听力正常耳鸣患者治疗前后诱发性耳声发射的临床研究

目的:分析耳鸣与耳蜗毛细胞早期损害的关系,以及听力正常耳鸣患者治疗后基本痊愈和显效的病耳耳蜗毛细胞恢复情况。方法:40例(66耳)纯音听力正常的耳鸣患者,行诱发性耳声发射检查:瞬态耳声发射(TEOAE)和畸变产物耳声发射(DPOAE)检查,并对耳鸣患者给予相应治疗,对基本痊愈和显效的病耳治疗前DPOAE或TEOAE未通过的复查DPOAE或TEOAE。结果:①治疗前TEOAE检查28耳通过,38耳未通过;DPOAE检查34耳通过,32耳未通过;②经治疗,38耳治疗前TEOAE检查未通过的患耳基本痊愈和显效的病耳有15耳,复查TEOAE,3耳通过;32耳DPOAE检查未通过的患耳基本痊愈和显效的病耳有13耳,复查DPOAE,4耳通过。结论:部分听力正常的耳鸣患者已有耳蜗毛细胞的损害,而且不易恢复。     

顺铂对耳蜗毒性的实验研究

目的 :探讨顺铂对耳蜗毒性的影响。方法 :将豚鼠 12只随机分成顺铂组、对照组 ,每组 6只。顺铂组连续 5d腹腔注射顺铂 ,2ml·kg- 1·d- 1;对照组连续 5d腹腔注射生理盐水 ,2ml·kg- 1·d- 1。两组豚鼠均于实验结束后测耳蜗血流、耳蜗电图 ,断头 ,取耳蜗 ,用不同方法染色固定 ,铺片及电镜观察。结果 :顺铂组动物在给药后体重减轻 ,耳廓反射减退 ,耳蜗血流下降 ,阈值提高 ,毛细胞大片缺失 ,两组比较 ,差异有显著性 (P <0 .0 1)。顺铂组血管纹较对照组血管纹明显扩张 ,红细胞聚集。扫描电镜下观察 ,顺铂组的绝大部分内、外毛细胞的纤毛散乱 ,倒伏 ,甚至缺失 ;透射电镜下观察 ,顺铂组血管纹线粒体水肿变性。结论 :顺铂对耳蜗有损坏作用。     

辅舒良咽鼓管逆行灌注治疗分泌性中耳炎疗效观察

目的:探讨辅舒良咽鼓管逆行灌注治疗分泌性中耳炎的疗效.方法:采用辅舒良咽鼓管逆行灌注法和传统方法治疗分泌性中耳炎.结果:实验组治愈率61.8% ,好转率29.4%,无效率8.8%,总有效率91.2%;与传统组相比疗效有显著差异(P<0.01).实验组与对照组治疗后咽鼓管功能之间具有显著性差异(P<0.01).结论:辅舒良咽鼓管逆行灌注法能改善咽鼓管功能状态,提高患者听力,是治疗分泌性中耳炎的一种有效方法.     

元话语标记语对听力理解的影响研究

海兰(Hyland)通过大量研究证明元话语标记语有助于外语学习者提高阅读理解能力。元话语标记语研究多集中在对阅读和写作方面的研究,听力理解方面研究较少,为验证元话语标记语的输入是否能够提高讲座式听力水平,77名英语专业学生参与了元话语标记语的实证研究。实验前对学生进行听力水平测试后,学生被随机分为实验组和对照组,实验组进行了元话语标记语的输入强化训练,对照组按照传统模式上课,经过一学期32课时训练后,两组学生进行听力水平测试。通过配对样本T检验,结果显示,实验组分数较之对照组有显著性的提高(p <0. 05)。该研究可以为元话语标记语在听力理解方面提供研究思路,补充听力教学理论指导。     

926例新生儿听力筛查体会

目的:通过新生儿听力筛查,早期发现听力障碍患儿,做到早发现、早诊断、早干预.方法:采用丹麦生产的AccuScreen听力筛查仪.结果:初筛通过率71.49%,复筛通过率98.48%,听力障碍发生率0.22%.结论:通过新生儿听力筛查可及早发现听力障碍惠儿,并进行早期干预,有效促进婴幼儿语言的发育.     

