OBJECTIVE:This study aimed to investigate the relationships between cortical auditory evoked potentials (CAEPs), behavioral aided hearing thresholds, and functional auditory performance to validate CAEPs as an objective tool for assessing hearing aids fitting and to develop an integrated test battery for children with hearing loss. METHODS:Thirty children (aged 24-60 months) with bilateral sensorineural hearing loss were participated in this study. CAEPs were recorded in sound field using the HEARLab™ system in response to three speech stimuli (/m/,/g/,/t/) presented at 55, 65, and 75 dB SPL. Participants were categorized into Group A (CAEPs present for all stimuli at 55 dB SPL, n = 12) and Group B (absent waveforms at 55 dB SPL, n = 18). Aided sound-field thresholds were behaviorally assessed, and functional auditory performance was evaluated using the validated Mandarin version of the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) scale. RESULTS:Group A demonstrated aided thresholds within the speech banana across all tested frequencies, whereas Group B exhibited significantly higher thresholds. CAEPs detectability was strongly dependent on sensation level (SL), with waveforms consistently detected above 10 dB SL. P1 latency decreased significantly with increasing SL (β = -0.513 ms/dB, p < 0.001), while P1 amplitude increased (β = 2.827 μV/dB, p < 0.001). A strong positive correlation was observed between CAEP scores and PEACH questionnaire results (r = 0.884, p < 0.001). CONCLUSION:CAEPs provide an objective and frequency-specific neurophysiological method for verifying HAs fitting outcomes in children who are unable to cooperate with conventional subjective testing.

目的 调查北京农村老年人听力损失患病率,分析听力损失与慢病的相关性.方法 采用纯音测听筛查设备和健康问卷,对北京市密云区22个行政村943例60岁以上老年人进行测试和调查.根据较好耳的听力状况将人群分为三组,分别为听力正常、轻度听力损失和听力异常,将年龄、性别、糖尿病、高血压、高血脂、冠心病以及噪声接触史等作为自变量,听力损失严重程度作为因变量进行多元有序Logistic回归.结果 943例受试者,年龄(70.3±6.8)岁.以较好耳听力为准,286例(25.0％)为轻度听力损失,632例(67.0％)为听力异常.听力异常组平均年龄高于轻度听力损失人群和听力正常人群,差异有统计学意义(P<0.001).多元有序Logistic回归表明,总人群中,糖尿病人群听力损失严重程度增加一个等级的可能性是非糖尿病者的1.751倍.女性人群中,糖尿病人群听力损失严重程度增加一个等级的可能性是非糖尿病者的2.156倍.结论 农村老年人群,特别是女性中,糖尿病可能与听力损失严重程度增加有关.

噪声下数字言语测试(digits in noise,DIN)是为评估噪声下的言语识别能力而开发的听力筛查工具,受试者通过识别一组噪声环境中的三位数字获得识别阈,并以此作为是否转诊的指标.DI N作为一种快速、有效且经济、便捷的听力筛查手段,能够突破听力测试环境、设备和人员等限制,帮助人群大众早期发现听力损失;对于满足老龄化社会条件下对听力损失早发现、早干预的需求,具有重要的现实意义;也可以作为助听器使用者和人工耳蜗植入者效果评估及参数调整的有效测试工具.

文章介绍北京协和医学院护理学院本科生毕业论文网络指导及线上答辩的过程,并评价其实施效果.研究发现,网络指导及线上答辩在应对突发情况、缩短空间距离、促进学术交流等方面的相对优势较明显;但该形式下仍存在学生学习效率难以管控、论文指导及答辩效果可控性低等问题.建议今后可通过师生协作提高网络指导质量、熟悉软件平台操作及完善应急方案等方式,提升网络指导毕业论文及线上答辩的过程质量.

