Objective To explore the role of multi-media teaching in the ENT physician training. Methods 32 further-study professionals were randomly divided into 2 groups. The control group received traditional teaching methods(n = 16), and the experimental group received the multi-media teaching method (n = 16). After the training, all trainees would take the theory test and skill assessment Results The basic theory and clinical skill scores of the experimental group are better than the control group at the end of the training. Conclusion Multi-media teaching method is very suitable for ENT refresher training.

Objective To investigate the combining anticancer effect of tamoxifen(TAM) and ?-interferon on breast cancer cells in vitro and its mechanism.Methods MCF-7 ER-positive breast cancer cell lines were treated with tamoxifen alone,or in combination with ?-interferon and/or estrogen in vitro.Cell proliferation was evaluated by MTT assay;FCM was used to determine the distribution of cell cycle,cell apoptosis and protein expression of Bcl-2,Bax,Fas,FasL,Caspase-8,and the activity of Caspase-3.Results TAM inhibited the proliferation of ER-postive breast cancer cells with cell cycle arrest in G0/G1 phase and with induction of apoptosis,and the proliferation-promoting effect of estrogen on MCF-7 was blocked by TAM.Anticancer effect of TAM was enhanced when cells were pretreated with ?-interferon for 24 hours.Bcl-2 protein expression was down-regulated and Caspase-8 was up-regulated by TAM and/or ?-interferon,but these drugs did not affect Bax,Fas,FasL protein expression and the activity of Caspase-3.Conclusions TAM has anticancer effect by inhibiting proliferation and inducing apoptosis in ER-positive breast cancer cells in vitro,and ?-interferon can enhance anticancer effect of TAM on breast cancer cells.The mechanism of these effects may be related with the down-regulation of Bcl-2 expression and up-regulation of Caspase-8 by TAM and ?-interferon.

Objective To investigate the effect of PBL teaching method in the otomicrosurgery anatomy training.Methods 40 students were randomly divided into 2 groups:the control group received traditional teaching methods(n=20),and the experimental group received the PBL teaching method(n = 20).After the training,all trainees would accept the theory test,while all anatomical specimens of the two groups would receive clinical skills ratings.Results The scores of the basic theory and clinical skills of the experimental group are better than the control group at the end of the training.Conclusion PBL teaching method is very suitable for otomicrosurgery anatomy training and can enable students to achieve better results.

OBJECTIVE: To explore the function of outer hair cells and its influencing factors in the workers of occupational exposure to low frequency electric and magnetic fields. METHOD: 502 high-strength LF EMFs-exposed workers were taken as the study subjects. The field intensity indicator and noise analyzer were employed for the examination of the electromagnetic energy intensity and noise value at the working sites. Self-administered questionnaires were adopted. Universal hearing screening by distortion product otoacoustic emission (DPOAE) and pure tone audiometry (PTA) were done. 100 workers who had abnormal POAE were taken as the observation group and 100 workers who had normal DPOAE were taken as the control group. The workers need be confirmed with ABR testing when the pure tone threshold of two consecutive frequencies were above 20 dB HL or DPOAE detection in any frequency did not pass. Multiple factor analysis with logistic regression was performed for the risk factors. RESULT: The average electric power density in job locations was 21-38 KV/m, which was higher than national standard (< 5 kv/m). Average noise-level in job locations was 52-65 dBHL, which was within the standard (< 85 dB(A). Questionnaire presented that low frequency electric and magnetic fields might increase the incidence of headache, insomnia and tinnitus in the observed group. The incidence of abnormal DPOAE was higher in the subjects of the observed group (P < 0.01). At 676, 933, 3616, 5 130, 7253 Hz, the DPOAE amplitudes of the observed group workers were significantly lower than the control group. Multivariate analysis showed that the risk factors of abnormal DPOAE included exposure of EMF, length of service, daily exposure time, conservatory measures might be protective factors. CONCLUSION The changes of DPOAE indicated that the exposure to low frequency electric and magnetic fields had a subtle, discreet and localized impairing effects on outer hair cells. Exposure of low frequency electric and magnetic fields, length of service, daily exposure time might be risk factors, conservatory measures might be protective factors.
Auditory Threshold ; Case-Control Studies ; Electromagnetic Fields ; adverse effects ; Hair Cells, Vestibular ; pathology ; Humans ; Magnetic Fields ; adverse effects ; Male ; Noise ; adverse effects ; Occupational Exposure ; Surveys and Questionnaires

