Inhibition of lead-induced hepatic inflammation by inhibiting neutrophil granule protein in mice / 中国职业医学

Objective To explore the beneficial effects and mechanisms of neutrophil elastase (NE) and myeloperoxidase (MPO) on lead-induced hepatic inflammation in mice. Methods The specific pathogen free male C57BL/6 mice were randomly divided into four groups： control group, lead-exposed group, NE inhibitor group, and MPO inhibitor group, with three mice in each group. The mice in lead-exposed group, NE inhibitor group, and MPO inhibitor group were intraperitoneally injected with a dose of 10 mg/kg body mass of lead acetate solution, while the mice of control group received an equal volume of 0.9% saline three times per week for four weeks. In the last seven days, mice in both inhibitor groups were intraperitoneally injected with a dose of 40 mg/kg NE inhibitor sivelestat sodium or MPO inhibitor 4-aminobenzoic acid hydrazide (4-ABAH) once per day. Mouse body weight and liver histopathological changes were observed. The mRNA expression of genes associated with inflammation, such as tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), interleukin-6 (Il6), and nucleotide-binding oligomerization domain-like receptor protein 3(Nlrp3), apoptosis-associated speck-like protein (Asc) and cysteinyl aspartate specific proteinase (Caspase1) in the mouse liver tissues was detected by real-time quantitative polymerase chain reaction. The protein expression of NLRP3, ASC, and CASPASE-1 was detected using Western blotting. Results The activities of mice in all four groups were generally normal, and there was no significant difference in body weight (P>0.05). The results of hematoxylin-eosin staining showed that the cell size of hepatocytes varied in the lead-exposed mice, with indistinct cell boundaries, indicating early inflammatory responses in liver tissues. After intervention with NE or MPO inhibitors, the early inflammatory responses improved in the liver tissues of the mice in both inhibitor groups, with a better improvement observed in MPO inhibitor group compared with the NE inhibitor group. The mRNA expression of Tnfa, Il1b, Il6, Nlrp3, Asc, and Caspase1, as well as the protein expression of ASC, and CASPASE-1 in the livers of mice in the lead-exposed group was higher compared with those in the control group (all P<0.05). Compared with the lead-exposed group, the relative mRNA expression of Tnfa, Il1b, Il6, Nlrp3 and Asc was decreased in the liver tissues of mice in the NE inhibitor group (all P<0.05), while the relative expression of mRNA of Tnfa, Il1b, Il6, Caspase1 and the protein expression of ASC and CASPASE-1 were decreased in the liver tissues of mice in the MPO inhibitor group (all P<0.05). Conclusion Lead induce hepatic inflammation in mice by activating NLRP3 inflammasome. The inhibition of NE or MPO improve the lead-induced hepatic inflammatory responses in mice by alleviating NLRP3 inflammasome activation.

Efficacy analysis of neoadjuvant chemotherapy for resectable locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma at the gastroesophageal junction / 肿瘤研究与临床

Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy for the resectable locally advanced adenocarcinoma at the gastroesophageal junction.Methods:A retrospective cohort study was conducted to analyze 86 patients with resectable locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma at the gastroesophageal junction (T 3-4N +M 0) who were admitted to the Panzhihua Central Hospital of Sichuan Province from January 2013 to January 2016. All the patients were divided into the neoadjuvant chemotherapy group [preoperative XELOX regimen (oxaliplatin + capecitabine) adjuvant chemotherapy + surgery + postoperative XELOX regimen adjuvant chemotherapy, 46 cases] and non-neoadjuvant chemotherapy group (surgery + postoperative XELOX regimen adjuvant chemotherapy, 40 cases) according to whether neoadjuvant chemotherapy was performed before surgery. The total gastrectomy + Roux-en-Y esophagojejunostomy + D 2 lymphadenectomy or proximal subtotal gastrectomy + esophageal gastric remnant anastomosis + D 2 lymphadenectomy were applied to patients by the same team of doctors. The observation indicators included treatment situations, results of postoperative pathological examination and prognosis in the two groups. Results:In the neoadjuvant chemotherapy group, 25 patients (54.3%) had partial remission (PR), 21 patients (45.7%) had stable disease (SD), the clinical response rate was 54.3% (25/46), tumor control rate was 100.0% (46/46), and clinical stage reduction rate was 37.0% (17/46). Compared with the non-neoadjuvant chemotherapy group, the neoadjuvant chemotherapy group had a higher R 0 resection rate [100.0% (46/46) vs. 80.0% (32/40), χ2 = 4.024, P = 0.045], and in the neoadjuvant chemotherapy group, the pathological complete remission [tumor regression grade (TRG) 0] rate was 13.0% (6/46), and the overall pathological response (TRG 1 + TRG 0) rate was 56.5% (26/46). The postoperative pathological examination showed that the neoadjuvant chemotherapy group and the non-neoadjuvant chemotherapy group had statistically significant differences in the longest tumor diameter, vessel carcinoma embolus, perineural invasion, and pathological TNM staging (all P < 0.05). However, there was no statistical difference in the total humber of lymph nodes, the number of positive lymph nodes, pathological T stage, N stage, and human epidermal growth factor receptor 2 (HER2) expression in specimens (all P > 0.05). In the neoadjuvant chemotherapy group, 6 patients had grade 3 adverse reactions, and chemotherapy was suspended or the dose was adjusted. Adverse reactions in the blood system included the red blood cells reduction, white blood cells reduction and thrombocytopenia. Other adverse reactions included nausea, vomiting, and decreased appetite. There were no deaths related to radiotherapy. In the neoadjuvant chemotherapy group, the median tumor-free survival time was 20 months (5-36 months), and the 1-year and 3-year tumor-free survival rates were 89.5% and 52.4%, respectively; the median postoperative overall survival time was 20 months (9-36 months), and the 1-year and 3-year overall survival rates were 91.0% and 48.0%, respectively; 12 patients had tumor recurrence. In the non-neoadjuvant chemotherapy group, the median tumor-free survival time was 19 months (10-35 months), and the 1-year and 3-year tumor-free survival rates were 87.3% and 30.0%, respectively. The median postoperative overall survival time was 20 months (10-35 months), the 1-year and 3-year overall survival rates were 87.0% and 18.6%, respectively; 14 patients had tumor recurrence. There was a statistical difference in the tumor-free survival between the two groups ( χ2 = 4.522, P = 0.03), and there was no statistical difference in the overall survival between the two groups ( χ2 = 3.717, P > 0.05). Conclusions:XELOX regimen neoadjuvant chemotherapy is safe and effective for patients with resectable locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma at the gastroesophageal junction. It can decrease the tumor clinical stage and increase the R 0 resection rate and tumor-free survival rate.

Expression of TLR4/MyD88/NF-κB pathway genes and its related inflammatory factors in secondary spinal cord injury / 浙江大学学报·医学版

OBJECTIVE: To investigate the expression of Toll-like receptor 4 (TLR4)/myeloid differentiation factor (MyD88)/nuclear factor-κB (NF-κB) pathway genes and related inflammatory factors tumor necrosis factor-α (TNF-α), interleukin (IL)-12, IL-6 in patients with secondary spinal cord injury (SSCI) and the correlations with prognosis. METHODS: The clinical data of 105 SSCI patients and 40 healthy subjects were reviewed. According to Frankel's classification of spinal cord injury, the patients were divided into complete injury group and incomplete injury group, and according to the improvement of Japanese Orthopedic Association (JOA) scores, the patients were divided into good prognosis group and poor prognosis group. The expression of TLR4, MyD88, NF-κB in peripheral blood mononuclear cells (PBMC) and serum TNF-α, IL-12, IL-6 levels were compared between SSCI patients and healthy controls, between patients with complete and incomplete injury, between patients with poor and good prognosis. Logistic regression analysis was used to analyze the risk factors leading to poor prognosis of SSCI, and Pearson's correlation analysis was used to analyze the correlation between JOA score and the above indicators. RESULTS The expressions of TLR4, MyD88, NF-κB in PBMC and serum TNF-α, IL-12, IL-6 levels in SSCI patients were significantly higher than those in healthy subjects (all P<0.01), those in complete injury group were higher than those in incomplete injury group, and those in poor prognosis group were higher than those in good prognosis group (all P<0.01). The proportions of patients with Frankel grade A, spinal cord edema or hemorrhage, spinal cord injury length longer than 4 cm in poor prognosis group was significantly higher than those in good prognosis group (all P<0.01). Logistic regression analysis showed that Frankel grade, spinal cord edema or hemorrhage, length of spinal cord injury, relative expressions of TLR4, MyD88, NF-κB in PBMC, serum levels of TNF-α, IL-12 and IL-6 were risk factors for poor prognosis in SSCI patients (P<0.05 or P<0.01). Pearson's correlation analysis showed that JOA improvement rate was negatively correlated with the relative expressions of TLR4, MyD88, NF-κB mRNA in PBMC and serum TNF-α, IL-12, IL-6 levels (P<0.05 or P<0.01). CONCLUSIONS The activation of TLR4/MyD88/NF-κB pathway and the up-regulation of the expression of related inflammatory factors TNF-α, IL-12 and IL-6 are involved in the progression of SSCI, which are closely related to the neuroinflammatory injury, and can be used as reference indexes for evaluating prognosis in SSCI patients.

