Based on the performance management theories and methods, the factors affecting clini-cal teachers' teaching motivation were analyzed in domestic university affiliated hospitals. In consideration of the functional position of university affiliated hospitals and the responsibilities of clinical teachers, the Delphi, KPI and other methods were used to identify key index and respective weight of teaching perfor-mance evaluation, therefore the teaching performance evaluation system including teaching load, teaching quality and teaching capacity in three dimensions were constructed. Then this index system was applied to a university affiliated hospital as an example to verify its feasibility, scientificity and effectiveness. Further-more, the evaluation system was embedded to information platform of educational administration manage-ment, and was proved as a useful teaching performance information management tool that provided reference for hospital performance payment distribution, title evaluation and recommendation, and teaching awards evaluation at all levels, etc. Consequently, theoretical and methodological references were provided for improving clinical teachers' teaching enthusiasm.

Objective To explore the value of SERVQUAL in surgical nursing of acetabular dysplasia adult patients.Methods A total of 83 adult acetabular dysplasia patients were selected as research objects,totally 41 patients without SERVQUAL modelscale were selected as the control group,and 42 patients with SERVQUAL model scale were selected as the observation group,care quality and nursing ability,satisfaction,treatment compliance rate and the incidence of nursing work defects of two groups were analyzed.Results The observation had higher nursing ability score and nursing quality score,higher nursing satisfaction and treatment compliance,and lower the incidence of nursing work defects than that of the control group (P ＜ 0.05).Conclusion SERVQUAL applied in the surgical care of adult patients with acetabular dysplasia can effectively improve the quality of care,and nursing ability,enhance patients'satisfaction and compliance,greatly reduce the incidence of nursing work defects,and guarantee the smooth operation,so it is worth promoting.

Objective To explore the value of SERVQUAL in surgical nursing of acetabular dysplasia adult patients.Methods A total of 83 adult acetabular dysplasia patients were selected as research objects,totally 41 patients without SERVQUAL modelscale were selected as the control group,and 42 patients with SERVQUAL model scale were selected as the observation group,care quality and nursing ability,satisfaction,treatment compliance rate and the incidence of nursing work defects of two groups were analyzed.Results The observation had higher nursing ability score and nursing quality score,higher nursing satisfaction and treatment compliance,and lower the incidence of nursing work defects than that of the control group (P ＜ 0.05).Conclusion SERVQUAL applied in the surgical care of adult patients with acetabular dysplasia can effectively improve the quality of care,and nursing ability,enhance patients'satisfaction and compliance,greatly reduce the incidence of nursing work defects,and guarantee the smooth operation,so it is worth promoting.

OBJECTIVE: To investigate the pure tone audiometry characteristics and curative effect in sudden hearing loss patients with hypertension. METHOD: One hundred and fifty-seven inpatients (168 ears) with hypertension suffered from sudden hearing loss were included in this study. We retrospectively analyzed the audiological index of these patients by comparing the pure tone audiometry (PTA) among patients in the aspects of gender, age, affected side, duration of hypertension, with or without inducement, concomitant symptoms and other combined diseases. The hearing threshold at different frequency was also compared, as well as the curative effect among patients with diverse audiological characteristics. RESULT: Of the contemporaneous sudden hearing loss patients (874 cases), the prevalence of hypertension was 17.96%, where the male ones accounted for. 28.69% (103/359) and the female ones accounted for 19.42% (54/278) respectively with statistically significant difference between genders (P < 0.01). The prevalence of hypertension in 34-44 years old group, 45-49 years old group, 60-69 years old group and over 70 years old group was 12.69% (25/197), 22.51% (70/311), 47.62% (40/84), 48.89% (22/45) respectively, which were statistically different (P < 0.01). The number of impaired ears with audiogram configuration characterized by rise type, downslope type, flat type and completely deafness type was 18 (10.71%), 61 (36.31%), 41 (24.40%), and 48 (28.57%), respectively. The decrease of hearing threshold in PTA were increasingly severe as the increasing impaired-frequency, and the difference of the degree of hearing impairment among these three types of frequencies was statistically significant (P < 0.01). The hearing threshold means of each frequency had no significant difference among patients with various gender, age and Cardiovascular Risk Stratification (P > 0.05). The hearing threshold means of each frequency of unilateral hearing loss patients was significantly higher than that of bilateral hearing loss patients (P < 0.05). The hearing threshold means at 125 Hz, 250 Hz, 500 Hz and 1 kHz showed significant difference among patients with different duration of hypertension (P < 0.05). The total effective rate of sudden hearing loss in patients with hypertension was significantly lower than that in the sudden hearing loss patients without hypertension (19.64%, 61.57% respectively, P < 0.01). The total effective rate presented significant difference among patients with different duration of hypertension and different Cardiovascular Risk Stratification (P < 0.05). CONCLUSION The prevalence of sudden hearing loss in hypertension patients was higher in male than in female, which rose with age and combined disease. The hearing threshold means at mid-frequency and high-frequency were higher than that at low-frequency. The total effective rate of sudden hearing loss was relatively low in patients with hypertension. The longer the duration of hypertension and the higher the Cardiovascular Risk Stratification, the lower the total effective rate. Comprehensive understanding of audiological characteristics and hypertension condition plays a crucial role in type-specific treatment of sudden hearing loss.
Adult ; Aged ; Audiometry, Pure-Tone ; Deafness ; Female ; Hearing Loss, Bilateral ; Hearing Loss, Sudden ; complications ; Hearing Loss, Unilateral ; Hearing Tests ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

