BACKGROUND: Extended high frequency audiometry is able to detect early cochlea damage. So it is useful in monitoring ototoxic, senile and noise induced hearing loss.OBJECTIVE: To study with extended high frequency audiometry the auditory function of people in highland of qinghai province without noise pollution and evaluate the sensitivity of this method in diagnosing early noise induced hearing loss. To provide the epidemiological data for early control of noise induced hearing loss in this area.DESIGN:It is a transverse comparison among normal people in two areas.SETTING: This study was cooperated by the Otolaryngeal Department of Gulou Hospital affiliated to Nanjing Medical College, the Otolaryngeal Department of Xijing Hospital of the Fourth Medical College and Auditory Research Center of Giessen University, Germany.PARTICIPANTS: Totally 300 people lived in highland of qinghai province received hearing test including extended high frequency audiometry. At the same time another 300 people were chosen in Nanjing city as control group.METHODS: The subjects in the two groups received the whole set of hearing tests including extended high frequency audiometry and answered a questionnaire about their personal history. The mean hearing thresholds from 0. 25-16 kHz between the two groups were compared with t-test.MAIN OUTCOME MEASURES: The difference of mean hearing thresholds from 0. 25-16 kHz between the two groups.RESULTS: There was no significant difference between hearing threshold of low frequencies and speech frequencies. The hearing threshold of high frequencies rose with the stepping-up of testing frequencies which made the possibility of measuring the hearing threshold reduced. But the hearing threshold above 6 kHz of the people in area without noise pollution was significantly higher than that of the control( P ＜ 0.05) . No difference between children and adolescence was found in the 2 groups. The epidemiological data revealed that the people without noise pollution had unperceptible hearing damage compared with the control group.CONCLUSION: The damage of impulsive noise to hearing began at 20 kHz and developed from 20 kHz to 10 kHz. If it was not protected, it would be extended to the speech frequencies and the hearing loss would get worse. So the extended high frequency audiometry was thought helpful to screen noise induced hearing loss early.

Objective To observe the application effect of point massage combined with physiotherapy in the treatment of insomnia for community elderly.Methods 30 elderly patients with insomnia who accepted point massage combined with physiotherapy were selected as observation group,and 30 elderly patients treated in tertiary hospital with insomnia who took alprazolamum for treatment were selected as control group.The SRSS score of the two groups before and after treatment,as well as treatment efficacy were compared.Results The insomnia treatment efficacy of the observation group was higher than that of the control group(Z =2.45,P <0.05).The SRSS rating of the observation group before treatment was (30.76 ±7.1 9)points and after treatment was (1 5.43 ±3.95)points.The SRSS rating of the control group before treatment was (32.33 ±6.98)points,which after treatment was (21 .93 ±6.73)points.The SRSS scores of both two groups after treatment were decreased (t =1 0.23,5.87,all P <0.05),with obvious differ-ences.The SRSS scores of the observation group decreased more obviously and was lower than that of the control group (t =4.56,P <0.05).Conclusion The point massage combined with physiotherapy can effectively improve insomnia of the elderly,which is also with advantages of easy operation and no obvious side effects and high cooperation degree etc,and it is suitable to be promoted in community.

Objective To survey the dietary iodine intake among residents in the coastal province of Fujian after universal salt iodization. Methods Using multi-stage stratified random sampling method, four different geographic areas of coastal cities, inland cities, coastal rural and inland rural areas were selected; 3 counties (cities, districts) were selected from each area; 30 families were selected from each of those counties (cities, districts). Total dietary study method was applied to investigate the basic information, all food and water intake during the investigation, the spice variety, quantity and cooking methods, and recipes. All foods consumed were divided into 13 classes:grains and their products, beans(including nuts) and their products, potato and its products, meat and its products, eggs and their products, aquatic products, milk and dairy products, vegetables, fruits and their products, sugar and sugar products, beverage and water, alcohol and seaweeds. Food samples were collected and iodine contents of different types of food were measured, and daily food consumption of the reference man(adult male) in the four areas was calculated. Then the male adult dietary iodine intake in the four areas and Fujian Province was estimated. Results A total of 69 families(accounting for 19.2% of the 359 families surveyed) ate seaweed foods during the three days survey period. The average salt intakes per reference man were 4.5, 5.8, 7.5, 12.3 g, respectively, in coastal cities, inland cities, coastal rural and inland rural. The adult male dietary iodine intake in Fujian Province was 343.8μg/d, and the values were 234.4, 347.1, 328.4, 465.3μg/d, respectively, in coastal cities, coastal rural, inland cities and inland rural. If people did not eat seaweed foods, the results would be 239.7, 137.5, 253.6, 200.3, 367.4μg/d. The main sources of dietary iodine intake were vegetables (33.2%), seaweeds(30.3%), meat(13.4%) and aquatic products(13.0%). If people did not eat seaweed foods, the results would be vegetables(47.6%), meat(19.1%) and aquatic products(18.7%), and iodine contribution rate of the 3 types of food was 85.4%. Conclusions Under the conditions of eating iodized salt, male adult dietary iodine intake is appropriate in different areas of Fujian Province. There is no such problem as iodine excessive. Iodized salt is the main source of dietary iodine. Residents in coastal city, if not eating seaweed foods, will be at risk of iodine deficiency, even if they eat iodized salt.