The course of audiology is both important and difficult to the undergraduate education of otolaryngology.Through a series of reforms in teaching contents and methods of audiology,the students'effect of study were greatlyimproved,and thus these reforms were generally appreciated by both teachers and students. In conclusion, the act of theteaching reform not only advanced the students' learning enthusiasm and gumption, but also helps the development andexercise in their clinical thinking ability.

Objective To find out the difference in Multi-channel Cochlear mapping between SPrint speech processor and ESPrit speech processor (ESPrit 3G) for better guidance of the mapping.Methods Nine cases of total deafness patients (aged 2-54 years old) using SPrint changed to using ESPrit 3G after 6 to 24 months. The threshold (T-L) of electro-audiogram using different speech processor, comfortable level, sound field audiometry in various ESPrit 3G programs and questionnaire results were compared and analyzed statistically.Results Using various speech processor programs, four patients(The first group) felt satisfied with hearing effects. There was no difference comparing with SPrint. There was significantly different in T-L and C-L acquired from five patients(The second group) with two speech processors (P0.05). The results of sound field audiometry showed significant difference in the first group and the second group using programs from SPrint(P

1.Conclusion ABR can evaluate the function of brainstem of patients with severe traumatic brain injury in PVS and provide evidence for prognosis.

Objective To study the relationship between the (C 106T) single nucleotide polymorphsim of promoter region of aldose reductase gene and type 2 diabetes mellitus with nephropathy in Chinese Han from Chongqing. Methods The (C 106T) allele and genotype of 192 patients of type 2 diabetes were examined by polymerase chain reaction agarose gel electrophoresis and restriction enzyme Bfa Ⅰ. Results The frequencies of both allele C and genotype CC were significantly higher in type 2 diabetes patients with albuminuria than in those without albuminuria. Logistic regression analysis showed that allele C and genotype CC were associated with diabetic nephropathy in type 2 diabetes mellitus patients( P =0.032 and 0.046, respectively). Conclusion This finding suggests that (C 106T) single nucleotide polymorphism in the aldose reductase gene promoter region may be associated with diabetic nephropathy of Chinese Han type 2 diabetes. It may be a functional polymorphism and can serve as an inherited marker for susceptibility of diabetic nephropathy.

Objective To observe the effects of Coptidis Rhizoma on gastrointestinal motility functions, MTL and GAS in spleen-deficiency rats; To explore the dose-effect mechanism of “invigorating stomach” and “spoiling appetite”.Methods Fatigue and troublesome were used to establish exhausted spleen-deficiency models. 60 SD rats were randomly divided into blank control group, model group, positive medicine group, Coptidis Rhizoma high-, medium- and low-dose groups, with 10 rats in each group. Each medication group received relevant medicine for gavage, while the blank control group and model group received normal saline for gavage, once a day for 14 d. The general gastrointestinal motility functions, MTL and GAS of rats in each group were observed.Results Compared with blank control group, the gastric residual rate of model group was significantly higher; small intestinal propulsion rate, MTL, and GAS were significantly lower (P<0.05,P<0.01). Compared with model group, the gastric residual rate in Coptidis Rhizoma low-dose group was significantly lower; small intestinal propulsion rate, MTL and GAS increased significantly (P<0.05,P<0.01); small intestinal propulsion rate and MTL in Coptidis Rhizoma high-dose group were significantly lower (P<0.05).Conclusion High-doseCoptidis Rhizoma leads to “spoiling appetite”, and low-dose Coptidis Rhizoma leads to “invigorating stomach”, which may be related to adjusting gastrointestinal motility directly or adjusting the secretion of gastrointestinal hormones.

Objective To evaluate and compare the results of air-conduct and bone-conduct auditory brainstem response(ABR)for the purpose of clinical application of the bone-conduct ABR.Methods A group of normal hearing young adults(61 ears)were measured with click stimulation air-conduct ABR and bone-conduct ABR in a soundproof chamber.Results The waveforms of bone-conduct ABR were almost the same as those of air-conduct ones with the threshold of 26.08?7.71 dB(nHL),but with a lower rate of wave derivation.There were no significant differences between male and female for both air-conduct and bone-conduct ABR testing.The threshold for bone-conduct ABR was higher than that of air-conduct one with a very high positive correlation(r=0.7740)and there were significant differences (P0.05) for the wave intervals.Conclusion The limitation of the bone-conduct ABR application and the differences from air-conduct should be considered when it was used clinically.