Long Term Effects Observation on Acupuncture of Liji Therapy for Primary Dysmenorrhea of Cold-damp Stagnation Type / 世界科学技术-中医药现代化

Objective: To evaluate the long term efficacy of treating the primary dysmenorrhea of cold-damp stagnation type by Acupuncture of Liji therapy. Methods: In this study, a total of 76 cases of primary dysmenorrhea of cold-damp coagulation type were randomly divided into the acupuncture of Liji therapy group, and the body acupuncture group, with38 cases in each group. Both groups were continuously treated 3 menstrual cycles, and followed up in the third and six menstrual cycles after the end of the treatment. Visual analogue scale for abdominal pain and Dysmenorrhea Symptoms scale were used as therapeutic indexes. Remove shedding cases, the long-term effects and scores of the 2 groups were compared. Besides, untoward and side effects needed to be recorded. Results: There were 2 cases lost in the acupuncture ofLiji therapy group and 1 cases in the body acupuncture group. After treatment, The clinical comprehensive efficacy of acupuncture ofLiji therapy group was better than that of body acupuncture group (P ＜ 0. 05) . Both groups of VAS scores and dysmenorrhea symptom scores were decreased to different degrees during treatment and follow-up period (P ＜ 0.05) .The follow-up data of the body acupuncture group after six menstrual cycles were higher than that of the third menstrual cycles after treatment. Compared with the two groups, the acupuncture of Liji therapy group was superior to the body acupuncture group during the third menstrual cycles follow-up (P ＜ 0.05) and six menstrual cycles follow-up (P ＜ 0.01) .The treatment satisfaction of acupuncture of Liji therapy and body acupuncture was 91.67％ and 72.97％. There were no adverse reactions in the two groups during the study period. Conclusion: Acupuncture of Liji therapy can effectively relieve dysmenorrhea symptoms and the general discomfort caused by dysmenorrhea, the long-term effect is stable and durable. primary dysmenorrhea of cold-damp stagnation type with acupuncture of Liji therapy has definitely long term curative effect. In addition, the treatment of patients with acupuncture of Liji therapy is more satisfactory, it is worthy of cilnlcal application.

The Relationship between the Development of Auditory and Speech in Children with Hearing Loss after Hearing Aid Fitting / 听力学及言语疾病杂志

Objective To study the relationship between the development of auditory and speech in children with hearing loss after hearing aid fitting and discuss the development of speech with the ability of auditory in children at different stages of evaluation, with different degrees of hearing loss and different ages respectively.Methods A total of 19 children (14 boys and 5 girls) with hearing loss participated in this study.The age at hearing aid fitting ranged from 3 to 8 years old with a mean of 5.42±1.86 years old.According to their hearing levels, the children in this study were divided into two groups: the moderate hearing loss group (n=10) and the severe group (n=9).According to their ages at hearing aid fitting, all children in this study were divided into two groups: the less than or equal to six years old (n=11) and greater than six years old (n=8).MAIS and MUSS were used to evaluate their abilities of auditory and speech at pre-fitting, 1, 3, 6, 9 and 12 months after hearing aids were worn respectively.A linear and regression analysis was done in the statistic procedure.Results There was a significant correlation between the scores of MAIS and MUSS (R=0.774,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for the different evaluating stages respectively.The correlations were pre-fitting (R=0.710,P<0.05), 1 month after hearing aid fitting (R=0.774,P<0.05), 3 months after hearing aid fitting (R=0.814,P<0.05), 6 months after hearing aid fitting (R=0.819,P<0.05), 9 months after hearing aid fitting (R=0.707,P<0.05), 12 months after hearing aid fitting (R=0.649,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for MAIS (items 3~6) (Sound awareness) and MAIS (items 7~10) (Sound understanding).The correlations for MAIS (items 3~6) were (R=0.768,P<0.05), and for MAIS (items 7~10) (Sound understanding) (R=0.794,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different group of ages.The correlations for the group of <6years old were (R=0.808,P<0.05), and for the group of the ≥6 years old (R=0.775,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different groups of hearing loss levels.The correlation for the group of moderate hearing loss was (R=0.771,P<0.05), and the group of severe hearing loss (R=0.787,P<0.05).Conclusion The development of auditory ability is closely related to the speech ability.The speech abilities increase with the improvement of auditory abilities.The less severe the hearing loss is, the longer the use of hearing aids, the younger the children are, the better the speech ability improved with auditory ability development after hearing aid fitting.

