OBJECTIVE: To compare the auditory steady-state response (ASSR) test data of severe sensorineural hearing loss children with cochlear lesion and those with retrocochlear lesion and find some specific phenomena of retrocochlear lesion in ASSR, then to improve diagnostic accuracy in clinical practice. METHOD: Between 2008 to 2012. 96 children (179 ears) were diagnosed with "retrocochlear auditory nerve lesion" and recieved ASSR test (" retrocochlear lesion" group). Eighty-one (143 ears) the same age children (143 ears) were diagnosed as "cochlear auditory nerve lesion" and selected them as the "cochlear lesion" group. Twenty-six (50 ears) normal hearing children at the same age who had ASSR test records selected from the pediatric hearing center database of our hospital were selected as "normal control" group. Compare the difference of ASSR threshold, ASSR elicit rate and ASSR audiogram among the three groups. RESULT: (1) ASSR threshold: Compared each frequency threshold in ASSR test with cochlear.lesion group, the retrocochlear lesion group with wave V and wave I had no significant difference in 500 Hz and 1000 Hz but had significant difference in 2000 Hz and 4000 Hz. As for the retrocochlear lesion group without wave V and wave I, there was a decline in 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz compared with cochlear lesion group. (1) ASSR elicit rate: When compared to retrocochlear lesion group, the cochlear lesion group had a significance lower elicit rate in the four frequency. (3) Number of elicit reactions in ASSR test . In the retrocochlear lesion group, the elicit reactions in all the four frequency in ASSR test was significantly higher than ochlear lesion group. (4) ASSR audiogram type. The proportion of rising curve audiogram in retrocochlear lesion group was 26.83% (with wave I and wave V), 40% (with wave I and without wave V ) and 33.80% (without wave I and wave V). CONCLUTION (1) Children with a severe hearing loss in ABR test and a rise type audiogram in ASSR test should be most possibly considered as retrocochlear lesion. (2) ASSR threshold cannot be used in determinate the severity of hearing loss in children with retrocochlear lesion.
Auditory Threshold ; Child ; Cochlea ; pathology ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans ; Labyrinth Diseases ; Vestibulocochlear Nerve Diseases ; diagnosis

Objective:To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.Method:802 infants(1179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE).However, they failed in the first or & and second hearing screening. Auditory brainstem response (ABR) , distortion product otoacoustic emissions(DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.Result:Among 802 cases(1179 ears),the ratio of single-ear(53.2%) is higher than both-ears(39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation ;25.8% infants once suffered from hypercholesterolenia failed in the hearing screening,which was higer than the other known risk factors.P＜0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk fators group(10.8%);56.9% of the infance who did not pass the hearing screening were found none risk factors, 42.3% of the infances who had high risk factors was normal hearing level;96 cases(138 ears) undergone twice assesement, in morderat disorder group, more cases(74.3%) changed better , and less disorder group(40.9%), severe disorder group (33.3%).Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases(12 ears) diagnosised auditory neuropathy.Conclusion:The important factors make the follow-up decision incluing perinatal history,hearing level and age.Maybe some high-factors we did not realized. Gene screening should be paied more attention in the future work.

Objective To observe the effect of comfort levels in patients during long-term video electroencephalographic(VEEG) monitoring on the monitoring effect. Methods A total of 168 patients with consecutive epilepsy were observed about the Bruggrmann comfort scale(BCS) and artifacts of VEEG during VEEG monitoring. Pearson′s correlation coefficient was used to evaluate a possible correlation between BCS and artifacts. Results The average single score before VEEG, including psychological comfort, social comfort, comfortable environment and overall comfort was (2.87±1.04), (2.63±0.98), (2.40± 1.25), (2.84 ± 0.90), (2.69 ± 1.07) points, which was (2.06 ± 1.38), (1.66 ± 1.40), (1.89 ± 0.57), (1.83 ± 1.24), (1.86 ± 1.19) points after VEEG. There was significant difference between 2 groups (t=4.011-6.353, P<0.05). The overall comfort score and the average single project blinks or eye movement artifacts, physical artifacts, chewing or swallowing artifacts and electrocardiogram artifacts were negatively correlated (r=-0.843--0.585, all P < 0.05), which would reduce the number of these artifacts when increased; there was no correlation (r=-0.204,-0.158, P>0.05) between the average single score of comfort and sweating, skin artifacts, and electrocardiogram artifact. Conclusions There is a significant negative correlation between patient's BCS and the occurrence of artifacts during VEEG monitoring. Comfort evaluation and comfort care before monitoring has great significance in raising the long-term VEEG monitoring accuracy.

Objective:To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. Method: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. Result:The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave Ⅰ,Ⅲ and Ⅴ latencies Ⅰ-Ⅲ ,Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals and postconceptional age. Wave Ⅰ and Ⅴ latencies, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals differed significantly between the two groups. Conclusion:The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

Objective: To investigate the effects of gonadotropin-releasing hor-mone-antagonist (GnRH-ant) on the proportion and toxicity of mice uterine nature killer (uNK) cells during implantation window. Methods: Sixteen C57BL/6 mice were randomly divided into GnRH-ant group and control group, with 8 mice in each group. From the 3rd day of the estrous cycle, GnRH-ant (1.5 μg/100 g) was injected intraperitoneally into the mice of the GnRH-ant group for 7 days continuously, and the control group was injected with the same volume of normal saline at the same time point. On the 7th day, the mice of the two groups were injected with human menopausal gonadotropin (40 U/100 g). The next day, they were injected with human chorionic gonadotropin (100 U/100 g) and sacrificed after 48 h. The uterus tissues were taken out for primary digestion to obtain single-cell suspension. Flow cytometry was used to analyze the proportion of uNK cells and the expression levels of toxicity molecules perforin (Pf) and granzyme B (Gz-B). Results: Compared with the control group, the proportion of uNK cells in GnRH-ant group increased (P=0.000), the proliferation level increased (P=0.000), the apoptosis level decreased (P=0.004), and the expression of toxicity molecules Pf (P=0.000) and Gz-B (P=0.034) were up-regulated. Conclusion: GnRH-ant may up-regulate the proportion of uNK cells and enhance their toxicity in the implantation window period of mice.

