Objective To study the curative effects of Gushen Shuer Pian on sensorineural deafness and tinnitus.Methods 120 patients were divided randomly into double blind-treatment and control groups and open-treatment group, and investigated by using the combination of Chinese traditional and western medicine.The examination of blood, urine , hepatic and kidney function,as well as pure tone audiometry, were made before and after taking Gushen Shuer Pian and control drugs.Results The effective rates of Gushen Shuer Pian were 42.9% and 90.7% for deafness and tinnitus respectively.The differences were significant between the treatment group and control group(effective rates of the latter were 18.7% and 40.5%, respectively).The symptoms of aural fullness, dizzness and insommia were alleviated.There were no side-effects during the treatment, and no effects on the function of liver and kidney.Conclusion Gushen Shuer Pian has a nice effectiveness on deafness and tinnitus.

耳聋是人类最常见的遗传病之一.20世纪80年代以来,对遗传性聋的基因定位和基因克隆的研究发展飞速.

Objective To study the ultrastructural changes of the organ of Corti induced by infrasound in guinea pigs. Methods Twenty albino guinea pigs were randomly divided into four groups. Fifteen guinea pigs were exposed to 8 Hz infrasound of 135 dB SPL for 90 minutes and sacrificed at 2 hours, 2 days and 7 days, respectively, after infrasound exposure. The remaining five animals served as a control group. Results The ultrastructure of the inner ear was damaged to different extent. The number of outer hair cells (OHCs) of the organ of Corti decreased significantly in all experimental groups. Focal or scattered OHC losses and / or disorganized stereocilia of OHCs were found from the basal to third cochlear turns, compared with the control group. Conclusion High-level infrasound can cause damage to the inner ear of guinea pigs.

Objective To understand minute anatomy and adjacent relationship of human internal acoustical meatus(IAM). Methods The technique of computer assisted three dimensional reconstruction from serial sections was used to reconstruct the structures of human temporal bone in 5 cases. Results The reconstructed images in different angle showed the clear spatial relationship of structures inside and around IAM. The 3-D measurement showed that the average length of IAM was 6.47±0.83~12.01±1.79mm. The distance between the basal turn of cochlea and labyrinth segment of facial nerve was 0.09～0.26mm. The distances from ampulla of the superior semicirular canal to the geniculate ganglion,the labyrinth segment of facial nerves and Bill′s bar were 2.25±0.28mm,1.21±0.09mm and 1.94±0.42mm,respectively. Conclusion These images and data can′t be obtained easily by traditional dissecting methods are very useful to the surgery of middle cranial fossa.

目的观察强次声波暴露后豚鼠畸变产物耳声发射(DPOAE)的变化情况.方法将15只豚鼠置于频率8Hz、强度为135dB SPL的次声声场中连续暴露90分钟.分别于强次声波暴露前及暴露后即刻(2h内)、2天和5天做畸变产物耳声发射测试.结果强次声波暴露后豚鼠DPOAE的幅度值在各个频率段与暴露前相比均有明显的降低(p＜0.01),随着时间的推移,各个频率的幅度虽有一定的恢复,但仍明显低于暴露前水平(p＜0.01).结论强次声波可导致豚鼠耳蜗外毛细胞功能明显减退.

目的综合颞骨连续切片、计算机三维重建技术和体视学研制颞骨系列立体解剖图谱.方法制作50套带参照点的颞骨连续切片,应用计算机三维重建技术恢复颞骨内系列结构的三维形态,配合体视镜制作系列颞骨结构立体图谱.结果共进行针对骨迷路、膜迷路、听骨链、耳内肌、面神经、圆窗龛和膜、后壶腹神经、内淋巴囊、前庭水管、耳蜗导水管、前庭蜗神经的三维重建48例次,选取最佳的有代表性的图片制成系列颞骨立体解剖图谱,系统显示了上述结构的细微形态和结构间的空间关系,应用于颞骨手术指导和颞骨解剖教学.结论颞骨立体解剖图谱是一种强有力的新型解剖工具,在耳科以及其他学科均有很好的推广应用前景.

目的介绍用于颞骨病理学研究的分子生物学新技术.方法所有颞骨火棉胶切片均来自解放军总医院颞骨库,基于颞骨火棉胶切片的DNA提取、PCR扩增、原位杂交、原位PCR和免疫蛋白染色技术被用来研究老年性耳聋的分子病理机制.结果除了原位PCR技术,基于颞骨火棉胶切片的DNA提取、PCR扩增、原位杂交和免疫蛋白染色技术均取得了可接受的、有用的结果来帮助解释老年性耳聋的机制.结论存档的颞骨标本是非常珍贵的资源,加以利用可以揭示各型耳聋的分子病理机制.

