Effects of wheat protein on hot-extrusion 3D-printing performance and the release behaviours of caffeic acid-loaded wheat starch.

In this study, the effects of wheat protein (WP) on the hot-extrusion 3D-printing (HE-3DP) performance of wheat starch (WS) gels, as well as effects of such gels on the encapsulation of caffeic acid, were investigated for the first time. The HE-3DP results show that the addition of WP can reduce print-line width and improve printing accuracy and fidelity, and the best printing results were achieved when using gels with 10 % WP. The rheological results show that WP reduced the gels' linear viscoelastic region (LVR), yield stress (τy), flow stress (τf) and consistency factor (K) but increased their structural recovery rate, which facilitated smooth extrusion during 3D printing and, thus, improved printing accuracy. The analysis of X-ray diffraction and small-angle X-ray scattering indicates that adding WP to WS could increase the mass fractal dimension and lead to denser gel network structures. The results regarding release kinetics demonstrate that the maximum release of caffeic acid from gels decreased by 28 % with the addition of WP, indicating slow-release behaviour. This study provided valuable information about processing wheat products via 3D printing.

Composite formation of whey protein isolate and OSA starch for fabricating high internal phase emulsion: A comparative study at different pH and their application in biscuits.

The composites formed by whey protein isolate (WPI) and octenyl succinate anhydride (OSA)-modified starch were characterized with a focus on the effect of pH, and their potential in fabricating high internal phase emulsions (HIPEs) as fat substitutes was evaluated. The particles obtained at pH 3.0, 6.0, 7.0, and 8.0 presented a nanosized distribution (122.04 ± 0.84 nm-163.24 ± 4.12 nm) while those prepared at pH 4.0 and 5.0 were remarkably larger. Results from the shielding agent reaction and Fourier transform infrared spectroscopy (FT-IR) showed that the interaction between WPI and OSA starch was mainly hydrophobic at pH 3.0-5.0, while there was a strong electrostatic repulsion at pH 6.0-8.0. A quartz crystal microbalance with dissipation (QCM-D) study showed that remarkably higher ΔD and lower Δf/n were observed at pH 3.0-5.0 after successive deposition of WPI and OSA starch, whereas slight changes were noted for those made at higher pH values. The WPI-OSA starch (W-O) composite-based HIPEs made at pH 3.0 and 6.0-8.0 were physically stable after long-term storage, thermal treatment, or centrifugation. Incorporation of HIPE into the biscuit formula yielded products with a desirable sensory quality.

Identification of Key Genes Related to Immune Cells in Patients with COVID-19 Via Integrated Bioinformatics-Based Analysis.

COVID-19 has spread all over the world which poses a serious threat to social economic development and public health. Despite enormous progress has been made in the prevention and treatment of COVID-19, the specific mechanism and biomarker related to disease severity or prognosis have not been clarified yet. Our study intended to further explore the diagnostic markers of COVID-19 and their relationship with serum immunology by bioinformatics analysis. The datasets about COVID-19 were downloaded from the Gene Expression Omnibus (GEO) dataset. The differentially expressed genes (DEGs) were selected via the limma package. Then, weighted gene co-expression network analysis (WGCNA) was conducted to identify the critical module associated with the clinic status. The intersection DEGs were processed for further enrichment analysis. The final diagnostic genes for COVID-19 were selected and verified through special bioinformatics algorithms. There were significant DEGs between the normal and COVID-19 patients. These genes were mainly enriched in cell cycle, complement and coagulation cascade, extracellular matrix (ECM) receptor interaction, and the P53 signaling pathway. As much as 357 common intersected DEGs were selected in the end. These DEGs were enriched in organelle fission, mitotic cell cycle phase transition, DNA helicase activity, cell cycle, cellular senescence, and P53 signaling pathway. Our study also identified CDC25A, PDCD6, and YWAHE were potential diagnostic markers of COVID-19 with the AUC (area under curve), 0.958 (95% CI 0.920-0.988), 0.941(95% CI 0.892-0.980), and 0.929 (95% CI 0.880-0.971). Moreover, CDC25A, PDCD6, and YWAHE were correlated with plasma cells, macrophages M0, T cells CD4 memory resting, T cells CD8, dendritic cells, and NK cells. Our study discovered that CDC25A, PDCD6, and YWAHE can be used as diagnostic markers for COVID-19. Moreover, these biomarkers were also closely associated with immune cell infiltration, which plays a pivotal role in the diagnosis and progression of COVID-19.

