双侧突发性耳聋疗效的影响因素分析

目的:探讨影响双侧突发性耳聋疗效的因素。方法:回顾性分析2011年2月至2013年5月我科收治的24例(48耳)双侧突发性耳聋的病例资料。其中,男性18例(75.0%),女性6例(25.0%)。年龄14-72岁,平均年龄49.3岁。按照听力曲线分型,低中频下降型0耳(0.0%),中高频下降型16耳(33.3%),平坦型18耳(27.5%),全聋型14耳(29.2%)。分析和比较具有不同听力曲线分型、伴发症状、年龄、伴发疾病、听力损失程度、发病至干预时间的双侧突发性耳聋患者总有效率的差异。结果:具有不同听力曲线类型、发病至干预时间、听力损失程度以及是否伴有高血压、糖尿病、高血脂、眩晕症状的双侧突发性耳聋患者的总有效率比较差异均无统计学意义(P0.05)。伴发耳鸣的双侧突发性聋患者治疗总有效率显著高于不伴发耳鸣患者,差异有统计学意义(P0.05)。年龄≤60岁的双侧突发性耳聋患者的治疗总有效率显著高于年龄60岁者(P0.05)。结论:伴发耳鸣、年龄小于60岁的双侧突发性耳聋患者的治疗效果相对较好,而听力曲线类型、听力损失程度、发病至干预时间、是否伴发眩晕症状与其治疗效果均无关。     

突发性耳聋患者焦虑抑郁状况及其影响因素分析

目的:探讨突发性耳聋患者焦虑、抑郁现状,并分析导致患者焦虑、抑郁的影响因素。方法:采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价2015年2月至2017年12月我院耳鼻喉科收治的156例突发性耳聋患者的焦虑、抑郁心理状态,收集患者一般资料、发病以及治疗情况,采用Logistic多元回归分析突发性耳聋患者焦虑、抑郁的影响因素。结果:本组患者中发生焦虑者48例,发生率为30.77%,发生抑郁者41例,发生率为26.28%。单因素分析结果显示,突发性耳聋患者焦虑、抑郁的发生与年龄、性别、经济收入、文化程度、伴随症状种类数、听力损失程度、耳聋耳鸣程度、合并基础疾病种类数、治疗疗效有关(P0.05)。多因素分析结果显示,年龄为30-60岁、重度或极重度耳鸣、听力损失程度≥70 dBHL、合并基础疾病≥3种、治疗无效是突发性耳聋患者发生焦虑的危险因素,女性、重度耳聋、合并基础疾病≥3种、治疗无效是突发性耳聋患者发生抑郁的危险因素。结论:突发性耳聋患者焦虑、抑郁发生率较高,其焦虑、抑郁水平受年龄、性别、耳聋耳鸣程度、合并疾病种类数、治疗疗效影响,医护人员应关注患者心理健康,积极治疗原发疾病,控制基础疾病,并进行心理疏导,以减轻患者焦虑、抑郁水平。     

伴感音神经性聋的耳鸣患者的临床特征与心理障碍的相关性研究

目的:分析伴感音神经性聋耳鸣患者的临床特征与心理障碍的关系。方法:选取2016年2月至2016年10月大连大学附属中山医院耳鼻咽喉二科收治的46例(60耳)伴感音神经性聋的耳鸣患者为研究对象,采用耳鸣残疾评估量表(THI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)评价患者的心理障碍情况,分析耳鸣频率、听力损失频率、耳鸣响度、听力损失的特点及其与THI、SAS、SDS评分的关系。结果:低频耳鸣多见于低频听力损失,中频耳鸣多见于全频型和中高频型听力损失,高频耳鸣多见于中高频听力损失。耳鸣响度主要集中分布在中高响度,在轻度听力损失中以低、中响度为主;在中、重度听力损失中,均以中、高响度为主,经Spearman相关性分析显示,耳鸣匹配响度与听力损失程度的关系呈正相关(P0.05);三组患者THI评分之间的差异无统计学意义(P0.05);与轻度患者相比,中、重度患者SAS评分和SDS评分均明显升高,而重度患者SAS评分和SDS评分均显著高于中度患者,且差异均具有统计学意义(P0.05);经Spearman相关性分析显示,听力损失程度与THI评分无关(P0.05),与SAS评分、SDS评分呈正相关(P0.05)。结论:耳鸣频率与听力损失频率具有一致性,耳鸣匹配响度与听力损失程度也具有一致性,听力损失程度与THI评分无相关性,与SAS及SDS评分具有相关性,耳科医生在临床诊断中针对患者适当配合使用相关药物和心理疏导,有助于患者的康复。     

