基于电沉积富集-LIBS的水中Cd元素高灵敏稳定测量研究

针对水体痕量Cd元素的高灵敏稳定检测,基于Al片电沉积富集(ED)结合激光诱导击穿光谱(LIBS)检测的ED-LIBS水中Cd分析方法,实验研究了富集时间、富集电压、导电溶质KCl浓度以及电极表面砂纸打磨对Cd元素富集结果的影响。结果表明,经砂纸打磨Al片电沉积富集后,Cd元素富集稳定性得到提升,同时优化确定的富集电压、富集时间和KCl浓度分别为−2.4 V、1200 s和2 g/L。利用该方法,Cd元素检测限和相对标准偏差分别为0.0021 mg/L和3.30%,满足《生活饮用水卫生标准》指标检测需求,为水体中痕量Cd元素的高灵敏稳定分析提供了有力的检测手段。

激光诱导击穿光谱(LIBS)法微损快速检测党参中Pb

中药材重金属元素快速检测对污染监控及人们健康具有重要意义。激光诱导击穿光谱技术(Laser induced breakdown spectroscopy,LIBS)属于一种快速检测方法,研磨压片等预处理方法相对样品消解已有所简化,但破坏了样品的物理性质,且不能满足中药材大宗品种、大批量检测需求。若进一步简化样品预处理,将更加凸显LIBS快速检测的优势。采用Pb溶液浸泡法获得不同Pb含量的党参切片样品,依次获取Pb LIBS光谱强度,通过排序初步判断Pb含量高低,随机从各含量梯度样品中抽取样品,将其分为三份:38个A样用于ICP-MS检测,建立定标曲线,从而获取B样和C样中Pb真实含量,10个B样作为Pb浓度已知的参考定标样品,用于待测党参样品中Pb微损检测,19个C样用于验证B样微损检测准确性。建立的微损定标曲线线性相关系数R^(2)为0.7764,可用于切片党参LIBS快速检测,对待测党参切片样品检测平均相对误差为3.74%,与电感耦合等离子体质谱(ICP-MS)法对比,相关系数R^(2)为0.7957,验证了LIBS技术微损检测的可行性。制备的党参参考定标样品可多次重复用于待测样定标和仪器标定等。实验对待测党参样品仅进行切片处理,避免了研磨、压片等预处理,更加充分地体现LIBS快速检测的优势,为LIBS技术应用于中药材重金属元素快检等领域提供了一种新方法。

Clinical observation of extraction-site incisional hernia after laparoscopic colorectal surgery

BACKGROUND Laparoscopic colorectal cancer surgery increases the risk of incisional hernia(IH)at the tumor extraction site.AIM To investigate the incidence of IH at extraction sites following laparoscopic colo-rectal cancer surgery and identify the risk factors for IH incidence.METHODS This study retrospectively analyzed the data of 1614 patients who underwent la-paroscopic radical colorectal cancer surgery with tumor extraction through the abdominal wall at our center between January 2017 and December 2022.Diffe-rences in the incidence of postoperative IH at different extraction sites and the risk factors for IH incidence were investigated.RESULTS Among the 1614 patients who underwent laparoscopic radical colorectal cancer surgery,303(18.8%),923(57.2%),171(10.6%),and 217(13.4%)tumors were ex-tracted through supraumbilical midline,infraumbilical midline,umbilical,and off-midline incisions.Of these,52 patients developed IH in the abdominal wall,with an incidence of 3.2%.The incidence of postoperative IH was significantly higher in the off-midline incision group(8.8%)than in the middle incision groups[the supraumbilical midline(2.6%),infraumbilical midline(2.2%),and umbilical incision(2.9%)groups](χ^(2)=24.985;P<0.05).Univariate analysis showed that IH occurrence was associated with age,obesity,sex,chronic cough,incision infection,and combined diabetes,anemia,and hypopro-teinemia(P<0.05).Similarly,multivariate analysis showed that off-midline incision,age,sex(female),obesity,incision infection,combined chronic cough,and hypoproteinemia were independent risk factors for IH at the site of laparoscopic colorectal cancer surgery(P<0.05).CONCLUSION The incidence of postoperative IH differs between extraction sites for laparoscopic colorectal cancer surgery.The infraumbilical midline incision is associated with a lower hernia rate and is thus a suitable tumor extraction site.