OBJECTIVE: Our purpose was to investigate occupational high-strength very low frequency electric and magnetic fields (VLF EMFs) and assess changes of function of the inner ear. METHOD: The people exposed to high-strength VLF EMFs were divided into three groups: long- term exposure group ( > 5 years), short-term exposure group (< 5 years) and the control group. The field intensity indicator and noise analyzer were employed for the examination of the electromagnetic energy intensity and noise value at the working sites. Self-administered questionnaire was adopted. Universal hearing screening by pure tone audiometry (PTA) and distortion product otoacoustic emission (DPOAE) were done. The subjects who failed the screening tests were confirmed with auditory brainstem response (ABR) test. RESULT: The frequency of the electromagnetic field was 20 kHz, the average electric power density in job locations was 21-38 kV/m, which was higher than national standard (< 5 kV/m). Average noise-level in job locations was 52-65 dBHL, which was within the standard. Questionnaire presented that VLF EMFs might increase the incidence of headache, insomnia and tinnitus in long-term exposure. The incidence of abnormal DPOAE was higher in the subjects of the long-term exposure group than the short-term exposure group and the control group (P < 0.01). At 676, 933, 3616, 5130, 7253 Hz, the DPOAE amplitudes of the long term exposure group workers were significantly lower than the short-term exposure group and the control group. There was no obvious difference of the incidence of abnormal DPOAE between the short-term exposure group and the control group. The result of ABR with those subjects with abnormal DPOAE were no significant abnormalities. CONCLUSION The average electric power density in job locations was significant worse than health standards. The changes of DPOAE indicated that the exposure to high-strength VLF EMFs had a subtle, discreet and localized impairing effect on outer hair cells. Effective intervention measures should be taken.
Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; Electromagnetic Fields ; adverse effects ; Hair Cells, Auditory ; radiation effects ; Humans ; Male ; Occupational Exposure ; Otoacoustic Emissions, Spontaneous ; Surveys and Questionnaires

Objective:To evaluate the correlation between ultrasound parameters of internal carotid artery blood flow and regional cerebral oxygen saturation (rScO 2) in elderly patients undergoing coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). Methods:Sixty-four elderly patients undergoing elective CABG under CPB, aged 60-80 yr, regardless of gender, with body mass index of 18.1-28.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with New York Heart Association class Ⅱ or Ⅲ, with left ventricular ejection fraction≥50%, were selected. The rScO 2 and ultrasonic parameters of internal carotid artery including peak systolic velocity (PSV-ICA), end-diastolic velocity (EDV-ICA), diameter (D-ICA) and blood flow volume (Q-ICA) were recorded before anesthesia induction (T 0), at surgical skin incision (T 1), at 30 and 60 min of CPB (mean value was calculated, T 2), and at 30 and 60 min after termination of CPB (mean value was calculated, T 3). The ratio of unilateral internal carotid artery blood flow to cardiac output (Q/CO) was calculated. The receiver operating characteristic curve was used to analyze the accuracy of ultrasound parameters of internal carotid artery blood flow in predicting rScO 2 < 60%. Results:PSV-ICA was positively correlated with rScO 2 at T 0, T 1 and T 3 ( P<0.05), but no correlation was found between PSV-ICA and rScO 2 at T 2 ( P>0.05). There was no correlation between EDV-ICA and rScO 2 at each time point ( P>0.05). Q-ICA was positively correlated with rScO 2 at each time point ( P<0.05). Q/CO was not correlated with rScO 2 at T 1 ( P>0.05), but Q/CO was positively correlated with rScO 2 at T 2 and T 3 ( P<0.05). During the non-CPB period (T 0, T 1, T 3), the cutoff values of PSV-ICA and Q-ICA in predicting rScO 2< 60% were 51.35 cm/s and 283.5 ml/min respectively, the sensitivity was 0.900 and 0.900 respectively, and the specificity was 0.610 and 0.857 respectively (AUC=0.761, P=0.006; AUC=0.903, P< 0.001). During the CPB period, the cutoff values of Q-ICA and Q/CO in predicting rScO 2<60% were 296.5 ml/min and 5.84% respectively, the sensitivity was 0.900 and 0.800, and the specificity was 0.545 and 0.659 (AUC=0.764, P=0.001; AUC=0.748, P=0.002), respectively. Conclusions:PSV-ICA and Q-ICA are positively correlated with rScO 2 during the non-CPB period, and Q-ICA and Q/CO are positively correlated with rScO 2 during the CPB period in elderly patients undergoing CABG. PSV-ICA, Q-ICA and Q/CO can accurately predict rScO 2<60%.