非抗生素治疗与耳毒性反应

临床上药物治疗繁多,其中有一些药物能够引起不同程度的耳毒性反应,其发生机理比较复杂,临床上可表现为耳鸣或听力减退。其中以抗生素最不多见,尚有不同非抗生素类药物在临床上未被注意。 1 水杨酸类 有动物实验结果认为本药的耳毒性是使耳蜗内生化酶的活力改变所致,而无耳蜗形态改变。临床上小剂量(600mg以下)长期应用不致内耳损伤,但大剂量应用时可引起耳鸣或耳聋,减少剂量可使症状较快消失,多为可逆性。     

标准化病人在中医临床课程教学和技能考核中的应用

目的:研究标准化病人(standardized patients,SP)教学法在高职高专中医学临床课程实践教学中的作用.方法:随机抽取2010级中医学专业66名学生分为实验组与对照组,对照组采用传统教学法,实验组采用标准化病人教学.理论及实践教学结束后,随机对两组学生进行临床技能考核,比较两组学生临床能力得分.结果:实验组学生在问诊、体格检查、以及对四诊资料的采集、归纳整理的能力明显高于对照组(P＜0.05),而辨证论治的能力与对照组相比没有显著性差异(P＞0.05).结论:利用标准化病人开展中医学临床课程实践教学能显著提高学生的临床技能.     

降纤酶治疗短暂性脑缺血发作的疗效观察

目的:探讨降纤酶治疗短暂性脑缺血发作(transient ischemic attacks,TIA)的疗效.方法:随机选出两组TIA患者各40人,观察降纤酶治疗组与刺五加对照组的疗效.结果:治疗组总有效率90%,对照组总有效率65%,两者比较有显著性差异(P＜0.01),且治疗组的血液流变学比对照组改善显著,无副作用发生.结论:降纤酶治疗TIA疗效显著.     

推理策略的导入对CET4听力题型的不同影响

通过对西安工业大学10级非英语专业大学生听力教学中推理策略的培训旨在研究推理策略对听力题型的影响.结果表明经过为期一学年的推理策略培训后,实验组与对照组听力成绩在长对话和复合式听写题型有显著性差异,短对话和短文理解题型无显著性差异.本文分析了原因,并提出了今后听力教学的建议.     

心理干预对PTCA围手术期患者的影响

目的:探讨心理干预对冠心痛介入术(PTCA)治疗患者身心康复的影响.方法:冠心病患者40例,随机分为实验组和对照组各20例,均行经皮冠状动脉腔内成形术(PTCA)治疗,术前后实验组患者配合系统的心理干预,对照组按常规护理.结果:抑郁和焦虑自评量表(SDS、SAS)评分入院时2组比较差异无显著性意义.PTCA后实验组SAS及SDS评分较治疗前及对照组比较均明显下降(P0.01).结论:心理干预对PTCA后患者的身心康复有明显促进作用.     

Ototoxic destruction by co-administration of kanamycin and ethacrynic acid in rats

It is well known that ethacrynic acid (EA) can potentiate the ototoxicity of aminoglycoside antibiotics (AmAn) such as kanamycin (KM), if they were applied at the same time. Currently, to create the model of EA-KM-induced cochlear lesion in rats, adult rats received a single injection of EA (75 mg/kg, intravenous injection), or followed immediately by KM (500 mg/kg, intramuscular injection). The hearing function was assessed by auditory brainstem response (ABR) measurement in response to click and/or tone bursts at 4, 8, 12, 16, 20, 24, and 32 kHz. The static microcirculation status in the stria vascularis after a single EA injection was evaluated with eosin staining. The pathological changes in cochlear and vestibular hair cells were also quantified after co-administration of EA and KM. After a single EA injection, blood flow in vessels supplying the stria vascularis rapidly diminished. However, the blood supply to the cochlear lateral wall partially recovered 5 h after EA treatment. Threshold changes in ABR were basically parallel to the microcirculation changes in stria vascularis after single EA treatment. Importantly, disposable co-administration of EA and KM resulted in a permanent hearing loss and severe damage to the cochlear hair cells, but spared the vestibular hair cells. Since the cochlear lateral wall is the important part of the blood-cochlea barrier, EA-induced anoxic damage to the epithelium of stria vascularis may enhance the entry of KM to the cochlea. Thus, experimental animal model of selective cochlear damage with normal vestibular systems can be reliably created through co-administration of EA and KM.     

