OBJECTIVE To study the characteristic of auditory brain stem responses (ABRs) to air-and bone-conducted tone pip recorded in adults with normal hearing, to access the feasibility of estimating pure tone behavioral thresholds using tone-pip evoked ABR and to examine the effects of bone-conducted ABR to tone pips on differentiating the type of hearing loss. METHODS Air-and bone-conducted ABR to tone pips were recorded from otologically normal persons (n=20, male/female 10/10) using Smart EP auditory evoked potential system. RESULTS ABR thresholds to air-conducted tone pips were (24.8?7.3) , (16.1?6.5) , (13.5?5.5) , (11.9?5.8) dB nHL for 0.5, 1, 2 and 4 kHz, and were (9.5?9.3) , (13.4? 6.6) , (12.2?6.0) , (12.2?7.2) dB higher than the pure tone behavior thresholds respectively; The ABR thresholds to bone-conducted tone pips were (28.4?9.2) , (19.0?7.4) , (15.1?7.7) , (13.6?6.4) dB nHL for 0.5, 1, 2 and 4 kHz, and were (32.0?10.3) , (19.4?10.0) , (14.2?8.2) , (16.1 ?6.9) dB higher than the pure tone behavioral thresholds respectively. There were no statistically significant differences between the ABR thresholds to AC and BC tone pips. The wave forms of tone-evoked ABR were similar to those of click-evoked ABR. The detectability of Wave Ⅰ and Wave Ⅲ decreased with the decrease of tone pip frequency. The wave latencies of tone-pipevoked ABR were longer than those of click-evoked ABR, and they prolonged with the decrease of tone pip frequency. The Wave Ⅴ latency of ABR to BC 0.5 and 1 kHz tone pips at thresholds were longer compared that to AC. CONCLUSION The thresholds of tone-pip evokedABR were useful in estimating the pure tone behavioral threshold and bone-conducted tone-evoked ABR might be helpful in differentiating the type of hearing loss.

Objective To compare the accuracy of auditory brain stem response (ABR) thresholds to tone burst and tone burst ipsilaterally masked by notched noise in estimating puretone thresholds of adults with normal hearing.To study characteristics of ABRs evoked by tone burst and tone burst in notched noise of two different intensities.These three kinds of ABRs were named as follows:tb-ABR,amtb-ABR and bmtb-ABR.Methods Puretone audiometry,ABRs to tone burst and tone burst ipsilaterally masked by notched noise of different intensities were tested in 20 adults (totally 40 ears) with normal hearing.Results ①Thresholds for tb-ABR,amtb-ABR and broth-ABR of each frequency all approximated each other,and there were no statistically significant differences between them.②The mean differences between puretone thresholds and thresholds for tb-ABR,amtb -ABR and bmtb-ABR of each frequency were all less than 15 dB.Those mean differences of different ABRs of the same frequency were approximate to each other and had no statistically differences.③No matter what kind of ABR was tested,the latencies of wave V shortened with increase of frequency in each ABR at the same intensity.When the intensity and frequency of the tone burst were the same,the latency of wave V of tb-ABR was always statistically shorter than that of amtb-ABR.The latter was also always statistically shorter than that of bmtb-ABR.Conclusion Thresholds for ABRs to tone burst and tone burst ipsilaterally masked by notched noise were useful in predicting puretone thresholds.

Objective To compare the results of TEOAE and DPOAE in the same population of normal newborns, to provide information on choosing appropriate screening tools.Methods A two-steps protocol was taken with the first screening during the first 48 to 72 hours of birth and rescreened from one to two months old if the newborns failed the first screening.For each step of screening, TEOAE and DPOAE were performed simultaneously using AccuScreen hearing screening instrument (Madsen-GN Otometrics, Taastrup, Denmark).A total of 1 062 normal newborns (F/M=508/554) delivered in Peking Union Medical College Hospital were enrolled in this research for the first screening.Infants who failed either TEOAE or DPOAE screening in the first screening were referred to a second screening.Among them, 135 performed both DPOAE and TEOAE in the second step.The newborns who failed the second screening would receive ABR when they were 3 months old.Results In the first screening,the failure rate for TEOAE was 11.0% (117/1 062) and 13.7% (145/1 062) for DPOAE.In the second screening step, the failure rates were 17.8% (24/135) and 20.7% (28/135) for TEOAE and DPOAE, respectively.Chi-square and Fisher's test showed that the failure rates of DPOAE were significant higher than TEOAE for both steps (P<0.001).The agreements between TEOAE and DPOAE were 96.0% and 95.6% for the first and second steps respectively, and the kappa values were 0.817 and 0.857.As to the average time taken to accomplish the screening for one ear, TEOAE was 24±25 s and DPOAE was 40±34 s during the first screening;in the rescreening, TEOAE was 52±41 s and DPOAE was 73±62 s.Paired-t tests showed that the differences between DPOAE and TEOAE testing time were statistically significant (P=0.000) in both screening steps.Finally, 7 newborns (10 ears) were diagnosed conductive hearing loss(except 1 ear was sensorineural hearing loss).Conclusion As a screening tool, TEOAE got lower refer rates and took less time than DPOAE implicating TEOAE a better screening tool for normal neonates.

