Discussion on Standardization of Forensic Assessment of Olfactory Dysfunction / 法医学杂志

With the development of society, the improvement of living standards and the advancement of research methods, olfactory function has been paid more and more attention. Therefore, higher requirements for the forensic identification of olfactory function have also been put forward. Standardization construction of forensic medical examination and identification of olfactory dysfunction is urgently needed. Based on a comprehensive review of olfactory function and forensic assessment of olfactory dysfunction, this paper elaborates on problems related to the principles and timing of forensic assessment of olfactory dysfunction, the requirements of identification of traumatic olfactory dysfunction, the subjective and objective methods of examination of olfactory function. Strict control of the above issues is an important mean of standardization of forensic assessment of olfactory dysfunction.

Analysis on Forensic Expertise of 49 Medical Disputes in Prenatal Examination / 法医学杂志

OBJECTIVES@#To analyze the cases of medical disputes involving prenatal examination from a point of view of forensic expertise, and to discuss the risk of medical disputes and the preventive measures.@*METHODS@#A retrospective analysis was conducted on 49 forensic expertise cases of medical disputes in prenatal examination which were identified in Academy of Forensic Science and Shanghai Di'an Forensic Science Limited Company from 2010 to 2017.@*RESULTS@#In recent years, the number of medical disputes involving prenatal examination showed an increasing trend year by year. The common causes of medical disputes were: uninformed or insufficiently informed disclosure （20 cases）; the propaganda and application of three-dimensional, four-dimensional ultrasound were not standardized （14 cases）; ultrasound examination and serological screening process were not standardized （12 cases）; no antenatal counseling （2 cases）, etc.@*CONCLUSIONS@#In order to minimize the occurrence of such medical disputes, hospitals or related associations should avoid the risk of prenatal examination through the standardization of management and operation.

Retrospective Analysis of 24 Cases of Forensic Medical Identification on Traumatic Tympanic Membrane Perforations / 法医学杂志

OBJECTIVES@#To study the case characteristics of forensic medical identification of traumatic tympanic membrane perforations, and to discuss the key points of forensic medical identification and evaluations methods for tympanic membrane perforations.@*METHODS@#Twenty-four cases of traumatic tympanic membrane perforations accepted by the Academy of Forensic Science during 2017 were retrospectively analysed. The data of perforation size, form, predilection site, healing time and healing mode were evaluated.@*RESULTS@#For the traumatic tympanic membrane perforations, the study showed that the small size of perforation （<1/2 quadrant） with irregular shape was common. The location of perforations was almost on the anterior and inferior quadrant, and centripetal migration healing was common. The healing rate within 6 weeks was up to 90%.@*CONCLUSIONS@#In the identification cases of traumatic tympanic membrane perforations, the key is to determine whether it is traumatic and whether it will heal spontaneously within 6 weeks. It is suggested to check the tympanic membrane weekly by an otic endoscope combined with acoustic impedance measurement at the sixth week, which can improve the accuracy, objectivity and scientificity of the identification.

Application of low-concentration contrast agent and low-dose technology in 320-slice CT pulmonary angiography / 医疗卫生装备

Objective To explore the feasibility of low-concentration contrast agent and low-dose technology for pulmonary angiography by comparing the image quality and radiation doses to the patient by different tube voltages and concentrations of contrast agents.Methods Totally 60 patients suspected with pulmonary embolism were divided into C, L1 and L2 groups, of which,Group C had the scanning parameters of 120 kV and 350 mgI/ml,Group L1 had the parameters as 100 kV and 350 mgI/ml and Group L2 had the parameters of 100 kV and 270 mgI/ml.The three groups had the tube voltage as 500 mA, the contrast agent dose as 25 ml,physiological saline dose as 40 ml and flow rate as 4.5 ml/s.SPSS 19.0 software was used to compare and analyze the CT values of pulmonary artery segment,superior vena cava and ascending aorta,main pulmonary artery noises,the image quality as well as the radiation doses of volume scanning. Results The three groups had the main pulmonary aortas and their branches display clearly to meet clinical requirements.When compared with Group C,Group L1 had higher CT values of the main pulmonary aorta and its branches,higher image noise while lower radiation dose (P<0.01);Group L2 had equivalent CT values of the main pulmonary aorta and its branches (P>0.05),higher image noise while lower radiation dose (P<0.01).When compared with Group L1,Group L2 had lower CT values of the main pulmonary aorta and its branches (P<0.01),and equivalent image noise and radiation dose (P>0.05).Conclusion Low-concentration contrast agent and low-dose technology gains feasibility and advantages when used in 320-slice CT pulmonary angiography.