目的研究中国汉族人群10个遗传性聋基因座位的短串连重复序列(STR)的遗传多态性.方法应用PCR方法对10个位点进行扩增,变性聚丙烯酰胺凝胶电泳分离,记录基因型.采用PPAP软件计算正常人各STR位点等位片段频率、基因型频率、预期基因型频率、多态信息量(PIC)和Hardy-Weinberg平衡吻合性检验.结果中国汉族人群D6S287、D8S1132、D13S1275、D15S130、D1S2726、D4S3038、D2S2380、D22S282、D14S1042、D7S529各位点分别检出10个、9个、8个、7个、7个、7个、6个、6个、6个及5个等位片段,多态性分布均符合Hardy-Weinberg平衡定律.各位点PIC值分别为0.879、0.854、0.864、0.821、0.686、0.794、0.764、0.732、0.773、0.712;杂合度均高于0.7.结论中国汉族人群10个位点STR均具有较高的杂合度和多态信息量,是较理想的遗传标记.

Most of the evoked potentials have time varying characteristic. The response is transient and its response spectral is varying during the response period. The key point of the time - varying filtering method is that the filter varies as the response changes, so it can get the signal effectively and raise the signal to noise ratio. In present report, we compared these two methods, and our result shows that the raise of signal to noise ratio is significant by using the time - varying filtering method. This technique can reduce the background noise and repetitions, and the waveform is clearer than that of usual average.

Purpose To develop localization method of mutated genes in cellodin embedded temporal bone sections. Methods Five cases of temporal bone with mtDNA4977 deletion and five cases without mtDNA4977 deletion identified by nested PCR were chosen in this study and a new technique of in situ hybridization in celloiding embedded temporal bone sections firstly developed by author was used to localize the mtDNA4977 deletion. Results The positive signal representing mtDNA4977 deletion was found in 3 of 5 cases of temporal bone sections with mtDNA4977 deletion proven by PCR and in none of 5 cases without mtDNA4977 deletion. Conclusion Cochlea is constituted by a great number of variable shaped and functional cells. The technique of in situ hybridization in celloidin embedded temporal bone section can detect and distinguish the specific gene or mutated gene among the different cells in cochlea. It provides a powerful tool to study the etiologic mechanism of deafness at the molecular cellular level.

目的探讨线粒体DNA(mitochondrial DNA,mtDNA)缺失与噪声性聋的关系.方法 3月龄大鼠分噪声暴露组和无暴露对照组,各20只.噪声暴露组暴露于108～110 dB SPL的白噪声 4 h/d,共40 d;对照组不接触噪声.噪声暴露结束2周后测试两组大鼠的听性脑干反应(auditory brainstem response,ABR)阈值,聚合酶链反应(polymerase chain reaction,PCR)检测其耳蜗、蜗核、颞叶脑组织和颞肌组织中是否存在mtDNA4834缺失,对存在的缺失进行定量分析;PCR产物进行克隆、测序.结果噪声暴露组大鼠出现永久性阈移,其ABR平均阈值(±s,下同)为(75.25±6.17)dB SPL (40耳),对照组为(34.75±3.80)dB SPL(40耳),两组ABR阈值的差异具有非常显著性意义(P<0.01).噪声暴露组大鼠的耳蜗、蜗核、颞叶脑组织中mtDNA4834缺失发生率(24/40、16/20、18/20)明显高于对照组,两组之间的差异具有非常显著性意义(P<0.01);而与听觉无关的颞肌组织中mtDNA4834缺失发生率(2/20)在两组中均很低,两组之间的差异无显著性(P>0.05);噪声暴露组大鼠的耳蜗、蜗核、颞叶脑组织和颞肌中mtDNA4834缺失占总mtDNA的平均百分率(±s)分别为(0.998 8±0.551 6)×10-2%、(1.060 9±0.672 0)×10-2%、(1.206 0±0.687 5)×10-2%和(0.206 4±0.142 7)×10-2%,其中颞肌组织最低.结论长期噪声暴露可引起耳蜗、蜗核及颞叶脑组织mtDNA4834缺失;mtDNA4834缺失与噪声性聋的发病有关.

Objective:To determine the presence of herpesvirus in temporal bone of the presbycusis patients and its relationship with presbycusis.Method:A single pair oligonucleotide primers selected within a highly conserved region of the DNA polymerase gene of the herpesvirus was used to amplify related viral genomes, i e, herpes simplex virus type 1, herpes simplex virus type 2, Epstein Barr virus, and cytomagelovirus, by PCR from temporal bone sections. A simple restriction enzyme analysis of these amplified products allowed accurate characterization of the herpesvirus type.Result:The genomes of herpes simplex virus were found in sections from 4 patient with presbycusis (positive cases/all cases: 4/17), meanwhile, no herpes virus were found in all sections from age matched control group (0/14).Conclusion:The latent herpes virus DNA was detected in some temporal bones with presbycusis. It is suggested that herpesvirus as an autoimmune stimulate factor is one of the pathogenic causes for presbycusis.

