目的：探讨相关因素对突发性耳聋疗效及预后的影响。方法应用Logistic回归分析80例突发性耳聋病例资料，对性别、年龄、病程、听力损失程度、听力曲线类型等多种因素进行筛选，获得临床上与突发性耳聋效疗及预后相关的因素。结果初诊病程、患者的年龄、治疗前耳聋程度、听力曲线类型均与疗效、预后相关(P<0.05)；性别、伴随症状、患耳部位与疗效无明显相关性(P>0.05)。结论突聋患者年龄越小、病程越短，其疗效和预后越好；听力损失程度越高、听力曲线为全聋型预后越差。

Objective To explore the effect of anshinoneⅡA(Tan ⅡA) on induction of apoptosis in human nasopharyngeal carcinoma CNE1 cells and on expression of Bcl-2 gene and COX-2 promoter.Methods CNE1 cells were cultured in vitro and treated with various concentrations of TanⅡA.The cytotoxicity effect of Tan ⅡA against CNE1 cells was evaluated by MTT assay.The cell cycle distribution,apoptotic rate and Bcl-2 expression were investigated by flow cytometry.COX-2 promoter activity was detected by the dual luciferase assay.Results TanⅡA treatment inhibited CNE1 cell proliferation in a concentration-and time-dependent manner(P0.01).Compared with the control group,TanⅡA groups had significantly higher apoptosis rates(P0.01),and the apoptosis rates increased with the increase of Tan ⅡA concentration;the cells were blocked in the G2/M phase.TanⅡA inhibited Bcl-2 protein expression in a concentration-dependent manner within 6 h after treatment(P0.05).Bcl-2 expression was initially increased and then decreased with the increase of TanⅡA concentrations(P0.05) 24 h after treatment.Activity of COX-2 promoter decreased with the increase of TanⅡA concentration(P0.01).Conclusion TanⅡA can inhibit the growth and promote the apoptosis of CNE1 cells;inhibition of Bcl-2 expression and COX-2 activity might be one of the mechanisms for the TanⅡA-induced CNE1 cell apoptosis.

喉癌约占全身恶性肿瘤的5.7%～7.6%,90%以上的喉癌病理类型是鳞状细胞癌[1、2].喉鳞型细胞癌(LSCC)的临床表现包括声音嘶哑、喉痛、呼吸困难或痰中带血,并常伴有颈部肿块.

目的研究正常人及慢喉喑(慢性喉炎、声带小结、声带息肉)患者的嗓音声学参数变化,探讨嗓音声学测试在慢喉喑疾病嗓音障碍程度评估及辨证分型中的作用。方法对40例正常嗓音者和90例慢喉喑患者进行嗓音声学检测,同时对慢喉喑患者进行辨证分型,分为肺脾气虚组、肺肾阴虚组及痰凝血瘀组,分析各组的声学特征。结果慢喉喑各证型的基频微扰(jitter)、振幅微扰(shimmer)、标准化噪声能量(NNE)、谐噪比(HNR)及信噪比(SNR)与正常组比较差异均有显著统计学意义。慢喉喑各证型组中,从气虚组到阴虚组再到痰凝血瘀组,jit-ter、shimmer、NNE均呈现升高趋势,而HNR、SNR降低,但各组间比较,部分参数值差异有统计学意义。结论嗓音声学检测有助于慢喉喑各疾病程度的评估,可以为慢喉喑辨证分型提供一定的参考。

Objective To observe the clinical effects of Qingyi Decoction in the prevention and treatment of hyperamylasemia and acute pancreatitis following endoscopic retrograde cholangio pancreatography(ERCP).Methods Forty-six subjects were randomized into two groups: treatment group in which 23 cases were treated with routine therapy plus Qingyi Decoction,and control group in which 23 cases were treated with simple routine therapy.The numbers of the onset of hyperamylasemia and acute pancreatitis were observed.The level of blood amylase,and the time of blood amylase restoration to normal and clinical symptoms relief were observed.Results The hyperamylasemia and acute pancreatitis happened less frequently in treatment group than in control group.The blood amylase in the treatment group was lower than that in control group(P 0.05~0.01).The time of clinical symptoms relief and the restoration of blood amylase to normal was shorter in treatment group than in control group(P 0.05).Conclusion Qingyi Decoction can reduce the onset of hyperamylasemia and acute pancreatitis following ERCP and accelerate the restoration of blood amylase and clinical symptoms relief.

Objective:To approach the application value in diagnosing and treating functional disturbance of biliary passage after cholecystectomy(PCBD)with determination of treatment based on pathogenesis obtained through syndrome differentiation in TCM.Method:31 cases of PCBD were divided into 3 patterns according to syndrome differentiation,which were group of depression of liver-QI,group of stasis of hepatic blood,and group of hepatochlic hygropyrexia.Bupleurum Liver-Soothing Powder was the fundamental formula,and modified by syndrome in clinic practice.Result:19 cases were cured,9 cases were effective,and 3 cases were ineffective.The total effective rate was 90.32%(95%CI=75.0%-98.1%).All cases were follow-up visited for 3 to 6 months and no case was recurred.Conclusion:The therapeutic efficacy of determination of treatment based on pathogenesis obtained through syndrome differentiation in TCM on PCBD is exact and reliable.

Objective To investigate the applied value of APACHEⅡ,Ranson,Balthazar scoring system predicting the severity and prognosis and indicating clinical therapy for severe acute pancreatitis(SAP).Methods All 120 cases of SAP evaluated by APACHEⅡ,Ranson and Balthazar scoring system were retrospectively analyzed.Results APACHEⅡ scores in organ dysfunction group were significantly higher than in the group without organ dysfunction(P0.05).The APACHEⅡ scores in death cases were higher than in survival cases(P0.05).The incidence of organ failure in higher score group was more than that in low score group(P0.05).In Ranson scores,there was no significant difference between death group and survival group(P0.05).The CTIS scores of Balthazar scoring system were closely related to the prognosis.In the mortality in the higher score group was significantly higher than that in the lower score group(P0.01).Conclusion APACHEⅡ and Ranson combined with Balthazar scoring system could be used to evaluate the diagnosis,treatment and prognosis of SAP.