OBJECTIVES: This study aimed to evaluate the benefits of ClearVoice strategy on speech perception in noise and in everyday listening situations in Cantonese-speaking cochlear implant users. METHODS: Twelve experienced adult users of the Harmony implant and HiRes 120 sound processing participated in the study. The study employed a prospective within-subjects design wherein speech recognition in adults using HiRes 120 without ClearVoice turned on (control option) was compared to their performance with HiRes 120 with ClearVoice turned on. Each subject was evaluated with two different ClearVoice gain settings: -12 dB (ClearVoice medium) and -18 dB (ClearVoice high) after one-week of use. The Cantonese hearing in noise test and a questionnaire were used as the outcome measures. RESULTS: Subjects performed significantly better with ClearVoice medium than with control option in noise. No significant difference in performance was noted among the 3 settings in quiet. Most subjects reported high level of satisfaction with ClearVoice in daily listening situations and preferred to keep ClearVoice on. CONCLUSION: ClearVoice can help cochlear implant recipients to hear better in noise.
Adult ; Cochlear Implantation ; Cochlear Implants ; Hearing ; Humans ; Noise ; Prospective Studies ; Speech Perception ; Surveys and Questionnaires

Adult ; Aged ; Female ; Hepatitis, Chronic ; mortality ; therapy ; Humans ; Liver Failure ; therapy ; Male ; Middle Aged ; Prognosis ; Sorption Detoxification ; Survival Rate

Objective To compare the efficacy of percutaneous and endoscopic treatment for the biliary stricture(BS) after liver transplantation (LT).Methods The result of percutaneous transhepatic cholangiography (PTC) and drainage ( PTC group) and endoscopic retrograde cholangiopancreatography (ERCP group) for the BS in 132 post-LT patients were analyzed retrospectively.Ninety-nine patients received PTC treatment,and 59 patients received ERCP treatment,26 patients converted to PTC treatment because of the poor efficacy or failure of the ERCP treatment.The operation success rate,complication rate,cure rate and remission rate of the two groups were compared with X2 test.Results The BS types of PTC and ERCP group were different significantly( P ＜ 0.01 ),with more non-anostomotic stricture in PTC group and more anostomotic stricture in ERCP group.The operation success rate of PTC group was higher than of ERCP group( 100％ vs 97％ ) (P ＜0.01 ),and the complication rate of PTC group was lower than of ERCP group.The overall cure and remission rate of PTC and ERCP group were not different significantly(32.3％ vs 45.8％,94.9％ vs 88.1％ ) (P ＞0.05).The cure and remission rate of PTC and ERCP treatment for each subtype of BS were not different significantly ( P ＞ 0.05 ).Conclusions The efficacy of PTC treatment for the post-LT BS is equivalent to that of ERCP treatment.PTC can be considered the first-line option for the post-LT BS.

Anemia, Sideroblastic ; complications ; Bone Marrow Cells ; pathology ; Female ; Humans ; Hydrops Fetalis ; etiology ; Infant, Newborn ; Pancreatic Diseases ; complications

OBJECTIVETo study the epidemiological and clinical characteristics and risk factors of cirrhosis-related hepatocellular carcinomas (HCC) in patients with hepatitis C virus (HCV) infection.

METHODSEighty-nine compensated and decompensated HCV cirrhosis patients were analyzed and followed-up. The main clinical and laboratory variables were analyzed as incidence factors of HCC with univariate analysis and multivariate analysis regression models.

RESULTSThe patients were followed-up for 86 months. Thirty-five of the 89 patients had HCC during the 86 months follow-up. Their five and ten-year cumulative incidences were 16.9% and 40.4% respectively. Of the 35 HCC patients, 4 had a family history of hepatitis C, 12 had a familial history of HCC, and 7 had a history of alcohol ingestion. Five and ten-year cumulative incidences of HCC in patients with hepatic steatosis were 24.6% and 51.0% respectively. Five-year and ten-year cumulative incidences of HCC in patients with non-hepatic steatosis were 8.7% and 26.2% respectively, and the difference in the cumulative incidences between them was significant (P < 0.05). Hepatic steatosis severity was associated with the severity of the cirrhosis. ALT and TBil levels were higher in the HCC group than in the non-HCC group, ALB was lower in the HCC group than in the non-HCC group, and the differences between them were significant (P < 0.05). Child-Pugh score and the severity of the hepatic steatosis during follow-up were independently correlated with HCC.

CONCLUSIONHCC is the most important and frequent outcome of chronic hepatitis C cirrhosis. Child-Pugh score and the severity of the hepatic steatosis are related to the risk factors. History of alcohol ingestion and family history of hepatitis C are also related to liver cancer.

Aged ; Carcinoma, Hepatocellular ; etiology ; Female ; Follow-Up Studies ; Hepatitis C, Chronic ; complications ; Humans ; Liver Cirrhosis ; complications ; Liver Neoplasms ; etiology ; Male ; Middle Aged ; Risk Factors

Objective To evaluate the role of hepatic artery interventional therapy for the prevention and treatment of biliary complications in orthotopic liver transplantation(OLT) with hepatic artery stricture (HAS). Methods We retrospectively analyzed biliary complications of 22 OLT recipients with HAS from Oct 2003 to Mar 2006 and evaluated the role of hepatic artery interventional therapy. Results One of three OLT recipients receiving early retrieval second transplants died of severe infection. The remaining 18 recipients were complicated with elevated?-glutamyl transferase and alkaline phosphatase, among them eleven (61. 1%) developed biliary stricture(BS) ,1(5. 6%) suffered from biliary leakage. Six (50%) of the 12 patients receiving hepatic artery interventional therapy developed BS later which was ameliorated by biliary interventional treatment. One of 2 patients receiving no hepatic artery interventional therapy developed BS which was cured by conservative treatment. None of the 4 patients receiving hepatic artery interventional therapy after the establishment of BS was cured and 3 (3/4) were improved and 1 (1/4) continued to deteriorate after hepatic artery and biliary interventional treatment. Conclusions Patients with HAS after OLT have a high rate of biliary complications. The result of hepatic artery interventional therapy to prevent and treat biliary complications of the patients with HAS is not satisfactory.