Screening for hearing loss in early childhood programs

This study assessed the feasibility of doing hearing screening in Migrant, American Indian and Early Head Start programs using otoacoustic emissions (OAE) technology. Staff members were trained to screen 0–3-year-old children for hearing loss using hand-held OAE equipment and a multi-step screening and referral protocol. Of the 3486 children screened as a part of the study, 77% passed an OAE screening at the first step, 18% more passed an OAE screening at the second step, and 5% were ultimately referred for medical or audiological follow-up. Eighty children were identified as having a hearing loss or disorder of the outer, middle or inner ear requiring treatment. Of these 80, six had permanent bilateral or unilateral hearing loss. Although the protocol suggested that the multi-step screening procedure should be completed within a 4-week time period or less, analysis of the data showed that for children requiring more than an initial OAE screening, the length of time over which the screening was completed ranged from 7 to 12 weeks. The median time required to complete a single OAE screening session was 4 minutes per child. The results demonstrate that OAE screening of young children using this protocol is practical and effective. The implications for conducting periodic hearing screening throughout early childhood are discussed.     

Late phonological development in Spanish children with bilateral hearing loss / Desarrollo fonológico tardío en niños españoles con pérdidas auditivas bilaterales

Abstract

This study has a twofold objective: to analyse and compare the phonological processes in a sample of Spanish children with hearing loss, both with a cochlear implant and with a hearing aid, with a group with normal hearing; and to determine whether there are differences between the participants with a cochlear implant and with a hearing aid in the frequency and nature of the phonological processes. The sample is made up of 168 participants, eight with hearing loss (four with an implant and four with a hearing aid) and 160 with normal hearing. Samples of spontaneous speech were collected and transcribed using the tools from the CHILDES project. For the analysis, the phonological processes paradigm was adopted, evaluating phonological development based on normative error rates. The participants with a hearing loss show slower phonological development in terms of phonological processes, along with atypical processes. Furthermore, the participants with cochlear implants committed more phonological errors than those that wear a hearing aid. The implications of the results are discussed, and it is recommended that auditory stimulation should be done early in children with hearing loss regardless of their technical aid.     

Consensus on early identification of hearing loss?

The National Institutes of Health Consensus Development Conference on Early Identification of Hearing Impairment was convened to address the advantages of early identification of hearing impairment and the consequences of late identification of hearing impairment, the issue of which children should be screened for hearing impairment and when, the advantages and disadvantages of current screening methods, the question of which model for hearing screening and follow-up is preferred, and future directions for research in diagnosis and management of hearing impairment in infants and young children. Among their findings, the panel concluded that (1) all infants admitted to the neonatal intensive care unit be screened for hearing loss prior to discharge, (2) universal screening be implemented for all infants within the first 3 months of life, (3) the preferred model for screening should begin with an evoked otoacoustic emissions test and should he followed by an auditory brainstem response test for all infants who fail the evoked otoacoustic emissions test, (4) comprehensive intervention and management programs must be an integral part of a universal screening program, (5) universal neonatal screening should not be a replacement for ongoing surveillance throughout infancy and early childhood, and (6) education of primary caregivers and primary health care providers on the early signs of hearing impairment is essential.     

Verbal information-processing capabilities and cochlear implants: implications for preoperative predictors of speech understanding

In this study, we examined preoperative verbal cognitive capacity in 11 deafened adults who were cochlear implant candidates and reexamined level of speech understanding after 6-8 months' experience with the implant. Verbal cognitive performance in the implant group was compared in a group of normal hearing subjects and in nonimplanted group of deafened adults. The three groups performed on par with each other with an exception: The individuals in the cochlear implant group and the nonimplanted group of deafened adults performed significatly worse than those of normal hearing in tasks in which use of internal speech is a key feature (i.e., rhyme judgement and lexical decision tasks). Postoperative observations of the implanted individuals' level of speech understanding suggest that it is possible to predict the level of speech understanding by means of a properative cognitive assessment. The characteristics of three verbal cognitive abilities prove to be critical indicators of 6 - 8 months' postoperative outcome: internal speech functioning, speed of verval information processing, and working memory capacity - the first factor proved the most decisive. We discuss the results with respect to direct versus indirect predictors of outcomes from cochlear implant operations and the effect of auditory deprivation on deafened adults' capability to process auditory information.     