影响口腔鳞状细胞癌患者预后的临床病理因素分析

目的:研究影响口腔鳞状细胞癌(Oral squamous cellcar cinoma,OSCC)术后患者预后的临床病理因素。方法:回顾性研究55例手术治疗的原发口腔鳞状细胞癌患者与预后相关的因素:年龄、性别、发病部位、颈部淋巴结转移情况、肿瘤细胞分化程度等。结果:平均发病年龄为57.35±12.02岁,牙龈鳞癌的复发转移率最高(45.5%),舌部第二(44%),颊部第三(37.5%),唇癌预后最好(0.0%)。术前颈部淋巴结转移情况、肿瘤细胞分化程度与预后有关。肿瘤细胞的分化程度与术前淋巴结转移无显著相关性。术前有颈部淋巴结转移合并中低分化与预后差相关。结论:口腔鳞状细胞癌的预后与发病部位无显著相关性。肿瘤中低分化及术前有淋巴结转移者易出现术后复发转移。     

哈尔滨医科大学附属第二医院耳鼻咽喉科

目的：探讨影响突发性聋的疗效与预后的相关因素。方法：回顾性分析了80例（91耳）交发性聋患者的临床资料。结果：（1）听力损失程度越轻者,治疗总有效率越高。（2）伴有眩晕者,治疗总有效率为34．5％,无眩晕者为69．4％,（3）发病天数≤7天者总有效率为77.1％,≤14天者为77．1％,〉14天者为57．9％。结论：伴有眩晕的突聋患者听力损失较重,疗效及预后较差,初诊时听力损失较轻的,听力恢复较好。患者就诊越及时,疗效越好.     

《喉镜》:报告称阳痿治疗药物或导致耳聋

据英国《每日电讯报》5月19日报道,《喉镜》杂志刊登最新研究警告说,服用伟哥等治疗阳痿的药物可能会导致耳聋。研究发现,伟哥和类似的壮阳药物与全球成百上千例听力突然丧失病例关联极大。继美国发现大批服用伟哥的患者出现听力问题之后,医生开始发出警告,服用伟哥之类的药物或导致听力受损。在美国、东亚和澳大利亚三地进行的"阳痿药物与听力丧失"问卷调查发现,47%的感觉神经性听力丧失(单耳或双耳听力快速丧失)疑似病     

高压氧联合地塞米松治疗突发性耳聋的疗效及对血液流变学的影响

目的:研究高压氧联合地塞米松治疗突发性耳聋的疗效及对血液流变学的影响。方法:选择2012年6月至2015年1月在我院接受治疗的突发性耳聋患者90例(124耳)进行研究。根据数字法随机分成观察组(45例,60耳)及对照组(45例,64耳),两组均给予常规的改善内耳微循环及神经营养类制剂治疗,对照组另给予地塞米松治疗,观察组在对照组基础上另给予高压氧治疗,治疗1个疗程后对比两组疗效,听力改善程度以及血液流变学指标变化。结果:观察组的总有效率是98.33%,显著高于对照组的89.06%,差异有统计学意义(P0.05)。治疗后观察组的听力损失程度显著优于对照组,纯音听阈显著低于对照组,差异有统计学意义(P0.05)。治疗后观察组的高切粘度、中切粘度、低切粘度、红细胞聚集指数均分别显著低于对照组,红细胞变形指数显著高于对照组,差异均有统计学意义(均P0.05)。结论:高压氧联合地塞米松治疗突发性耳聋患者具有更为显著的疗效,且可有效改善患者的血液流变学指标,值得临床推荐。     

