Characteristics of normal newborn transient-evoked otoacoustic emissions: Ear asymmetries and sex effects

Transient-evoked otoacoustic emissions (TEOAEs) were recorded from more than 30000 newborns over a six year period. Analysis was performed on all the TEOAEs that passed the bedside universal hearing screen (n=60431), in order to characterize the normal properties of neonatal TEOAEs and to study ear and sex effects. Short recording times (median=33 s) were observed in combination with high entire TEOAE level (median=18.8 dB SPL for an 81.8 dB SPL peak stimulus), and high reproducibility (median=86%). Signal-to-noise ratio (S/N) of the TEOAE was highly frequency-dependent, being poorer at low frequencies. Prolonged averaging increased median reproducibility to 97%, but the minor S/N-improvement at low frequencies did not justify the longer test time. Highly significant mean lateral asymmetries (right >left) and sex differences (female >male) existed in entire TEOAE level, S/N TEOAE, and in half-octave frequency bands (700–4000 Hz). Mean lateral and sex entire TEOAE level differences were 1.1 dB and 1.3 dB, respectively. Stimulus levels were not affected by ear or sex. Hence, physiological differences at the level of organ of Corti were demonstrated in newborns.     

Topology Optimization and Multiobjective Optimization for Drive Axle Housing of a Rear Axle Drive Truck

As one of the important load-bearing components of a truck, the drive axle housing must meet the requirements of stiffness and strength. The traditional design method uses redundancy design to meet the performance requirements. The joint design between the three-dimensional mathematical model and finite element model is adopted, and the optimal design of the drive axle housing is realized based on topology optimization and multiobjective optimization. Firstly, the static analysis of the drive axle housing of a rear axle drive truck was carried out with four typical working conditions. It was concluded that the four working conditions all operate under the yield limit of the material, and it was found that the maximum equivalent stress of the four working conditions occurs at the step of the half-shaft casing. Among the four working conditions, the most critical one is the maximum vertical force working condition. Then, based on the maximum vertical force working condition, the fatigue life analysis is conducted, and the minimum fatigue life appears at the transition position of the half-shaft sleeve and the arc transition position of the main reducer chamber. The remaining parts can meet the design requirements. The overall safety factor of the drive axle housing is mainly between 1 and 5 when operating under this working condition. Then, through modal analysis, the first to sixth natural frequency and vibration modes of the drive axle housing are extracted. Based on the modal analysis, the dynamic characteristics of the drive axle housing are further studied by harmonic response analysis and random vibration analysis. Finally, two kinds of lightweight optimization schemes for the drive axle housing are given. Topology optimization reduces the mass of the drive axle housing by 17.4%, but the overall performance slightly decreases. Then, the five dimensional parameters of the drive axle housing are selected as design variables. The mass, maximum deformation, equivalent stress, service life, and the first-, second- and third-order natural frequencies are defined as objective functions. Through the optimal space-filling design method, the experimental designs are performed and the sample points are obtained. Based on the results of experiment design, the multiobjective genetic algorithm and response surface method are combined to optimize the objective functions. The analysis results show that the mass is reduced by 4.35%, the equivalent stress is reduced by 21.05%, the minimum life is increased by 72.28%, and the first-, second-, and third-order natural frequency are also increased to varying degrees. Two different optimization strategies are provided for the design of the drive axle housing.     

