Objective To prospectively study the difference of urinary N-acetyl-β-D-glucosaminidase( UN-AG) and retinol binding protein(URBP) in contrast-induced nephropathy (CIN). Methods The clinical data of 150 patients undergoing coronary angiography were documented. The urine and blood samples before,24 hours after and 48～72 hours after the procedure were collected;Serum creatinine (SCr) and urinary ereatinine (UCr)were tested by enzymic method. UNAG and URBP were tested by ELISA in CIN and control group. CIN was defined as an increase in SCr of ≥44 μmol/L or >25% from baseline 48 ～72 h after the procedure. 27 age- , sex- , results of coro-nary angiography-matched cases were taken as control group. Results CIN was diagnosed in 13 of 150 patients (8.7%). In CIN group, UNAG/UCr were significantly higher than that in control group[ 1.97 (1.06,2.64) U/mmol vs 1.07 (0, 68,1.88 ) U/mmol, Z = 2.076, P = 0.039 ] before ;24 hours after the procedure, UNAG/UCr was signifi-cantly up-regulated in CIN group from baseline level [ 2.82 ( 1.88 ,4.26) U/mmol vs 1.97 (1.06,2.64) U/mmol, Z =2.607,P =0. 009]. ROC curve analysis showed that baseline UNAG could be used as an early predictor for CIN, the AUC =0. 776 ,P =0.023 ;when cut off value = 8.08 U/L,the sensitivity and specificity of UNAG were 0. 771 and 0. 713 respectively. The percentage of patients of UNAG over 8.08 U/L in CIN group was significantly higher than that in control group[77.1% (10/13) vs 29.6% (8/27) ,Z =2. 564,P =0. 011 ] ,the related risk factor is 5.58,95% CI was 1.24 ～ 25.08. Conclusion UNAG could be used as a predictor of CIN before the procedure and its postprocedure 24 h level maybe useful in early diagnosis after the procedure.

Objective To study the accuracy of traditional basilar membrane displacement evaluation criteria for evaluating hearing compensation performance of round window-stimulated middle ear implant, so as to provide the theoretical basis for performance evaluation of round window-stimulated middle ear implant. Methods An acoustic microscopic finite element model of cochlea was constructed based on experimental data of the cochlea geometry. Reliability of this model was verified by comparison with experimental measurement values of inner hair cell, outer hair cell, tectorial membrane displacement. Based on this model, the displacement of basilar membrane and the stereocilia shear displacement of inner hair cells under forward stimulation and round-window stimulation were comparatively analyzed. Using the stereocilia shear displacement of inner hair cells as the criterion for sense of sound, the equivalent sound pressure level (SPL) deviation under round-window stimulation was studied when using traditional basilar membrane displacement as evaluation criterion. Results At 5 kHz characteristic frequency of the studied slice of cochlea, under sound pressures with the same amplitude, the displacement of basilar membrane and the stereocilia shear displacement of inner hair cells under round-window stimulation were lower than that under forward stimulation. Conclusions Under forward stimulation, the inner hair cells were more excited and the performance for sense of sound was better than that under round-window stimulation. Concurrently, using the displacement of basilar membrane under forward stimulation as the criterion of hearing compensation performance would overestimate hearing compensation performance of middle ear implant under round-window stimulation; but the deviation was relatively small, which was a relatively reliable evaluation method.

OBJECTIVE: To analyze the clinical characteristics and diagnosis of silicosis with pulmonary tuberculosis and pulmonary aspergillosis. METHODS: The clinical data of a case of silicosis combined with pulmonary tuberculosis and aspergillosis was analyzed retrospectively. RESULTS: The clinical symptoms of this patient were chest tightness, suffocation, cough, expectoration and hemoptysis. The patient was diagnosed as tuberculosis in the local hospital in 2015. Two previous sputum smears of the patient were positive for mycobacterium tuberculosis. Both qualitative analysis of blood tubercle bacilli and sputum smear examination of acid-fast bacilli were negative. Chest computed tomography(CT) showed right lung pneumoconiosis with large shadow, left lower lobe of lung with uneven density and flake shadow, low density necrotic foci, a cavity with smooth wall. Sputum fungal culture: Aspergillus fumigatus(+++); bronchoscopic lung biopsy showed: Aspergillus pneumoniae. CONCLUSION: Low immunity, malnutrition and long-term use of antibiotics and hormones are the high risk factors of pulmonary aspergillosis. It is helpful to combine laboratory examination, patients′ clinical manifestations and chest CT characteristics, and to analyze the condition comprehensively for the early diagnosis of silicosis with pulmonary aspergillosis.