Correlation study of estrogen receptor and MRI morphological features for breast cancer / 医疗卫生装备

The expression status of estrogen receptor (ER) and MRI features of breast cancer were introduced,which included needle-like edge,ring enhancement,types of time-to-intensity curve (TIC) as well as the relationship between ADC values.The breast cancer patients with expression statuses had different MRI features including MRI morphology,enhancement state,enhancement mode and diffusion,and the main cause was that ER positive expression suppressed neovascularization to influence the focal fibrosis,necrosis,growth rate,perfusion and etc.Hormone level was pointed out to be evaluated by morphological manifestations of MRI dynamic enhancement and ADC value of diffusion weighted imaging,so that valuable information could be provided for the prognosis evaluation,treatment planning as well as the studies on ER expression status and TIC types.

Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.</p><p><b>METHODS</b>Participants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.</p><p><b>RESULTS</b>In total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.</p><p><b>CONCLUSIONS</b>Hemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.</p>

Research on Auditory Long Latency Response in Normal Hearing Subjects / 法医学杂志

OBJECTIVES@#To explore the characters and the relationship among latency response, amplitude and sound stimulus intensity of auditory long latency response（ALR）, and to investigate the significance of ALR applied in auditory threshold prediction.@*METHODS@#Total 46 subjects （92 ears） with normal hearing were tested by ALR. The ALR waves of the subjects were elicited by 5 sound stimulus intensity according to the order of 70, 50, 30, 20 and 10 dB nHL. By making N₁ wave and P₂ wave, the values of 3 observed indexes （the latencies of N₁ wave and P₂ wave and N₁-P₂ amplitude） were obtained, and the variation trend of the observed indexes were statistically analyzed. The differences in the frequency of the indexes were observed.@*RESULTS@#The rate of ALR waves from 46 subjects （92 ears） with normal hearing was 100%. The latencies of N₁ wave and P₂ wave delayed gradually and N₁-P₂ amplitude declined with sound stimulus intensity descending.@*CONCLUSIONS@#In suitable conditions, ALR is a stable technology for hearing thresholds prediction. The relation between sound stimulus intensity and latency of N₁ wave, latency of P₂ wave and N₁-P₂ amplitude of ALR plays an important part in auditory thresholds assessment.

Human Sulfatase-1 Improves the Effectiveness of Cytosine Deaminase Suicide Gene Therapy with 5-Fluorocytosine Treatment on Hepatocellular Carcinoma Cell Line HepG2 In Vitro and In Vivo / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human sulfatase-1 (Hsulf-1) is an endosulfatase that selectively removes sulfate groups from heparan sulfate proteoglycans (HSPGs), altering the binding of several growth factors and cytokines to HSPG to regulate cell proliferation, cell motility, and apoptosis. We investigated the role of combined cancer gene therapy with Hsulf-1 and cytosine deaminase/5-fluorocytosine (CD/5-FC) suicide gene on a hepatocellular carcinoma (HCC) cell line, HepG2, in vitro and in vivo.</p><p><b>METHODS</b>Reverse transcription polymerase chain reaction and immunohistochemistry were used to determine the expression of Hsulf-1 in HCC. Cell apoptosis was observed through flow cytometry instrument and mechanism of Hsulf-1 to enhance the cytotoxicity of 5-FC against HCC was analyzed in HCC by confocal microscopy. We also establish a nude mice model of HCC to address the effect of Hsulf-1 expression on the CD/5-FC suicide gene therapy in vivo.</p><p><b>RESULTS</b>A significant decrease in HepG2 cell proliferation and an increase in HepG2 cell apoptosis were observed when Hsulf-1 expression was combined with the CD/5-FC gene suicide system. A noticeable bystander effect was observed when the Hsulf-1 and CD genes were co-expressed. Intracellular calcium was also increased after HepG2 cells were infected with the Hsulf-1 gene. In vivo studies showed that the suppression of tumor growth was more pronounced in animals treated with the Hsulf-1 plus CD than those treated with either gene therapy alone, and the combined treatment resulted in a significant increase in survival.</p><p><b>CONCLUSIONS</b>Hsulf-1 expression combined with the CD/5-FC gene suicide system could be an effective treatment approach for HCC.</p>