成年功能性构音障碍患者辅音错误类型及方式分析

目的 探讨成年功能性构音障碍患者辅音发音错误的特点,为制定语音训练方案提供依据.方法以42例成年功能性构音障碍患者为研究对象,借助计算机语音工作站对患者进行语音评估,对其辅音的发音错误类型及方式进行分析.结果42例成年功能性构音障碍患者主要的辅音发音错误类型为置换、扭曲,其次为脱落.按发音部位,错误辅音依次为舌尖后音(39例,92.86%)、舌尖前音(31例,73.81%)、舌面音(22例,52.38%)、舌根音(19例,45.24%)、舌尖中音(18例,42.86%)、唇齿音(6例,14.29%)及双唇音(6例,14.29%);辅音错误频率由高至低依次为/sh/、/zh/、/ch/、/r/、/z/、/c/、/s/、/q/、/x/、/j/、/g/、/k/、/h/、/t/、/l/、/d/、/f/、/p/.辅音错误方式有:舌前音化(22例,52.38%)、非送气化(12例,28.57%)、侧化构音(12例,28.57%)、辅音脱落(9例21.42%)、舌后音化(8例,19.05%)、舌面音化(4例,9.52%)、双唇音化(4例,9.52%)、唇齿音化(3例,7.14%).结论成年功能性构音障碍患者的辅音发音错误类型主要是置换和扭曲;错误辅音主要为舌尖后音、舌尖前音、舌面音、舌根音、舌尖中音;辅音发音错误方式主要为舌前音化、非送气化、侧化构音、辅音脱落.     

突发性耳聋的病因及其治疗进展

突发性耳聋（sudden hearing loss）属耳科常见急症之一,是突然发生的原因不明的感音神经性耳聋.病人的听力突然明显减退（多为单侧耳）,一般在数分钟或数小时内下降至最低点,少数病人可在三天以内丧失听力;大部分病人伴有耳鸣,部分病人有耳内发闷、胀满及阻塞感;有一少部分病人有耳聋同时伴有眩晕,自觉有旋转感,常伴恶心、呕吐,多于发病一周左右减轻,除第Ⅷ颅神经外,无其它颅神经症状.近几年来,国内外学者对其发病的原因和治疗进行了深入系统的研究,现将有关突发性耳聋病因及治疗进展进行综述.     

凝胶渗透色谱-多角度激光散射联用技术研究 红芪多糖中4个组分分子特征

目的:测定红芪多糖3(HPS-3)中4个组分的绝对分子量,相对分子质量分布,均方根旋转半径(Rg),多分散系数(Mw/Mn)等分子特征参数,以均方根旋转半径(Rg)对重均分子量(Mw)作图,计算4个组分在溶液状态的构象。方法:采用凝胶渗透色谱-多角度激光散射(GPC-MALLS)联用技术,流动相为含0.02%NaN3的0.1 mol.L-1NaNO3溶液,Ultrahydro-gelTM1000,500色谱柱串联。结果:HPS-3的4个组分中,HPS-3-C的Mw最大(1.986×105g.mol-1);其次为HPS-3-B(1.113×105 g.mol-1)和HPS-3-D(8.457×104 g.mol-1);HPS-3-A的Mw最小(1.223×104 g.mol-1),而Rg最大(55.5 nm)。HPS-3-D相对分子质量分布范围最广,Mw/Mn 2.543。在流动相中,HPS-3-A为球型构象,HPS-3-C为无规则线团构象,HPS-3-B和HPS-3-D则均为高枝化度结构。结论:为进一步研究HPS-3中4个组分分子特征与其生物活性的关系提供必要依据。     

基于相同载体体系的中药成分自乳化制剂的制备及其体外透皮吸收特性考察

目的:制备同时适合于黄芩素、黄连素及大蒜素3种中药成分的自乳化载体体系,并考察这3种自乳化制剂的体外透皮吸收效果。方法:采用饱和溶解度法、伪三元相图法、正交试验筛选最佳的空白处方组成及基质用量。以Franz扩散池和离体大鼠皮肤进行体外透皮吸收试验,采用HPLC分别测定3种自乳化制剂中黄芩素、黄连素及大蒜素的累积透皮渗透量,并分别与黄芩素散剂、黄连素散剂及大蒜素散剂进行比较。结果:最佳处方为油酸乙酯-聚氧乙烯氢化蓖麻油40-聚乙二醇400载体体系,所形成的自乳化制剂粒径适宜,其微观形态呈较规整的球形。透皮吸收10 h,黄芩素、黄连素及大蒜素3种自乳化制剂的药物透皮速率分别为6.898 6,7.600 4,190.040μg·cm~(-2)·h~(-1),累积透皮渗透量分别为71.38,85.54,1 795.16μg·cm~(-2)。结论:成功制备了不同种类中药成分均能使用的自乳化载体体系,且该自乳化制剂的体外透皮吸收效果良好,可为后续中药复方自乳化制剂的制备及其透皮给药吸收研究提供实验依据。     

