简介:《喉科手术学》2000年出版,2002年第2次印刷。近十年间随着医学技术飞跃发展,喉科手术也在不断更新及创新。为了适应新的形式,人民卫生出版社于2007年出版了《喉科手术学》第2版。此版主要围绕有关保留、改菩喉功能的理论,特别是新发展的手术为主要增修内容,增加了与保留和改善喉功能研究发展相关的喉及喉咽的解剖及生理:增补了保留或改善喉功能的手术、喉显微手术、喉咽癌激光手术、喉返神经单、双侧麻痹及喉手术后喉功能不良新发展的喉功能整复术、喉误吸手术、喉蹼切除术、喉肉芽肿切除术、杓状软骨脱位、骨折和固定的整复术:补充了喉气管狭窄,喉、喉咽和颈食管癌等新的手术方法;充实了甲状腺肿瘤手术,颈淋巴结清扫术内容,
简介:Aratmodelofchronictympanicmembraneperforationwasdevelopedtobeusedinthesearchofnewmaterialsforthesealingoftheseperforations.AlongitudinalstudywascarriedoutinratssubjectedtoincisionalmyringotomyfollowedbytheapplicationofmitomycinCaloneorwithdexamethasone.Ratswerecheckedatdays3,7,10,14andweeklythereafteruntilperforationclosure,forupto6months.Theadditionofdexamethasoneisakeycomponentinordertoobtainachronicopening.Myringotomiestreatedwithsalinehadameanhealingtimeof8.5days.At8weeks,between62.5%and77.7%oftympanicmembranestreatedwithmitomycinCanddexamethasoneremainedperforatedandat6monthsthisnumberfellto21.4%.Thistechniqueisabletomaintainmosttympanicmembraneperforationspatentforatleast8weeks.Thisratmodelisadequateforitsuseinpreclinicalortranslationalresearch.
简介:Objective:EvaluatingtheauditoryfunctioninpatientswithchronichepatitisCtreatedwithsofosbuvirandribavirin.Methods:Thisstudyinvolved80patientswithchronichepatitisCwhoagreedtoreceivesofosbuvirandribavirin.Allparticipantsweresubjectedtobaselineotologicalandaudiologicalassessmentjustbeforetreatment.Theaudiologicalassessmentincludedstandardpuretoneaudiometry,extendedhighfrequencyaudiometry,immitancemetryandotoacousticemissions(OAEs)(transientanddistortionproduct).Accordingtobaselinehearingthresholdmeasurements,thestudypopulationwasdividedinto2groups.Group1included42patientswithnormalhearingsensitivity(250e8000Hz),andGroup2included38patientswithsensorineuralhearingloss.After24weeksoftherapy,otologicalandaudiologicalassessmentswererepeatedandcomparedbetweenthetwogroupsandbeforeandaftertherapy.Results:Post-treatmenthearingthresholdevaluationshowednosignificantdifferencefrompretreatmentevaluationatalltestedfrequencies.Therewasnostatisticallysignificantdifferencebetweenpreandpost-treatmentotoacousticemissionsresults.Conclusion:TherapywithsofosbuvirandribavirininchronichepatitisChasnonoticeableeffectsoncochlearfunctions.
简介:ObjectiveToinvestigatetheearlychangeofcochlearribbonsynapsesoninnerhaircellsinresponsetoaminoglycosideototoxicity.MethodsC57BL/6Jmicereceivedintraperitonealinjectionofgentamicin(100mg/kg/day),andtheapicalcoilorganofCortiwasexaminedonthe4th,7thand10thday(n=10).Litter-mateswithoutgentamicintreatmentservedascontrols(n=10).RIBEYEonthepresynapticmembraneandAMPAreceptorsonthepostsynapticmembranewerelabeledwithCtBP2orGluR2/3respectively.Threedi-mensionreconstructionwasconductedusingthe3DSMAX8.0software.ResultsTherewerenodisruptionsofouterorinnerhaircellsinallgroups.However,thenumberofribbonsynapsesoncochlearinnerhaircellsincreasedsignificantlywithin7daysaftergentamicinexposure(P<0.01),followedbyasignificantde-creaseafter7days.ConclusionDuringtheearlystageofaminoglycosideototoxicity,increasedpopulationofcochlearribbonsynapsesmayindicateasignificantdown-regulationofsynapticfunction.
