Objective Application of auditory brainstem response (ABR) in the study on the relationship of neonates with hypoxic-ischemic encephalopathy (HIE) and the children with hearing loss and auxiliary determine the prognosis of encephalopathy. Methods We prospectively selected neonates diagnosed as HIE in the department of neonatology of the Chengdu Women and Children Central Hospital from January, 2006 to June, 2008. Neonatal ABR was tested and the prognosis of neonates were observed through 3-year followed up in order to analyze the relationship between HIE severity and the severity of hearing handicap and the relationship between the severity of hearing handicap and prognosis. Statistical analysis was performed using SPSS 18.0. χ2 test was used to compare the rate between groups. Results 40 cases involving 80 ears were included, of which 33 cases accomplished the 3-year follow-up for prognosis. The results showed that, 86.3% HIE neonates had hearing handicap (mainly mild hearing loss, 40.0%). Medium-severe HIE groups had more serious hearing handicap than Mild HIE group with a statistical significance (continuity correction χ2=7.383, P=0.007). ABR results showed that, mild HIE is mainly manifested as I wave PL prolonged or poorly differentiated, accounting for 78.1%; medium - severe HIE are mainly manifested as III and V wave PL prolonged central segment abnormalities, accounting for 95.8%; the hearing threshold no more than 60 dB group had better prognosis than the hearing threshold more than 60 dB group prognosis (Fisher exact probability P=0.001). Conclusion ABR reflects that HIE severity and was positively related to the severity of hearing handicap. The more serious hearing loss in neonates is, the worse prognosis the neonates have. ABR can be used to assist the assessment of the prognosis of neonatal HIE.
ObjectiveTo investigate the effect of distortion product otoacoustic emission (DPOAE) in hearing assessment for children with mumps, by comparing the results of DPOAE and auditory brainstem response (ABR) threshold value examination. MethodsA total of 116 children (232 ears) with mumps and 50 healthy children (100 ears) without mumps received DPOAE and ABR threshold value examination between March 2010 and October 2012. The results of these two examinations were compared in the first place. Then, The passing rate of DPOAE and the normal rate of ABR were compared between the two groups. ResultsThe passing rate in the mumps group was significantly lower than that in the control group[94.83% (220/232), 100.00% (232/232); P<0.05]. The pure tone test of 6 children (12 ears) in the mumps group who did not pass the DPOAE screening test showed that they had slight or moderate hearing loss. The ABR hearing thresholds of all children were normal. No significant difference was detected in Ⅲ wave latency, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals based on 75 dB nHL (P>0.05). However, there was a significant difference in the latency of I wave, V wave and interval between Ⅰ and Ⅴ between the two groups (P<0.05). The normal rate of ABR was significantly higher than the passing rate of DPOAE in the mumps group (P<0.05). ConclusionThe hearing is normal in all mumps children. However, mumps virus infection can affect the function of the eighth nerve and some auditory nuclei in the brainstem. Although DPOAE can be a useful method for hearing assessment in the mumps children, other hearing tests including ABR should also be considered.
The quality of disinfectant, disinfection devices and disposable medical devices is closely related to the patients' safety. Hospital infection management department must carry out the audit responsibilities for qualification documents of disinfectant, disinfection devices and disposable medical devices, to guarantee legality, safety and effectiveness of products used in hospital. This paper mainly introduces the implementation of qualification documents audit in West China Hospital, Sichuan University, including system construction, process reengineering, documents audit scope and key points, and document management.