Objective To investigate the different characters between conventional frequency audiometry (125 Hz～8 kKHz) and high frequency audiometry (9～16 kHz)in the normal youth and provide the references for the clinical application of the HFA.Methods 52 male and 48 female normal-hearing subjects were tested with both conventional-frequency (0.25～8 kHz) and high-frequency (10～18 kHz) audiometry.Results Data showed that no difference between male and female in different frequencies. However, the threshold of HFA went up gradually with the frequency increasing. The average threshold of HFA was significantly higher than that of CFA and speech frequency (SFA) and had a positive correlation with both CFA and SFA. Conclusion The results of this study suggest that HFA might be used as an early indicator for CFA and SFA hearing loss resulting from acoustic trauma, ototoxicity and presbycusis.

Objective To explore the expression of SP-A in surface active substance of sputum pulmonary of dysfunctional venti-latory weaning response patients and to study changes of expression of SP-A and oxygenation index ,arterial partial pressure of oxy-gen .Methods The mechanical ventilatory patients were divide into dysfunctional ventilatory weaning response group (group A) and easily weaning group(group B) ,then collected sputum from ventilators at different times :on the first day ,two and seven days after using ventilators .Used ELISA to test level of SP-A and oxygenation index ,arterial partial pressure of oxygen in sputum of group A and group B .Results For group A ,SP-A content oxygenation index and arterial partial pressure of oxygen were significantly less than those for group B(P<0 .05);after two days ,for group A ,SP-A content in sputum was significantly less than that on the first day ,and SP-A content in sputum was significantly less than that on the second day (P<0 .05);two days later ,oxygenation index and arterial partial pressure of oxygen were significantly lmore than those on the first day (P<0 .05) and there was no statistical difference in oxygenation index and arterial partial pressure of oxygen between the seventh day and the second day (P>0 .05) .Con-clusion Dysfunctional ventilatory weaning response and lung injury related to ventilator can be diagnosed early through the test of SP-A content in sputum ,which provides a brand-new way and method of treatment in dysfunctional ventilatory weaning response and lung injury related to ventilator .

BACKGROUND: Electromagnetic pulse (EMP) radiation can affect the learning and memory function of experimental rats and induce injury of hippocampal issues and change of ultrastructure of rats.OBJECTIVE: To observe the effects of EMP on injury of hippocampal neurons cultured in vitro and [Ca2+]i, and analyze deeply possible mechanism of cerebral injury induced by EMP.DESIGN: Randomized controlled animal experiment.SETTING: Department of Pathology, Chengde Medical College.MATERIALS: Several Wistar neonate rats, of either sex (half and half),were selected. Source of EMP radiation was high intensity EMP dummy source.METHODS: The experiment was performed from March to December 2004 at the Academy of Military Medical Science and Chengde Medical College, respectively. Several Wistar neonate rats were decapitated to take out the brains under narcotization. Hippocampal tissues were isolated. The cell suspension was adjusted to 5×108 L-1 for inoculation. Grouping: ①Cultured cells were assigned into control group and radiation group. Cells were collected immediately after radiation to perform observation of morphology and determination of free calcium ion concentration. ②Other cultured cells were divided into control group, 0-hour radiation group and 12-hour radiation group. Cell apoptosis rate and necrosis rate were determined. (Dosage of cultured cells: one culture flask of each group was checked in each item for 3 times). EMP radiation was in 6×104 V/m, with pulse rise time of 20 ns,pulse width of 30 μs, frequency of 2.5 pulses/min, totally for 2 minutes.EMP radiation was performed in primary cultured hippocampal neurons,and then morphological change of neurons was observed under inverted phase contrast microscope before and after radiation. Cell apoptosis and necrosis were measured with FACS method; Free [Ca2+]i concentration in neurons was measured with Fluo-3-AM fluorescent probe loading and laser confocal microscopy scanning.MAIN OUTCOME MEASURES: Morphological change of neuron, cell apoptosis rate and necrosis rate and free [Ca2+]i concentration.RESULTS: ①Immediately after EMP radiation, the onset of colliquation appeared in nerval cells gradually, and neurite was recovery and degeneration. ②Apoptosis rate after 12-hour EMP radiation recovered as compared with that at hour 0 after radiation, but significantly increased as compared with the control group [(59.27±1.27)%, (72.17±6.21)%, (17.45±5.63)%,P＜0.05]. ③Necrosis rate at hour 0 and hour 12 after radiation increased as compared with the control group, but there was no statistical significant difference [(13.71±2.31)%, ( 11.96±1.04)%, (8.45±0.67)% ,P ＞ 0.05].④[Ca2+]i fluorescence intensity at hour 0 after EMP radiation was higher obviously than that in the control group (107.34±26.14,54.93±16.08,P ＜ 0.05).CONCLUSION: EMP induces morphological injury, necrosis and increase of apoptosis rate in hippocampal neurons, and Ca2+ fluorescence intensity increases markedly in neurons.