Evaluation of the detection rate of high­grade gastric intraepithelial neoplasia using linked color imaging and white light imaging.

As an endoscopic technology for the enhancement of images, linked color imaging (LCI) performs well when used for the early detection and diagnosis of gastrointestinal cancer. However, literature data are lacking for LCI in the detection of high-grade gastric intraepithelial neoplasia. Therefore, the aim of the present study was to investigate the efficacy of LCI compared with traditional white light imaging (WLI) in the detection of high-grade gastric intraepithelial neoplasia via the comparison of detection rates between senior and junior endoscopists using both techniques. Overall, 84 lesions from 81 patients with high-grade gastric intraepithelial neoplasia diagnosed between January 2017 and December 2017 were considered. Following the exclusion of three patients with two lesions, 78 patients who had only one lesion were enrolled. The two types of endoscopy, WLI and LCI, were performed in the same patients under the same conditions. Four senior and four junior endoscopists retrospectively compared the images. The detection rate of high-grade gastric intraepithelial neoplasia was significantly higher with LCI than with WLI when performed by senior and junior endoscopists. With WLI, the detection rate obtained by senior endoscopists was significantly higher than that obtained by junior endoscopists. However, for LCI, the detection rates for junior and senior endoscopists were comparable. Interobserver agreement was good to satisfactory. These findings indicate that LCI is superior to WLI in the detection and identification of gastric cancer and provides highly accurate diagnostic results from endoscopic examinations, regardless of the experience of the endoscopist. LCI may be used to narrow the gap in the detection rate of high-grade gastric intraepithelial neoplasia between junior and senior endoscopists.

Preparation and characterization of debranched starches: Influence of botanical source and debranching time.

The influence of botanical source (waxy corn, glutinous rice, tapioca and potato), either based on crystallization or morphology, and the debranching time (6-48 h) on the physicochemical properties of debranched starches (DBSs) were systematically investigated. The divergence of depolymerization among different botanical sources within same hydrolysis time suggested that the debranching treatment was not only depending on the molecular profile and crystalline structure, but also related with the granular size and morphology of native starches. Fourier transformation infrared spectroscopy (FT-IR), X-ray diffraction (XRD), differential scanning calorimetry (DSC) suggested that long-term debranching reaction produced DBSs with improved degree of crystallization and reduced iodine binding capacity. Simulated in-vitro digestion assay showed that the proportion of digestive fractions from different botanical originated DBSs differed greatly. Additionally, prolonging the debranching time yielded increased level of resistant starch. The study may provide guidance for exploring DBSs with various molecular weight to fulfill their tailored applications.

Comparison of laboratory parameters, clinical symptoms and clinical outcomes of COVID-19 and influenza in pediatric patients: A systematic review and meta-analysis.

BACKGROUND: New and more severe clinical manifestations associated with the coronavirus disease 2019 (COVID-19) are emerging constantly in the pediatric age group. Patients in this age group are also primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies comparing influenza and COVID-19 to show which condition causes a more severe form of disease amongst the pediatric age group are scarce. AIM: To compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza. METHODS: A systematic and comprehensive search was carried out in databases and search engines, including EMBASE, Cochrane, MEDLINE, ScienceDirect and Google Scholar from 1964 until January 2022. A meta-analysis was carried out using a random-effects model and pooled odds ratio (OR) or standardized mean difference (SMD) and 95%CI. RESULTS: A total of 16 studies satisfied the inclusion criteria. Pediatric COVID-19 patients had a significantly reduced risk of cough (pooled OR = 0.16; 95%CI: 0.09 to 0.27), fever (pooled OR = 0.23; 95%CI: 0.12 to 0.43), and dyspnea (pooled OR = 0.54; 95%CI: 0.33 to 0.88) compared to influenza patients. Furthermore, total hemoglobin levels (pooled SMD = 1.22; 95%CI: 0.29 to 2.14) in COVID-19 patients were significantly higher as compared to pediatric influenza patients. There was no significant difference in symptoms such as sore throat, white blood cell count, platelets, neutrophil and lymphocytes levels, and outcomes like mortality, intensive care unit admission, mechanical ventilation or length of hospital stay. CONCLUSION: COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group. However, further longitudinal studies of the outcomes between influenza and COVID-19 pediatric patients are needed.

