Objective To study the normal ranges and features for click-auditory brainstem responses of children in 3~5 years old.Methods Normal results of click-ABR from 132 normal children (224 ears)were ana-lyzed.The children were divided into three groups:Group A (74 ears from children of 3 years old),Group B (78 ears from children of 4 years old)and Group C (72 ears from children of 5 years old).The ABR data were statisti-cally analyzed by ANOVA with SPSS.Results At 80 dB nHL,the wave Ⅰ,Ⅲ,and Ⅴ latencies and intervals of wave Ⅰ- Ⅲ,and wave Ⅰ-Ⅴ of ABR for 3 -year old children were 1.24 ±0.09 ms,3.53 ±0.16 ms,5.39 ± 0.23 ms,2.30±0.15ms and 4.15 ±0.22 ms,respectively,and for 4 -year-old children,they were1.23 ±0.10 ms,3.52±0.39 ms,5.30±0.21 ms,2.28±0.39 ms and 4.07 ±0.22 ms,respectively.For 5 - year-old chil-dren,they were1.24±0.10 ms,3.67±0.63 ms and 5.34±0.19 ms,2.42±0.63 ms and 4.09±0.19 ms,respec-tively.The thresholds for 3-year children were 22.57 ±4.40 dB nHL,for 4 - year children,21.15 ±4.83 dB nHL,and for 5 - year children,21.11±3.48 dB nHL.Among three groups,only latency of wave V and interval of wave I-V had statistical differences,and a further analysis showed the statistical differences in Groups A and B. No statistical differences were observed in Groups B and C.The latency of wave I and thresholds of ABR for the children of different ages were not significantly different.Conclusion The resvits of this study suggest the brainstem may mature at 4 years old.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus)in patients with metabolic syndrome combined with sensorineural deafness using 1 H magnetic resonance spectroscopy (1 H-MRS),and to find out the early warning indicators of sensorineural deafness in patients with metabolic syndrome.Methods The pure tone audiometry (PTA)was performed in 142 pa-tients with metabolic syndrome (diagnosed by endocrinology department),and 15 healthy subjects as the control group.The patients were divided into four groups:the metabolic syndrome group;the metabolic syndrome group with unilateral,the bilateral deafness group,and the control group.Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate contrast to choline (NAA/Cho)as well as to creatine (NAA/Cr),myo-inosi-tol to creatine (mI/Cr)and choline to creatine (Cho/Cr)ratios in the auditory cortical separately in these groups. ROC curves were made for those metabolism markers to find the best diagnostic threshold.Results Significantly lower values of NAA/Cho ratio and higher values of Cho/Cr were observed in metabolic syndrome in the control group (P<0.05),Cho/Cr higher than those (P<0.05).NAA/Cho ratios in the injured and uninjured auditory cortex of MS with unilateral deafness were significantly lower than those in the control group (P<0.05).A self-comparison was made between the inj ured and uninj ured auditory cortex,the result showed that NAA/Cho ratio had significant differences.All of the metabolisms were tested by the curve of ROC.The area of NAA/Cho under the ROC curve was 81%,which had a higher accuracy.NAA/Cho equating to 1 .82 could be used as the boundary indi-cators between metabolic syndrome without deafness and with deafness groups.The areas of the other indicators un-der the ROC curve were <50%.Conclusion NAA/Cho may be the early warning marker of sensorineural deafness in patients with metabolic syndrome.

Transient Evoked otoacoustic emissions(TEOAE) in 25 hearing- normal youngers was analysed to study its basic character and the influences of different stimulus intensities on the amplitude and the power spectrum which may be useful to identify the hearing-loss subjects as the standardline. We find that the average amplitude of TEOAE is 5.97, 9.22, 12. 76 dB SPL under three intensities,the frequencies of the spectrum distribute from 0 to 6 000 Hz. The two maximal values are located in 1 025 Hz and 1 513 Hz seper-ately. The amplitude of TEOAE increases with the stimulus tone's growth. We conclude that it's necessary to consider completely when evaluating the patient's hearing function by TEOAE's power spectrum on account of its incontinuity and decrease in high frequency.

Objective The purpose of this study w as to obtain tympanometric norms in Sichuan young adult population and compare the results with data obtained for a non-Hispanic Caucasian population. Methods Normative values for peak compensated static acou stic admittance(Peak Ytm), acoustic equivalent volume(Vea), and tympanometric wi dth(TW) were obtained for 102 Sichuan young adults. Results Significant differences were fo und between Roup′s results and ous for Peak Ytm, Vea and TW. The present study showed lower Peak Ytm, smaller Vea and larger TW values overall. Gender differences were noted for Peak Ytm and Vea in Sichuan subjects . Male had higher Peak Ytm and bigger Vea values than female. Conclusion We should establish our own tympanometric norm s to guide our audiological clinical work.