黑龙江省部分地区非综合性耳聋的分子病因学调查

目的:采用基因诊断的方法调查和分析黑龙江省部分地区非综合性耳聋(NSHL)的分子病因学。方法:调查对象为哈尔滨医科大学附属第四医院耳鼻咽喉科门诊收治的116例来自黑龙江省部分地区的散发非综合征型耳聋患者和29例听力正常样本,均经过纯音听阈、声导抗、耳声发射、听性脑干诱发电位等检查,其中51例属于重度或极重度感音神经性耳聋,采集其外周血并提取DNA行GJB2、Slc26A4、GJB3、SrRNA1555基因编码区测序。结果:与耳聋相关的基因突变位点主要为GJB2-235、Slc26A4-IVS7-2和GJB2-299,其中GJB2-235基因变异为最主要方式,约占总检出耳聋患者的45.2%,其次为该基因的299位点,突变比率为16.1%。另一个主要突变基因是Slc26A4,主要在IVS7-2位点发生突变,约占Slc26A4基因位点突变的84.6%,在整个耳聋基因突变群体中约占17.7%。但上述基因突变位点在29例听力正常样本中无发生。结论:黑龙江省部分地区NSHL患者存在GJB2-235、Slc26A4-IVS7-2和GJB2-299位点突变。     

331例头癣临床流行病学特征分析CSCD

目的分析无锡及周边地区2001—2020年头癣患者病原菌种类及流行病学特点。方法回顾性分析2001—2020年无锡市第二人民医院皮肤科门诊临床诊断符合头癣,且真菌培养阳性的331例患者的检测结果,结合患者性别、年龄等基本信息进行分析。结果331例患者中,男性183例(55.29%),女性148例(44.71%),发病年龄2个月~81岁。成人(≥18岁)头癣39例,男性7例(17.95%),女性32例(82.06%);儿童头癣292例,男童177例(60.6%),女童115例(39.4%)。成人头癣各年龄段散发,儿童头癣年龄段主要集中在5~11岁,176例(61.11%)。头癣致病菌以犬小孢子菌为主(228例,68.88%),其余依次为:紫色毛癣菌(27例,8.16%)、红色毛癣菌(25例,7.55%)、断发毛癣菌(23例,6.95%)、须癣毛癣菌(22例,6.65%)、石膏样小孢子菌(6例,1.81%)。临床分型以白癣为主247例(74.62%),其余依次为脓癣55例(16.62%),黑点癣28例(8.46%),未见黄癣。结论无锡及周边地区头癣患者年龄集中在5~11岁,以亲动物性犬小孢子菌引起的白癣最常见。     

赣州地区肺癌病理特征与临床流行病学调查研究

目的探讨赣州地区肺癌流行病学与病理特征,旨在了解该地区肺癌流行趋势,提高疾病筛查率,降低肺癌风险。方法选取我院2018年1月～2019年12月收治的300例肺癌患者为研究对象,分析患者的一般资料,并总结肺癌流行病学和病理特征。结果 300例肺癌患者中,发病年龄40岁144例,≥40岁156例;男性患者155例,女性患者145例;城镇居民168例,农村居民132例;其中抽烟、饮酒者的肺癌构成比高于非抽烟、饮酒者,两者比较差异有统计学意义(P0.05)。从肺癌患者年龄分布看,40岁患者中,男女发病率构成比无差异性(P0.05);年龄40～79岁和80岁的两个年龄段患者中,男性肺癌患者构成比高于女性,两者比较具有统计学差异(P0.05)。从肺癌病理类型看,男性患者腺癌和鳞状细胞癌构成比高于女性患者(P0.05),而不同性别的小细胞癌和大细胞癌构成比无差异性(P0.05)。结论赣州地区肺癌患者的发病年龄、性别比较无差异性,吸烟、酗酒是该病的重要因素,且该病多发于青壮年和老年群体,男性以腺癌和鳞状细胞癌为主。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细