Objective To assess the impact of intravenous esketamine administered prior to car-diopulmonary bypass(CPB)initiation on ventricular function and internal carotid artery blood flow in pa-tients undergoing heart valve replacement surgery.Methods Sixty patients underwent elective CPB heart valve replacement,38 males and 22 females,aged 18-75 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅱ or Ⅲ,NYHA cardiac function classification Ⅰ-Ⅲ,and a left ventricular ejection fraction(LVEF)of≥45％,were selected.The patients were randomly divided into two groups:esketamine group(group E)and normal saline group(group C),30 patients in each group.Total intravenous anesthesia was used during the operation.Following the initiation of CPB,group E received an intravenous infusion of es-ketamine at a rate of 0.5 mg·kg-1·h-1 until the conclusion of the procedure,while group C received an equivalent volume of normal saline concurrently at the same rate.HR,MAP,CVP,and cardiac output index(CI)were recorded before anesthesia induction,during skin resection,and within 60 minutes after stopping CPB.LVEF,left ventricular global longitudinal strain(GLS),global longitudinal time-to-peak strain standard deviation(GLTSD),global circumferential strain(GCS),global circumferential time-to-peak strain standard deviation(GCTSD),right ventricular ejection fraction(RVEF),right ventricular GLS,and GLTSD were obtained during skin resection,within 40 minutes of CPB,and 60 minutes after stopping CPB.rScO2,BIS,concentrations of Hb and lactic acid(Lac),peak systolic flow velocity(SPV),quantity of flow-internal carotid artery(Q-ICA),and blood flow resistance index(RI)were recorded before anesthesia induction,during skin resection,within 40 minutes of CPB,and within 60 minutes after stopping CPB.Concentrations of cardiac troponin Ⅰ(cTnⅠ),alanine aminotransferase(ALT),creatinine(Cr),and neuron-specific enolase(NSE)were recorded before anesthesia induction and 6 hours after operation.Spon-taneous resuscitation after CPB,postoperative extubation time,duration of ICU stay,total hospital stay,in-cidence of adverse cardiac events,and 30-day postoperative mortality were recorded.Results Compared with group C,group E exhibited a significant increase in CI within 60 minutes after stopping CPB(P＜0.05).The LVEF,RVEF,and right ventricular GLS demonstrated significant increases within 60 minutes after stopping CPB in group E compared with group C(P＜0.05).The left ventricular GLS and left ven-tricular GCTSD displayed significant increases 30 minutes after stopping CPB in group E compared with group C.The RI exhibited a significant increase within 40 minutes of CPB in group E compared with group C(P＜0.05).There were no significant differences in cTnⅠ,ALT,Cr,NSE,spontaneous resuscitation affter CPB,postoperative extubation time,duration of ICU stay,total hospital stay,incidence of cardiac adverse events,and 30-day postoperative mortality between the two groups.Conclusion Administration of esket-amine following the onset of CPB in patients undergoing cardiac surgery demonstrates a significant elevation in CI post-CPB cessation.Furthermore,it may augment ventricular longitudinal strain,thereby enhancing myocardial contraction,leading to increased postoperative ventricular ejection fraction,and sustaining hemo-dynamic stability.