Objective To investigate the effects of cochlear implantation on residual hearing and to evaluate the potential impact of long -term electrical stimulations on residual hearing .Methods 58 hearing impaired children with cochlear implants were included in this study .All subjects could cooperate with behavioral audiometry .Audio-metric evaluations were carried out pre -implantation and 3 ,12 ,24 months post -implantation respectively .Of 58 subjects ,43 were followed up more than 1 year and 17 were followed up more than 2 years .Results All 58 subjects showed significant differences (P<0 .05) between pre- and 3 months post-implantation of residual hearing at the individual frequencies of 0 .25 ,0 .5 ,1 ,2 and 4 kHz .43 subjects followed up more than 1 year showed statistic differences (P<0 .05) between pre- and 3 months post -implantation ,pre- and 12 months post-implantation at 0 .25 ,0 .5 ,1 ,2 and 4 kHz respectively .Comparing 3 months with 12 months post -implantation ,there were sta-tistic differences at 0 .25 and 0 .5 kHz ,while no significant difference (P>0 .05) at 1 ,2 and 4 kHz .Of 17 subjects followed up more than 2 years ,there were significant differences (P<0 .05) between pre- and various return visits post-implantation .Post-implantation return visits ,there were significant differences between 3 months and 12 , 24 months at 0 .25 and 0 .5 kHz respectively ,not any significant differences on 1 ,2 and 4 kHz .There were no sig-nificant differences on each frequency between 12 months and 24 months post- implantation .Conclusion Residual hearing after cochlear implantation could decrease to some extent for various reasons .There were significant differ-ences between 3 and 12 months post-implantation at 0 .25 and 0 .5 kHz .Not any significant differences were ob-served between 12 months and 24 months post-implantation at each frequency .

Objective The aim of the present study was to investigate the ability to perceive syllables phrases ,mono-syllabic words ,disyllabic words ,when using a CI and an HA in non -implanted ears (bimodal fitting) ,and the relationship be-tween aided thresholds in the HA ear and bimodal effectiveness .Methods Eighteen children who consistently used a bimodal fitting participated in the study .The loudness of speech in the HA ear matched that with implanted ear ,and the aided thresh-olds in the HA ear were obtained .The recognition rate of syllables phrases ,monosyllabic words ,and disyllabic words was tested under the aforementioned two modes in both the quiet and noisy backgrounds .Results The speech performance of children for monosyllabic words were 82 .67% ± 12 .23% ,83 .61% ± 12 .22% ,for disyllabic words 76 .00% ± 16 .13% ,78 .11% ± 14 .84% , for syllables phrases 60 .11% ± 17 .18% ,65 .43% ± 16 .76% ,with a CI alone or with bimodal fitting in a quiet environment ,re-spectively .In a noisy environment ,monosyllabic words were 75 .50% ± 14 .12% ,76 .83% ± 14 .15% ,and disyllabic words were 68 .22% ± 17 .15% ,77 .18% ± 16 .83% ,and syllables phrases were 49 .39% ± 19 .26% ,56 .33% ± 19 .55% .The results sug-gested that speech performance in a quiet or a noisy environment was significantly better with bimodal hearing than with a CI a-lone .All were statistically significant except the recognition rate of monosyllabic words in quiet background (P<0 .05) .Signifi-cant negative correlations were found between aided thresholds at 250 and 500 Hz ,and the bimodal advantages were noticeable for the some speeching perception .Conclusion Bimodal hearing enhances speech performance for deaf patients .The low -fre-quency residual hearing in the HA ear may play a major role in enhancing auditory and speech performance .