OBJECTIVE: To investigate the characteristics of tinnitus in patients with auditory neuropathy spec- trum disorder (ANSD). METHOD: This study recruited 14 ANSD patients with tinnitus. All the ANSD patients un- derwent detailed history taking, audiological examinations and assessments of tinnitus. This study analyzed the correlation of tinnitus status and hearing loss, and discussed the effects of sex, age, and the course of disease on tinnitus in ANSD patients. RESULT: (1) In the ANSD patients, tinnitus often occurred in 3 years after the onset of hearing loss; (2) Tinnitus was highly prevalent in ANSD patients, and the severity of tinnitus was mostly from mild to moderate; (3) There was no obvious correlation between the subjective grading of tinnitus and hearing loss de- gree, and the impact of curve patterns of hearing loss on the level of tinnitus need much more evidence-based proof; (4) Along with the course extension, the impact of tinnitus on the quality of life was much more obvious; (5) Some risk factors such as noise exposure could be the reasons of aggravating the degree of tinnitus. CONCLUSION Tinnitus in ANSD patients has its unique clinical features. The study of Tinnitus in ANSD patients can provide clinical basis for further research in ANSD.
Hearing Loss ; Hearing Loss, Central ; complications ; diagnosis ; Humans ; Prevalence ; Quality of Life ; Tinnitus ; complications ; diagnosis

OBJECTIVE: To investigate the efficacy of combined medical treatment on auditory neuropathy spectrum disorder and the effect of related factors on the prognosis. METHOD: Eleven cases (22 ears) diagnosed as auditory neuropathy spectrum disorder using multiple criteria including pure tone auditory threshold, impedance audiometry, acoustic reflexes, distortion products otoacoustic emission (DPOAE) and auditory brainstem response (ABR) were subjected to combined medical treatment . Eleven auditory neuropathy spectrum disorder patients diagnosed during the corresponding period but refused treatment were selected as control group. The change of pure tone auditory threshold and speech discrimination score after treatment or follow-up were evaluated for both 2 groups, and the relationship between the patients' gender, age, accompanying symptoms and curative effect were also analyzed. Data were analyzed by SPSS 19.0 statistical software using pared-sample t-test, independent-sample test and Pearson's chi-square test. RESULT: The effective rate of combined medical therapy was 59.09% (13/22) in the therapy group. PTA levels before and after-treatment were (53.92 +/- 18.86) dB HL and (47.44 +/- 14.98) dB HL respectively in 22 ears with the combined medical therapy, the improvement of which showed statistically significance (t = 5.20, P < 0.05). No obvious hearing change was noted in the 11 patients who refused therapy (P > 0.05). Speech discrimination score before and after-treatment were (29.20 +/- 25.80)% and (41.60 +/- 22.90)% respectively for the treatment group. The average improvement of speech discrimination score was (12.40 +/- 13.80)% with statistically significant difference (t = 4.02, P < 0.05). Patients accompanied with tinnitus had relatively poorer effect compared with individuals without tinnitus (t = -3.85, P < 0.05). Age is negatively correlated with the prognosis (r = -6.72, P < 0.05). Gender had no effect on the prognosis (P > 0.05). CONCLUSION The combined medical therapy with glucocorticoids helps improving the pure tone auditory threshold and speech discrimination score of auditory neuropathy spectrum disorder. In light of our findings we support the combined medical therapy as an option for patients with auditory neuropathy spectrum disorder.
Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Hearing Loss, Central ; drug therapy ; Humans ; Infant ; Male ; Treatment Outcome ; Young Adult