目的 获得听力正常老年人P1-N1-P2各波在不同言语刺激参数下的参考值并分析其特征.方法 使用澳大利亚HEARLab辅助皮层测试模块,对61例听力正常老年人在3种言语刺激声下进行测试,每种言语刺激声测试4个强度,获取各反应波潜伏期幅值的参考值.采用方差分析评估刺激声特性对波形特征值的影响.结果 ①61例受试者P1、N1、P2波均引出的引出率为91.8％;②刺激声为/g/时,听力正常老年人较青年人潜伏期延长幅值增大;③刺激声频率一定时,信噪比为10 d B诱发的反应波幅值最小,潜伏期最长;④刺激声强度一定时,较低频率语音/m/和/g/产生的振幅大于高频语音/t/.结论 听力正常老年人P1-N1-P2波引出率低于青年人,波形特征值亦有明显不同.刺激声特性对听力正常老年人P1-N1-P2特征值有显著影响.

新医科背景下,护理专业研究生教育培养机遇和挑战并存,全面权衡外部机遇与挑战,提出相应的对策十分必要.该文探讨在新医科背景下我国护理专业研究生教育的现状,分析其优势、劣势,提供相关的对策建议,为新医科背景下护理研究生教育培养工作提供思路和方向.

To improve nursing students' research capacity, School of Nursing, PUMC explored the mode of scientific research and teaching for nursing undergraduates which meet the needs of healthcare in China and so to develop an integrated and systematic program ofresearch training, and meanwhile to cultivate students' scientific research and innovation. The “three-stage scientific research training system” stimulated undergraduates' interest in scientific research and innovation, activated their independent and critical reasoning and innovation, and thus to contribute to the capacity development of research as well as innovation.

Objective: To summarize the experience of the diagnosis, treatment and effects of the cases with coexistence of first branchial cleft anomaly(FBCA) and microtia with congenital aural atresia or stenosis(external auditory canal stenosis, EACS). Method: This was a retrospective study. The clinical data of 5 patients with microtia and EACS in Beijing Tongren Hospital of Capital Medical University from October 2015 to March 2018 were collected, including 3 males and 2 females, aged from 5 to 28 years. The clinical characteristics, imaging findings, treatment methods and effects of 5 patients were analyzed. Result: The 5 cases were all coexistence of EACS and FBCA, three of who associated with cholesteatoma of external auditory canal. CT showed external auditory canal stenosis with soft tissue shadow, sometimes gas or bone septum found inside, filling in the external auditory canal, combined with canal bone destruction irregularly. All patients underwent surgical resection of FBCA, 3 patients accompanied by cholesteatoma resection and canalplasty. The postoperative follow-up ranged from 10 to 39 months, and no recurrence of infection was observed. Conclusions: EACS and FBCA both result from maldevelopment of the first branchial cleft. These two malformations, FBCA and EACS with or without cholesteatoma, can occur simultaneously, in which situation CT shows external auditory canal stenosis with soft tissue shadow inside. These patients underwent surgical resection of FBCA combined with cholesteatoma resection with good result.

介绍英国学习障碍专业护理本科教育模式,从知识、技能、实践方面分析培养目标,并结合我国护理教育现状,对我国相关领域护理本科教育的发展提出建议,优化课程设置,促进培养全面型人才.

目的 调查北京市护理专业实习学生从事老年护理意愿的现状并分析其影响因素.方法 采用自行设计的一般资料问卷和老年护理意愿调查问卷,对北京市4所高校的438名护理专业实习学生进行调查.结果 学生从事老年护理意愿得分为(3.19±0.56)分,4个维度得分由高到低依次为知觉行为控制、主观规范、行为态度和行为意向.多元逐步回归分析结果显示,父母与家中老年人的关系、建立家庭后是否愿意与父母同住、是否参加过老年志愿活动是护理专业实习学生从事老年护理意愿的影响因素(P＜0.05).结论 目前北京市护理专业实习学生从事老年护理的意愿较低.建议各高校进一步规范和完善老年护理课程体系,加强老年护理服务意识,进而增强老年护理服务意愿.

介绍赴英国诺丁汉大学交流学习过程中有关英国助产学专业本科教育等内容;通过对比国内外发展情况,以期为我国助产学专业本科教育的发展提供参考.