Flexibility Analysis of Bacillus thuringiensis Cry1Aa / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the flexibility and mobility of the Bacillus thuringiensis toxin Cry1Aa.</p><p><b>METHODS</b>The graph theory-based program Constraint Network Analysis and normal mode-based program NMsim were used to analyze the global and local flexibility indices as well as the fluctuation of individual residues in detail.</p><p><b>RESULTS</b>The decrease in Cry1Aa network rigidity with the increase of temperature was evident. Two phase transition points in which the Cry1Aa structure lost rigidity during the thermal simulation were identified. Two rigid clusters were found in domains I and II. Weak spots were found in C-terminal domain III. Several flexible regions were found in all three domains; the largest residue fluctuation was present in the apical loop2 of domain II.</p><p><b>CONCLUSION</b>Although several flexible regions could be found in all the three domains, the most flexible regions were in the apical loops of domain II.</p>

Posture evoked response detecting in normal lower limb muscle and its influencing factors / 法医学杂志

OBJECTIVE@#To analyze the latency of posture evoked response of normal lower limb muscle in different stimulations and explore its influencing factors.@*METHODS@#The normal lower limb was induced to produce postural evoked response by the dynamic posturography through two kinds of perturbations, the supporting surface rotation stimulation (Toes-up and Toes-down) and the horizontal perturbation stimulation (Forward and Backward). The latencies of tibialis anterior muscle and gastrocnemius muscle were recorded by surface electromyography acquisition system. The differences of the left and right limb, gender and height on the latency of postural evoked response were analyzed.@*RESULTS@#(1) Under the Toes-up and Backward perturbation, the latency of tibialis anterior muscle was longer than gastrocnemius muscle; under the Toes-down and Forward perturbation, the latency of gastrocnemius muscle was longer than tibialis anterior muscle. (2) The latencies of left limb and right limb had no significant difference. (3) The latency in male was longer than that in female. (4) The latency gradually increased with the increase of height.@*CONCLUSION@#In the postural evoked response, different perturbations, gender and height have significant impacts on the latency of posture evoked response of lower limb muscle. However, the effect of height and gender should be not considered referring to the same individual.

Characteristics of computed dynamic posturography of patients with peripheral vertigo / 法医学杂志

OBJECTIVE@#To quantify the posture control ability of patients with peripheral vertigo by computed dynamic posturography (CDP).@*METHODS@#Ninety-one subjects diagnosed with peripheral vertigo by caloric test were divided into unilateral vestibular dysfunction group (unilateral group) and bilateral vestibular disorder dysfunction group (bilateral group). CDP tests including sensory organization test (SOT) and motor control test (MCT) were performed on all subjects. The CDP results were compared with the normal data by t-test.@*RESULTS@#In unilateral group, there was no statistically significant difference in SOT compared with normal data (P > 0.05). In bilateral group, the composite equilibrium score was lower than the normal data, especially during the moving of the platform and the changes of visual stimulation (P < 0.05). In MCT test, the latencies of both groups showed no statistically significant difference compared with normal data (P > 0.05).@*CONCLUSION@#During the non-acute period of peripheral vertigo, patients could maintain static equilibrium. Compared with normal people, dynamic equilibrium function is normal in patients with unilateral vestibular dysfunction, but declined in patients with bilateral vestibular dysfunction.

Research on Chinese medicine syndrome distribution of asymptomatic HIV infection patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore Chinese medicine syndrome distribution laws of asymptomatic HIV infection patients.</p><p><b>METHODS</b>Using Chi-square test, Chinese medicine syndrome distribution laws were compared and analyzed in 1 156 asymptomatic HIV infection patients from March 2009 to October 2011 from four aspects, i.e., age, possible infection time, disease duration, and different routes of infection.</p><p><b>RESULTS</b>Qi deficiency syndrome (QDS) and internal dampness-heat accumulation syndrome (IDHAS) were dominant in all syndrome types. Along with aging, QDS showed a growing tendency, while IDHAS showed obvious declining tendency. There was no obvious change in other syndrome types. There was statistical difference in the distribution of each syndrome type among each age period (P < 0.01). Within 15 years, along with the increase of infection time, QDS showed a growing tendency, while IDHAS ratio showed an obvious declining tendency. No obvious laws were found in other syndrome types. There was statistical difference in the distribution of each syndrome type (P < 0.01). Along with the prolongation of disease duration, the case number of each syndrome showed a decreasing trend, but QDS and IDHAS still accounted for higher ratios in each stage. There was statistical difference in the distribution of each syndrome type (P < 0.01). As for infection routes, QDS was predominant in paid blood donation, blood transfusion infection, intravenous drugs. IDHAS was predominant in sexual transmit. No obvious laws were found in other syndrome types. There was statistical difference in the distribution of each syndrome type (P < 0.01).</p><p><b>CONCLUSIONS</b>DIS, IDHAS, and no confirmable syndrome typing were dominant in asymptomatic HIV infection patients. Deficiency and dampness were important pathological factors for them.</p>

Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.</p><p><b>METHODS</b>The survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.</p><p><b>RESULTS</b>The analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).</p><p><b>CONCLUSIONS</b>The prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.</p>

Research on rules of distribution and development of traditional Chinese medicine syndromes of 2,237 HIV/AIDS cases / 中国中药杂志

HIV/AIDS patients in high prevalence areas with different routes of infection (sexually transmitted 878 cases, 527 cases of intravenous drug user, paid blood donor 652 cases) were choosen for traditional Chinese medicine (TCM) syndrome investigation for one-year clinical follow-up. This paper primarily concluded the nature, location and pathogenesis of AIDS diseases. Deficiency of Yang and Yin, combining deficiency of Qi are the basic deficiency syndromes, while stagnation of dampness, toxic fire are the excess syndromes; the disease location of HIV infector is spleen, main syndrome is deficiency of spleen Qi; the disease location of AIDS patient is kidney, main syndrome is deficiency of spleen and kidney Yang. The pathogenic development tendency is from deficiency of Qi to combining stagnation of dampness and toxic fire, finally to deficiency of Qi and Yin, deficiency of Yang.

Study of traditional Chinese medicine syndrome features of AIDS-related chronic diarrhea / 中国中药杂志

<p><b>OBJECTIVE</b>To study the AIDS-related chronic diarrhea in traditional Chinese medicine (TCM) clinical manifestations and syndrome factors, explore the characteristics of syndrome.</p><p><b>METHOD</b>A multicenter, prospective collection of 311 cases of AIDS patients with chronic diarrhea, study the characteristics of TCM syndrome by using the method of descriptive statistics and exploratory factor analysis.</p><p><b>RESULT</b>The common clinical manifestation of TCM: fatigue (229 cases, 73.63%), bowel (229 cases, 68.81%), diarrhea (194 cases, 62.38%), thin fur (201 cases, 64.63%), pink tongue (166 cases, 53.38%), greasy fur, thready pulse (126 cases, 40.51%), sink vein (64 cases, 20.58%), slippery pulse. 17 common factors were extracted, common disease syndrome factor as the spleen, stomach, liver, gallbladder and colon syndrome factors of disease, Qi, Yang deficiency, Qi stagnation, dampness and heat evil.</p><p><b>CONCLUSION</b>AIDS-related chronic diarrhea symptoms involving multiple organs, the disease belongs to deficiency and excess.</p>

Study on quality of life of asymptomatic HIV infected persons with traditional Chinese medicine / 中国中药杂志

<p><b>OBJECTIVE</b>Study on quality of life of asymptomatic HIV infected persons with traditional Chinese medical, which can provide the clinical basis for improving the quality of life.</p><p><b>METHOD</b>This study applied a randomized, double-blind, and placeb-parallel control designed method to select 1 200 persons in the asymptomatic period of HIV infection as the subjects. The subjects were randomly divided into the treatment group and the control group at the ratio of about 2:1. According to the results of monthly differential diagnosis of TCM, the test group and the control group were given homologue Chinese drugs preparations and model Chinese drugs. The total study period was 18 months. Using PRO scale and the world health organization AIDS determination of quality of life short scale form (WHOQOL-HIV-BREF) to investigate asymptomatic HIV infected persons, according to different times, we calculated the total score and each domain score of quality of life of the treatment group and control group, we did statistical analysis.</p><p><b>RESULT</b>Form the PRO scale,we can see that the treatment group showed a trend of stability, compared with the control group with significant statistical difference (P < 0.05) after 6 months; from the WHOQOL-HIV scale analysis, we can see that compared with before treatment, the quality of life of the treatment group was increased, the difference was significant (P < 0.05), but the quality of life of the control quality of life was decreased, the differences was significant (P < 0.05).</p><p><b>CONCLUSION</b>Dialectical therapy of Chinese medicine can significantly improve the patient's quality of life, which can provide the basis for the prevention and control policy formulation and implementation with asymptomatic HIV infected persons.</p>