Enhanced stability of nitrogen-doped carbon-supported palladium catalyst for oxidative carbonylation of phenol

Enhancing the stability of supported noble metal catalysts emerges is a major challenge in both science and industry.Herein,a heterogeneous Pd catalyst(Pd/NCF)was prepared by supporting Pd ultrafine metal nanoparticles(NPs)on nitrogen-doped carbon;synthesized by using F127 as a stabilizer,as well as chitosan as a carbon and nitrogen source.The Pd/NCF catalyst was efficient and recyclable for oxidative carbonylation of phenol to diphenyl carbonate,exhibiting higher stability than Pd/NC prepared without F127 addition.The hydrogen bond between chitosan(CTS)and F127 was enhanced by F127,which anchored the N in the free amino group,increasing the N content of the carbon material and ensuring that the support could provide sufficient N sites for the deposition of Pd NPs.This process helped to improve metal dispersion.The increased metal-support interaction,which limits the leaching and coarsening of Pd NPs,improves the stability of the Pd/NCF catalyst.Furthermore,density functional theory calculations indicated that pyridine N stabilized the Pd^(2+)species,significantly inhibiting the loss of Pd^(2+)in Pd/NCF during the reaction process.This work provides a promising avenue towards enhancing the stability of nitrogen-doped carbon-supported metal catalysts.

Establishment of an indirect immunofluorescence assay for the detection of African swine fever virus antibodies

African swine fever(ASF)continues to cause enormous economic loss to the global pig industry.Since there is no safe and effective vaccine,accurate and timely diagnosis of ASF is essential to implement control measures.Indirect immunofluorescence assay(IFA)is a gold standard serological method recommended by the World Organization for Animal Health(WOAH).In this study,we used primary fetal kidney cells to establish a wild boar cell line(BK2258)that supported the efficient replication of ASF virus(ASFV)SD/DY-I/21 and showed visible cytopathic effect(CPE).Moreover,using BK2258,we established a sensitive and specific IFA for ASFV antibody detection.To standardize and evaluate the performance of this assay,we used serum samples from pigs infected with the low virulent genotype I SD/DY-I/21 and genotype II HLJ/HRB1/20,and immunized with the vaccine candidate HLJ/18-7GD,field samples,and negative serum samples.The IFA reacted with the ASFV-positive sera and displayed bright fluorescence foci.There was no non-specific green fluorescence due to cellular senescence or other cell damage-causing factors.Compared to a commercial indirect enzyme-linked immunosorbent assay(iELISA),ASFV antibodies were detected 1–4 days earlier using our IFA.The detection limits of the IFA and iELISA for the same ASFV-antibody positive serum samples were 1:25,600 and 1:6,400,respectively,indicating that the IFA is more sensitive than iELISA.The newly established IFA was highly specific and did not cross-react with sera positive for six other important porcine pathogens(i.e.,Classical swine fever virus(CSFV),Porcine reproductive and respiratory syndrome virus(PRRSV),Porcme circovirus type 2(PCV2),Pseudorabies virus(PRV),Foot-and-Mouth disease virus type O(FMDV/O),and Porcine epidemic diarrhea virus(PEDV)).This study thus provides a sensitive,specific,and reliable detection method that is suitable for the serological diagnosis of ASF.

Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy:A New Technique for Selective Clamping of the Portal Vein

Objective:A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions.Methods:Rabbits undergoing hepatectomy were randomly assigned to 4 groups:intermittent portal triad clamping(PTC),intermittent portal vein clamping(PVC),intermittent portal vein blocker with an airbag-selective portal vein blood arrester(APC),and without portal blood occlusion(control).Hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate,blood loss,liver function,hepatic pathology,hepatic inflammatory cytokine infiltration,hepatic malondialdehyde levels,and proliferating cell nuclear antigen levels.Results:Liver damage was substantially reduced in the APC and PVC groups.The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals.Bleeding was significantly higher in the control group than in the other groups.The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy.Thus,more operative time was saved in the APC group than in the PVC group.Moreover,the total 7-day survival rate in the APC group was higher than that in the PTC group.Conclusion:Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy.This technique may also help prevent liver damage in patients requiring hepatectomy.