Objective To construct RhoA siRNA plasmid expression vector.Methods According to the computer aided design,RhoA-specific siRNA gene was synthesized and cloned into the RNAi-Ready Pgenesil-1 Vector.The constructed RhoA-RNAi plasmid were transfected into human HEPG2 cell.Western blot was used to detect the effect of RhoA-RNAi plasmid.Results The recombinant was cloned and the se- quence was obtained.RhoA-RNAi plasmid can down-regulate the expression of RhoA in human hepatocel- lular carcinoma cell line HEPG2.Conclusion Successfully cloning the recombinant makes it possible for searching new mechanism of RhoA in hepatocellular carcinoma.

Objective To study the quantitative fiber tractography variations and 3D simulation patterns in patients with multiple sclerosis (MS),and assess the correlation between quantitative fiber tractography and scores of expanded disability status scale (EDSS).Methods MR diffusion tensor imaging was applied in 28 MS patients and 28 age-matched healthy volunteers.Then,quantitative tractography was generated in all subjects; and mean numbers of tracked lines and fiber density were measured.Paired-samples t tests were used to compare tracked lines and fiber density in MS patients with those in controls.Analysis of variance of ADC value and FA value was applied to MS patients having demyelinating plaque and normal appearing white matter,and controls.Linear regression model was used to determine the relationship between quantitative fiber tractography and scores of EDSS in MS patients.Results Tractography's tracked lines (2220±100) and fiber density (0.75±0.04) in MS patients were less than those in controls (2750±70) and (0.93±0.02,P＜0.05).In MS patients having plaque and normal appearing white matter,and controls,the ADC values of ROI were (1.23±0.13)× 10-3 mm2/s,(0.76±0.09)×10-3 mm2/s and (0.63±0.10)×10-3 mm2/s,respectively,with a gradual declined trend; and the FA values were 0.24±0.04,0.42±0.07 and 0.48±0.06,respectively,with a gradual increased trend; significant differences were noted between each 2 groups (P＜0.05).Both tracked lines and fiber density were found negative correlations with scores of EDSS in MS patients (P＜0.05).Conclusion Damages of white matter tracts in MS patients can be detected by diffusion tensor fiber tractography,and it provide more space information than conventional MRI.

OBJECTIVES: To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. METHODS: Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted before surgery. Device activation was arranged 8 weeks after operation. Audiometric testing was taken to evaluate the change in hearing. Patients were asked to wear the device and come back for fine tuning as needed. Outcome measurements were undertaken at 3 and 6 months after device activation. The outcome measures included sound-field thresholds, Cantonese Hearing in Noise Test (CHINT), Abbreviated Profile of Hearing Aid Benefit (APHAB) and International Outcome Inventory for Hearing Aids (IOI-HA). RESULTS: The application of the VSB improved the aided thresholds and improved speech intelligibility in quiet and noise without significant changes in hearing thresholds. CONCLUSION: VSB is considered as a safe, effective and reliable auditory rehabilitation option for Cantonese speaking adults with mixed hearing loss.
Adult ; Bone Conduction ; Ear, Middle ; Hearing ; Hearing Aids ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Noise ; Ossicular Prosthesis ; Outcome Assessment (Health Care) ; Prospective Studies ; Speech Intelligibility

BACKGROUNDAn epidemiologic link between hepatitis C virus (HCV) and abnormal glycometabolism had been established. This study was designed to investigate the prevalence of type 2 diabetes mellitus and insulin resistance, and to explore the relation between insulin resistance and hepatitis C virus genotype, serum hepatitis C virus-RNA level in chronic hepatitis C (CHC) patients.

METHODSThree hundred and fifty-nine consecutive patients (CHC, n = 296; chronic hepatitis B (CHB), n = 63) were evaluated. HCV genotyping was performed by restriction fragment method and serum hepatitis C virus-RNA quantified PCR for all CHC patients in the baseline serum. Fasting levels of insulin and glucose were measured in all patients and the homeostatic assessment of insulin resistance was calculated in the baseline serum.

RESULTSType 2 diabetes mellitus was diagnosed in 15.5% of 296 CHC patients. Insulin resistance was present in 23.8% of the 235 nondiabetic CHC patients, in 23.1% of the 182 nondiabetic and noncirrhotic CHC patients, and associated with high serum HCV RNA level (OR: 1.754; 95%CI: 1.207 - 2.548, P = 0.003) and age > 40 years (OR: 3.542; 95%CI: 1.257 - 9.978, P = 0.017). Insulin resistance was less frequent in CHB than in matched CHC (7.9% vs. 21.4% respectively, P < 0.0001).

CONCLUSIONThe incidence of insulin resistance in CHC was significantly higher than that in CHB patients, associated with high serum HCV RNA level and age > 40 years.

Adult ; Aged ; Blood Glucose ; metabolism ; China ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; virology ; Female ; Genotype ; Hepacivirus ; classification ; genetics ; pathogenicity ; Hepatitis C, Chronic ; blood ; metabolism ; virology ; Humans ; Insulin ; blood ; Insulin Resistance ; genetics ; physiology ; Male ; Middle Aged ; Polymerase Chain Reaction ; RNA, Viral ; genetics ; Risk Factors