Objective To study the false negative results of Gelle test .Methods Hearing test data between August 2013 to July 2014 were retrieved from outpatient records with hearing complaints of tinnitus or hearing loss . Recruiting criteria:no history of otitis media ,normal tympanic membrane ,no radiologic manifestations of lesions in middle ear and mastoid and abiltly of clear expression of changes of hearing .A total of 60 patients(120 ears ) were tested with conventional pure tone audiometry (PTA) and Gelle test .Acoustic immittance and distortion product otoacoustic emission (DPOAE) were tested in 110 and 113 ears ,respectively .Results Among 120 ears ,7 were di‐agnosed as conductive hearing loss ,23 as mixed hearing loss ,52 as sensorineural hearing loss ,and 38 as normal hearing by pure tone audiometry .The negative Gelle test results were detected in 5 ,11 ,16 and 3 ears ,respective‐ly .110 ears were tested with tympanometry ,types A ,B and C tympanograms were found in 102 ears ,2 ears and 6 ears ,respectively ,and the negative Gelle test results were 22 ,2 and 4 ,respectively .DPOAEs were recordable in 56 ears and negative in 57 ears ,and negative Gelle tests were recorded in 12 and 17 ears respectively .Conclusion False-negative results were found in all types of PTA ,tympanometry and DPOAE .It indicates that Gelle test might not be sensitive and accurate enough to evaluate the integrity and mobility of ossicular chain .Gelle test com‐bined with PTA and DPOAE may be better for assessment of hearing loss and entity of ossicular chain .

Objective To study the characteristic of acoustically short latency negative response (ASNR) in auditory brainstem response (ABR) evoked by tone burst in children with hearing loss. Methods ABRs to click and tone burst were recorded from 0～6 years old children with hearing loss using SmartEP auditory evoked potential system. The threshold and latency was analyzed if ASNR was recorded. Results Among all the 80 ears tested, ASNR were recorded in 7 ears (8.75%) when using click, and in 40 ears (50%) when using tone burst. ASNR was most frequently evoked by 1 kHz tone burst (in 37 ears), and 2 kHz (in 25 ears) was the second. Among the ears with ASNR, the lowest threshold of ABR wave V was 65 dB nHL. The lowest threshold of ASNR was 80dB nHL. The latencies of ASNR for 0.5,1,2 and 4 kHz tone burst was 6～8, 5～7,3～5 and 3～4 ms, respectively. The latency decreased along with the increase of intensity. Conclusion ASNR can be recorded while recording tone-burst ABR, but it has no effect in predicting hearing level using the wave V threshold of tone-burst ABR.

Objective To investigate the effect of acupuncture at Baihui (DU20) and Zusanli (ST36) acupoints on the cognitive function and the oxidation protective mechanism of cortex in vascular cognitive impairment (VCI) rats, providing experimental evidence for the clinical treatment of VCI. Methods The VCI model was established by fluorescent microemboli injection through internal carotid artery. Randomly divided into the control group (n=12), the model group (n=12), the positive drug group (n=12), the acupuncture treatment group (n=12). Two weeks after modeling, the rats in the acupuncture treatment group were stimulated for 30 minutes with daily electroacupuncture at Baihui and Zusanli acupoints. The positive drug group was treated with donepezil hydrochloride 0.5206 mg/kg orally daily for 30 days. After the treatment, the water maze test was used to test the cognitive learning ability of rats. The content of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and hydrogen peroxide (H2O2) in the cortex of rats were detected by biochemical methods. Results Compared with the model group, the number of passing through the platform (7.5 ± 1.9, 6.8 ± 2.2 vs. 3.7 ± 1.0) of acupuncture treatment group and positive drug group were significantly higher (P<0.05), and the total distance in target quadrant (495.4 ± 89.4 cm, 487.6 ± 96.2 cm vs. 341.4 ± 67.3 cm) were significantly longer (P<0.05). In acupuncture treatment group and the positive drug group, the activity of SOD in the cortex (17.3 ± 3.3 U/mg, 15.1 ± 2.5 U/mg vs. 9.7 ± 4.9 U/mg) was significantly higher (P<0.05), but the MDA (9.1 ± 2.2 μmol/L, 8.4 ± 3.7 μmol/L vs. 15.2 ± 4.4μmol/L), and H2O2 (85.2 ± 16.2 μmol/L, 82.1 ± 13.2 μmol/L vs. 114.7 ± 24.8 μmol/L) were significantly lower (P<0.05). In acupuncture group, the activity of GSH-Px (14.5 ± 3.7 U/mg vs. 9.0 ± 2.5 U/mg) was significantly higher than that in control group (P<0.05). There was no significant difference between acupuncture group and positive drug (P>0.05). Conclusions Acupuncture at Baihui and Zusanli acupoints can improve the behavior scores of rats with VCI, increase the contents of total SOD and GSH-Px,decrease the content of MDA and H2O2 in brain,and enhance antioxidant effects, while inhibiting peroxidation, improve free radical metabolism.