Objective To explore the clinical application value of three-dimensional reconstruction of maxillary canine pulp volume /tooth volume (PV/TV)in individual gender determination.Methods There were 103 patients (51 males and 52 females) with CBCT imaging data from September 2015 to August 2016, Shanxi Medical University, department of radiology, Mimics 17.0 software was used to measure pulp volume of maxillary canines and tooth volume, and to calculate the ratio of pulp volume/tooth volume.The data were processed by SPSS16.0 statistical software and Fisher discriminant method. The gender determination function was obtained and Cross -Validated method for performance evaluation. Results When gender determination was determined by tooth volume (TV) and pulp volume/tooth volume (PV / TV) as the study index, the gender discriminant function was Y=0.009(TV)+28.896(PV/TV) - 6.962, Cross-validated method for the effect of evaluation, to determine the compliance rate: 51 males, the correct rate of 64.7%;52 female, the correct rate of 78.8%. Conclusion The tooth volume (TV) and pulp volume/tooth volume (PV/TV)can be used as a research indicator of gender inference, it provides a new method and avenue for the gender determination in forensic medicine.

OBJECTIVE: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. METHOD: Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. RESULT: Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate. CONCLUSION There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.
Audiometry, Pure-Tone ; Deafness ; Hearing Loss ; Hearing Loss, Sensorineural ; complications ; pathology ; Humans ; Tinnitus ; complications ; pathology

Objective To investigate the association between the plasma levels of 20 amino acids and the risk of diabetes in middle-aged and elderly population.Methods This study was a part of the Chinese multi-provincial cohort study conducted in communities of Shougang.In 2007 and 2012,the population was investigated for diabetes and other risk factors.Blood samples collected from 475 people were tested for various amino acid levels by liquid chromatography-tandem mass spectrometry.A multivariate logistic regression analysis was used to analyze the association between plasma amino acid levels and diabetes risk.Results The age of the selected population at baseline was (58.7±6.3) years,and the blood glucose level at baseline was (5.68 ± 1.34) mmol/L.Among them,56 (11.79％) subjects were diabetes.Multivariate logistic regression analyses showed that after adjusting for age,gender,body mass index,systolic blood pressure and dyslipidemia,individuals with plasma branched-chain amino acid (valine,leucine and isoleucine) and cysteine in the highest tertile levels were at high risk of diabetes with the ORs of 3.61 (95％ CI 1.48-8.80),3.27 (95％ CI 1.34-7.99),2.46 (95％ CI 1.04-5.84) and 2.09 (95％ CI 1.02-4.27),respectively.After 5 years' followed up,5.73％ (24/419) subjects developed diabetes.Compared with those in the lowest tertile,individuals with plasma branched-chain amino acid (total concentration),phenylalanine,and tyrosine levels at baseline in the highest tertile had 3.69 times,3.61 times and 4.14 times higher risk to develop new diabetes,respectively.In contrast,individuals with plasma glycine level in the highest tertile had only 76％ (OR 0.24,95％ CI 0.06-0.91) risk for the development of diabetes compared with those with plasma glycine level in the lowest tertile.Conclusions The increase in plasma branched-chain amino acid and cysteine levels is significantly associated with an increase in incident diabetes.Subjects with higher levels of branched-chain amino acids and aromatic amino acids (phenylalanine,tyrosine) had a significantly higher risk of developing new-onset diabetes,while those with higher glycine levels had a significantly lower risk of developing diabetes in 5 years.

Objective:To assess whether apolipoprotein E-containing HDL-C (APOE-HDL-C) is causally associated with coronary heart disease (CHD) risk.Methods:In total, 5 417 cardiovascular disease-free participants at baseline were followed up for up to 10 years in the Chinese Multi-provincial Cohort Study. APOE-HDL-C and HDL-C were measured in all participants. APOE-HDL-C/total HDL-C ratio was calculated. Multivariate Cox regression was employed to assess the association between HDL-C related biomarkers and 10-year CHD incident risk.Results:A total of 100 incident CHD events occurred during a mean 6.8 years follow-up. High levels of baseline HDL-C related biomarkers were significantly negatively associated with incident CHD risk. Comparison with participant with lowest level of APOE-HDL-C/total HDL-C ratio, those with highest level of APOE-HDL-C/total HDL-C ratio had 74% decreased risk of CHD ( HR=0.26, 95% CI: 0.12-0.71). The individual with the highest level of APOE-HDL-C/total HDL-C ratio had the lowest absolute risk[0.48% (0.44%-0.52%)] of CHD, which was significantly lower than that [0.83% (0.78%-0.88%)] of the individual with the highest level of HDL-C. Conclusions:Our findings revealed that the APOE-HDL-C/total HDL-C ratio was significantly related to a 10-year increased risk of incident CHD, even beyond HDL-C. It seemed that APOE-HDL-C could serve as a new indicator of the anti-atherosclerotic function of HDL.