Application of flipped classroom combined with problem-based learning in the teaching of diagnostic audiology / 中华医学教育探索杂志

Objective:To investigate the teaching effect of flipped classroom combined with problem-based learning (PBL) in the teaching of the Diagnostic Audiology course.Methods:A total of 72 undergraduate students majoring in audiology and speech rehabilitation in the classes of 2019 and 2020 in Chongqing Medical University were enrolled as subjects, and three chapters of the Diagnostic Audiology course were selected for teaching reform. The 34 students in the class of 2019 were enrolled as control group and received lecture-based learning (LBL), and the 38 students in the class of 2020 were enrolled as experimental group and received flipped classroom combined with PBL. The teaching effect was evaluated by comparing the two groups in terms of classroom test scores, classroom participation scores, degree of satisfaction with teaching effect, and overall satisfaction with teaching. SPSS 23.0 software was used to perform the t-test, the chi-square test, and the Mann-Whitney U test. Results:The experimental group had a significantly higher classroom test score than the control group (25.95±1.21 vs. 23.21±1.55, P<0.001). In terms of classroom participation scores, the experimental group had significantly higher scores of participation in class discussion, cooperative and collaborative abilities, and questioning skills than the control group (all P<0.001). In terms of the degree of satisfaction with teaching, compared with the control group, the experimental group had significantly higher degrees of satisfaction in the dimensions such as interest in learning, mastery of theoretical knowledge, teamwork and collaboration abilities, self-learning ability, and self-presentation ( P=0.005, 0.009, 0.001, 0.016, and 0.005). In addition, the experimental group had a significantly higher degree of overall satisfaction with teaching than the control group ( P=0.006). Conclusion:Flipped classroom combined with PBL has a good teaching effect in the Diagnostic Audiology course and thus holds promise for further application.

Construction of basic rehabilitation training course for family doctor teams serving for people with disabilities based on WHO rehabilitation competency framework / 中国康复理论与实践

ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.

Construction of a new skill training program of sensory system for medical students in "5 + 3"education model / 中华医学教育探索杂志

To explore the organ-system oriented integrated program, this project constructed a new clinical skill training program of sensory system for"5+3" medical students. According to the current trend and requirement of medical teaching reform, taking into consideration of the present status of clinical skills teaching, this project integrated the basic and clinical teaching contents of otolaryngology, ophthalmology and dermatology to design a new training program of clinical skills for"5+3"medical students. Specifically, the project group edited a new textbook and syllabus, and set up a specialized teaching group. In this system, the training models included simulation training and practical bedside training, the assessment included operation ability and analyzing ability for clinical cases, and the training contents involved all conventional skills of each specialty. It has been demonstrated that the new training program is capable of promoting the clinical skills of students quickly and effectively.

A prospective controlled study on the proper time of intratympanic steroid for profound sudden sensorineural hearing loss of total frequency type / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the proper time of intratympanic steroid as combination therapy in treatment of patients with profound sudden sensorineural hearing loss(SSNHL) of total frequency type.@*Methods@#This prospective study included 50 patients with SSNHL in the First Affiliated Hospital of Chongqing Medical University from June 2017 to February 2018.All these patients had profound hearing loss averaged more than 81 dB at all frequencies (250-8 000 Hz). They were divided into two groups.The patients in group A were treated with simultaneous oral prednisone (1 mg/kg, qd) and intratympanic methylprednisolone (40 mg, qd) for 5 days.The patients in group B were treated with oral prednisone for 5 days as in group A, and then those who had no significant improvement were subsequently treated with intratympanic methylprednisolone (40 mg, qd)for further 5 days.All patients were treated with additional intravenous batroxobin and ginkgo biloba leaves extract.Following examination of pure tone audiogram, hearing gains and effective rates were statistically analyzed in both groups with SPSS software package(version 20.0).@*Results@#Hearings in both groups were improved significantly after treatment.In group A(20 cases), hearing gain was (29.2±22.7) dB and total effective rate was 65.0%, while in group B(22 cases), they were (27.3±22) dB and 68.2% respectively.There were no significant differences in hearing gain and recovery rate between two groups (hearing gain, P=0.793; total effective rate, P=0.827).@*Conclusions@#For patients with profound SSNHL of total frequency type, the efficacies of intratympanic steroid as simultaneous and subsequent therapy are equivalent. Therefore, subsequent intratympanic glucocorticoid is recommended for SSNHL patient of total frequency type to reduce complications and medical expenses.

