Objective To explore the real ear to coupler difference (RECD) changes in children with hearing aids .Methods 132 severe to profound hearing impaired children who came to hearing center for hearing aids exami-nation and adjustment were recruited into the study .They were put into 6 groups according to the test age ,<1 yr group(15 cases) ,1 yrs group(26 cases) ,2 yrs group(36 cases) ,3 yrs group(29 cases) and 4 yrs group(26 cases) . And all of them had the RECD tests for both ears with custom earmolds .Results The average RECDs for both ears decreased with the age increased .There were statistically differences for the same lateral ears when age differences surpass 2 years except for the difference for left ears between the children in the <1 yr group and 2 yrs group .This study showed there were statistically differences between left and right ears for majority of groups (except for 2 yrs group) .Conclusion RECD is an important factor for individual adjustment .The current results show that the chil-dren with hearing aids should have RECD tests for both ears at least once per two years .

Objective To study the correlation between cognitive distress and tinnitus related handicaps.Methods One hundred and ninety-two primary tinnitus subjects ninety-nine males and ninety-three females were included in this study.The average age was 45±15.52 years old.The average durations of tinnitus for male and female were 25.67±37.71 months and 27.12±45.42 months, respectively.The patients were asked to fill the Mandarin tinnitus questionnaire (MTQ) and Mandarin (Chinese) tinnitus handicap inventory (THI-CM).The correlation between cognitive distress (CD) and tinnitus related handicap was studied.Results The average score of MTQ was 36.95±20.06.The average score of CD (Q17,18,23,41, and 42)was 2.61.The average score of question 17,18, 23,41, and 42 of MTQ was 2.81,2.63,2.59,2.40, and 2.41,respectively.The average score of THI-CM was 23.89±20.06.The correlation between CD and THI-CM was 0.64(P<0.01);for male and female were 0.63 and 0.66(P<0.01),respectively.The correlations between CD and THI-CM among young, middle and old age groups were 0.02,0.07 and 0.38(P>0.01),respectively.The correlations between CD and THI-CM among the nondisabled, mild, moderate and severe groups according to the scores of THI-CM were 0.30(P<0.01),0.29(P>0.01),-0.12(P>0.01), and 0.23(P>0.01),respectively.Conclusion No strong correlation was demonstrated between the CD and the THI-CM.The same results were shown for males and female.No correlation was demonstrated between ages and cognitive distress.Correlation coefficient of cognitive distress was increased with age.The tinnitus handicaps of patients might be vulnerable to cognitive distress with ageing.

Objective To explore the signal-to-noise ratio loss (SNR loss) of the people with normal pure-tone audiograms .Methods A group of 10 patients were recruited into the study ,who complained they could not hear speech clearly in the real world environment but had normal pure-tone audiograms ,immittance and word rec-ognition score (WRS) results .The Mandarin hearing in noise test (M-HINT ) was administered to them and the results were compared to the normal ranges published in the journal .Results All of them had SNR loss when noise (speech spectrum) came from front of them ,but 9 patients had SNR loss when noise came from 90 degree left or 90 degree right of them .Conclusion The current study showed the patients had speech hearing loss in the noisy envi-ronment ,regardless of whether they had normal audiograms ,immittance and WRS results .So we should pay atten-tion to such patients and adopt some special tests (eg M-HINT) .It is better for us to communicate and counsel with them .

To explore the role of the Chk2 protein expression and DNA double strand breaks (DSBs) repair in low dose hyper-radiosensitivity (HRS)/increased radioresistance (IRR) of non-small cell lung cancer, A549 cells were subjected to irradiation at the dosage ranging from 0.05-2 Gy. Clonogenic survival was measured by using fluorescence-activated cell sorting (FACS) plating technique. Percentage of cells in M-phase after low doses of X-irradiation was evaluated by phospho-histone H3-FITC/PI and Western blotting was used to detect protein expression of Chk2 and phospo-Chk2. DNA DSBs repair efficiency was also measured by induction and persistence of γ-H2AX. The results showed that the killing ability of irradiation with A549 cells increased at low conditioning dose below 0.3 Gy. Within the dose of 0.3 to 0.5 Gy, A549 cells showed a certain extent of radiation resistance. And when the dose was more than 0.5 Gy, survival fraction exhibited a negative correlation with the dosage. There was no difference between the 0.1 or 0.2 Gy dosage groups and the un-irradiated group in terms of the percentage of cells in M phase. But in the high dosage group (0.3-1.0 Gy), the percentage of cells in M phase was decreased markedly. In addition, the percentage of cells in M phase began to decrease two hours after irradiation. One hour after irradiation, there was no conspicuous activation of Chk2 kinase in 0.1 or 0.2 Gy group, but when the irradiation dose reached 0.3 Gy or higher, Chk2 kinase started to be activated and the activation level showed no significant difference among high dosage groups (0.4, 0.5, 1.0 Gy). Within 1 to 6 h, the DNA DSBs repair efficiency was decreased at 0.2 Gy but increased at 0.5 Gy and 1.0 Gy, which was in line with Chk2 activation. We are led to conclude that the mechanism of HRS/IRR in A549 cell line was probably due to early G(2)/M checkpoint arrest and enhanced DNA DSBs repair. In this regard, Chk2 activation plays a key role in G(2)/M checkpoint activation.