Forensic medical identification of 355 cases with hearing impairment / 法医学杂志

OBJECTIVE@#To analyze the difference of subjective hearing threshold and objective hearing threshold, and to discuss the importance of standard for hearing evaluation in forensic medicine.@*METHODS@#Three hundred and fifty-five cases (387 ears) of forensic medical identification with hearing impairment were retrospectively analyzed including the items entrusted and hearing test results. All cases were collected from 2004 to 2012 in the forensic science center.@*RESULTS@#In the 387 ears, 218 ears (56.3%) were evaluated the degree of disability and 106 ears (27.4%) were identified the degree of damage. In the disability degree evaluation, the subjective hearing threshold and the objective hearing threshold were significant different in 120 ears (55.0%), while in damage degree evaluation, the subjective hearing threshold and the objective hearing threshold were significant different in 69 ears (65.1%).@*CONCLUSION@#Because of camouflaging or exaggerating the hearing impairment by the wounded, the subjective hearing threshold can't accurately assess the existence and the degree of hearing impairment. In the forensic identification, auditory brainstem response, 40 Hz auditory event related potential and auditory steady-state response should be combined in the application to evaluate the hearing impairment for the wounded in order to ensure the reliability of the evaluation of hearing impairment.

Comparisons among three frequency-specific auditory evoked potentials in normal hearing adults / 法医学杂志

OBJECTIVE@#To provide supports for the application of auditory evoked potential (AEP) in the evaluation of behavioral threshold, by studying the difference and relevance between the pure tone audiometry (PTA) and three frequency-specific auditory evoked potentials, including 40 Hz auditory event related potentials (40 Hz AERP), tone burst auditory brainstem response (Tb-ABR) and auditory steady-state response (ASSR).@*METHODS@#Three frequency-specific AEP and PTA thresholds were recorded at speech frequency (0.5, 1, 2, 4 kHz) from thirty-four adults with normal hearing (68 ears). Then, the relationship between the AEP thresholds and PTA thresholds were analyzed respectively.@*RESULTS@#There were good correlations between three frequency-specific AEP thresholds and PTA thresholds at speech frequency. However, the difference of thresholds between each frequency-specific AEP and PTA was not same. The difference of thresholds were the smallest and the relevance were the best between 40 Hz AERP and PTA at 0.5 kHz, and between ASSR and PTA at 2, 4 kHz. At 1 kHz, there were not statistical difference between ASSR, 40 Hz AERP and PTA, while the relevance of 40 Hz AERP was better than ASSR.@*CONCLUSION@#Different methods should be chosen to assess the objective behavioral thresholds at different frequency.

Identifying malingering symptoms of balance disorders by computerized dynamic posturography / 法医学杂志

OBJECTIVE@#To develop an objective criteria with computerized dynamic posturography (CDP) for identification of non-organic or malingering symptoms of balance disorders.@*METHODS@#One hundred and four normal subjects were instructed to feign balance disturbance after naturally performing on CDP. Paired t-test was used to determine if there was significant difference of CDP equilibrium scores between normal and malingering performance. The CDP records including raw curve of 50 subjects were critically evaluated by previously published seven criteria in indicating malingering performance. If the sensitivity of a criterion was greater than 90%, it would be accepted as our laboratory's identifying criterion. The CDP records of remaining 54 subjects were used to test the sensitivity and specificity of the accepted criteria.@*RESULTS@#There were statistically significant differences of CDP equilibrium scores between normal and malingering performance (P < 0.01). The mean equilibrium scores of malingering performance were lower than that of normal performance. The sensitivity and specificity of our criteria for identifying malingerers were 92.5% and 98.2%, respectively.@*CONCLUSION@#It is necessary to identify malingering performance before analyzing the CDP equilibrium scores. Our identifying criteria of malingerers seems to be quite useful and accurate.

The progress in the study on auditory evoked potentials / 法医学杂志

Auditory evoked potential (AEP) is the electric activities originating from auditory systems evoked by sound stimulus. AEP include cortical electric response audiometry (CERA), auditory brainstem evoked response (ABR), 40 Hz auditory event related potentials (40 Hz AERP), auditory steady-state response (ASSR), etc. For the subjects who cannot provide reliable or accurate behavioral hearing threshold, those techniques have been explored to evaluate the behavioral hearing threshold objectively. These techniques are reviewed in this article and are found that they could reflect the behavioral hearing threshold very well. CERA is difficult to operate because it is affected by the subject's wakefulness. ABR is the most widely used method currently and is not affected by the subject's consciousness, but it only reflects high frequencies. 40 Hz AERP has good sensitivity, while its results highly depend on the subject's consciousness. ASSR can be operated by using multiple frequency stimuli simultaneously to both ears and the test time is short. It is still a very difficult task to combine different techniques according to their characteristics in forensic audiology.