简介：Objective:Establishnormativedatafortympanicelectrocochleography(TMECochG)parametersinnormalhearingadultswithoutMeniere'sdisease's(MD)symptoms.DescribeTMECochGvariablesthathelptodistinguishnormalfromMDears.Materialandmethods:Weenrolled100subjects(N?200ears),59females,agedbetween19and71yearsfrom09/2010to04/2014.Inclusioncriteria:normalotomicroscopy,hearingthresholds25dBnHLfrom250to4000Hz,normaltympanogram,nosymptomsofMDaccordingtotheAAO-HNS1995criteriaandGibson'sscore<7.Weexcludedsubjectswithdizziness,auralfullnessorothersymptomsofendolymphatichydrops.Thefollowingparameterswereanalyzed:SP/APamplituderatio,SP/AParearatioandthedifferencebetweenAPlatencywithrarefactionandcondensationstimuli.Results:Therewasnosignificantdifferencebetweenrightandleftears(Intraclasscorrelationcoefficient<0.6).SP/APamplituderatiovariedbetween0.084and0.356andSP/AParearatiobetween0.837and1.671(percentiles5and95).TheAPlatencydifferencetorarefactionandcondensationclickswasbetween0.0and0.333ms.Conclusion:NormativedataforTMECochGparameterswereestablishedin100normalhearingsubjectswithoutMD.Thesedatacanbeusedtodistinguishnormalfrompathologicalfindingsandinfollow-upofMDpatients.

简介：目的构建含有人E2F2基因和绿色荧光蛋白基因（pEGFP）的腺病毒载体,为聋病的基因治疗奠定实验基础。方法根据已知的E2F2基因序列设计并合成相应的双链DNA,将其与酶切线性化的pDC315-EGFP载体片段连接,构建穿梭质粒pDC315-GFP-E2F2,并将其与腺病毒骨架质粒pBHGlox△E1,3Cre共转染HEK293细胞,同源重组产生重组腺病毒。对重组腺病毒进行扩增、纯化及滴度测定,用聚合酶链反应和测序方法验证穿梭质粒pDC315-GFP-E2F2穿梭质粒的构建;通过荧光显微镜和Westernblot（蛋白质印迹）方法,分别检测质粒pDC315-GFP-E2F2和重组腺病毒表达E2F2蛋白情况。结果经聚合酶链反应鉴定和测序分析,证实穿梭质粒pDC315-GFP-E2F2与设计一致;经荧光显微镜检测,分别由穿梭质粒pDC315-GFP-E2F2、重组腺病毒转染的HEK293细胞均可观察到GFP表达;经WesternBlot检测出在72kDa～95kDa处有条特征带,其大小和E2F2-GFP融合蛋白（～76kDa）相吻合;滴度测定为1×1011PFU/ml（PFU,plaqueformingunit,空斑形成单位）。结论成功构建了人E2F2基因重组腺病毒载体,并能在HEK293细胞中表达。

简介：摘要目的研究“集中培训+交流合作+自主发展”干预模式在预防糖尿病足中的应用效果。方法选择158例2型糖尿病合并糖尿病高危足患者为研究对象，随机分为观察组和对照组各79例，对照组实施糖尿病常规护理，观察组施行“集中培训+交流合作+自主发展”的干预模式。结果观察组在遵医用药、足部护理、血糖监测、饮食控制、加强运动各维度得分、糖尿病足知识及足部自我护理优良率均高于对照组，糖尿病足发生率(1.27%)明显低于对照组(8.86%)（P<0.05）。结论“集中培训+交流合作+自主发展”干预模式能提高2型糖尿病患者自我管理水平，有效预防糖尿病足的发生。

简介：Managingmicrotiapatientsisalwaysachallenge.Multidisciplinaryapproach,goodfamilysupport,wellestablisheddoctorepatientrelationshipandwellorganisedpatient-supportgroupsaretheessentialelementsforsuccess.Withtheadvancementofimplantablehearingdevices,moreoptionswillbeavailableforthemicrotiapatients.Otologistsplayaleadingroleinthewholemanagementprocess.Theynotonlyprovideproperguidancetothepatientsinchoosingthecorrectpathofthetreatment,butalsoplayakeyroleinorganisingandmaintainingacosteffectivemultidisciplinaryrehabilitationteamforthemicrotiapatients.