Objective To explore the clinical value of ITMAIS in the early prelingual auditory development (EPLAD)assessment for bilateral profound hearing impaired children with hearing aids.Methods Profound sensorineural hearing impaired children fitted with hearing aids during October 2008 and July 2011 in our center were recruited in this retrospective study, and they would be tested with the ITMAIS at baseline, 3 months, and 6 months after hearing aids fitting.A total of 51 children were recruited in the study, and divided into 2 age groups according to the age at fitting, 1 yr group (28 children) and 2 yrs group (23 children).Results The EPLAD of children in both groups improved significantly in the first half of year after fitting (P<0.05).The mean EPLAD levels of children in both groups were close to or achieved the mean level of severe sensorineural hearing impaired children without intervention when they had had the hearing aids for 6 months.Conclusion Hearing aids could help the children with profound sensorineural hearing loss to improve the abilities of EPLAD.ITMAIS is a simple, an effective tool for assessing the early outcome of children with hearing aids, especially for the children who could not cooperate with the behavioral hearing test.

Objective We undertook this study to analyze anxiety in tinnitus patients .Methods The partici‐pants were recruited from patients seeking treatment for primary tinnitus and were asked to complete self rating anx‐iety scale(SAS)and Chinese (Mandarin) tinnitus handicap inventory(THI -CM) .Results A total of 224 tinnitus patients were included in the study .The mean score of SAS was 46 ± 2 .55 .The average SAS score among different degrees of anxiety (no ,mild ,moderate ,severe) participants were 65 .63% ,20 .54% ,8 .04% ,5 .80% .The average SAS score for male and female were 46 .35 ± 12 .81 ,46 .28 ± 12 .40 ,respectively .No statistic differences were ob‐served among different genders whenever the degrees of anxiety and different ages (p>0 .01) .The mean SAS scores among young ,middle ,old age groups were 47 .72 ± 12 .80 ,44 .56 ± 12 .83 ,40 .28 ± 7 .24 ,respectively .The pearson correlation between tinnitus duration and the score of SAS was 0 .36(P=0 .594) .The pearson correlation between the scores of THI-CM and SAS was 0 .548(P<0 .01) .Conclusion Most tinnitus participants had mild or didn't have anxiety .Only 13 .84% participants have moderate or severe anxiety .Tinnitus handicap degree increased with the increase of anxiety .No anxiety difference was observed among different sex ,tinnitus duration and age groups . The anxiety of young age group was more severe than that of old groups .

Objective To investigate the prostecdtive efficacy of one-stage bone grafting in man-aging chronic osteomyelitis after debridement.Methods From March 1999 to May 2003, 79 patients with chronic osteomyelitis including 28 patients with nonunion underwent one-stage autogenous bone graft-ing, allografts or mixed bone grafting after debridement in Nanjing General Hospital of Nanjing Military Command.All patients were followed up for a mean period of 77 months (60-111 months).Results Six patients (8%) , including two with autogenous bone grafting, three with allografts and one with mixed bone grafting, were confirmed with recurrence of infection, with no statistical difference among three methods of bone grafting.Of 28 patients with nonunion, 23 patients with autogenous bone grafting and two with allografting obtained union, the other three patients with mixed bone grafting obtained union in two patients but resulted in recurrence of infection with nonunion in one, with cure rate of 96% (27/28).Conclusions One-stage bone grafting after debridement for infection and bone union can reach cure rate of over 90%.The recurrence of infection mostly occurs within the first year after operation, with stable long-term curative effect.

OBJECTIVETo study the effect of Shengqi Jiangtang Granule (SJG) on rat model of insulin resistance (IR) and explore the mechanism.

METHODSIR model was induced by high fat diet and peritoneal injection of streptozotocin in Wistar rats. Model rats were randomly divided into the model group, the low, medium and high dose SJG groups treated with corresponding dose of SJG, and thc RGL group with rosiglitazone (RGL). A normal control group was also set up. Blood glucose (BG), protein expression of endothelin-1 (ET-1) and protein kinase C (PKC) in aortic tissue were detected.

RESULTSBG decreased in the high and medium dose SJG groups and the RGL group after treatment, and the lowest level was shown in the high dose SJG group. Compared with that in the normal group, the expressions of ET-1 and PKC obviously increased in the model group (P<0.05), which was lowered in the RGL group and the high and medium dose SJG groups after treatment in a dosage-depending manner, showing significant difference to those in the model group (P < 0.05).