BACKGROUND: Electromagnetic pulse (EMP) irradiation can cause the decline of learning and memory abilities of rats, and lead to the intracellular calcium overloading of hippocampal neurons in vitro, and then result in necrosis and apoptosis. Physical shield can alleviate the damage of electromagnetic irradiation on experimental animals, but studies of the medicine prevention and protection on cell models are still in lack.OBJECTIVE: To observe the possibility of medicine in preventing and protecting the EMP-induced injury of hippocampal neurons in vitro.DESIGN: A randomized controlled animal experiment.SETTING: Division of Basic Medical Sciences, Chengde Medical College.MATERIALS: The experiments were carried out in the Academy of Military Medical Sciences and Chengde Medical College from January 2004 to January 2005. Several neonatal Wistar rats were used.METHODS: The neonatal Wistar rats were killed by cutting heads to remove brain, and the hippocampal neurons were primarily cultured and identified. After pretreatment with MK801 [N-methyl-D-aspartate (NMDA)receptor antagonist] and nifedipine (L-type Ca2+ channel blocking agent),the primarily cultured hippocampal neurons were irradiated with EMP. The condition of our experiment was 6×l04 Y/m, pulse rise time was 20 ns,pulse width was 30 ms, and frequency was 2.5 pulse per minute for 2 minutes. The neurons cultured in special petri dish, which could be observed under LSCM high amplified resolution, were divided into EMP irradiation group, MK801 20 μmol/L group, MK801 20 μmol/L+ nifedipine 1 μmol/L group. The cellular activities were detected with methyl-thiazol-tetrazolium (MTT) colorimetry; The rate of apoptosis was detected with FASC method;The intracellular free Calcium concentration ([Ca2+]i) was determined by loading with Fluo-3-AM Ca2+ fluorescent probe (Molecular Probes Company) on the laser scanning confocal microscope.MAIN OUTCOME MEASURES: The intracellular calcium overloading,cellular activity and rate of apoptosis were compared.RESULTS: ① The [Ca2+]i fluorescent intensity in the EMP irradiation group immediately after irradiation was significantly higher than that in the normal control group (107.34±26.14, 54.93±16.08, P＜0.05); As compared with the EMP irradiation group, the [Ca2+]i fluorescent intensity was decreased in the MK801 20 μmol/L group (81.29±19.96, P ＜ 0.05), and further decreased in the MK801 20 μmol/L+ 1 μmol/L nifedipine group (69.82±25.54, P＜0.05), but both were higher than that in the normal control group (P＜0.05). ②The A values that reflected the activity of cell proliferation MK801 20μmol/L group and MK801 20 μmol/L+1 μmol/L nifedipine group (0.25±0.06, 0.27±0.07) were obviously higher than that in the EMP irradiation group (0.17±0.08, P ＜ 0.05), but still lower than that in the normal control group (0.33±0.08, P ＜ 0.05). ③ The rate of apoptosis in the EMP irradiation group immediately after irradiation was significantly higher than that in the normal control group [(68.63±9.04)%, (20.14±4.34)%,P＜0.01]; As compared with the EMP irradiation group, the rate of apoptosis was decreased in the MK801 20 μmol/L group (62.12±11.08)%, and further decreased in the MK801 20 μmol/L± 1 μmol/L nifedipine group [(53.69±13.60)%, P ＜ 0.05], but both were higher than that in the normal control group (P ＜ 0.01).CONCLUSION: Pretreatment with MK801 and nifedipine can partly block EMP induced damage in hippocampal neurons in vitro. Intracellular Ca2+ Overloading may play an important role in the injury of EMP on hippocampal neurons.