Comparison of adenoma detection in different colorectal segments between deep-sedated and unsedated colonoscopy.

To investigate if deep-sedated colonoscopy affects adenoma detection in certain colorectal segment. Review of colonoscopy reports, electronic images and medical records of individuals underwent screening colonoscopy with or without propofol sedation between October 2020 and March 2021 from seven hospitals in China. A total of 4500 individuals were analyzed. There was no significant difference in ADR between deep-sedated colonoscopy and unsedated colonoscopy [45.4% vs. 46.3%, P > 0.05]. The APP of deep-sedated colonoscopy was lower than unsedated colonoscopy (1.76 ± 0.81 vs. 2.00 ± 1.30, P < 0.05). Both average number of adenomas and luminal distention score of splenic flexure and descending colon were lower in deep-sedated colonoscopy (P < 0.05), and average number of adenomas was positively correlated with an improved distension score in splenic flexure and descending colon (splenic flexure r = 0.031, P < 0.05; descending colon r = 0.312, P < 0.05). Linear regression model showed deep-sedated colonoscopy significantly affected luminal distention of splenic flexure and descending colon as well as average number of adenomas detected in splenic flexure (P < 0.05). Deep-sedated colonoscopy decreased adenoma detection in splenic flexure and the luminal distention of splenic flexure and descending colon compared with unsedated colonoscopy.

Effect of freezing-assisted treatment on the formation of stable VII -type complex of fried sweet potato starch and its mechanism.

To comprehensively understand the effect of freezing-assisted treatment on the physicochemical properties of the fried sweet potato starch, the structural changes at granular and crystalline level were investigated. The results suggested that the freezing temperature exerted a significant effect on the interactions between sweet potato starch (SPS) and fried oil. With decreasing the freezing-assisted temperature, the gelatinization enthalpy of the fried frozen SPS remarkably increased by 1.5-4.9 J·g-1 and the transition temperatures of the second peak were elevated from 132.5°C to 136.5-141.1°C compared to that of native SPS, which suggested that more stable VII -type starch-lipid complexes were formed during frying. This finding was consistent with the results of the X-ray diffractometer that the intensity of the diffraction peak at 20.1° for V-type complex increased sharply as the temperature decreased from 20°C to -80°C, and the corresponding relative crystallinity and R1047/1022 values were increased from 16.5% and 0.35 to 26.4% and 0.45, respectively. The scanning electron microscopy revealed that the lower freezing-assisted temperature before frying promoted a membrane-like material covered on surfaces. The results showed that decreasing the freezing temperature promoted the formation of stable VII -type complex during frying. PRACTICAL APPLICATION: The purpose of this study was to comprehensively understand the effect of freezing-assisted treatment on the physicochemical properties of the fried sweet potato starch. These results provided useful information and effective method for producing fried starch-based foods with low digestibility.

Retardant effect of different charge-carrying amino acids on the long-term retrogradation of normal corn starch gel.

The effects of different charge-carrying amino acids (lysine, aspartic acid, and tyrosine) on the long-term retrogradation properties of normal corn starch (NCS) gel were studied by differential scanning calorimetry, X-ray diffractometry, low-field nuclear magnetic resonance, and dynamic rheological tests. The results suggested that these amino acids could inhibit the long-term retrogradation of NCS gels, among which the positively charge-carrying amino acid (lysine) showed the most significant inhibitory effect and the zero net charged amino acid (tyrosine) exhibited the worst inhibitory effect. These amino acids significantly decreased the retrogradation enthalpy, hardness, and R1047/1022 value of NCS gels, as well as inhibited the recrystallization of NCS. The results of retrogradation kinetics suggested that the recrystallization of NCS with amino acids followed the instantaneous nucleation and the crystallization rate constant k of recrystallization was reduced by these amino acids. The amino acids could interact with starch molecules to form hydrogen bonds and steric hindrance during the recrystallization process, which prevented the formation of double helix structures, as well as reduced the water diffusion and exudation from NCS. Therefore, the lysine could be used as a good retrogradation inhibitor for starch in food industry.

A pH-sensitive curcumin loaded microemulsion-filled alginate and porous starch composite gels: Characterization, in vitro release kinetics and biological activity.