Learning for Everyday Life: Pupils’ conceptions of hearing and knowledge about tinnitus from a teaching–learning sequence

As a result of young people frequently exposing themselves to loud sounds, researchers are advocating education about the risks of contracting tinnitus. However, how pupils conceive of and learn about the biological aspects of hearing has not been extensively investigated. Consequently, the aim of the present study is to explore pupils’ learning about hearing and tinnitus. Pupils in Grades 4, 7, and 8 (aged 10–11, n = 48; aged 12–13, n = 71; aged 13–14, n = 80) were studied. The pupils’ learning was evaluated in connection with a teaching intervention based on a teaching–learning sequence (TLS) about sound, hearing, and health. In pre‐, post‐, and delayed post‐tests, pupils were asked to use drawing and writing to express their answer to the question: ‘What happens to a sound that has reached your ear?’ A questionnaire concerning tinnitus, experiences of tinnitus, and listening behaviour was also given. The results show that the pupils’ knowledge of hearing and tinnitus had increased as a result of the intervention and that this knowledge was well retained one year later. The pupils in Grade 4 learned just as much as the older pupils, although it was more difficult for them to understand cell structures and causal chains. To conclude, pupils are capable of learning about hearing and tinnitus already at the age of 10–11. Knowledge of hearing and tinnitus may be an important prerequisite for conceptualizing the risk of being exposed to loud sounds.     

Entertainment television and hearing students' attitudes regarding the pediatric cochlear implant

The cochlear implant, a bionic technology that restores sound sensation in some patients, has become ethically controversial in the 20 years since its introduction. This controversy recently has entered American entertainment culture, with the issue of pediatric implants emerging in episodes of popular TV programs. This pilot study examines the effects of one such TV episode on the attitudes of hearing college students with minimal prior exposure to the controversy, using a posttest-only control group design. The control group (N = 17) watched an unrelated entertainment video and filled out an original 10-item attitude scale. The treatment group (N = 18), which viewed an episode of the dramatic series Gideon's Crossing addressing the cochlear implant issue, also filled out the attitude scale. A t test was applied, and it was determined that no significant difference existed between the two groups' attitudes regarding pediatric cochlear implants. Although there was wide variability on individual items, overall scores indicated that both groups were neutral, or undecided, regarding cochlear implantation in children.     

Improving flexible thinking in deaf and hard of hearing children with virtual reality technology

The study investigated whether rotating three-dimensional (3-D) objects using virtual reality (VR) will affect flexible thinking in deaf and hard of hearing children. Deaf and hard of hearing subjects were distributed into experimental and control groups. The experimental group played virtual 3-D Tetris (a game using VR technology) individually, 15 minutes once weekly over 3 months. The control group played conventional two-dimensional (2-D) Tetris over the same period. Children with normal hearing participated as a second control group in order to establish whether deaf and hard of hearing children really are disadvantaged in flexible thinking. Before-and-after testing showed significantly improved flexible thinking in the experimental group; the deaf and hard of hearing control group showed no significant improvement. Also, before the experiment, the deaf and hard of hearing children scored lower in flexible thinking than the children with normal hearing. After the experiment, the difference between the experimental group and the control group of children with normal hearing was smaller.     

Contribution of a contralateral hearing aid to perception of consonant voicing, intonation, and emotional state in adult cochlear implantees

Binaural hearing in cochlear implant (CI) users can be achieved either by bilateral implantation or bimodally with a contralateral hearing aid (HA). Binaural-bimodal hearing has the advantage of complementing the high-frequency electric information from the CI by low-frequency acoustic information from the HA. We examined the contribution of a contralateral HA in 25 adult implantees to their perception of fundamental frequency-cued speech characteristics (initial consonant voicing, intonation, and emotions). Testing with CI alone, HA alone, and bimodal hearing showed that all three characteristics were best perceived under the bimodal condition. Significant differences were recorded between bimodal and HA conditions in the initial voicing test, between bimodal and CI conditions in the intonation test, and between both bimodal and CI conditions and between bimodal and HA conditions in the emotion-in-speech test. These findings confirmed that such binaural-bimodal hearing enhances perception of these speech characteristics and suggest that implantees with residual hearing in the contralateral ear may benefit from a HA in that ear.     

听觉障碍儿童人格特征比较研究

以艾森克人格问卷(EPQ)为工具,对西安市30名听觉障碍儿童的人格特征进行测定,探讨了影响听觉障碍儿童人格发展的因素,并得出了以下结论:(1)听障男童在内外倾和掩饰性上显著高于正常男童;听障女童在精神质和掩饰性上显著高于正常女童,但在神经质上显著低于正常女童;听障男童在精神质上显著高于听障女童,其他人格维度上性别差异不显著。(2)农村听障儿童的内外倾性显著高于城市听障儿童,其他方面没有显著差异。(3)八年级听障儿童在内外倾和精神质上要显著优于六年级听障儿童,在神经质和掩饰性上二者差异不显著。