Analysis of clinical characteristics of sigmoid sinus diverticulum / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze the clinical features of 8 patients with sigmoid sinus diverticulum and to improve the level of diagnosis and treatment. METHODS The tinnitus patients were asked in detail about the history, and performed a series of routine hearing tests (pure tone audiometry, acoustic impedance audiometry, otoacoustic emission inspection and brainstem auditory evoked potential (BAEP) etc.) and temporal bone HRCT scan. Eight cases were diagnosed with sigmoid sinus diverticulum, in which six cases undertook a surgery to reconstruct the sinus wall while the other 2 cases chose conservative treatment. RESULTS The diagnosis of 6 cases was proved to be correct by surgery, and the pulsatile tinnitus disappeared after reconstructing the sinus wall. No one recurred after following up from 2 to 12 months. Two cases of conservative treatment had no obvious improvement in symptoms. CONCLUSION Clinical manifestation, hearing examination, temporal bone CT/HRCT and Cranial CTA/CTV contributed to the diagnosis of sigmoid sinus diverticulum. Sinus wall reconstruction is a better approach.

Multi-center study on the treatment of sudden deafness accompanied with tinnitus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and the effects of different drug therapies in patients of sudden deafness accompanied with tinnitus.</p><p><b>METHODS</b>The international standardized clinical research methods, the unified design and program were used in the study. The patients of sudden deafness accompanied with tinnitus, aged between 18 to 65 years old, were recruited, whose duration was less than two weeks with no medication. The patients were divided into four types according to the hearing curve: type A was acute sensorineural hearing loss in low tone frequencies, type B was acute sensorineural hearing loss in high tone frequencies, type C was acute sensorineural hearing loss in all frequencies and type D was total deafness. Each type had four different treatment programs, based on the unified designed randomized table.</p><p><b>RESULTS</b>A total of 1024 cases with single side sudden deafness were recruited in the study by 33 hospitals in China from August 2007 to October 2011. Among the 1024 cases, 922 cases were accompanied with tinnitus (90.04%). By classification of audiogram, among the 922 cases, 169 cases were type A (82.44%), 127 cases were type B (90.07%), 370 cases were type C (92.04%), and 256 cases were type D (92.75%). The tinnitus mostly was persistent and low tone tinnitus. The degree of the tinnitus was mostly 2-3 grade. The curative effects of different types were analyzed, type A had the highest rate of 96.18%, type C was 87.75%, type B was 81.51%, and type D had the lowest rate of 75.32%. Significant difference of curative rate between different types was detected (χ² = 125.33, P = 0.000). There had no significant difference between the four different treatment groups (all P > 0.05).</p><p><b>CONCLUSIONS</b>In the cases with single side sudden deafness accompanied with tinnitus, the type in low tone frequencies has the best curative effect, followed by the type in all frequencies. The type in high tone frequencies and the total deafness type have poor curative results. The steroid plays a good effect in the treatment.</p>

Combined oral and intratympanic glucocorticoids treatment for severe to profound sudden sensorineural hearing loss / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo evaluate the efficacy of combined oral and intratympanic glucocorticoids treatment for severe to profound sudden sensorineural hearing loss(SSNHL).METHODSFifty-four patients with severe to profound SSNHL were retrospectively studied. They were treated with oral steroids, vasodilators, anticoagulants. The patients who accepted intratympanic methylprednisolone sodium succinate were included the therapy group, the others were included in the control group. Hearing improvements were analyzed respectively after two weeks.RESULTSHearing in both groups were improved significantly after treatment(P<0.01), but there was no difference in hearing improvements between two groups(P=0.194). The efficacy for severe SSNHL patients in therapy group was equal to those who were in control group (P=0.251), so was the efficacy for profound SSNHL patients in both groups(P=0.380).CONCLUSIONThe combined systemic and intratympanic glucocorticoids treatment was effective for patients with severe to profound SSNHL, but while with no better efficacy than oral glucocorticoid alone.

The Regulatory Functions of Aquaporin 2 by Deamino Arginine Vasopressin in Cochleas of Gui nea Pigs / 听力学及言语疾病杂志

Objective To investigate the expression of aquaporin 2 (AQP2) in an endolymphatic hydrops ani-mal model .Methods Forty adult guinea pigs were randomly divided into experiment group and control group (20 animals in each group ) . Guinea pigs in the experiment group were treated with deamino arginine vasopressin (DDAVP) intraperitoneally at the dosage of 4 μg · kg -1 · d-1 for 7 days ,while those in the control group were treated with physiological saline .The endolymphatic hydrops and expression of AQP2 in cochleas of all animals were evaluated by Hematoxylin and Eosin stain ,immunohistochemistry and Western blot .Results The endolymphatic hydrops in the experiment group were more severe than that in the control group(P<0 .05) .Expression of AQP2 were found in the stria vascularis and spiral ganglions in both groups with similar patterns .Both immunohistochem-istry and Western blot showed that the expressions of AQP2 in the experiment group were significantly stronger(P<0 .05 ) .Conclusion DDAVP can up-regulate the expression of AQP2 in the cochleae of guinea pigs ,thus may be closely related to the pathogenesis of endolymphatic hydrops .