简介：Applicationofsurgicalendoscope,usedaloneorincombinationwiththesurgicalmicroscope,fortheoperativemanagementofearandtemporalboneconditionsmayallowimprovedaccessandclearanceofdisease.Preservationofnormalstructuresmayalsobeimproved.Astheuseofthistoolisincreasing,theneedforbetterunderstandingoftheanatomyoftheearisbecomingevident.Thisisparticularlysoforendoscopicsurgeryaimingatremovaloflesionsinvolvingtheinfra-cochlearcorridorand/orpetrousapex.Humantemporalbone-derivedlabyrinthcasts(molds),originallymadeforendolymphaticductandsacanalysiswhichgenuinelyrepresentthemembranouslabyrinthanditsadjacentsofttissues,weremorphometricallyanalyzedintermsoftheanatomicrelationsbetweenstructuresinandaroundtheinfra-cochlearcorridor.Thedistancebetweenthepetrouscarotidartery(PCA)andthebasalturnofthecochlea,thedistancebetweenPCAandinfra-cochlearvein(ICV)/cochlearaqueduct(CA),andthedistancebetweenthelowersurfaceofbasalcochlearturnandthepointwherethecarotidarteryandjugularvein(JV)meetclosetothejugularforamen,weremeasuredtobearound1.3mm,6mmand8mmrespectively,thusconstitutinganapproximate68mm2infra-cochlearcorridor.Thisanalysisandfurtherstudywithlargersamplesmightbehelpfulforoperationviathiscorridorledtothepetrousapexwherecholesterolgranuloma,cholesteatomaandotherlesionsarenotuncommon.

简介：目的探讨4～6岁听障儿童看图讲述的特点及与健听儿童的差异。方法参考听障儿童语言能力评估标准中看图讲述能力三级水平,编制4幅彩图，对44名听障儿童和14名健听儿童进行测验。结果听障儿童看图讲述的得分存在显著的年龄差异（F=4.173，P＜0.05）；听障儿童与同龄健听儿童的得分也存在显著差异（P＜0.01）。结论听障儿童看图讲述的能力与其认知发展存在密切关系；4岁听障儿童看图讲述能力落后于同龄健听儿童。

简介：目的构建人野生型Cx30与红色荧光蛋白DsRed的融合蛋白表达载体,为揭示Cx30突变患者发病机制提供实验依据。方法用PCR法扩增GJB6基因,将PCR产物与T载体连接,用双切酶酶切pEASY-GJB6与载体DsRed-N1,连接回收后的片断,构建野生型Cx30编码序列与PDsRed2表达载体,测序鉴定序列正确性。将GJB6-DsRed用脂质体转染HEK293细胞,荧光显微镜观察表达的融合蛋白。结果GJB6-DsRed在HEK293细胞中高效表达,表达主要位于细胞膜中。结论成功构建了人野生型Cx30与红色荧光蛋白DsRed的融合蛋白表达载体,为进一步研究非综合征性聋的致聋机制奠定了基础。

简介：连接蛋白(connexins,Cxs)组成缝隙连接通道,使相邻细胞离子、代谢物质和分子量小于1～1.5kDa的信使分子直接转运.缝隙连接是细胞间通讯的结构基础,对胚胎发育、形态建成、增殖分化以及细胞群的协调活动具有重要意义.

简介：《喉科手术学》2000年出版，2002年第2次印刷。近十年间随着医学技术飞跃发展，喉科手术也在不断更新及创新。为了适应新的形式，人民卫生出版社于2007年出版了《喉科手术学》第2版。此版主要围绕有关保留、改菩喉功能的理论，特别是新发展的手术为主要增修内容，增加了与保留和改善喉功能研究发展相关的喉及喉咽的解剖及生理：增补了保留或改善喉功能的手术、喉显微手术、喉咽癌激光手术、喉返神经单、双侧麻痹及喉手术后喉功能不良新发展的喉功能整复术、喉误吸手术、喉蹼切除术、喉肉芽肿切除术、杓状软骨脱位、骨折和固定的整复术：补充了喉气管狭窄，喉、喉咽和颈食管癌等新的手术方法；充实了甲状腺肿瘤手术，颈淋巴结清扫术内容，

简介：目的考察3-6岁听障儿童语言功能发展的特点。方法利用《听障儿童语言功能评估》对202例3-6岁听障儿童进行跟踪评估,分别在基线期、6个月后、12个月后进行测试;对3次评估结果进行比较,分析不同年龄组之间的差异,并将听障儿童评估分数与健听儿童参考值对比。结果听障儿童的各项语言功能随时间推移极显著提高（P=0.000〈0.01）;听障儿童年龄越大,语言功能越强,年龄组之间存在显著差异（P〈0.05）;所有年龄段听障儿童基线评估得分均低于3岁健听儿童期望值,康复12个月后,3、4岁听障儿童达到同龄健听儿童期望值,5、6岁听障儿童和同龄健听儿童仍有差距。结论听障儿童的语言功能和健听儿童存在差距,但经过康复可有较大提升,且干预年龄越小,提升速度越快。