碱性成纤维细胞生长因子(bFGF)是由155个氨基酸组成的多肽,很多文献表明bFGF能刺激多种组织细胞的增殖、分化,且对多种组织细胞的损伤修复有促进作用.bFGF对全身脏器的影响如: 中枢神经系统和周围神经系统研究较多,近来bFGF在内耳发育、内耳感觉上皮损伤后修复、再生及其在临床上对感音神经性聋的防治均有报道,表明bFGF在内耳生物学作用中起重要角色.以下就bFGF在内耳发育、内耳感觉上皮损伤后修复再生等方面作用进行综述.

目的了解正常人Corti's器的超微结构特征.方法用扫描电镜观察成年人和胎儿的Corti's器.结果成人和胎儿Corti's器基底圈内、外毛细胞排列规则,中圈和顶圈毛细胞排列不规则,内毛细胞以一排,外毛细胞以三排排列.可观察到列外的内、外毛细胞,四排排列和自然缺失的外毛细胞.外毛细胞粗大的静纤毛以及由于固定不及时引起的外毛细胞静纤毛气球样改变.结论用扫描电镜观察成人和胎儿Corti's器的精细结构,发现了毛细胞排列的基本规律和一些异常的形态.及时固定是保存Corti's器结构完好的必要条件.

目的探讨听觉器官中线粒体DNA缺失在老年聋发病中的意义.方法:饲养不同年龄组的大鼠,测试ABR阈值,PCR检测其耳蜗、蜗核、大脑、颞肌和外周血中是否存在mtDNA4834缺失,对存在的缺失进行定量分析;PCR产物进行克隆、测序.结果:老年组大鼠的ABR平均阈值为92.22±10.60dBSPL(n=20),中年组为42.75±5.73dBSPL(n=24),青年组为30.50±1.54dBSPL(n:24),老年组大鼠的ABR阈值明显高于中年组和青年组,其差别具有非常显著性的意义(方差分析,P＜0.01);(2)所有老年大鼠的听觉器官和颞肌中均存在mtDNA4834缺失,其缺失发生率高于中年组,青年组mtDNA4834缺失发生率最低;(3)定量分析显示不同年龄大鼠听觉器官中mtDNA4834缺失占总mtDNA的百分比不同,老年组mtDNA4834缺失占总mtDNA的百分比高于中年组.结论:老年大鼠的ABR阈值明显升高,其包括耳蜗、蜗核在内的多种组织中普遍存在的mtDNA4834缺失,提示mtDNA缺失在老化和老年聋的发生中具有重要意义.

Objective To observe the efiect of polyaspartic acid (PAA) on gentamicin - inhibiting inositidelipid messenger system in guinea pig cochlea and investigate the protective mechanism of polyaspartic acid on gentamicin - ototoxicity. Methods By using incorporation of [3H] - inositol and high performance liquid chromatography (HPLC) technique to determine inositol phosphates (IPs), polyphosphatidylinositol (PPI) and PPI phospholipase C (PLC) in guinea pig cochlea at different using drug time and in different using drug groups. Results①After using drug 1 - day, there was not significant difference of IPs, PPI and PLC among four groups (P 0.05 ) . ② After using drug 5 ?days , compared with PAA + GM group and other two control groups, there was a significant difference of IPs,PPI and PLC in using only GM group (P 0.01) , PPI was increase, IPs and PLC were decrease.③After using drug 10- days , compared with PAA+ GM group and other two control groups, there was a significant difference of Ips, PPI and PLC in using only GM group(P 0.01) ; but, compared with using only GM 5-days, there was not sinigficant change of PPI, IPs and PLC were increase. Conclusion PAA has significance preventing effects on gentamicin - inhibiting inositidelipid messenger system in guinea pig cochlea , which shows that PAA has protective effect on gentamicin - ototoxicity in guinea pig.

目的探讨强声暴露后豚鼠耳蜗毛细胞感受器电位(receptor potential,RP)变化和复合神经动作电位(compound action potential,CAP)的关系.方法在成功建立豚鼠耳蜗毛细胞电反应记录方法后,将同一强度、不同频率的强声施加于受试耳,观察外毛细胞频率响应和RP及圆窗CAP的变化.结果外毛细胞在不同频率强声暴露后,特征频率(characteristic frequency,CF)的RP反应幅度减小,刺激声强度与RP的I-O曲线线性增加,CF的频率选择性下降.频率低于CF的强声较高于CF的强声更易引起CF的RP 下降.重复暴露有累加效应.同步记录的圆窗CAP未见阈移.结论低频强声引起耳蜗外毛细胞RP损伤也遵循半倍频程漂移规律.损伤机制可能与外毛细胞静纤毛及盖膜受累有关.

临床上水杨酸钠广泛用于解热、镇痛及抗炎治疗,在治疗风湿热和其它结缔组织疾病时所使用的剂量常足以导致耳鸣和听力下降.在一定范围内,听力损失的程度随水杨酸钠在血浆中的浓度的增加而加重[1].鉴于此,目前多利用水杨酸钠制作耳鸣的动物模型[2,3].