Unveiling the secrets of gastrointestinal mucous adenocarcinoma survival after surgery with artificial intelligence:A population-based study

BACKGROUND Research on gastrointestinal mucosal adenocarcinoma(GMA)is limited and controversial,and there is no reference tool for predicting postoperative survival.AIM To investigate the prognosis of GMA and develop predictive model.METHODS From the Surveillance,Epidemiology,and End Results database,we collected clinical information on patients with GMA.After random sampling,the patients were divided into the discovery(70%of the total,for model training),validation(20%,for model evaluation),and completely blind test cohorts(10%,for further model evaluation).The main assessment metric was the area under the receiver operating characteristic curve(AUC).All collected clinical features were used for Cox proportional hazard regression analysis to determine factors influencing GMA’s prognosis.RESULTS This model had an AUC of 0.7433[95% confidence intervals(95%CI):0.7424-0.7442]in the discovery cohort,0.7244(GMA:0.7234-0.7254)in the validation cohort,and 0.7388(95%CI:0.7378-0.7398)in the test cohort.We packaged it into Windows software for doctors’use and uploaded it.Mucinous gastric adenocarcinoma had the worst prognosis,and these were protective factors of GMA:Regional nodes examined[hazard ratio(HR):0.98,95%CI:0.97-0.98,P<0.001]and chemotherapy(HR:0.62,95%CI:0.58-0.66,P<0.001).CONCLUSION The deep learning-based tool developed can accurately predict the overall survival of patients with GMA postoperatively.Combining surgery,chemotherapy,and adequate lymph node dissection during surgery can improve patient outcomes.

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding.It emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per day.Initial computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development.Hemoglobin levels progressively decreased to 7 g/dL.Emergency arterial angiography and iliac arterycovered stent placement were performed,followed by balloon angioplasty.Despite initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic colonoscopy.This identified a neoplasm and potential perforation at the proximal rectum.An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and ileostomy.Postoperative recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.CONCLUSION In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.

Is Peer Victimization Associated with Higher Online Trolling among Adolescents?The Mediation of Hostile Attribution Bias and the Moderation of Trait Mindfulness

Background:In recent years,online trolling has garnered significant attention due to its detrimental effects on mental health and social well-being.The current study examined the influence of peer victimization on adolescent online trolling behavior,proposing that hostile attribution bias mediated this relationship and that trait mindfulness moderated both the direct and indirect effects.Methods:A total of 833 Chinese adolescents completed the measurements of peer victimization,hostile attribution bias,trait mindfulness,and online trolling.Moderated mediation analysis was performed to examine the relationships between these variables.Results:After controlling for gender and residential address,the study found a significant positive correlation between peer victimization and online trolling,with hostile attribution bias serving as a mediator.In addition,trait mindfulness moderated the direct relationship between peer victimization and online trolling.Specifically,the effect of peer victimization on online trolling was attenuated when adolescents had high levels of trait mindfulness.The results of the study emphasized the joint role of peer and personal factors in adolescents’online trolling behavior and provide certain strategies for intervening in adolescents’online trolling behavior.Conclusion:The results of the study suggest that strategies focusing on peer support and mindfulness training can have a positive impact on reducing online trolling behavior,promoting adolescents’mental health,and their long-term development.

Determination of Ten Kinds of Alpha-2 Agonists Residues in Animal Derived Food by UHPLC-Triple Quadrupole/Composite Linear Ion Trap Mass Spectrometry

[Objectives]The paper was to establish an ultra high performance liquid chromatography-quadrupole/linear ion trap complex mass spectrometry for the determination of 10 kinds ofα2-receptor agonists in animal derived food.[Methods]The samples were extracted with sodium carbonate buffer solution and ethyl acetate,and analyzed by mass spectrometry after solid phase extraction and high performance liquid chromatography separation.[Results]Ten kinds ofα2-receptor agonists showed a good linear relationship in the range of 1-100μg/mL,with the average recovery of over 69%and the relative standard deviation less than 8.32%.The detection limit of 10 kinds of α_(2)-receptor agonists was up to 1μg/kg.[Conclusions]The method has good selectivity and strong anti-interference ability,and can meet the requirements of 10 kinds ofα2-receptor agonists residues in animal derived food.

