraduate education. Aim: To describe the application of the OSCE to the development of Lifelong Learning and Continuing Professional Development (CPD) for General Dental Practitioners (GDPs). Methods: A postgraduate course was designed as an OSCE for GDPs. The OSCE comprised 12 stations covering different aspects of general dentistry. After an introductory seminar outlining the aim of the course, the participants spent 7 min at each station. Each question or task required 10 answers and was designed to highlight areas of weakness or interest and to stimulate further study of the presenting topic. Solutions and answers were provided at each station for self‐assessment along with a list of locally presented courses related to that subject. Participants were invited to leave contact details and to make suggestions for future postgraduate courses. The final session consisted of a group discussion and participants were invited to complete an evaluation form to express opinions on the course. Results: The evaluation demonstrated that most candidates found participation in the OSCE stimulated their interest in CPD. The OSCE also highlighted areas of weakness in knowledge of certain clinical procedures. Group discussion confirmed that practitioners found the hands‐on component valuable and that they were likely to participate in further OSCEs to enhance their CPD. Suggestions received during the discussion were used to modify the course. Conclusions: The OSCE course fulfilled its aim of assisting practitioners to organise their CPD. The reflective nature of the course was helpful in evaluating clinical knowledge and the unique multidisciplinary style fulfilled its objective in promoting thoughts regarding future study.     

听神经病患者的助听效果分析

目的:探讨听神经病的助听器配戴效果。方法:为14例患者(28耳)选配了Phonak、GN Resound、Widex、Siemens等品牌的助听器。采用声场评估、言语识别率测试及问卷调查等方式进行助听效果评估。结果:声场评估中,全部患者助听听阈均有提高,与裸耳听阈之间有显著性差异(P<0.05),而对言语的大声和响器的大声无不适感觉;言语识别率测试13例24耳助听前后结果经t检验,差异无显著性意义(P>0.05),3例4耳助听前后比较差异有显著性意义;3例患者填写了问卷调查表,显示患者总体上对声音舒适度及声音辨别能力感到满意,但对噪音环境下的声音分辨率不满意。结论:听神经病的助听效果因人而异,多数效果不理想,少数感到助听器对声音听取有帮助。