该文将从老年医疗服务、文化艺术与精神照护、老年日间照护项目和机构养老服务4个方面简要介绍加拿大Baycrest老年医学中心的医疗照护模式,以及提供这些医疗服务的多学科协作团队.提出了在老年医疗和护理中要重视个体化关怀、建立“日间照料”照护模式、坚持创新和专业化原则的建议.

Objective:To explore the normal value and characteristic of cortical auditory evoked potential (P1-N1-P2) in normal hearing young adults.Method:Thirty normal hearing young people were recruited for this study. Cortical auditory evoked potential (P1-N1-P2) was performed at three different speech stimuli (/m/, /t/, /g/) and three different sound intensity (55, 65, 75 dB SPL) using the Australia HEARLab test system. Analysis of Variance (ANOVA) was used to evaluate the influence of speech stimuli and sound intensity and gender to latency and amplitude of P1-N1-P2.Result:①The normal range of latency and amplitude of P1-N1-P2 for three different speech stimuli and stimuli intensity were established. ②There were significant differences among three different speech stimuli for latency (P< 0.05) and amplitude (P< 0.05) of N1 and the latency of wave P2 (P< 0.05). ③There were no significant differences among three different stimulus intensity for the amplitude and latency of P1-N1-P2 (P> 0.05). ④There were significant differences between gender for amplitude of the wave N1 and P2 and the latency of N1 (P> 0.05).Conclusion:We initially acquired the normal range of cortical auditory evoked potential (P1-N1-P2) with different speech stimuli and different stimulus intensities in normal hearing young adults. It is also found that P1-N1-P2 values evoked by different speech stimuli showed diffrenent characteristics and stimulus frequency had a significant influence on N1 and P2 wave characteristics. This study provides reference and experience for the further application of this technology in clinical practice.

目的 了解北京市护理本科生的自我领导力发展现状,为提出自我领导力发展策略提供依据.方法 采用过程性的自我领导力发展问卷和自我领导力发展路径问卷对3所高等院校的543名护理本科生进行调查.结果 过程性的自我领导力发展问卷得分为(3.57±0.54)分;发展路径问卷中,具备自我领导力者占63.5％(333/524),部分具备自我领导力者占7.8％(41/524),评价存在矛盾者占7.6％ (40/524),不具备自我领导力者占21.0％(110/524).结论 北京市护理本科生自我领导力发展情况较好,但仍存在一些值得关注的问题.教育者可结合学生的发展路径,采取积极措施,帮助引领其自我领导力的全面发展,为护理专业培养更多优秀的专业人才.

基于国家健康服务需求的变化,根据国家政策方针的指导性原则,以国际的视角、务实的精神和专业的态度,结合学院教学工作的具体实践,从更新教学理念、特色人才培养改革、拓展人才培养策略3个方面进行了护理专业特色人才培养的实践与理论的探索,积极推进了护理专业教育教学改革的工作,为其他院校进行护理本科人才培养改革提供借鉴和参考.

Objective:To investigate the reliability and validity of the Chinese version of the Satisfaction with Amplification in Daily Life (SADL).Method:Ninety adult hearing aid users were evaluated with Chinese version of the SADL.Result:①Reliability:Cronbach's α score of overall SADL score was 0.814 and the four subdomains were 0.543-0.824. ②Validity: The correlation coefficients between overall SADL score and the four subdomains were 0.514-0.826(all P<0.01).There were weak or no correlations among the four subdomains. The evaluation of content validity by expertreview showed the questionnaire had good content validity. SADL total scores in bilateral hearing aid userswere significantly higher than those in unilateral hearing aid users (t=2.192,P<0.05).Conclusion:The Chinese version of the SADL meets many psychometric criteria of a robust instrument. It possesses appropriate validity and good reliability, and can be used to measure the outcome for adult hearing aid users in China.