Objective:To explore the influence of airway mucus plugs on patients with bronchial asthma and its management.Methods:In this cross-sectional study, from January 2020 to June 2022, 100 patients who were diagnosed with asthma and underwent chest CT examination in the Outpatient Department of Peking University Third Hospital were included. The chest CT results and medical history, pulmonary function, fractional exhaled nitric oxide (FeNO), blood routine, total allergen IgE, Aspergillus fumigatus M3 allergen-specific IgE antibody test results were collected. According to the results of chest CT, the asthma patients were divided into group with mucus plugs and those without mucus plugs. Distribution of airway mucus plugs and the mucus plug scores based on lung segments were calculated. The relationships of mucus plugs with medical history, pulmonary function [These included before and after the bronchodilation test, forced vital capacity percent of predicted value (FVC%pred), forced expiratory volume in one second percent of predicted value (FEV 1%pred), FEV 1/FVC, peak expiratory flow percent of predicted value (PEF%pred), maximal mid-expiratory flow percent of predicted value (MMEF%pred), maximal expiratory flow at 25%, 50%, 75% of vital capacity remaining percent of predicted value (MEF 25%pred, MEF 50%pred, MEF 75%pred)], FeNO, and peripheral blood eosinophil (Eos) counts were analyzed. The logistic regression model was used to analyze whether airway mucus plug was a risk factor for asthma exacerbation, and the corresponding intervention strategies were explored. Results:Among the 100 patients with asthma, 24 cases were in the mucus plug group and 76 cases were in the non-mucus plug group. The distribution of mucus plug was more common in the lower lungs (30.53% and 9.16% in the lower and upper lobe of left lung, respectively; 29.01%, 14.50% and 16.80% in the lower, middle and upper lobe of right lung, respectively). The average score of mucus plug was (4.42±3.12) points. The body mass index (BMI), the number of visits to a doctor due to asthma exacerbations, FeNO, peripheral blood Eos counts in the mucus plug group were higher than those in the non-mucus plug group [(24.95±4.34) vs (23.22±2.91) kg/m 2, 0(0, 1) vs 0(0, 0), 97(37, 169) vs 31(18, 59) ppb (1 ppb=1×10 -9), 0.41(0.15, 0.70) vs 0.18(0.09, 0.37)×10 9/L](all P<0.05), and FVC%pred, FEV 1%pred, FEV 1/FVC, PEF%pred, MEF 50%pred, MEF 25%pred, MMEF%pred, MEF 75%pred were lower than those in the non-mucus plug group [(87.49±19.32)% vs (97.34±14.24)%, (76.49±19.58)% vs (91.07±18.33)%, (72.44±10.91)% vs (79.48±8.13)%, (82.36±24.46)% vs (93.83±18.27)%, (53.03±24.81)% vs (75.75±27.15)%, (46.47±22.92)% vs (64.09±25.90)%, (50.28±23.73)% vs (74.53±26.80)%, (71.30±27.55)% vs (89.92±26.82)%] (all P<0.05). In the group with mucus plug, the airway mucus plug score was positively correlated with the patient′s body weight and the number of peripheral blood Eos counts at enrollment ( r=0.413, 0.478; all P<0.05), and negatively correlated with FVC%pred and FEV 1%pred ( r=-0.576, -0.465; all P<0.05). Logistic regression analysis showed that airway mucus plug score was a risk factor for acute asthma attack ( OR=1.269, 95% CI: 1.031-1.562; P=0.024). Conclusions:Asthma patients have a high incidence of airway mucus plug, which is related to the level of Eos inflammation and body size. Airway mucus plugs can promote airflow obstruction and acute exacerbation of asthma. In clinical practice, appropriate asthma management policies can be formulated for airway mucus plugs to delay the progression of asthma and reduce the number of acute attacks.

