希—内学习能力测验在中国聋儿中使用的信度和效度

采用经部分修改的希－内学习能力测验（Ｈ－ＮＴＬＡ）量表对全国２１个省、市、自治区１７５８名３－１７岁聋儿逐人测试。样本人群地区分布、家长职业构成与１９９０年全国人口普查资料一致。１７５８名聋儿智商呈现正态分布（ｇ１＝０．０１１Ｐ＞０．０５，ｇ２＝０．０５８Ｐ＞０．０５）。测试员间信度系数０．９８１（Ｎ＝２４），复测信度０．８４１（Ｎ＝１３６），分半信度０．９２７（３－８岁）及０．８５４（９－１７岁）。各分测验得分随年龄增加而增加，小年龄组增加明显，大年龄组增加缓慢。各分测验之间、各分测验和总离差智商之间大多数相关系数有显著统计学意义。智商与学习成绩（语文及数学）相关系数０．２０８（Ｐ＜０．０１Ｎ＝２２４），与教师评语等级相关系数０．４４（Ｐ＜０．０５ｄｆ＝１６），表明经修订的Ｈ－ＮＴＬＡ量表适用于中国听力语言障碍人群进行智力评定。     

哑性二尖瓣狭窄发生机理探讨

对2－DE检查确定的42例哑性二尖瓣狭窄（SMS）与同期有相应心杂音的二尖瓣狭窄（MS）的超声征象对比，探讨SMS的发生机理．并通过对两组按二尖瓣口几何面积分类统计百分率比较，认为最轻度二尖瓣狭窄也是产生SMS的重要因素。     

Visual impairment in the hearing impaired students

Background:

Ocular problems are more common in children with hearing problems than in normal children. Neglected visual impairment could aggravate educational and social disability.

Aim:

To detect and treat visual impairment, if any, in hearing-impaired children.

Setting and Design:

Observational, clinical case series of hearing-impaired children in schools providing special education.

Materials and Methods:

Hearing-impaired children in selected schools underwent detailed visual acuity testing, refraction, external ocular examination and fundoscopy. Ocular motility testing was also performed. Teachers were sensitized and trained to help in the assessment of visual acuity using Snellen''s E charts. Refractive errors and squint were treated as per standard practice.

Statistical Analysis:

Excel software was used for data entry and SSPS for analysis.

Results:

The study involved 901 hearing-impaired students between four and 21 years of age, from 14 special education schools. A quarter of them (216/901, 24%) had ocular problems. Refractive errors were the most common morbidity 167(18.5%), but only 10 children were using appropriate spectacle correction at presentation. Fifty children had visual acuity less than 20/80 at presentation; after providing refractive correction, this number reduced to three children, all of whom were provided low-vision aids. Other common conditions included strabismus in 12 (1.3%) children, and retinal pigmentary dystrophy in five (0.6%) children.

Conclusion:

Ocular problems are common in hearing-impaired children. Screening for ocular problems should be made mandatory in hearing-impaired children, as they use their visual sense to compensate for the poor auditory sense.     

Reinstatement of speech in mute schizophrenics by operant conditioning

Student nurses trained in the use of operant shaping and positive reinforcement of imitative behaviour attempted to reinstate speech in 13 schizophrenics who had been mute from 11 to 42 years. Six of the 13 subjects showed improved speech after 15 sessions. Speech improvement was significantly greater under contingent reinforcement conditions than in a control condition using non-contingent reinforcement. Five of the six improved subjects had substantially retained their reacquisition of speech at 1-year follow-up. There was no evidence that age or duration of mutism influenced treatment outcome.     

聋哑大学生心理健康状况评估分析

目的　了解聋哑大学生的心理健康状况及相关因素。方法　使用 SCL-90量表和自编的调查问卷对天津理工大学聋人工学院 1 5 8名聋哑大学生进行测查。结果　 1聋哑大学生除人际敏感因子外 ,其他各因子均值全部显著高于 1 986年全国常模 ,阳性项目数和阳性筛查率也显著高于其它各种群体。但同 1 999年大学生修正常模相比没有显著性差异 ,只有躯体化、焦虑和精神病性 3项因子分略高 ;阳性项目数显著低于聋校学生。 2家庭经济状况和所学专业是影响聋哑大学生心理健康状况的重要因素 ,性别、年级、城乡地区、残疾等级、残疾年限等因素对聋哑大学生心理健康状况无显著性影响。结论　应重视聋哑大学生心理卫生问题 ,加强聋哑大学生心理健康教育和咨询工作 ,提高对聋哑大学生的社会支持     

Challenges during anaesthetic management of a 38-year-old deaf and mute patient under general anaesthesia

Congenitally deaf and mute adult patients have speech and language disabilities. Establishing meaningful communication with these patients is a challenge in acute hospital-care settings, particularly when anaesthetic care is to be provided. Several methods can be adopted to facilitate interaction, such as sensitisation of health-care providers and training them in ways to communicate effectively. A thorough preoperative assessment and customised perioperative management satisfying the patients needs will ensure a successful outcome. Implementing pain protocols and using tools such as Visual Analog Scale (VAS) will mitigate stress and surgical related complications.     