简介：Objective:TodemonstratetheperformancebenefitoftheAutomaticSceneClassifier（SCAN）algorithmavailableintheNucleus6（CP900series）soundprocessoroverthedefaultprocessingalgorithmsofthepreviousgenerationNucleus5（CP810）andFreedomHybridTMsoundprocessors.Methods:Eighty-twocochlearimplantrecipients（40Nucleus5processorusersand42FreedomHybridprocessorusers）listenedtoandrepeatedAzBiosentencesinnoisewiththeircurrentprocessorandwiththeNucleus6processor.Results:TheSCANalgorithmwhenenabledyieldedstatisticallysignificantnon-inferiorandsuperiorperformancewhencomparedtotheNucleus5andFreedomHybridsoundprocessorsprogrammedwithASCtADRO.Conclusion:TheresultsofthesestudiesdemonstratethesuperiorperformanceandclinicalutilityoftheSCANalgorithmintheNucleus6processorovertheNucleus5andFreedomHybridprocessors.

简介：王某,女,1994年8月30日出生,自幼听力言语障碍,出生后6个月发现听力下降,对用力呼叫无反应,否认各种疾病史.剖腹产出生、个人史、家族史、母亲妊娠史均无异常.1岁2个月会走路,体格发育正常.耳科检查外耳、外耳道、鼓膜均正常.听力检查:1996年12月11日北京儿童医院检查ABR100dB(nHL)双耳无反应;1996年12月13日中国聋儿康复研究中心做ABR125dB(SPL)无反应,40HzAERP125dB有反应;行为测听检查250Hz70dB500Hz80dB1KHz85dB2KHz90dB4KHz95dB有反应,鼓声检查(+),DPOAE检查双耳正常.门诊医生进一步检查言语,对语言的理解优于表达,可听懂一些指令,初步考虑高频听力损失严重及单纯性言语发育迟缓.

简介：TheGJB2gene(connexin26)hasbeenshowntoberesponsibleforDFNB1andDFNA3.WescreenedtheGJB2genein488patientswithprelingualdeafness(Group1),124withpostlingualdeafness(Group2),and117normalhearingsubjects(Group3).Wefoundthat,inGroup1,65patients(13.32%)werehomozygotesorcompoundheterozygotesand51patients(10.45%)carriedasinglepathogenicmutation.The235delCmutationwasthemostfrequentmutation,accountingfor73.22%oftheknownpathogenicallelesinGroup1.NohomozygotesorcompoundheterozygotesweredetectedinGroup2orGroup3.Somepostlingualdeafpatients(2.42%)andnormalhearingsubjects(4.27%)were235delCcarriers.Ourpreliminarydataindicatethat235delC,themostfrequentmutationidentifiedinthisstudy,isamajorcauseforprelingualdeafness.

简介：ObjectiveToinvestigatetheearlychangeofcochlearribbonsynapsesoninnerhaircellsinresponsetoaminoglycosideototoxicity.MethodsC57BL/6Jmicereceivedintraperitonealinjectionofgentamicin(100mg/kg/day),andtheapicalcoilorganofCortiwasexaminedonthe4th,7thand10thday(n=10).Litter-mateswithoutgentamicintreatmentservedascontrols(n=10).RIBEYEonthepresynapticmembraneandAMPAreceptorsonthepostsynapticmembranewerelabeledwithCtBP2orGluR2/3respectively.Threedi-mensionreconstructionwasconductedusingthe3DSMAX8.0software.ResultsTherewerenodisruptionsofouterorinnerhaircellsinallgroups.However,thenumberofribbonsynapsesoncochlearinnerhaircellsincreasedsignificantlywithin7daysaftergentamicinexposure(P<0.01),followedbyasignificantde-creaseafter7days.ConclusionDuringtheearlystageofaminoglycosideototoxicity,increasedpopulationofcochlearribbonsynapsesmayindicateasignificantdown-regulationofsynapticfunction.