Proposal on the cultivation of hearing aids fitting practitioner in China / 中华医学教育探索杂志

This paper discussed the current status of hearing aids fitting practitioners in China and proposed some proposals on how to cultivate qualified practitioners.The proposals includes setting up short-term training program,launching hearing aids fitting major in occupational schools and cultivating the hearing aids fitting practitioners from the would-be audiologists or otologists in an aim to meet the urgent hearing aids fitting need of Chinese deafness.

Expression Patterns of Nedd4 Isoforms and SGK1 in the Rat Cochlea / 听力学及言语疾病杂志

Objective To investigate the cellular localization of the neural precursor cell-expressed, developmentally downregulated isoforms(Nedd4), Nedd4- 1/2 and Nedd4- 2, and the serum glucocorticoid- inducible kinasel(SGK1) in various subregions of the rat cochlea. Methods The expression patterns of Nedd4-1/2, Nedd42 and SGK1 in the cochlea of rat were studied by immunohistochemistry with the specific polyclonal rabbit antibodies against the rat Nedd4-1/2, Nedd4-2 and SGK1. Results All three proteins were extensively expressed in various regions of the rat cochlea. They were found in the stria vascularis, spiral ligament, organ of Corti, spiral limbus, spiral ganglion and Reissner's membrane. Conclusion Our findings suggest that there exists a Na+ transport system in the cochlea consisting of SGK1, Nedd4 isoforms and ENaC, which may work in concert to transport Na+ and to maintain homeostasis in the inner ear as they do in other tight epithelia.

Expression Patterns of Aquaporins in the Cochlea and Endolymphatic Sac of Guinea Pig / 听力学及言语疾病杂志

Objective To investigate the cellular localization of aquaporins(AQPs) and its significance in various subregions of the cochlea and endolymphatic sac of guinea pig.Methods Adult guinea pigs were used and the expression patterns of AQP1,2,3 and 4 in the cochlea and endolymphatic sac were studied immunocytochemically. Paraffin- embedded sections were labeled with the specific polyclonal rabbit antibodies against the rat AQP1, 2, 3, and 4.Results In the cochlea, AQP1, 3, 4 were widely distributed in various subregions including the stria vascularis, spiral ligament, organ of Corti and spiral ganglion in the similar patterns except that AQP3 in the stria vascularis was weaker than AQP1 and AQP4. AQP2 was labeled only in the Reissner's membrane. In the endolymphatic sac, AQP1, AQP3 and AQP4 were strongly expressed in the epithelial cells and subepithelial cells with the exception that AQP3 was a little weaker than AQP1 and AQP4. No AQP2 immunoreactivity was detected in the endolymphatic sac.Conclusion Our immunohistochemical results suggest that different members of AQPs family in labyrinth may work in concert to regulate endolymph and to maintain homeostasis in the inner ear.

Effect of Gentamicin on the Expression of Subunit Isoforms of Na, K-ATPase in Stria Vascualris of Guinea Pig / 听力学及言语疾病杂志

ObjectiveTo investigate the expression of asubunit isforms of Na,K-ATPase in stria vascularis of guinea pig, and the effect of gentamicin on it. MethodsThe expression of a subunit isoforms of Na, K-ATPase in stria vascualris of guinea pig and its change after gentamicin exposure were identified immunocytochemically using the specific mouse antibodies a gainst the α1 ,α2 and α3 subunits of rat Na,K-ATPase. ResultsAll marginal cells,intermediate cells and basal cells of stria vas cualris showed positive expression of α1 isoform and negative expression of α2 and α3 isoforms. The immunostaining of α1 isform was attenuated significantly after gentamicin esposture. ConclusionGentamicin significantly inhibits the expression of Na, K-ATPase α1 subunit isoform of the stria vascularis, sequentially inhibits the activity of Na,K-ATPase.

Expression of ? Subunit Isoforms of Na,K-ATPase in the Inner Ear of Guinea Pig / 听力学及言语疾病杂志

Objective To investigate the distribution and its significance of ? subunit isoforms of Na,K-ATPase in the inner ear of guinea pig.Methods The expression of ? subunit isoforms of Na,K-ATPase in labyrinth was studied immunocytochemically with the specific mouse antibodies against the ? 1?? 2 and ? 3 subunits of rat Na,K-ATPase.Results The expression of Na,K-ATPase ? subunit isoforms varied among different cell regions of the inner ear. The ? 1 subunit isoform was widely distributed in almost all regions, and was most abundant in the stria vascularis, sensory cells of the crista ampullaris and macula of the saccule, and the spiral ganglion cells, while the ? 2 and ? 3 subunit isoforms were present primarily in the spiral ganglion cells,the organ of Corti and stria vascularis.Conclusion The differential expression of Na,K-ATPase subunit isoforms presumably reflects different K + and Na + transport capacities among inner ear cells which, working in concert, serve to maintain homeostasis in inner ear.