Characteristics of Dry and Wet Climate in Shandong Province Based on Standardized Precipitation Index

Based on the monthly precipitation data of 116 meteorological stations in Shandong Province during 1970-2021,standardized precipitation index(SPI)was calculated,and the methods of linear fitting,mutation test and Morlet wavelet analysis were used to analyze the change trend and temporal and spatial distribution characteristics of SPI index in the past 52 years.The results show that there were more normal years in Shandong Province,and the frequency reached 38.46%.There was severe drought in the 1980s and more wet years after 2003.SPI index showed an upward trend in spring,summer and winter but a weak arid trend in autumn.In addition,intense dry weather was more frequent in summer.Spatially,the climate was normal or humid in most areas of Shandong Province.The regions with more wet years were located in the central and northeast Shandong and the peninsula,while the climate was normal in the southwest and north of Shandong.The areas with more dry years were mainly located in the northwest of Shandong Province.There was mainly local and global drought in Shandong Province,and the arid area showed a decreasing trend.In the past 52 years,Shandong Province experienced quasi-4 times of alternation between dry and wet climate.The long period of 21 a was the first main period,and the climate would be still wet in Shandong Province in the future.In terms of mutation,the climate in Shandong Province became humid after 2003,and 2003 was the mutation point.After the abrupt change,the climate changed from gradually drying to wetting.

Agrobacterium tumefaciens-mediated transformation of embryogenic callus and CRISPR/Cas9-mediated genome editing in‘Feizixiao'litchi

Litchi(Litchi chinensis Sonn.)is a type of commercially prevalent subtropical and tropical fruit.Since litchi has a highly heterozygous genetic background and a long reproductive cycle,conventional breeding methods(such as hybridization)have limited ability to nurture new litchi cultivars.Here,an efficient and stable Agrobacterium tumefaciens-mediated genetic transformation of embryogenic callus was established in‘Feizixiao’litchi.Transgenic materials were verified using polymerase chain reaction(PCR)analysis,β-glucuronidase(GUS)assay,and green fluorescent protein(GFP)assay.To implement the technology of the Clustered Regularly Interspaced Short Palindromic Repeats(CRISPR)/associated protein 9(CRISPR/Cas9)technology in‘Feizixiao’litchi and verify the validity of these transformation systems,the litchi polyphenol oxidase gene(LcPPO,JF926153)was knocked out.Various categories of mutations,covering base insertions,deletions,and substitutions,were found in transgenic materials via sequence analysis.The transformation system achieved high feasibility and efficiency,and the system of CRISPR/Cas9 was successfully employed to edit genes in‘Feizixiao’litchi.This work provides an essential foundation for investigating the functions of genes and accelerating litchi genetic improvement.