基础麻醉在配合度差的老年白内障患者超声乳化手术中的应用

目的　探讨表面麻醉联合基础麻醉下超声乳化术对配合度差（老年痴呆、智力低下、聋哑）的老年白内障患者的手术安全性,并观察术后并发症、最佳矫正视力、血液流变学及泪膜稳定性的变化情况。方法　选取６４例（８７眼）老年痴呆、智力低下、聋哑老年白内障患者,随机分为Ａ、Ｂ两组。Ａ组在表面麻醉下行白内障超声乳化＋人工晶状体植入术;Ｂ组采用表面麻醉复合基础麻醉下行白内障超声乳化＋人工晶状体植入术。术前、术中及术后２周观察最佳矫正视力、术后并发症、血液流变学及泪膜稳定性情况。结果　Ａ组患者麻醉效果Ⅲ级２２眼,Ｂ组患者Ⅲ级５眼,两组差异有统计学意义（χ２＝０．０００,Ｐ＜０．０５）;两组术前最佳矫正视力、心率、舒张压和收缩压、泪膜破裂时间（ｂｒｅａｋｕｐｔｉｍｅ,ＢＵＴ）、基础泪液分泌试验（ＳｃｈｉｒｍｅｒＩｔｅｓｔ,ＳＩＴ）差异均无统计学意义（均为Ｐ＞０.０５）,术中两组患者心率、舒张压和收缩压相比差异均有统计学意义（ｔ心率＝９．１５８,ｔ收缩压＝８．５５２,ｔ舒张压＝７．２５９,均为Ｐ＜０．０５）;术后２周两组患者最佳矫正视力相比差异有统计学意义（Ｐ＜０．０５）,而ＢＵＴ及ＳＩＴ差异均无统计学意义（均为Ｐ＞０.０５）。Ｂ组手术时间（１８．６±３．５）ｍｉｎ明显比Ａ组（２６．８±７．２）ｍｉｎ短,两组比较差异具有统计学意义（ｔ＝６．５２４,Ｐ＜０.０５）;对比两组术后并发症,Ａ组有１２眼（２７．２７％）,Ｂ组有５眼（１１.６３％）,Ａ组并发症发生率明显高于Ｂ组,两组差异具有统计学意义（χ２＝４．２６８,Ｐ＜０．０５）。结论　对配合度差的老年白内障患者（如老年痴呆、智力低下、聋哑）实施超声乳化手术时,选用表面麻醉联合基础麻醉能在术中获得更好的麻醉效果,提高患者的视觉质量,值得临床推广应用。     

440例聋儿教育康复的效果

目的：探讨聋儿教育康复模式及效果,方法：对440例＜7岁的聋儿分为2组,分别采用集中教育康复模式和家庭社区教育康复模式进行听觉语言训练,结果：440例聋儿经平均2年2个月的教育康复达到＞3级60例,康复率13．6％,康复有效255例占58．0％,两种式康复效果经配对对照观察差异无显著性。结论：聋儿家庭社区教育康复模式适合我国国情,是传统集中教育康复模式的有效补充,具有更大的受益面,值得推广。     

双歧杆菌WPG抑瘤作用的给药方法和剂量研究

目的研究双歧杆菌完整肽聚糖的不同给药方法及剂量对小鼠体内肿瘤的抑制效果。方法用肝癌细胞腋下接种制备肿瘤模型,观察双歧杆菌WPG对小鼠体内肿瘤的抑制作用;观察不同给药方法和剂量对淋巴细胞转化率、肿瘤的生长、抑瘤率及荷瘤小鼠生存期的影响。结果通过灌胃和注射给药都能明显抑制小鼠体内肿瘤的生长、提高淋巴细胞转化率、延长荷瘤小鼠的生存期,其中,注射给药优于灌胃给药;注射给药,双歧杆菌WPG量达0.5~0.6 mg/只时,对肿瘤的抑制效果最好。结论双歧杆菌WPG通过注射给药抑瘤效果最好,抑瘤作用的最适浓度为0.5~0.6mg/只。     

Speech audiometry by a speech synthesizer

Summary A preliminary report on speech test results with a portable, text-tospeech synthesizer is presented. The differentiation scores achieved at speed 80 words/min vary. So far the best mean differentiation scores in normal material are 75%. The increase of the presentation level improves the differentiation score, as does the decrease of word speed and training. The future and present uses of this system are discussed. These include: devices for the handicapped, e.g. to produce speech for the mute, man-machine communication through speech in industry control, data processing systems and uses in audiological diagnostics. The study is continued.