ICU clinical information system management mode / 医学研究生学报

With the development of health care, the use of modern medical devices and the improvement of hospital manage-ment system, Intensive care unit( ICU) emerges.ICU is a treatment-nursing ward, which is a collection of modern medical care tech-nology.With ICU information constructive practice of Nanjing General Hospital of Nanjing Military Region as the background, this pa-per introduces the target base、functional requirements、business processes of the intensive care information system management mode of operation from the perspective of clinical application.Furthermore, this paper describes the realization of the function of the mode of operation with cases as evidence.

Expression of skeletal muscle glucose and energy metabolism-related genes in Guangxi Bama minipigs with type 2 diabetes mellitus / 中国实验动物学报

Objective In this study, the glucose and energy metabolism-related genes (PGC-1α, Glut-4, ERRα, NRF-1, TFAM and mtDNA gene) were detected in type 2 diabetes mellitus ( T2DM) and non-T2DM minipigs, and the gene function was explored for T2DM pathogenesis.Methods The longissimus muscle of T2DM and non-T2DM Guangxi Bama mini-pigs was used as experiment material.The expression of glucose and energy metabolism-related genes was detec-ted by QRT-PCR.Results The expressions of PGC-1α, Glut-4, ERRαand NRF-1 genes were significantly higher than that of non-T2DM group, the expressions of TFAM and mtDNA gene were lower than that of non-T2DM group.Conclu-sions The upregulated expression of PGC-1αgene and its downstream genes Glut-4, ERRα, NRF-1 may improve the glu-cose metabolic functions in skeletal muscle in the Bama minipigs, whereas insufficient mitochondrial synthesis may induce decreasing ATP synthesis, and results in skeletal muscle insulin resistance, finally leading to the T2DM occurrence.

The Relationship between the Development of Auditory and Speech in Infants with Hearing Loss after Hearing Aid Fitting / 听力学及言语疾病杂志

Objective The aim of this study is to analyze the relationship between the development of audito‐ry and speech in infants with hearing loss after hearing aid fitting and discuss the development of speech with the a‐bility of auditory in infants with different degree of hearing loss and different stage of evaluation after hearing aid fit‐ting .Methods A total of 32 infants (17 boys and 15 girls) with prelingual hearing loss participated in this study . The age at hearing aid fitting ranged from 3 to 34 months with a mean of 15 .6 months .According to their hearing level ,all infants in this study were divided into three groups :group of profound hearing loss(16) ,group of severe hearing loss(11) ,group of moderate hearing loss(5) .CAP and SIR were used to evaluate their abilities of auditory and speech at pre -fitting ,1 ,3 ,6 ,9 and 12 months after hearing aid fitting respectively .A linear and regression a‐nalysis was done in the statistic procedure .Results There was a significant correlation between the scores of CAP and SIR for the three groups respectively .The correlation from low to high followed by the group of profound hear‐ing loss (R=0 .656 ,P=0 .000<0 .05) ,group of severe hearing loss (R=0 .758 ,P=0 .000<0 .05) ,group of mod‐erate hearing loss (R=0 .849 ,P=0 .000<0 .05) .There was also a significant correlation between the scores of CAP and SIR for the different evaluating stages respectively .The correlation from low to high followed by pre -fitting (R=0 .559 ,P=0 .000<0 .05) ,1 month after hearing aid fitting (R=0 .575 ,P=0 .000<0 .05) ,3 months after hearing aid fitting (R=0 .726 ,P=0 .000<0 .05) ,6 months after hearing aid fitting (R=0 .823 ,P=0 .000<0 .05) , 9 months after hearing aid fitting (R=0 .838 ,P=0 .000<0 .05) ,12 months after hearing aid fitting (R=0 .855 ,P=0 .000<0 .05) .Conclusion The development of auditory ability is closely related to speech ability which increases with the improvement of auditory ability .The less the infants have the hearing loss and the longer the infants use the hearing aids ,the higher the auditory ability is related to speech ability in infants after hearing aid fitting .

The Ability of Temporal Gap Detection in Listeners with Auditory Neuropathy Spectrum Disorder / 听力学及言语疾病杂志

Objective This study was aimed at investigating the ability of temporal gap detection (TGD) in listeners with auditory neuropathy spectrum disorder (ANSD ) .Methods The temporal gap detection thresholds were measured for subjects using a TGD program developed by University of California ,Irvine .Three groups of subjects were recruited in this study ,including 12 subjects with normal hearing ,12 subjects with sensorineural hearing loss (SNHL) ,and 15 subjects with ANSD .The differences of TGD thresholds among the three groups of subjects were analyzed using a one - sample ANOVA method .Results No significant difference of the TGD thresh‐old was observed between two ears for all the subjects .The mean and standard deviation of the gap - detection threshold for both ears was about 3 .9 ± 1 .1 ms ,3 .6 ± 1 .1 ms ,and 13 .7 ± 9 .9 ms for normal - hearing subjects , subjects with SNHL ,and subjects with ANSD ,respectively .The TGD threshold in subjects with ANSD was sig‐nificantly higher than those of in normal hearing group (P< 0 .01) and SNHL group (P< 0 .01) ,while no signifi‐cant difference was found in TGD thresholds between normal - hearing subjects and subjects with SNHL .Conclusion For listeners with auditory neuropathy spectrum disorder ,their ability to resolve temporal information was de‐graded with a large individual variability .