CONCLUSIONSJG can lower blood glucose and inhibit ET-1 and PKC expressions to improve vascular endothelial function, thus to promote insulin sensitiveness and alleviate IR.

Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; physiopathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelin-1 ; metabolism ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Male ; Phytotherapy ; Protein Kinase C ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Thiazolidinediones ; therapeutic use ; Treatment Outcome

Objective To study the relationship between environmental chemical elements,vires infection and dilated cardiomyopathy(DCM).Methods In 2008,233 patients with DCM(case group)and 150 patient with stable angina(control group)were chosen in Liaocheng People's Hospital and Yanggu People's Hospital,Shandong province.Population distribution and disease history were surveyed in the two groups.Human myocardial antibody IgG(AMA-IgG),Coxsackie B virus IgG(CBV-IgG),Adenofirus antibody IgG(ADV-IgG)were detected by ELISA in both the case group and the control group.Serum trace elements were detected in the two groups.The general chemical and toxicological indicators in drinking water of the high-and the low-incidence aireas of the disease were control group[60.00%(90/150),χ2=13.80,P<0.01)].Per capita annual income(Yuan,RMB)in the case group (3207.82±618.51)was lower than that of the control group[(5086.61±886.12),t=24.40,P<0.01].Personal alcohol consumption in the case group[(175.00±160.50)g/d]was higher than that of the control group[(110.22±100.03)g/d,t=4.40,P<0.01)].The rate of myocarditis in the case group[5.15%(12/233)]was higher than ADV-IgG in the cage group were 7.78%(7/90),6.67%(6/90)and 6.67%(6/90),respectively.Compared with those in the control group[3.33%(2/60),5.00%(3/60)and 5.00%(3/60),χ2=1.26,0.18,0.18,all P>0.05],no mg/L]in drinking water of the high-incidence areas were significantly higher than that of iron[(0.39±0.67)mg/L,t=2.11,P<0.05]and that of manganese[(0.15±0.14)mg/L,t=3.01,P<0.01]in the low-incidence arefas.The content of semm iron[(69.1±57.8)μmol/L]in the case group evidently exceeded the normal range(15.6-35.9 μmol/L)and obviously higher than that in the control group[(20.0±17.5)μmol/L,t=5.04,P<0.01].Conclusions Theso data do not support that DCM is related with persistent virus infection and autoimmunization.DCM is probably related with low incomes,high alcohol consumption,myocarditis,high iron and manganese contents in drinking water and high content of serum iron.

BACKGROUNDP-glycoprotein (P-gp) encoded by ATP-binding cassette sub-family B member 1 (ABCB1) gene is a kind of ATP-dependent drug transporter, which plays important roles in multidrug resistance (MDR) of human cancers, such as osteosarcoma. Curcumin is a natural phenolic coloring compound originating from the rhizomes of Curcuma longa, which is proved to possess antitumor biological activities including reversion of MDR. However, the effect and molecular mechanisms of curcumin to osteosarcoma MDR remain unclear.

METHODSWe established a human osteosarcoma drug-resistant cell line MNNG/HOS/MTX by pulse exposure to methotrexate (MTX) and verified that the new cell lines were cross-resistant to other anticancer agents. Then, according to the cytotoxicity assay, we reversed MDR of MNNG/HOS/MTX by 30 µmol/L curcumin, and detected the mechanisms of curcumin reversing MDR through Real-time PCR, Western blotting assay, and Rhodamine123 (Rh123) transport test. Finally, we evaluated the effect of curcumin reversing MDR in vivo by MNNG/HOS/MTX cells xenograft-nude mice model.

RESULTSMNNG/HOS/MTX was proved to be a human osteosarcoma MDR cell line. MTT tumor chemosensitivity test indicates that 30 µmol/L curcumin attenuates the half maximal inhibitory concentration (IC50) and resistance index (RI) to MTX, diamminedichloroplatinum (DDP), adriamycin (ADM), ifosfamide (IFO), and epirubicin (EPI) in MNNG/HOS/MTX cells (P < 0.05). Real-time PCR and Western blotting assays demonstrated that curcumin down-regulated P-gp expression of MNNG/HOS/MTX cells. Rh123 transport test showed that curcumin inhibited the transport function of P-gp in vitro. In vivo studies showed that curcumin displayed the features of sensitizing antitumor drugs and inhibiting the proliferation, invasion, and metastasis of osteosarcoma MDR cells.

CONCLUSIONDown-regulation of P-gp and inhibition of the function of P-gp efflux pump may contribute to MDR reversion induced by curcumin in vitro and in vivo.

ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Animals ; Antineoplastic Agents ; therapeutic use ; Cell Line, Tumor ; Curcumin ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Humans ; Male ; Methotrexate ; therapeutic use ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Osteosarcoma ; drug therapy ; genetics