To improve the controlled release and stability of the loaded drug, the alginate-porous starch solution, as the gel matrix (GM), was prepared and added into curcumin-loaded microemulsion (CUR-ME) in a certain proportion, and then mixed with slow-gelling agents (CaCO3 + d-glucono-δ-lactone) to prepared curcumin-loaded microemulsion gel (CUR-ME-G). With increasing the proportion of GM from 25% (CUR-ME3G1) to 83% (CUR-ME1G5), the drug loading efficiency increased from 24% to 98% and the maximum drug loading capacity (14.9 mg/g) was found in CUR-ME1G3 with 75% GM. Moreover, a denser structure that entrapped all microemulsion droplets was formed with increasing the proportion of microemulsion according to the observation of scanning electron microscopy. This was also confirmed by Fourier transform infrared spectroscopy and Raman spectroscopy that no new peaks appeared in CUR-ME-G, while the hydrogen bonding interactions might exist between curcumin and sodium alginate. The in vitro release of the CUR-ME-G followed diffusion-controlled mechanism that was consistent with the first-order kinetic model. The release rate depended on the components of the CUR-ME-G and the pH value of the release medium. CUR-ME-G with curcumin concentration of 0.20% exhibited the best biological activity. CUR-ME-G might provide a potential application in the smart drug delivery systems.

Preparation of VII-type normal cornstarch-lauric acid complexes with high yield and stability using a combination treatment of debranching and different complexation temperatures.

To improve the yield and stability of VII-type cornstarch-lauric acid complexes and inhibit the digestibility of starch, debranched cornstarch was used to complex with lauric acid under a low complexation temperature and a high complexation temperature (DSL30 and DSL90). Debranching treatment raised the yield of the complexes and the melting enthalpy, which reached 51.4% and 14.26 J/g for the complex DSL90, respectively. Complexes formed at high complexation temperature showed high melting temperature ranged in 102.71 °C-120.30 °C, indicating high thermal stability. As the complexation temperature increased from 30 °C to 90 °C, the complexes transformed from VI-type to VII-type. The combination of debranching treatment and increasing complexation temperature decreased the in vitro digestibility of the complexes. The highest resistant starch content was found in the complex DSL90, which also exhibited a lamellar structure under the scanning electron microscopy. The root mean square deviation under the molecular dynamics simulations of the complexes was lower than that of single amylose, suggesting that the complexation with lauric acid could keep the conformation of the amylose chain stable. Debranching treatment combined with a high complexation temperature may be used as an applicable method to prepare VII-type starch-fatty acid complexes with high stability.

Comparative study of the quality characteristics of fresh noodles with regular salt and alkali and the underlying mechanisms.

The quality properties of fresh noodles with NaCl and alkali were characterized by rheological, cooking, and texture properties. Microstructure, starch viscosity, protein conformation, gelatinization and protein polymerization during cooking, and water status were determined to investigate the mechanisms underlying their quality differences. The results showed that alkali induced more significantly increased (P < .05) gluten strength and noodle hardness, while NaCl resulted in superior dough extensibility. Pasting viscosity of alkali-flour increased and protein conformation changes were detected in alkaline noodles with increased ß-sheet and decreased α-helix structures. Both NaCl and alkali increased cooking loss. NaCl induced a fibrous gluten structure while alkali caused a membrane-like structure. Furthermore, remarkable protein aggregates were observed in alkaline noodles immediately after 2 min of cooking in non-reduced HPLC patterns, while 4 min in reduced patterns. Water-solids interaction in alkaline noodles was enhanced with decreased water mobility. NaCl induced no significant changes in protein aggregation and water status.

Thalidomide Inhibits TGF-ß1-induced Epithelial to Mesenchymal Transition in Alveolar Epithelial Cells via Smad-Dependent and Smad-Independent Signaling Pathways.

Recent evidence indicates that the epithelial to mesenchymal transition (EMT) in primary alveolar cells (AECs) plays an important role in idiopathic pulmonary fibrosis (IPF). In vivo models have suggested that thalidomide (THL) has anti-fibrotic effects against pulmonary fibrosis, but the underlying mechanism of this effect is not clear. This study investigated whether THL regulates alveolar EMT and the possible mechanisms underlying this process. CCL-149 cells were treated with TGF-ß1 in the presence of THL at the indicated concentrations. EMT was assessed by changes in cell morphology and in phenotypic markers. Signaling pathways involved in EMT were characterized by western blot analysis. THL inhibited the TGF-ß1 induction of α-SMA, vimentin, MMP-2/-9 and collagen type IV expression and restored the morphological changes in primary alveolar epithelial cells caused by TGF-ß1. TGF-ß1 induction of α-SMA expression was partially dependent on the activation of p38, JNK, ERK, Akt, Smad 2 and Smad3. Moreover, THL inhibited TGF-ß1-induced phosphorylation of p38, JNK, ERK, Akt, GSK3ß, Smad 2 and Smad3 without altering the total expression levels of those proteins. These findings indicate that TGF-ß1-induced EMT in alveolar epithelial cells is inhibited by THL via both Smad-dependent and non-Smad-dependent signaling pathways and suggests therapeutic approaches for targeting this process in pulmonary fibrosis.