Lexical tone perception in sensorineural hearing-impaired and auditory neuropathy spectrum disorder / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This study was aimed at investigating the ability of lexical tone perception in listeners with sensorineural hearing impairment and auditory. neuropathy spectrum disorder.@*METHOD@#Three groups of subjects were recruited in this study, including 11 subjects with normal hearing, 14 subjects with sensorineural hearing impairment, and 25 subjects with auditory neuropathy spectrum disorder. Ten monosyllabic syllables were selected, and combined with four lexical tones which were made up of 40 tone tokens as the original test materials. Then, these original words were recorded using one adult male and one adult female native Beijing Mandarin speaker. The speakers were asked to record these 40 monosyllabic words multiple times, and the 80 tokens in which the durations of four tones in each monosyllabic word were within 5ms precision were chosen as the test tone tokens. The subjects were asked to perform a four-alternative forced-choice study and select which tone they had heard.@*RESULT@#The mean and standard deviation of the tone perception correct scores for normal-hearing subjects, subjects with sensorineural hearing impairment, and subjects with auditory neuropathy spectrum disorder were (97.3 ± 2.8)%, (88.0 ± 9.9)%, and (65.7 ± 17.1)%, respectively. Significant differences in tone perception scores were found to be between subjects with normal hearing and subjects with sensorineural hearing impairment (P < 0.01) and between subjects with auditory neuropathy spectrum disorder (P < 0.01). In addition, a significant difference was found to be between subjects with sensorineural hearing impairment and auditory neuropathy spectrum disorder (P < 0.05). A significantly negative correlation was observed between tone perception score and pure tone hearing thresholds for both subjects with sensorineural hearing loss (r = -0.756, P < 0.01) and subjects with auditory neuropathy spectrum disorder (r = -0.546, P < 0.01).@*CONCLUSION@#As the hearing loss became more severe, the ability to perceive lexical tone for both subjects with sensorineural hearing loss and auditory neuropathy spectrum disorder reduced. Subjects with auditory neuropathy spectrum disorder had more degraded ability to perceive lexical tone and a larger individual difference, in comparison with subjects with sensorineural hearing loss.

Analysis of Psychological Needs of Blood Donation and Intervention Measures for Blood Donors / 现代检验医学杂志

Objective To investigate the characteristics of blood donors’psychological activity,take reasonable intervention measures to improve the success rate of blood donation recruitment and the ratio of repeated blood donation.Methods The data of blood donors’psychological activity was collected by distributing questionnaires randomly,and the psychological characteristics and worries were analysed.Results In terms of the blood donation purpose,there were 62.73% of the blood donors who donate blood for the first time and take the“utility psychological”as the principal thing.There were 76.01% of the blood donors who donate blood repeatedly and take the“dedication psychological”as the principal thing.In terms of wor-ries,there was 72.69% of the blood donors who donate blood for the first time and take the“safety of blood donation”as the principal thing.There was 77.91% of the blood donors who donate blood repeatedly and take the “service quality of blood donation”as the principal thing.Conclusion The success rate of blood donation recruitment and the ratio of repeated blood donation could be effectively improved by attaching importance to the psychological needs and worries of blood do-nors,by taking different psychological intervention measures strategies for different kinds of blood donors,and by meeting their needs and eliminating their worries.

Research and application of mobile nutrition order system in hospital / 医学研究生学报

Objective The aim of this paper was to develop the Mobile Nutrition Order System based on the technology of hospital information system to adapt the nutrition and food security management model in the new situation, so that the unified informa-tization management of diet for patients could be implemented by the Department of Nutrition. Methods The Mobile Nutrition Order System, with the functions of information entry, nutrition recipe, order making and data transmission, could be constructed by the com-bination of technologies between informatization and digital order. Results The automation of nutrition order in hospital was a-chieved, and the nutrition recipe and nutritional therapy could be realized in hospital, the effect was very obvious. Conclusion Since the application of Mobile Nutrition Order System, the labor intensity of servers has been reduced, saving working hours effective-ly.Meanwhile, the management of nutritional therapy was improved and the quality of logistics services in hospital and nutritional ther-apy ascend to a new high.

