多通道人工耳蜗在语前聋儿童及青少年中的应用

目的　通过对植入人工耳蜗的语前聋儿童和青少年的听力和语言能力的评估 ,探讨我国儿童在使用人工耳蜗后的听力和言语能力发展规律及影响因素。方法　 2 5例行人工耳蜗植入的语前聋儿童及青少年患者参与本组测试。选用《聋儿听觉言语康复评估方法》作为测试材料 ,分别进行声音、言语声和环境声的辨别 ,数词、单字词、双字词、3字词、韵母、声母、声调、封闭项列短句的识别 ,开放项列字词和开放项列短句识别 ,语言清晰度 ,模仿句长 ,听话识图和看图说话等方面测试。结果　受试者术后均能感知到声音 ,辨别不同类别的声音。封闭项列测试结果全部大于机会水平 ,正确识别率随人工耳蜗使用时间而不断增加 ,随植入时年龄的增长而呈下降趋势。术后约半年显现开放项列识别能力 ,使用人工耳蜗后对患儿的言语发育具有较大帮助。结论　尽早对语前聋患儿植入人工耳蜗及进行术后康复 ,以达改善听力 ,提高语言能力 ,促进身心全面发展的目的。     

Holmium: YAG laser surgery in obliterated cochleas: an experimental study in human cadaver temporal bones

A pulsed holmium: YAG laser ( = 2120 nm) was used to reopen the basal turn of artificially obliterated human cochleas in freshly dissected cadavers. This allowed intracochlear insertion of the stimulation electrode of a cochlear implant under simulated surgical conditions. Laser energy was transmitted through a 400-m nylon fiber via the opened facial recess directly to the round window niche. At an energy level of 500 mJ per 2.5 s pulse, a repetition rate of 2 Hz, and an exposure time of 20–30 s, the photo-ablative mechanism of laser-bone interaction led to a 8–10 mm recanalization of the basal turn of the cochlea without damaging surrounding structures. The artificial bony occlusion and the recanalized basal turn of the cochlea were visualized by means of computed tomography and studied under light microscopy, using a histologic thin-section technique.Presented at the XVth World Congress of Otorhinolaryngology, Istanbul, Turkey, 23 June 1993     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

鼻内窥镜下经筛窦行眶内壁骨折整复术

探讨应用鼻内窥镜下经筛窦行眶内壁折整复术。方法前鼻孔入路,内窥镜观察下将嵌入筛房的眶脂肪及内直肌还纳回眶内,硅胶板修补充填孔洞。结果１６例患者,平均术后观察８个月,复视消失,眼球内陷矫正,无硅胶排异。结论内窥镜下经筛窦行眶内壁骨折整复术,具有无皮肤瘢痕,手术损伤小,并发症少,且手术安全可靠。     

脊柱内固定对邻近运动节段的影响

为研究脊柱内固定对邻近关节突关节的影响,应用成年山羊20只,随机分长节段、短节段固定组和对照组,进行3个月、6个月的光镜、扫描电镜及透射电镜观察。结果发现近头侧2个邻近脊椎的关节突关节都出现了退变。长节段固定后邻近关节突关节早期就出现了较严重的退变,而短节段固定后其退变程度较轻。研究认为内固定后邻近运动节段的高应力环境是其关节突关节退变的主要因素,并有可能导致邻近运动节段的不稳定。     

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities

The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months.     

Regionally selective effects of intracerebral dopamine infusion on sensorimotor gating of the startle reflex in rats

Systemic administration of dopamine (DA) agonists markedly disrupts sensorimotor gating in rats as measured by prepulse inhibition (PPI) of the acoustic startle response. A qualitatively similar, but quantitatively weaker disruption of PPI follows DA infusion into the nucleus accumbens (NAC). The present study was designed to determine whether forebrain DA terminal fields other than the NAC contribute to the DAergic modulation of PPI. PPI was impaired significantly after infusion of DA (0–40 µg) into the NAC or anteromedial striatum, but not after DA infusion into the orbital cortex or posterolateral striatum. DA infusion into the amygdala also disrupted PPI, but this disruption was accompanied by a dose-dependent decrease in startle amplitude. These results suggest that DA overactivity in the both NAC and anteromedial striatum contribute to the gating-disruptive effects of systemically administered DA agonists, and that DA overactivity in mesocortical, mesoamygdaloid and non-limbic mesostriatal DA systems are not major substrates for a DAergic modulation of PPI.     

国产长效皮下埋植剂和Norplant的药物体外释放比较

本文研究了国产18-甲基炔诺酮硅橡胶长效皮下埋植剂的药物体外释放,并与进口Norplant进行了比较。释放试验采用水平振荡法,实验条件符合“漏槽”状态的要求。用紫外分光光度法在240 nm波长处测定18-甲基炔诺酮每天的体外释放量。二年多体外释放试验的实验结果表明:国产埋植剂的药物体外释放无爆破效应,释药速度稳定,为零级速度。平均每天释放量为85μg。体外释放的重现性好。进口Norplant则有明显的爆破效应,经10天释放,才趋于稳定,平均每天释药量为68μg。     

丙酸睾酮埋植剂在家兔体内的药动学研究

 目的观察丙酸睾酮埋植剂在家兔体内的释放过程，同时进行药动学研究。方法将自制的丙酸睾酮埋植剂植入家兔皮下，用RIA方法检测血清中睾酮含量，并用3P87软件估算了药动学参数。结果丙酸睾酮埋植剂在家兔体内释放过程符合一房室模型，c_max为4.65 ng·mL^-1，t_max为4.12 h。取出埋植剂后，血药浓度下降迅速，t_1/2为0.24 h，清除率123.88 mL·h^-1。结论认为用硅胶囊控制丙酸睾酮在动物体内的释放是可行的。     

Nucleus24M型人工耳蜗植入后电极阻抗的变化

目的：研究人工耳蜗植入后电极阻抗的变化规律，以便确定术后进行映射调图的时间表。方法：对16例植入Nucleus CI24M型人工耳蜗患者，于术中及术后1、1．5、2、4、6个月进行电极阻抗测试，统计分析电极阻抗的变化规律。结果：患者电极阻抗在术中检测时最低，开机时最高，以后若干次随访时，阻抗逐渐下降，并在2～4个月左右趋于稳定。结论：电极阻抗的稳定提示耳蜗内生物组织的病理过程渐趋稳定；对心理物理测试配合良好的患者，术后只进行2～4个月左右的映射调图即可。