Objective Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS)and network pharmacology technology combined with pharmacodynamic experiments were used to analyze the quality markers(Q-markers)in Saorilao Qingfei Zhike Capsules.Methods Using UPLC-Q-TOF-MS technology,the chemical components in different polar extracts of Saorilao Qingfei Zhike Capsules was analyzed.Potential pharmacological components were screened by using antitussive and expectorant models.The"components-targets-diseases"network was constructed and potential Q-markers were screened by network pharmacology technology.Then we conducted pharmacodynamic validation to confirm the Q-markers,which have antitussive and expectorant effects in Saorilao Qingfei Zhike Capsules.Results A total of 120 compounds were obtained from the Saorilao Qingfei Zhike Capsules through qualitative analysis.Among the extracts of different polarity,44 compounds were derived from petroleum ether extract,85 compounds were derived from ethyl acetate extract,79 compounds were derived from n-butanol extract,and 71 compounds were derived from water extract.The results of pharmacological experiments showed that among extracts of different polarity,petroleum ether extract had the best antitussive effect,while n-butanol extract had the best expectorant effect.Three core components for eliminating phlegm and relieving cough were screened through network pharmacology techniques:farcalinol,farcalinediol,and rubimaillin.Pharmacodynamic studies verified that all core components mentioned above have certain antitussive and expectorant effects.Conclusion Based on the above research,farcalinol,farcalindiol,and rubimaillin can be used as Q-markers for the antitussive and expectorant effects of Saorilao Qingfei Zhike Capsules.This paper provides reference for the quality standard of Saorilao Qingfei Zhike Capsules.

Objective Thresholds for auditory brain stem responses (ABRs) to tone burst and tone burst in notched noises of two different intensities were tested in adults with sensorineural hearing loss.The relationship between ABR and puretone thresholds was analyzed to identify an acoustic stimuli with better frequency-specificity.Methods Thirty-eight adults with sensorineural hearing loss (totally 45 ears) were included in the study.Tone burst used to elicit ABRs had 2.5 cycles on the rise and fall and no plateau.Notched noises of two different intensities were used to mask tone burst ipsilaterally when recording ABRs.Those two kinds of notched noises were 25 dB (intensity A) and 15 dB (intensity B) lower than tone burst in intensity respectively.Tone burst ABRs without masking were named tb-ABR,while tone burst ABRs in notched noises of intensity A and B named as amtb-ABR and bmtb-ABR.Thresholds for tb ABR,amtb ABR and bmtb-ABR were tested and analyzed.Results The regression coefficients between puretone thresholds and thresholds for tb-ABR,amtb-ABR and bmtb-ABR of all frequencies were greater than 0.8.The mean differences between ABR and puretone thresholds were all less than 10 dB.Tb-ABR thresholds the were the closest to puretone thresholds at 500 Hz,while bmtb ABR thresholds were the closest at the other three frequencies.Bmtb-ABR thresholds were more close to puretone thresholds in patients with steeply sloping hearing loss.Conclusion Thresholds for all those three ABRs could be used to predict puretone thresholds.In most condition,tb-ABR thresholds were able to estimate puretone thresholds.In some condition,different stimuli could be chosen to elicit ABR at different frequencies.It was reasonable to choose bmtb -ABR for puretone thresholds estimation in patients with steeply sloping hearing loss.

Objective To investigate the constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons. Methods Data of gastroscopy center during August 2015 to July 2016 were analyzed. A total of 603 patients were diagnosed as primary bile reflux gastritis. After gastroscopy, the standardized constitution in Chinese medicine questionnaire was used to evaluation the scores of all kinds of constitutional types. The Constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons were analyzed. Results Among all seasons, the positive detection rate showed significant difference (χ2=13.041, P=0.005), and summer group showed the highest among the four seasons (23.38% vs. 17.63%,χ2=12.414, P<0.001). Among all seasons, constitutional types of Chinese medicine of primary bile reflux gastritis had significant difference (χ2=37.441, P<0.001). Damp-heated type had significant difference among seasons (χ2=8.472, P=0.037), especially during the summer (χ2=5.847, P=0.016). Conclusions The summer may have more primary bile reflux gastritis chance to be diagnosed as primary bile reflux gastritis. Yang-deficiency type, Gentleness type, Qi-deficiency type and damp-heat type were more common in primary bile reflux gastritis patients.