Improvement of islet β-cell function after sleeve gastrectomy with ileal interposition duodenojejunal bypass in non-obese type 2 diabetes mellitus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the improvement of islet β-cell function after sleeve gastrectomy with ileal interposition duodenojejunal bypass operation in non-obese type 2 diabetes mellitus.</p><p><b>METHODS</b>Clinical data of 54 non-obese type 2 diabetes mellitus cases undergoing sleeve gastrectomy with ileal interposition duodenojejunal bypass operation in our hospital from March 2009 to October 2011 were retrospectively analyzed. Fasting glucose, glycosylated hemoglobin(HbA1c), fasting insulin, body mass index(BMI), insulin resistance index(HOMA-IR), homeostasis model β-cell function(HOMA-β), early phase insulin secretion index (DelteI30/DelteG30) and area under curve of insulin(AUCINS) were measured before operation, and 1, 3, 6, 12, 24 months after operation with standard oral glucose tolerance test(OGTT).</p><p><b>RESULTS</b>At 24 months after operation, HbA1c decreased from preoperative (8.2±0.8)% to postoperative (6.3±0.1)%(P<0.01), as did the fasting glucose [(9.2±0.6) mmol/L vs. (5.9±0.5) mmol/L, P<0.01] and HOMA-IR (2.1±0.6 vs. 0.8±0.3, P<0.01). The postoperative BMI was not significantly different from the preoperative level. HOMA-β increased (28.4±9.2 vs. 56.3±12.8, P<0.05). DelteI30/DelteG30 increased after surgery (0.8±0.2 vs. 1.8±0.7, P<0.01). AUCINS was (42.6±17.1) mIU/L, (31.5±18.6) mIU/L, (34.71±12.9) mIU/L, (49.2±16.3) mIU/L, (78.3±21.7) mIU/L, (74.8±15.2) mIU/L before operation and at postoperative 1 month, 3 months, 6 months, 12 months, 24 months, respectively, indicating an increase in AUCINS 6 months later. Linear correlation analysis showed that HbA1c was negatively correlated with HOMA-β, DelteI30/DelteG30 and AUCINS (r=-0.628, P<0.01; r=-0.571, P<0.01; r=-0.606, P<0.01), and positively correlated with HOMA-IR (r=0.784, P<0.01).</p><p><b>CONCLUSIONS</b>Sleeve gastrectomy with ileal interposition duodenojejunal bypass can improve islet β cells function. It plays an important role in the surgical treatment of diabetes.</p>

Early postoperative insulin-resistance changes after sleeve gastrectomy with ileal interposition duodenojejunal bypass operation / 中华内分泌外科杂志

Objective To evaluate the early effects on insulin resistance following sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Methods From Jun.2010 to Sep.2011,37 cases of type 2 diabetes mellitus patients [23 male,14 female; mean age (45.2 ± 2.4) years,mean BMI (21.7 ± 1.8) kg/m2] underwent sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Fasting plasma glucose(FPG),fasting insulin(FIns),body mass index(BMI),and homeostatic model assessment for insulin resistance (HOMAIR) were detected before surgery and on the 10th,20th,30th,and 60th day after surgery.Results The level of FPG was (6.8 ± 0.7) mmol/L,(7.2 ± 0.6) mmol/L,(6.9 ± 0.3) mmol/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(10.2 ±0.4)mmol/L].The difference had statistical significance (P ＜ 0.05).The level of Fins was (6.3 ± 1.1) mIu/L,(7.1 ± 1.3) mIu/L,and (7.3 ± 1.6) mIu/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(12.6 ± 1.4)mIu/L].The difference had statistical significance (P ＜ 0.05).The level of lnHOMA-IR was 0.7 ± 0.2,0.9 ± 0.5,and 0.8 ±0.4 respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery (1.8 ±0.6).The differenc had statistical significance(P ＜0.05).However,the change of BMI was not obvious between before surgery and on the 10th,20th,and 30th day after surgery.The difference had no statistical significance (P ＞ 0.05).on the 60th day after surgery,the level of FPG,Fins,lnHOMA-IR and BMI was significantly reduced compared with that before surgery.The difference had statistical significantce(P ＜0.05).Conclusion After sleeve gastrectomy with ileal interposition duodenojejunal bypass operation,the early improvement of insulin resistance occurs rapidly and it is iadependent of the loss of BMI.