Objective: To investigate the correlation between mild cognitive impairment (MCI) and bone metabolism level in the elderly. Methods: Fifty patients with MCI and ninety controls with normal cognitive function were recruited from Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Plasma levels of calcium and phosphorus metabolism indicators, bone resorption markers and bone formation markers were measured. Cognitive function was assessed by mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Results: Plasma level of osteocalcin was elevated in patients with MCI (P=0.001) compared with controls, while plasma level of calcium was decreased in the MCI group (P=0.045). Among patients with MCI, the score of MMSE positively correlated with plasma level of 25-hydroxy vitamin D3 (r=0.290, P=0.041), while negatively correlated with plasma level of parathyroid hormone (r=-0.349, P=0.025). Conclusion: MCI may be correlated with bone metabolism level in the elderly.

As a long-acting phosphodiesterase type 5 (PDE5) inhibitor, tadalafil is administered orally as the first line therapy for erectile dysfunction (ED). Its efficacy and safety have been confirmed by many clinical studies in the treatment of ED in general patients, elderly patients and those with diabetes mellitus or spinal cord injury or after prostate cancer surgery. With its prolonged action of 36 hours, tadalafil can not only increase the self-esteem of ED men but also improve the quality of life of both the patients and their partners.
Carbolines ; administration & dosage ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase Inhibitors ; administration & dosage ; therapeutic use ; Tadalafil

OBJECTIVETo investigate the clinical and hematological features and prognostic factors of primary myelofibrosis (PMF) patients in Shanghai and surrounding area of Shanghai, China.

METHODSThe clinical manifestations, laboratory parameters and survival were retrospectively analyzed in 75 PMF patients diagnosed from Jan, 1996 to Dec, 2013 in our hospital and were compared with those of Chinese subjects from Tianjin and foreign Caucasian patients, respectively. Comparison of categorical variables was performed by χ² test. Survival was estimated using the Kaplan- Meier method. Log- rank test was used to compare survival date. A Cox model was used for multivariate analyses.

RESULTSThe median age of the 75 patients was 56(19-81) years old. There were 51(68%) patients with HGB less than 100 g/L. The median value of HGB was 83 g/L. Similar with those from Tianjin, the patients in our study were significantly younger with higher proportion of severe anemia and lower platelet counts when compared with foreign Caucasian patients. Using IPSS and dynamic international prognostic scoring system (DIPSS) model, the survival curves of intermediate- 1, intermediate- 2 and high risk groups were significantly different. In univariate analyses, variables significantly correlated with poor prognosis were systemic symptoms, HGB<100 g/L, HGB<80 g/L, PLT ≤ 100 × 10⁹/L, WBC<10 × 10⁹/L and blood blasts ≥ 0.01. Multivariate analysis identified IPSS and HGB < 80 g/L as independent risk factors for survival.

CONCLUSIONChinese PMF patients may have characteristics of younger age at onset with more severe anemia. However, IPSS and DIPSS model are still suitable for Chinese patients to predict survival. To increase the weight of anemia severity may provide a better prognostic stratification for Chinese patients with PMF.

Adult ; Aged ; Aged, 80 and over ; China ; Humans ; Middle Aged ; Primary Myelofibrosis ; diagnosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVE: To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening. METHOD: 802 infants (1,179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE). However, they failed in the first or and second hearing screening. Auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests. RESULT: Among 802 cases (1,179 ears), the ratio of single-ear (53.2%) is higher than both-ears (39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation; 25.8% infants once suffered from hypercholesterolemia failed in the hearing screening,which was higher than the other known risk factors. P<0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk factors group (10.8%); 56.9% of the infancy who did not pass the hearing screening were found none risk factors, 42.3% of the infancy who had high risk factors was normal hearing level; 96 cases (138 ears) undergone twice assessment, in moderate disorder group, more cases (74.3%) changed better, and less disorder group (40.9%), severe disorder group (33.3%). Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases (12 ears) diagnosis auditory neuropathy. CONCLUSION The important factors make the follow-up decision including perinatal history, hearing level and age. Maybe some high-factors we did not realized. Gene screening should be paid more attention in the future work.
Auditory Threshold ; China ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Disorders ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Male ; Neonatal Screening ; Otoacoustic Emissions, Spontaneous ; Risk Factors

OBJECTIVE: To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. METHOD: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. RESULT: The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave I, III and V latencies I - III, III - V and I - V intervals and postconceptional age. Wave I and V latencies, I - III and III - V intervals differed significantly between the two groups. CONCLUSION The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.
Case-Control Studies ; Evoked Potentials, Auditory, Brain Stem ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; physiology ; Reflex, Acoustic