Objective To investigate the status quo of leadership of nursing undergraduates and analyze its influence factors. Methods A total of 341 nursing undergraduates were recruited by convenience sampling method and investigated with Questionnaire. Results The average score of leadership was 3.61 ±0.50. Five dimensions of the College Student Leadership Questionnaire scoring from high to low were leadership charisma, leadership forward vision, leadership resolution, leadership influence and leadership control. The influencing factors of the leadership of nursing undergraduates were sex ,grade,family monthly income per capita and the hours to attend social practice (P<0.05). Conclusion The overall level of leadership of nursing undergraduates is good, but can be improved greatly. Influencing factors include sex,grade,family monthly income per capita and the hours to attend social practice. Nursing colleges can provide the courses suitable for developing leadership among female.,and organize the activity purposely for each grade. The schools can also increase benefits for poor ones,and so that it will improve undergraduate nursing students' leadership.

Objective: To evaluate the auditory efficacy of Bonebridge implantation in patients with bilateral congenital malformation of external and middle ear. Methods: Eleven cases (6 males and 5 females) had unilateral Bonebridge implantation. The age ranged from 8 to 26 and the average age was 16.9. Seven to ten days after operation, the first fitting was undergone. In acoustic sound field, the average auditory thresholds were respectively measured for unaided ears and Bonebridge implanted ears by pure tone auditory (PTA, 0.25, 0.5, 1, 2 and 4 kHz). For the group over 12-year-old, MSTM was applied to evaluate speech discrimination score (SDS). For the other cases, MLNT was used as the test material. The auditory efficacy post Bonebridge implantation would be analyzed and evaluated by comparing the differences between unaided ears and Bonebridge implanted ears. Results: The bone conduction audibility threshold after Bonebridge implantation was as well as the preoperative. The auditory threshold with Bonebridge aided was improved to 25-35 dB HL, when compared to that of the unaided ears in the sound field. The SDS in the group over 12-year-old was improved about 50%; the efficacy was slightly limited for the other two cases (both less than 12 years old). Statistical analysis showed that there were significant differences between unaided ears and Bonebridge implanted ears in the sound field and SDS(P<0.05). Conclusions: The auditory efficacy of Bonebridge is significant and noticeable in patients with bilateral congenital malformation of external and middle ear. Bonebridge provides a new and effective way for patient with congenital malformation of external and middle ear to reconstruct hearing.

Objective:To investigate the surgical effects of round window implantation of vibrant soundbridge (VSB) for patients with congenital oval window atresia.Method:Retrospectively analyze the clinical information of 9 cases of congenital oval window atresia as well as the pre-and post-operative hearing and speech results.Three of them had undergone or attempted the vestibulotomy but obtained poor results.All cases underwent round window implantation of VSB.Result:All patients obtained an improvement of 21-33 dBHL after implantation.In the speech recognition rate test,the average increase of disyllabic words was 62％,and 60％ in the sentence test.During the follow-up of 51 months in average,2 cases had a decline of auditory benefit and finally 1 case regained the improvement after reoperation.Conclusion:Round window implantation can get a fairly good result in congenital oval windows atresia cases.

CONCLUSION:Application of the Vibrant Soundbridge to the round window (RW) membrane can be utilized as an efficient therapy for congenital oval window (OW) atresia.OBJECTIVE:To report the surgical technique and auditory outcome of an active middle ear implant (AMEI) system used in patients with congenital OW atresia.METHODS:Nine subjects with congenital OW atresia (six males and three females, ranging in age from 5.5 to 25 years, average 12.5 years) were implanted with an AMEI (Vibrant Soundbridge) at the round window (RW-Vibroplasty). Five cases were diagnosed as having isolated congenital OW atresia while four patients presented with combined external/middle ear malformation.RESULTS:An improvement of 30 dB in average pure-tone air conduction thresholds (0.5-4 kHz) was achieved, with the high frequencies showing greater results. The subjects achieved postoperative speech recognition scores of 80-100% on the Computerized Mandarin Speech Test System (CMSTS) sentence test. Bone conduction thresholds were confirmed as stable in all subjects postoperatively. Decline in auditory benefit was noticed in two subjects, who then underwent revision surgery. One of these revision surgery patients then experienced stable hearing recovery, while the other patient's hearing declined.