简介：国家卫生部批准的国家级继续教育项目【2009-07-01—018（国）】耳显微及耳神经外科高级研修班将于2009年10月15日-19日在成都举行，由解放军总医院、北京同仁医院、北京协和医院、北医三院、北大人民医院、海军总医院、华中科技大学附属协和医院、上海复旦大学五官科医院、上海交大附属新华医院、上海交通大学附属上海第六人民医院、

简介：ObjectiveTostudycharacteristicsofhearinglossafterexposuretomoderatenoiseexposureinC57BL/6Jmice.MethodsMaleC57BL/6Jmicewithnormalhearingatageof5-6weekswerechosenforthisstudy.Themicewererandomlyselectedtobestudiedimmediatelyafterexposure(GroupP0),or1day(GroupP1),3days(GroupP3),7days(GroupP7)or14days(P14)afterexposure.Theirbeforeexposureconditionservedasthenormalcontrol.Allmicewereexposedtoabroad-bandwhitenoiseat100dBSPLfor2hours,ABRthresholdswereusedtoestimatehearingstatusateachtimepoint.ResultsABRthresholdelevationwasseenateverytestedfrequencyatP0(P<0.01).Elevationathigh-frequencies(16kHzand32kHz)wasgreaterthanatlowerfrequencies(4kHzand8kHz,P<0.05).FromP1toP14,ABRthresholdscontinuouslyimproved,andtherewasnosignificantdifferencebetweenP14andbeforeexposure(P>0.05).ConclusionThereisafrequencyspecificresponseto100dBSPLbroad-bandwhitenoiseinC57BL/6Jmice,withthehigh-frequencybeingmoresusceptible.HearinglossinducedbymoderatenoiseexposureappearsreversibleinC57BL/6Jmice.

简介：遗传性耳聋包括非综合征型耳聋non—syndromichearingimpairment，NSHI）和综合征型耳聋（syndromichearingimpairment，SHI），其中NSHI占70％，，遗传缺陷是以感音神经性聋为主，基本无其他异常；SHI占30％，临床表现除听力障碍以外还伴有其他症状和体征。迄今为止，发现400多个遗传性综合征与耳聋有关，140多个基因位点与NSHI有关，确定60多个耳聋基因。

简介：WehavedeliveredviralvectorscontainingeitherChop2fusedwithGFP,Channelrhodopsin-2(ChR2),orHalorhodopsin(HaloR)fusedwithmCherry(toformlightgatedcationchannelsorchloridepumps,respectively),intothedorsalcochlearnucleus(DCN).OnetoeighteenmonthslaterweexaminedtheCNandinferiorcolliculus(IC)forevidenceofvirallytransfectedcellsandprocesses.ProductionofChR2andHaloRwasobservedthroughouttheDCN.Rhodopsinlocalizationwithinneuronswasdetermined,withelongate,fusiformandgiantcellsidentifiedbasedonmorphologyandlocationwithintheDCN.ProductionofChR2andHaloRwasfoundatboththeinjectionsiteaswellasinregionsprojectingtoandfromtheDCN.LightdrivenneuronalactivityintheDCNwasdependentuponthewavelengthandintensityofthelight,withonlytheappropriatewavelengthresultinginactivationandhigherintensitylightresultinginmoreneuronalactivity.Transfectingcellsviaviraldeliveryofrhodopsinscanbeusefulasatracttracerandasaneuronalmarkertodelineatepathways.Inthefuturerhodopsindeliveryandactivationmaybedevelopedasanalternativetoelectricalstimulationofneurons.

简介：1耳科常用激光激光是继原子能、计算机以及半导体之后,人类的又一重大发明。因其前所未有的高能量、高精确性等特点,激光自发明伊始即被广泛应用于包括临床医学在内的各个领域。在耳科学领域,空间狭小、组织功能脆弱等特征使得耳科手术始终充满了挑战。近年来,随着显微设备、激光设备及手术技术的不断进步,激光技术在耳科学的应用日趋普及并取得了巨大的成功。

简介：目的总结人工耳蜗植入前中耳炎性病变,以及植入后中耳、内耳感染的治疗经验.方法术前2例分泌性中耳炎伴乳突粘膜病变和1例慢性中耳炎选择一期手术;1例中耳乳突炎,1例胆脂瘤行分期手术.5例患者耳后切口经面神经隐窝入路植入电极,1例乳突根治术后术中借卵圆窗和鼓岬定位耳蜗钻孔部位植入电极,术中均进行电极阻抗测试和听神经遥测反应测试.结果1例术后中耳炎伴迷路炎经保守治疗痊愈.所有患者植入耳蜗工作正常,随访10-40月未见与中耳炎相关的并发症.结论极重度感音神经性聋伴分泌性中耳炎患者,原则上应分期手术;合并中耳乳突炎者,也应分期手术,完壁式和经典式乳突根治,根据病情均可选用.但中耳炎静止期鼓膜小穿孔者,可考虑一期手术.