Test-retest reliability of Mandarin acceptable noise level / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate test-retest reliability of Mandarin acceptable noise level(M-ANL) test materials.@*METHOD@#M-ANL was evaluated during three test sessions approximately one week apart, by testing 30 Mandarin-speaking people aged from 21 to 28 with normal aural/oral communication abilities. The participants completed the preference for background noise questionnaire before the first session. Analysis of the test-retest results were administered by SPSS 17.0 (Statistically Package for the Social Sciences Software Version 17.0).@*RESULT@#ANLs in the three sessions were (8.1 +/- 2.9), (7.4 +/- 2.2), (7.6 +/- 2.5)dB S/N, respectively. The correlation coefficients were 0.722, 0.746 and 0.849 between two of the three sessions. The correlation coefficients of the ANL and 7 questions of the questionnaire were below 0.3.@*CONCLUSION@#M-ANL test materials are found to have good test-retest reliability. Listeners' preference for background noise is not related to their acceptance of background noise. Listeners cannot accurately assess their ability to accept background noise.

The development of auditory performance and speech intelligibility at the early stage after hearing aid fitting in children with moderate or severe hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study is to evaluate the development of auditory performance and speech intelligibility within the first year after hearing aid fitting in children with moderate or severe hearing loss, investigate the effects of hearing level on auditory performance and speech intelligibility and provide a clinical database for their hearing and speech habilitation.@*METHOD@#Twenty-nine children participated in this study, ranging in age at hearing aid fitting from 3 to 8 years old with a mean of 5. 6 years old. 19 were boys and 10 were girls. According to their hearing level, they were divided into two groups. 14 children were in group of moderate hearing loss (41-60 dB HL). 15 children were in group of severe hearing loss (61-80 dB HL). The categories of auditory performance (CAP) and speech intelligibility rating (SIR) were used to evaluate their auditory performance and speech intelligibility. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting.@*RESULT@#There was significant difference in mean score of CAP between group of moderate hearing loss and severe hearing loss before hearing aid fitting (P 0.05). There was also significant difference in mean score of SIR between group of moderate hearing loss and severe hearing loss before hearing aid fitting (P 0.05). The mean scores of CAP for group of moderate hearing loss at 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting (P < 0.05). The mean scores of SIR for group of moderate hearing loss at 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting (P < 0.05); the mean score at 12 months after fitting was also significantly superior in comparison with the score at 1 month after fitting (P < 0.05). The mean scores of CAP for group of severe hearing loss at 3, 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting (P < 0.05); the mean scores at 9,12 months after fitting were significantly superior in comparison with the score at 1 month after fitting (P < 0.05). The mean scores of SIR for group of severe hearing loss at 3, 6, 9, 12 months after fitting were significantly superior in comparison with the score before hearing aid fitting (P < 0.05); the mean scores at 6, 9, 12 months after fitting were also significantly superior in comparison with the score at 1 month after fitting (P < 0.05).@*CONCLUSION@#Auditory performance and speech intelligibility in children with moderate or severe hearing loss improved significantly within the first year after hearing aid fitting. The development followed different trajectory.

Sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus / 中华普通外科杂志

Objective To evaluate sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus.Methods Forty one patients of nonobese Type 2 diabetes mellitus underwent sleeve gastrectomy with ileal interposition and duodenojejunal bypass.Fasting glucose ( FPG ),glycosylated hemoglobin ( HbAlc ),fasting insulin and C-peptide,triglycerides (TG),high density lipoprotein(HDL),low density lipeprotein(LDL) were measured preoperatively and on postoperative first,3rd,6th month.Results Mean postoperative follow-up was 9.6 months (range 6-21 months).95％ patients achieved adequate glycemic control (HbAlc ＜ 7％ ) without antidiabetic medication.Fasting glycemia decreased from ( 9.7 ± 0.4 ) mmol/L to ( 6.2 ± 0.3 ) mmol/L ( P ＜ 0.01 ).Glycosylated hemoglobin decreased from 8.1％ ± 1.4％ to 5.8％ ± 0.6％ ( P ＜ 0.01 ).2-hour postprandial blood glucose decreased from ( 13.6 ± 0.7 ) mmol/L to ( 10.6 ± 0.2 ) mmol/L ( P ＜ 0.01 ).Insulin resistance (Homa-R) decreased from 4.8 ± 1.3 to 1.2 ±0.4 (P ＜0.01 ).Fasting C-peptide increased from ( 3.3 ± 1.7 ) ng/ml to (4.9 ± 0.2 ) ng/ml ( P ＜ 0.01 ).Fasting insulin increased from ( 10.2 + 1.4 ) mlu/L to (15.6±0.7) mlu/L(P＜0.01 ).Triglycerides (TG) decreased from (3.1 ±0.5) mmol/L to (1.9 ±0.4) mmol/L ( P ＜ 0.01 ).High density lipoprotein (HDL) increased from ( 1.2 ±± 0.2 ) mmol/L to ( 1.9 ±0.8 ) mmol/L( P ＜ 0.01 ).Low density lipoprotein (LDL) decreased from (3.5 ± 0.3 ) mmol/L to (2.4 ±0.6) mmol/L (P ＜0.01 ).Hypertension was controlled in 3/7 cases.Microalbuminuria resolved in 78％ patients.Retinopathy was improved in 53％ cases.Conclusions Sleeve gastrectomy with ileal interposition duodenojejunal bypass is effective for treatment of nonobese type 2 diabetes mellitus as showed by 6 month's follow-up.