肝细胞癌患者中CAC1、CCNB2、Cyclin Y及Cyclin E1的表达及意义

目的 研究肝细胞癌(HCC)组织中细胞周期素依赖激酶2相关性Culin结构域1(CAC1)、细胞周期蛋白B2(CCNB2)、细胞周期蛋白Y(Cyclin Y)及细胞周期蛋白E1(Cyclin E1)的表达,探讨四者的临床意义。方法 应用R语言分析癌症基因组图谱数据库中HCC癌和癌旁组织中CAC1、CCNB2、Cyclin Y及Cyclin E1 mRNA的表达。免疫组化检测诊治的84例HCC癌组织及癌旁组织中CAC1、CCNB2、Cyclin Y及Cyclin E1蛋白表达。Pearson相关分析癌组织中各指标表达的相关性。统计学分析HCC癌组织中CAC1、CCNB2、Cyclin Y及Cyclin E1表达与临床病理参数的关系。Kaplan-Meier生存分析(Log-rank检验)分析CAC1、CCNB2、Cyclin Y及Cyclin E1表达与HCC患者生存预后的关系。结果 TCGA数据库HCC癌组织中CAC1、CCNB2、Cyclin Y及Cyclin E1 mRNA的表达显著高于癌旁组织,差异有统计学意义(P<0.05)。Pearson相关分析结果CAC1、CCNB2、Cyclin Y与Cyclin E1 mRNA表达均呈正相关(P<0.05)。癌组织中CAC1、CCNB2、Cyclin Y及Cyclin E1蛋白阳性表达率明显高于癌旁组织(P<0.05)。HCC患者不同肿瘤TNM分期及肿瘤数目的癌组织中CAC1、CCNB2、Cyclin Y及Cyclin E1蛋白表达差异有统计学意义(P<0.05)。84例患者随访2~60个月,随访期间死亡39例,失访2例,5年总体生存率52.44%(43/82)。CAC1、CCNB2、Cyclin Y及Cyclin E1阳性表达组的5年总体生存率分别低于阴性表达组患者(P<0.05)。结论 HCC中CAC1、CCNB2、Cyclin Y及Cyclin E1表达升高,四者表达与肿瘤TNM分期及肿瘤数目有关,有助于判断HCC患者的生存预后。

便携式激光诱导击穿光谱仪测定土壤中重金属

土壤重金属污染对农作物生长和人体健康都有严重危害,现场快速检测对土壤重金属污染调查、应急监测具有重要意义。采用自主研发的土壤重金属激光诱导击穿光谱现场快速检测仪对矿区周边土壤进行现场检测分析,以835个不同基质土壤的光谱数据建立定标数据库,通过支持向量机建立回归模型对土壤重金属元素含量进行定量反演。现场检测获取的全波段光谱波动在15%以内,Cd、Cr、Cu、Ni、Pb和Zn等6种元素光谱强度相对标准偏差平均值为6.31%。将检测结果与实验室电感耦合等离子体质谱法分析对比,6种元素的皮尔逊相关系数r在0.8501~0.9829,检测结果80%以上处于±30%相对误差区间分布。对比结果表明自主研发的土壤重金属激光诱导击穿光谱现场检测仪可以满足现场快速检测需求。

积极反刍思维训练对终末期肾病血液透析患者自我感受负担、知觉压力及自我效能的影响

目的:探究积极反刍思维训练对终末期肾病血液透析患者自我感受负担、知觉压力及自我效能的影响。方法:选择福建省立医院收治的终末期肾病血液透析患者106例作为研究对象,病例选取时间为2019年8月—2021年7月,采用随机数字表法对其分组,分为对照组和干预组,每组53例。对照组实施常规护理措施,干预组在对照组基础上进行积极反刍思维训练。干预前与干预后,分别调查统计两组患者的自我感受负担、知觉压力、自我效能。结果:干预后,干预组自我感受负担评分均明显低于对照组,差异均有统计学意义(P<0.05);干预后,干预组知觉压力显著低于对照组,差异有统计学意义(P<0.05);干预后,干预组合理休息、情绪控制、自我保健、遵医用药和健康问题评分均高于对照组,差异均有统计学意义(P<0.05)。结论:积极反刍思维训练能显著降低终末期肾病血液透析患者自我感受负担和知觉压力,同时也能提高患者的自我效能。

基于痰瘀互结探讨慢性阻塞性肺疾病气道重塑

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的病理基础是气道的重塑,基于痰瘀相关理论,认为久病肺虚,痰气、瘀血阻塞气道,是慢性阻塞性肺疾病气道重构的基本病机,文章中医学痰瘀互结相关理论对COPD气道重塑病因病机、治疗等方面进行阐述。

我国心系疾病中医护理研究的CiteSpace知识图谱可视化分析

目的:使用文献计量学方法分析我国心系疾病中医护理研究现状及热点。方法:检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库中的心系疾病中医护理相关研究,对纳入的文献进行可视化分析。结果:心系疾病中医护理研究文献量总体呈上升趋势,但作者及各研究机构间的合作不足,研究症状主要有便秘、焦虑、抑郁和失眠等,心系疾病中医护理研究领域更加关注老年群体,提倡辨证施护、舒适护理,以提高病人生活质量为目标。结论:心系疾病中医护理相关研究文献量较少,作者与研究机构间的合作有待加强,需优化心系疾病中医护理方案,为临床护士开展辨证施护、实施适宜的中医护理技术提供参考,推动中医护理长期、稳定地发展。

产教融合背景下医学检验技术专业学生创新创业教育平台建设

产教融合教育是产业与教育的深度合作,是对现有创新创业教育的深化和拓展。因此,以学生为中心,深化产教融合,构建医学检验专业大学生创新能力培养体系对于这门学科的建设极其重要。川北医学院建立创新创业管理信息平台及企业参与人才培养方案动态调整机制,完善双创考核评价的形式与内容;打造校企“三师型”师资队伍,指导学生创新创业;构建产教融合教育课程,加强思政教育,开展“立体式”实践教学;搭建产教融合项目孵化平台,培养学生的创新创业精神和能力,加强校企协同育人促进成果转化,探索产教融合背景下医学检验技术创新创业教育模式,为培养医学检验技术高素质应用型人才提供参考。

SPECT肾动态显像用于糖尿病早期肾损伤预测中的价值

目的 探究糖尿病早期肾损伤预测期间,以SPECT肾动态显像技术应用价值。方法 选取常州市第二人民医院接诊的糖尿病患者80例,起始时间自2019年1月开始,拟定相关计划,收集研究数据,至2023年6月截止,将纳入患者以尿白蛋白排泄率进行分组,微量组26例;正常组26例;大量组28例,均进行SPECT肾动态显像检测,分析患者生化指标、肾小球滤过率。结果正常组与微量组的生化指标水平对比差异无统计学意义(P>0.05)。大量组比正常组、微量组的生化指标水平高(P均<0.05)。微量组肾小球滤过率(69.15±15.47)ml/min与正常组肾小球滤过率(74.29±15.29)ml/min对比差异无统计学意义(P>0.05);大量组肾小球滤过率(63.19±13.54)ml/min低于正常组肾小球滤过率(74.29±15.29)ml/min(t=2.8287,P=0.0066)。结论 临床诊断糖尿病早期肾损伤过程中,以SPECT肾动态显像预测价值显著,能够作为早期预测肾脏功能损伤重要手段,协助医师了解患者疾病进展程度,便于开展对应措施进行施治。

耳后和鼓室内注射糖皮质激素治疗突发性聋的Meta分析

目的探讨耳后和鼓室内注射糖皮质激素治疗突发性聋的有效性及安全性。方法通过在中国知网、万方、维普、Pubmed、Cochrane和Embase等数据库检索自建库以来至2022年9月国内外公开发表的耳后和鼓室内注射糖皮质激素治疗突发性聋的随机对照研究,对符合纳入标准的研究进行Meta分析。结果本研究共检索1723篇,通过筛选后共纳入符合要求的文献33篇,其中1篇英文文献,其余均为中文文献。耳后组和鼓室组总有效率无显著性差异(RR=1.02,95%CI为0.98~1.07,Z=1.20,P=0.23),耳后组的治愈率明显高于鼓室组(RR=1.14,95%CI为1.00~1.29,Z=2.03,P=0.04)。通过亚组分析,耳后组和鼓室组合并突聋的糖尿病患者总有效率无显著性差异(RR=1.08,95%CI为0.99~1.17,Z=1.71,P=0.09)。在难治型的突聋患者的治疗中,鼓室组的有效率高于耳后组(RR=0.88,95%CI为0.80~0.97,Z=2.56,P=0.01)。两组之间耳鸣的有效率无显著性差异(RR=1.11,95%CI为0.95~1.30,Z=1.33,P=0.18)。在安全性比较方面,耳后组明显好于鼓室组(RR=0.33,95%CI为0.25~0.44,Z=7.57,P<0.01)。结论通过耳后注射糖皮质激素能获得和鼓室注射相似甚至更好的疗效。与鼓室注射相比,耳后注射更安全。