[High resolution melting analysis for detecting of JAK2V617F mutation in patients with myeloproliferative neoplasms].

This study was purposed to investigate the feasibility of high resolution melting (HRM) in the detection of JAK2V617F mutation in patients with myeloproliferative neoplasm (MPN). The 29 marrow samples randomly selected from patients with clinically diagnosed MPN from January 2008 to January 2011 were detected by HRM method. The results of HRM analysis were compared with that detected by allele specific polymerase chain reaction (AS-PCR) and DNA direct sequencing. The results showed that the JAK2V617F mutations were detected in 11 (37.9%, 11/29) cases by HRM, and its comparability with the direct sequencing result was 100%. While the consistency of AS-PCR with the direct sequencing was moderate (Kappa = 0.179, P = 0.316). It is concluded that the HRM analysis may be an optimal method for clinical screening of JAK2V617F mutation due to its simplicity and promptness with a high specificity.

The correlation between gatifloxacin's acute adverse reaction and intravenous drip velocity.

OBJECTIVE: To investigate the correlation between acute adverse reaction (AAR) and intravenous drip velocity of gatifloxacin. METHODS: Patients who had received intravenous gatifloxacin (0.2g/100 ml) infusion in the Emergency Center, Zhongnan Hospital, Wuhan University, Wuhan, China from January to August 2012 were enrolled in this study. Patients were randomly divided into 3 groups according to different drip velocities: Group A: velocity ≤10 drops per minute; Group B: <10 velocity ≤20 drops per minute; Group C: <20 velocity ≤30 drops per minute. The AAR and demographic data of patients were documented. RESULTS: Acute adverse reaction of the skin and digestive system were significantly positively related to intravenous drip velocity. The AAR of the cardiovascular system significantly increased when the intravenous drip velocity was beyond 20 drops per minute. The AAR of nervous system and abnormal glycometabolism has no significant correlation with intravenous drip velocity of gatifloxacin. CONCLUSION: Acute adverse reactions of skin, digestive system, and cardiovascular system would decrease with an appropriate velocity of intravenous gatifloxacin (0.2g/100 ml) less than 10 drops per minute.

Roles of p38 MAPK and JNK in TGF-ß1-induced human alveolar epithelial to mesenchymal transition.

BACKGROUND AND AIMS: Idiopathic pulmonary fibrosis (IPF) is associated with significant morbidity and mortality despite aggressive therapy. The aim of the present study is to investigate the roles of p38 MAPK and JNK in TGF-ß1-induced human alveolar epithelial to mesenchymal transition (EMT), which could be a possible mechanism of IPF. METHODS: A549 cells were treated with TGF-ß1 (3 ng/mL) for 48 h to induce EMT. The expression of mesenchymal phenotypic markers including desmin, α-smooth muscle actin (α-SMA) and vimentin, and expression of epithelial phenotypic markers including E-cadherin, zonula occludens-1 (ZO-1) and aquaporin-5 (AQP5) were detected by Western blot. The roles of p38 MAPK and JNK in TGF-ß1-mediated EMT were investigated using gene silencing and inhibitor SB-203580 and SP-600125. RESULTS: The data showed that TGF-ß1 induced A549 cells with an alveolar epithelial type II cell phenotype to undergo EMT. The process of EMT was accompanied by morphological alteration and expression of the myofibroblast marker desmin, α-SMA and vimentin, concomitant with a downregulation of the epithelial cell marker E-cadherin, ZO-1 and AQP5. TGF-ß1-induced EMT occurred through phosphorylation of p38 MAPK and JNK and was inhibited by inhibitor SB-203580 and SP-600125 and gene silencing. CONCLUSIONS: TGF-ß1 induces A549 alveolar epithelial cells (AECs) to undergo EMT partially via p38 MAPK and JNK activation and supports the concept of EMT in lung epithelial cells.