Objective To observe the effects of rehabilitation in the 55 prelingually deaf pediatric cases for two years after cochlear implantation ,factors including cochlear implantation and recovery time ;to compare the re-covery effects in the group of 1 to 3 years old children with the group of 3~5 years old (including the age of 3 years old) who lost their hearing before learning to speak ,and to provide clinical evidence for providing cochlear implant therapy to the prelingually deaf children as early as possible .Methods A total of 55 pediatric relingually deaf cases were included in this study .According to their implantation time and application duration ,they were divided into 2 groups :1 to 3 years old group (32 cases) ,and >3 to 5 years old group (23 cases) respectively .The hearing ,lan-guage and learning abilities on 1 ,3 ,6 ,12 ,18 ,24 months after cochlear implantation were evaluated ,using statisti-cal method to record CAP and SIR scores .Results The rehabilitation effects ,the average ages ,CAP ,speech rec-ognition rates and SIR were increased two years afterwards .The effects of younger age group were more noticeable than that in the older group .The differences between the two groups were statistically significant (P<0 .05) .Av-erage speech recognition rates ,average speech rehabilitation effects in each postoperative period of younger age group were better than those of in older age group ,showing significant differences (P<0 .05);CAPs in the younger age group on 1 ,3 and 12 months after CI surgery were significantly higher than those of in the older group (P value were 0 .001 ,0 .001 and 0 .002 ,respectively) .SIR in the younger age group at the time of 1 ,3 ,12 ,24 months were significantly higher than those of in the older group(P values were 0 .00 ,0 .00 ,0 .00 and 0 .024 ,respectively) . Conclusion Implanted age and recovery time are the key factors that influence the effects of postoperative rehabilita-tion .The younger when the children get cochlear implantation and the longer the recovery time takes during two years after cochlear implantation ,the better the results are .The standardization of domestic assessment for the re-covery effects and the international evaluation method have a certain degree of equivalence .

Objective To study the expression of signal transducer and activator of transcription 3 (STAT3) and Suppressor of cytokine signaling 3(SOCS3) in the middle ear cholesteatoma epithelium ,and the possible roles of STAT3 and SOCS3 in middle ear cholesteatoma .Methods The immunohistochemical assay was used to detect ex-pression of STAT3 and SOCS3 protein in 30 cases of middle ear cholesteatoma epithelial tissue and 20 cases of nor-mal external auditory canal skin tissues as the control group .Results STAT3 immunoreactivity was detected in the nuclei and cytoplasm of epithelial cells .The expression rates of STAT3 in middle ear cholesteatoma epithelial tissue were 76 .7% and higher than in the normal epithelium (25 .0% ) .The differences between the two groups were sta-tistically significant (P<0 .05) .SOCS3 immunoreactivity was detected in the cytoplasm of epithelial cells .The ex-pression rates of SOCS3 in middle ear cholesteatoma epithelial tissue were 33 .3% and lower than in the normal epi-thelium (65 .0% ) .The differences were statistically significant (P<0 .05) .The expression of STAT3 and SOCS3 in the middle ear cholesteatoma had negative correlation (r= - 0 .476 ,P<0 .05) .Conclusion The abnormal ex-pression of STAT3 and SOCS3 in the middle ear cholesteatoma may be involved in hyper proliferation and anti -ap-optosis of cholesteatoma cell ,and play an important role in the formation and development of middle ear cholesteatoma .

Objective To observe the expression of cAMP -response element binding protein (CREB) and N-methyl-D-aspartic acid receptor (NMDA ) after intracochlear electrical stimulation in the auditory cortex and inferior colliculus in infant rats with auditory deprivation .Methods Sixty six SD infant rats were randomly divided into 6 groups (11 rats each group):4 weeks ,and 6 weeks after injection of ototoxic drug ,the control group ,and 3 weeks and 5 weeks after injection of ototoxic drug with intra -cochlear electrical stimulation for one week .Gentami-cin sulphate (350 mg/kg body weight) and frusemide (200 mg/kg body weight) were injected subcutaneously in the skin folds on the lateral abdominal side and the dorsal neck area ,respectively .The expression of CREB and NMDAR1protein were detected by immunohistological staining .Results The results of immunohisto -chemistry revealed that protein expression of CREB and NMDAR1 in 4 week group of injection increased as compared to the control group ,while decreasing as compared to intracochlear electrical stimulation group ,significantly .However ,protein expression of CREB and NMDAR1 in 6 week group of injection decreased as compared to the control group and in-tracochlear electrical stimulation group ,significantly .Conclusion Auditory deprivation could result in the expres-sion of protein of CREB and NMDAR1 in auditory cortex and inferior colliculus increasing in an early stage and then de-creasing in infant rats .Intracochlear electrical stimulation could result in the expression of proteins of CREB and NMDAR 1 in auditory cortex and inferior colliculus increasing in infant rats .The dynamic variation of CREB and NMDAR1 expression in rat auditory cortex and inferior colliculus reflects synaptic plasticity in neurons of auditory pathway .

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .