Objective To compare the relationship of acceptable noise level (ANL) between monaural and binaural hearing aid in patients with bilateral moderate-to-severe hearing loss, and to investigate the clinical significance of the ANL in binaural hearing aid fitting and the predictive role in the hearing aid effect assessment.Methods A total of 15 patients with bilateral moderate-to-severe hearing loss were selected, and the most comfortable levels (MCL), background noise level (BNL) and calculate ANL were tested, respectively, in 4 conditions: without hearing aids, fitted only left ears, fitted only right ears and binaural fitting.Results The ANL in 15 subjects measured at 4 conditions were 18.87±5.26, 12.60±2.47, 12.00±2.90, and 5.13±1.25 dB S/N, respectively.The MCLs were 80.40±9.28, 63.73±5.15, 62.27±5.36, and 61.80±6.05 dB HL, respectively.The BNLs were 61.67±6.14, 51.13±3.94, 50.27±4.50, and 56.67±5.16 dB HL.The ANL difference between the only left and right fitting groups was not statistically significant(P>0.05).The ANL difference between the monaural or the binaural hearing aid group and without hearing aids group were statistically significant (P<0.05), respectively.Compared with the monaural hearing aid group, the binaural hearing aid group had significantly lower ANL(P<0.05).Conclusion For people with bilateral hearing loss, hearing aids can improve their ability to manage the background noise, and binaural hearing aid fitting is better than monaural.

Post-traumatic stress disorder (PTSD) is a mental disorder characterized by hyperarousal, flashback and avoidance behavior after experiencing traumatic events. This article reviews the diagnostic criteria, pathogenesis and treatment options of this disease.

Objective To investigate the premature spontaneous ovulation rates in in vitro fertilization-embryo transfer (IVF-ET) cycles using gonadotropin-releasing hormone antagonist (GnRH-ant) and gonadotropin-releasing hormone agonist (GnRH-a), as well as the risk factors for premature spontaneous ovulation. Methods The rates of premature spontaneous ovulation in a total of 10 612 cycles using GnRH-ant or GnRH-a were compared. Matched case-controlled study and binary logistic regression model were conducted to analyze the risk factors for premature spontaneous ovulation. Results The spontaneous ovulation rate in the whole for GnRH-a cycles was 0.15%(13/8 514), compared with a 1.62%(34/2 098) in GnRH-ant cycles (P<0.01). Further matched controlled study and regression analyze found out that higher basal FSH level was a predominant risk and prediction factor for spontaneous ovulation (OR=1.20, P=0.009). Conclusions In GnRH-ant cycles, spontaneous ovulation rate is about 10 times than which in GnRH-a cycles. Diminished ovarian function is a predominate risk factor for premature spontaneous ovulation.

Objective To explore the cost-effectiveness and clinical effect of three platinum based chemotherapy regiments for advanced non small cell lung cancer (NSCLC).Methods 100 patients who were diagnosed as NSCLC,were randomly divided into four groups.The group Ⅰ received NP which was given NVB and DDP.The group Ⅱreceived GP which was given GEM and DDP.The group Ⅲ received TP which was given taxotere and DDP.The clinical effect,adverse reaction and cost effectiveness of the three groups were assessed.Results The clinical effective rates of the three groups were 31.43%,36.36%,37.50% from Ⅰ to Ⅲ group.The adverse events of the group Ⅰ and group Ⅱ were more than those of the group Ⅲ.In the adverse effects of treatment,the major cytotoxicity was digestive reaction and leukopenia in the two groups,but they were tolerable.The ratios of cost effectiveness in the four groups were 550.22yuan,556.48yuan,583.23yuan from Ⅰ to Ⅲ group.Conclusion The NP group is the best one in total cost.

Nail unit tumors are a group of rare tumors only occurring in the nail unit, including onychopapilloma, onychomatricoma, onychocytic matricoma, onycholemmal carcinoma, and so on. These tumors have specific clinical manifestations and pathological features due to their special anatomical locations. This review focuses on clinical manifestations, histopathological characteristics and treatment of the above tumors.

At present, diabetes mellitus has become an increasingly serious disease which affects public health in the word. Clinical treatment of diabetes is mainly based on oral hypoglycemic drugs, insulin injections and lifestyle interventions (diet and exercise) . The new intervention method targeting intestinal microflora opens up new ideas for diabetes treatment. This article reviews the application of new intestinal microbial therapy (probiotic treatment, oral prebiotics/synbiotics, fecal microbiota transplantation) and treatment by regulating intestinal microflora (bariatric surgery, antibiotic therapy and traditional Chinese medicine) in diabetes. This article also summarized the nursing intervention based on intestinal microbial therapy so as to improve the understanding of the relationship between intestinal microflora and diabetes, and provide a reference for treatment and nursing care for type 2 diabetes.

OBJECTIVE: To analyze the characteristics of left ventricular rotation and twist in patients with essential hypertension (EH) of different left ventricular configurations by 3-dimensional speckle tracking echocardiography (3D-STE). METHODS: A total of 106 EH patients were divided into 4 groups: a left ventricular normal configuration (LVN) group (n=30), a concentric remodeling (CCR) group (n=31), a concentric hypertrophy (CCH) group (n=29), an eccentric hypertrophy (ECH) group (n=16), and a control group of 30 healthy subjects. The parameters of LVEF, peak basal rotation (Prot-B), peak apical rotation (Prot-A), left ventricular peak apical rotation (LV-rot), and left ventricular peak apical twist (LV-tw) were compared. RESULTS: The left ventricular mass index in the EH groups, which kept increasing, was higher than that in the normal control group (P<0.05). Compared with the normal control group, LVN and ECH group, the left ventricular posterior wall thickness, interventricular septum at end-diastole, and relative wall thickness significantly increased in the CCH and CCR group (P<0.05). LVEF showed no significant difference among the normal control, LVN, CCR and CCH group (P>0.05), but LVEF was lower in the ECH group than in other groups (P<0.05). Compared with the normal control group, Prot-B, Prot-A, LVrot and LVtw were significantly higher in the LVN, CCR and CCH group (P<0.05), but decreased in the ECH group (P<0.05). CONCLUSION 3D-STE can evaluate the left ventricular rotation and twist in EH patients with different configurations, and reflect changes in the left ventricular systolic function in EH of different configurations.
Adult ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology ; Ventricular Remodeling ; physiology

Currently, the value of adjuvant therapy after radical resection of esophageal squamous cell carcinoma remains elusive. Some studies have reported that radiotherapy can improve the locoregional control rate and overall survival of patients. However, the design of radiotherapy target area, intervention time and dose of radiotherapy are controversial. In this article, literature review was conducted and the current status and controversy of adjuvant radiotherapy after radical resection of esophageal squamous cell carcinoma were reviewed.

Based on the concept definition and research status of the core competencies for home-based elderly caregivers,combined with the current development situation of China's elderly care industry and the relevant experience of Japan,Germany,and other countries in the construction of elderly care service systems,this paper sorted out that the core competencies for home-based elderly caregivers in China at this stage,such as elderly care skills,legal and ethical qualities,communication skills,and digital intelligence application capabilities,were relatively weak and cannot meet the comprehensive requirements of the current complex social environment,the individual needs and complex psychology of disabled elderly,and traditional concepts for caregivers.By closely integrating the active aging strategy proposed by the Party and our country,it was clear that home-based elderly caregivers should possess four core competencies,including comprehensive elderly care skills,basic legal and ethical qualities,good communication skills,and necessary informatization application capabilities.It was recommended that training institutions and universities enhance the core competencies for home-based elderly care caregivers by conducting training courses in elderly care,basic legal ethics,communication skills,and the use of smart devices,with a view to providing references for the sustainable development of elderly care.

Venous thromboembolism(VTE)is a common disease with high morbidity and mortality.The incidence and mortality of VTE are higher in elderly patients and increased level of D-dimer,a thrombosis marker is positively related with age.Therefore,the diagnostic threshold needs to be adjusted to screen VTE with D-dimer level.Elderly patients may still have VTE after implementation of anticoagulant prevention,and increasing age is a high risk factor for bleeding after anticoagulant prevention.Whether elderly patients need to be monitored for anticoagulant prevention of VTE,and the relationship between age and VTE recurrence remains to be determined.In-depth re-search on the prevention of VTE in elderly patients and exploration of innovative VTE prevention strategies may ori-ent future research.