[Using three-dimensional CT to guide Le Fort I osteotomy in maxillary retrognathism patients].

OBJECTIVE: To analysis the maxillary bony structures by three-dimensional CT in maxillary retrognathism patients so as to provide information for Le Fort I osteotomy. METHODS: 20 maxillary retrognathism patients underwent Le Fort I osteotomy, while 20 patients with simple mandibular fractures were included as control group. All the patients received Skull 3-D CT before operation. The measurement about descending palatine artery and wing palatal was performed by Surgicase 5.0. The data were analyzed statistically. RESULTS: The average distance from the piriform aperture margin to wing palatal tube was (33.74 +/- 6.74) mm in the retrognathism group; while (35.67 +/- 7.50) mm in the control group, showing a significant difference between the two groups (P < 0.05), but there was no statistically difference in the height of pterygomaxillary junction between the two groups. CONCLUSION: The safe depth for Le Fort I osteotomy in patients with hypoplasia maxilla is 32 mm. CT scanning can provide guidance for osteotomy.

[Treatment of fracture of tibia and fibula with three dimensional diaplasis fixation].

OBJECTIVE: To study the clinical effect of three dimensional diaplasis fixation in fracture of tibia and fibula. METHODS: Twenty-one cases of fracture of tibia and fibula were treated with three dimensions fixation (12 males, 9 females, with an average age of 46 years). There were 5 cases in open fracture, 16 cases in closed fracture, and 4 cases in up-segment fracture, 8 cases in mid-segment fracture, 9 cases in below-segment fracture. Oblique fracture were in 10 cases, thrypsis were in 8 cases, multisegmental fracture were in 3 cases. RESULTS: (1) Conditions of diaplasis fracture: dissected diaplasis were in 11 cases, closely dissected diaplasis in 9 cases, functional diaplasis in 1 case. (2) Clinical healing time: the minimum time was 43 days and maximum time was 85 days with an average of 62 days. (3) Conditions of functional recovery: all the patients were followed up from 4 to 12 months, 13 cases were excellent, 8 cases were good. (4) Time of backouting three dimensional diaplasis fixation: the minimum time was 6 weeks and the maximum 12 weeks with an average time of 8.5 weeks. CONCLUSION: The three dimensional diaplasis fixation and the fracture extremity from such a three dimensional solid that it can satisfy crus biomechanics for treating fracture of tibia and fibula with unstressed barrier and uncentric stress. Moreover, the three dimensional diaplasis fixation is elastic, it's structure is so fixed that it can be favorable for bone union.

[Electrophysiological findings for 106 cases with auditory neuropathy].

OBJECTIVE: To analyses the clinical characteristics and electrophysiological finding of 106 patients with auditory neuropathy (AN). Investigate the differential curve type of pure tone audiogram and the abnormal ABR. METHODS: Review the history of patients, pure tone audiometry, middle ear acoustic reflexes, auditory brainstem response, distortion product otoacoustic emission and radiologic imaging studies of the brain of 106 patients with AN during December 2001 to May 2007 in retrospect. RESULTS: The 106 patients with AN were of both genders. The age were between 11-37 years old, and the average age was 17.5 years old. The most patients were adolescence (70.8%). Twelve cases of the 106 patients had evidence of other peripheral neuropathy in addition to hearing loss. Another 94 patients were idiopathic origins. The pure tone audiogram showed a minimal to moderate sensorineural hearing loss at low frequencies 0.5 kHz and 0.25 kHz in 209 ears (98.6%). The average hearing threshold (WHO 1997) in 23.2% of disordered ears at less than 25 dB in the "normal" range. Auditory brainstem response could not be recorded in 124 ears (58.5%) at maximum stimulus. The other 88 ears showed 1 or 2 wave, but the wave were small. There were 23 patients which one side ear ABR was 1 or 2 small waves presented, but the contralateral side were all waves absent. In 3 cases of AN with other peripheral neuropathy which ABR were both ears 1 or 2 small wave ear recorded. However, 1 patient in our sample could not be detected distortion product otoacoustic emission at 3-6 kHz (left ear) and 5-6 kHz (right ear). CONCLUSIONS: AN was not rare in adolescence. The average hearing threshold for AN should be discussed.