简介:ObjectiveTostudycharacteristicsofhearinglossafterexposuretomoderatenoiseexposureinC57BL/6Jmice.MethodsMaleC57BL/6Jmicewithnormalhearingatageof5-6weekswerechosenforthisstudy.Themicewererandomlyselectedtobestudiedimmediatelyafterexposure(GroupP0),or1day(GroupP1),3days(GroupP3),7days(GroupP7)or14days(P14)afterexposure.Theirbeforeexposureconditionservedasthenormalcontrol.Allmicewereexposedtoabroad-bandwhitenoiseat100dBSPLfor2hours,ABRthresholdswereusedtoestimatehearingstatusateachtimepoint.ResultsABRthresholdelevationwasseenateverytestedfrequencyatP0(P<0.01).Elevationathigh-frequencies(16kHzand32kHz)wasgreaterthanatlowerfrequencies(4kHzand8kHz,P<0.05).FromP1toP14,ABRthresholdscontinuouslyimproved,andtherewasnosignificantdifferencebetweenP14andbeforeexposure(P>0.05).ConclusionThereisafrequencyspecificresponseto100dBSPLbroad-bandwhitenoiseinC57BL/6Jmice,withthehigh-frequencybeingmoresusceptible.HearinglossinducedbymoderatenoiseexposureappearsreversibleinC57BL/6Jmice.
简介:Objective:Todeterminewhetheranew-bornchildfromafamilycarryingadeafnessgeneneedscochlearimplantationtoavoiddysphoniabyscreeningandsequencingadeafness-relatedgene.Results:BothscreeningandsequencingresultsconfirmedthatthenewbornchildhadanormalGJB2genedespitethefactthatshehasabrothersufferingfromhearinglosstriggeredbyanallelicGJB2c.176del16mutation.WeclonedtheGJB2genesderivedfromtheirrespectivebloodgenomicDNAintoGFPfusedplasmidsandtransfectedthoseplasmidsintothe293Tcelllinetotestforgenefunction.WhilethemutatedGJB2gene(GJB2c.176del16)ofherdeafbrotherwasfoundtobeunabletoformthegapjunctionstructurebetweentwoadjacentcells,thebabygirl’sGJB2generanintonosuchproblems.Conclusion:ThescreeningandsequencingaswellastheGJB2genefunctiontestsinvariablyshowedresultsconsistentwiththeABRtestedhearingphenotype,whichmeansthatthechild,withanormalwildtypeGJB2gene,doesnotneedearlyinterventiontopreventherfromdevelopinghearinglossanddysphoniaatalaterstageinlife.
简介:目的观察Nucleus24CA型人工耳蜗植入后电极阻抗、行为反应阈值(T-level,T级)及最大舒适级(C-level,C级)的变化规律,分析其内在联系,探讨其对术后调机的指导意义。方法对81例植入Nucleus24CA型人工耳蜗患儿,分别在术中、术后1、2、6个月进行电极阻抗阈值测试,收集术后对应T、C值,并对其变化规律及相关性进行统计学分析。结果电极阻抗值术中检测最低,术后1月开机最高,此后逐渐减低(P〈0.01);自蜗顶至蜗底各通道间电极阻抗值无显著差异(P〉0.05)。各电极通道T值、C值随术后时间延长逐渐增高(P〈0.05),并与电极阻抗值呈线性相关。结论测定电极阻抗值是评估人工耳蜗刺激电极状态的有效手段;术后2月应同时调试T值及C值,此后则应对C值进行重点调试。
简介:目的用细胞学方法,分析线粒体DNA12SrRNA基因中C1494T突变在氨基糖甙类抗生素聋发病机理中的作用.方法从携有线粒体DNAC1494T突变的母系遗传性氨基糖甙类抗生素性耳聋的中国大家系选择部分成员,另外从遗传背景相同的正常中国人群选择对照个体,分别建立淋巴细胞系;并通过细胞融合技术,将淋巴细胞系的线粒体分别融合到缺乏线粒体DNA的p0206细胞中,建立相应的转线粒体细胞系;家系成员与对照个体的淋巴细胞系和转线粒体细胞系,分别在不含/含有氨基糖甙类抗生素(巴龙霉素)的培养液中培养,以倍增时间(doublingtime,DT)作为细胞生长特性的评价标准,通过计算在正常和含有氨基糖甙类抗生素的培养液中倍增时间的比值,比较氨基糖甙类抗生素对细胞生长的影响.结果携有线粒体DNAC1494T突变家系成员较对照个体的淋巴细胞系的倍增时间比值平均增加了24%,但不同家系成员的细胞倍增时间比值的增加程度不同,自10%至50%不等;而当细胞核遗传背景相同后,家系成员较对照个体的转线粒体细胞系的倍增时间比值增长30%,并且来自不同表型的家系成员的细胞倍增时间比值基本相同.结论线粒体DNAC1494T突变可以造成细胞对氨基糖甙类抗生素的超敏性,但其效应要受到核基因的调控.