The effects of hearing level on auditory performance in infants with hearing aids / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The purpose of this study is to investigate the effects of hearing level on auditory performance in infants with hearing aids and provide a clinical database for their hearing and speech habilitation.@*METHOD@#A total of 32 infants with prelingual hearing loss participated in this study, ranging in age at hearing aid fitting from 3 to 34 months with a mean of 16 months. According to their hearing level, they were divided into three groups. Infants in group A were with moderate hearing loss (41-60 dB HL). Infants in group B were with severe hearing loss (61-80 dB HL). Infants in group C were with profound hearing loss (>81 dB HL). The infant-toddler meaningful auditory integration scale (IT-MAIS) was used to evaluate their auditory performance. The evaluation was performed before hearing aid fitting and 1, 3, 6, 9, 12 months after fitting.@*RESULT@#The mean scores of auditory performance showed significant improvements with time of hearing aid use for the three groups of infants (P 0.05). However, significant differences were observed between group A and C at 3, 6, 9, 12 months after fitting (P < 0.05). Significant differences were also shown between group B and C at 1, 3, 6, 9, 12 months after fitting (P < 0.05).@*CONCLUSION@#Auditory performance of infants with prelingual hearing loss developed significantly with the use of hearing aids within the first year after fitting. The degree of hearing loss in infants had significant influence on the development of auditory performance.

Effect of age at cochlear implantation on auditory performance at the early stage after surgery in infants / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the auditory performance of infants with cochlear implants at the early stage after surgery, summarize the development of auditory ability, investigate the effect of age at cochlear implantation on auditory performance within the first year after surgery and provide a reference for their habilitation program.@*METHOD@#A total of 272 infants with prelingually profound hearing loss participated in this study, ranging in age at cochlear implantation from 18 to 36 months. The mean age was 21 months with a standard deviation of 7 months. Infants with cochlear implants were divided into three groups according to their age at implantation. Infants in group A were implanted under 18 months of age. Infants in group B were implanted between 18 and 24 months of age. Infants in group C were implanted between 25 and 36 months of age. Categories of auditory performance (CAP) was used to evaluate the auditory performance, which rates auditory abilities in eight categories for a scale of 0 to 7.@*RESULT@#The mean scores of CAP for all infants at each interval were significantly different after implantation. Significant differences were observed in mean scores of CAP among these three groups in 1 and 3 months after switch-on. However there were no significant differences in pre-operation, 6, 9 and 12 months after switch-on.@*CONCLUSION@#There is a significant improvement in auditory performance of infants with prelingually profound hearing loss within the first year after cochlear implantation. The age at cochlear implantation has no critical influence on the development of auditory capabilities at the early stage after surgery. CAP is a practical tool which can be used in clinic in China.

Evaluation of a transient noise reduction strategy on the loudness perception and sound quality / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#A current technology for detecting and controlling transient noise in hearing aids (AntiShock) was evaluated. The objective was to evaluate AntiShock on loudness control and whether results in negative changes in sound quality of speech, transient noise and environmental noise and provide implications for hearing aid fitting.@*METHOD@#Twenty-four subjects with sensorineural hearing loss participated in the study. In a single-blinded paradigm, the subjects were asked to rate loudness of transient noise and distortion of speech, transient noise and environmental noise with the AntiShock in both on and off conditions.@*RESULT@#(1) The percentage of the transient noise rated as soft, comfortable, loud, too loud was 3.0%, 72.7%, 22.9% and 1.4%, respectively. There were significant differences in mean scores of loudness perception among listening conditions and between genders by a Two-Way ANOVA, the P values were 0.009 and 0.001, respectively. (2) The percentage of the speech rated as mild distorted, understandable, clear and very clear was 2.5%, 30.6%, 32.9% and 34.0%, respectively. There were significant differences in mean scores of speech distortion under different listening conditions by an One-Way ANOVA (P 0.05). (4) The percentage of the environmental noise rated as mild distorted, clear but soft, clear and natural was 0.4%, 0.8% and 98.8%, respectively. No significant differences in mean scores of nature of environmental noise was found between different listening conditions by an Independent-Samples T Test (P > 0.05).@*CONCLUSION@#AntiShock showed positive effects on the loudness control of the transient noise. Quality of speech, transient noise and environmental noise were not impacted by AntiShock.