酒精所致精神障碍的临床分析

目的探讨酒精所致精神障碍患者的临床特点。方法回顾分析精神专科医院2011年10月至2012年9月收治的196例酒精所致精神障碍患者,临床资料。结果长期饮酒对神经系统损害较大,精神障碍患者可出现不同程度的幻觉、幻视、妄想、抑郁、情绪高涨、兴奋躁动等不稳定症状,有些患者出现人格障碍及记忆障碍。患病率中文化水平低、体力劳动重的男性居多。对照组总有效率高于常规组（x2=4．6296,P〈0．05）。结论酒精可致精神和躯体损害,早期治疗能改善症状,少量抗精神药物及戒酒等综合性治疗可有效改善患者病情,值得在临床推广应用。     

特发性震颤的临床特点分析

目的探讨特发性震颤(essential tremor,ET)的临床特点。方法对92例ET患者的临床资料进行回顾性分析。结果92例ET中男58例,女34例,发病年龄12～80岁,平均(50.2±17.3)岁,病程6个月～60年,平均(16.2±8.9)年。49例(53.3%)患者有阳性家族史,多呈常染色体显性遗传,临床主要表现为单症状的姿势性震颤,累及部位依次为手(92.4%)、头(25.0%)、咽喉部(21.7%)、下颏(15.2%)等。16.3%患者因震颤致日常生活困难。42例饮酒患者中,85.7%显示对酒精有反应性。6.5%患者并发帕金森病(Parkinson’s disease,PD)。67.3%患者小剂量普萘洛尔治疗有效。结论本组ET患者男多于女,临床表现为单症状姿势性震颤,部分病例可伴发PD,小剂量普萘洛尔治疗大多有效。     

40例原发性胃肠道弥漫大B细胞淋巴瘤临床特征、细胞来源与预后分析

背景与目的:原发性胃肠道弥漫大B细胞淋巴瘤(primary gastrointestinal diffuse large B-cell lymphoma,PGI-DLBCL)的发病部位及其临床表现与胃肠道其它肿瘤性疾病难以鉴别,误诊率较高,且其标准治疗的方法仍未确定。本研究旨在分析PGI-DLBCL的临床特征、肿瘤细胞来源及预后,并探讨有效的联合治疗方法。方法:分析我院1998～2007年诊治的40例PGI-DLBCL,应用Kaplan-Meier法、log-rank检验和Cox回归模型对其临床资料和实验室检测结果进行生存分析及单因素和多因素预后分析。通过免疫组化染色分析34例患者的肿瘤细胞来源。治疗方法包括联合化疗、手术 联合化疗及放疗、单纯手术等,联合化疗方案为CHOP及CHOP样方案。结果:40例PGI-DLBCL患者中,年龄10～89岁中位年龄56.5岁,男女比例1.86∶1,胃与肠道的发病比率为1.05∶1。预后分析可追访病例38例中,死亡12例(31.6%),3年和5年生存率均为64.7%。9例多部位发病的患者中,8例(88.9%)在3年内死亡。9例(26.5%)肿瘤细胞来源于生发中心(germinal center,GC),25例(73.5%)来源于非生发中心(non-germinal center,non-GC)。单因素预后分析发现肿瘤细胞来源、国际预后指数(international prognosis index,IPI)、B症状对生存率的影响有显著性(P<0.05)。Cox多因素预后分析显示血清乳酸脱氢酶(LDH)升高组患者的死亡风险是LDH正常组的2.87倍。结论:PGI-DLBCL发病以中年男性为主,多部位发病是该类患者死亡的重要原因。肿瘤细胞来源、IPI、B症状对预测患者生存和指导治疗有重要作用,其中初诊时血清LDH水平升高是本组患者的独立预后因素。