Objective To explore the differences in clinical characteristics of sudden sensorineural hearing loss(SSNHL)between patients with coronavirus disease 2019(COVID-19)and those without-COVID-19.Methods 31 SSNHL patients with COVID-19 who were hospitalized in a department during the COVID-19 epidemic period(from December 2022 to January 2023)were included as the study group,and 12 SSNHL patients without COVID-19 who received treatment during the non-COVID-19 epidemic period(from December 2021 to January 2022)were co-llected as the control group.Two groups of patients received standardized treatment,and their clinical characteristics and prognosis were compared.Clinical characteristics of SSNHL patients with COVID-19 during the COVID-19 epidemic period were analyzed.Results The time interval from patients developed COVID-19 to the onset of SSNHL in the study group was 3-30 days.The time interval from onset to consultation were 3(1,7)days and 5(4,6)days in the study group and the control group,respectively,with no significant difference(P＞0.05).The average age of patients in the study group was(44.16±13.54)years,which was higher than that of the control group(35.23±9.24)years,and the difference was statistically significant(P＜0.05).The hearing at damaged fre-quency of the study group improved by 6.5(0.5,24.5)dB after therapy,which was lower than that of the control group(36.0[27.0,38.0]dB),with statistically significant difference(P＜0.05).There was a negative correlation of the interval of consultation with the average improvement level of hearing at damaged frequency(r=-0.318,P=0.033).The longer the interval,the less the hearing improvement and the worse the therapeutic effect.Corre-lation analysis was further conducted on the time interval from development of COVID-19 to SSNHL onset and the time interval of consultation in patients in the study group,which showed no correlation(r=-0.337,P=0.059).There was no statistically significant difference in the types and degree of SSNHL between two groups of patients(both P＞0.05).After standardized treatment,the rate of ineffective patients in the study group was 56.25％,which was higher than that in the control group(15.38％),and the difference was statistically significant(P＜0.05).Conclusion After adjusting the COVID-19 prevention and control policies,there are more hospitalized COVID-19 patients with SSNHL,with a higher proportion in patients of older age,with poorer efficacy,and inef-fective treatment.The earlier the treatment for SSNHL patients,the better the effect can achieve.COVID-19 may be a potential inducement and/or etiological factor of SSNHL,and further research is needed.

Objective:To investigate the clinical features of patients with congenital atresia of the oval window (CAOW).Methods:A retrospective analysis was conducted on 7 cases (8 ears) of surgically confirmed CAOW treated at our department from July 2018 to July 2024. Among the cases, 1 patient had bilateral CAOW, and 4 patients had unilateral CAOW combined with other types of ossicular chain malformations in the contralateral ear. We collected and analyzed the clinical data, audiological features, and temporal bone HRCT results of all patients.Results:The 7 patients were diagnosed at ages ranging from 8 to 19 years, with a mean age of (13.2±6.9) years. None of the patients exhibited significant auricular deformities. All presented with conductive hearing loss or mixed hearing loss predominantly of the conductive type, with an intact tympanic membrane. The diagnosis of CAOW was confirmed via endoscopic tympanotomy, revealing a concave oval window area on the medial wall of the tympanic cavity, sealed by a bony plate. All 8 ears exhibited additional ossicular chain deformities. Stapes absence was present in all 8 ears. Partial absence of the incus long process was observed in 3 ears, while, abnormal bony connections between the incus long process and the promontory were seen in 4 ears, 1 ear had a short malleolar handle, 1 ear had a smaller than normal malleus volume. In addition, facial nerve deformities were found in 6 ears, with 4 ears showing bifurcation of the facial nerve and 2 ears showing facial nerve obscuration of the oval window. Pure-tone audiometry revealed that 62.5% (5/8 ears) of patients had air conduction (AC) thresholds≥60 dB preoperatively, with a mean pure-tone average (PTA) of (69.0±11.8) dB HL and a mean air-bone gap (ABG) of (52.0±7.0) dB. The mean AC threshold and ABG were higher in the low-frequency (125-1 000 Hz) range compared to the high-frequency (2 000-8 000 Hz) range (both P<0.05). Preoperative HRCT showed abnormalities in all patients, with 7 ears being diagnosable as CAOW. Although the remaining 1 ear could not be diagnosed as CAOW, stapes and incus long process absence were detected. Conclusion:CAOW is rare in clinical, as the patients with non-progressive conductive hearing loss (AC≥60 dB, ABG≥50 dB) since childhood, intact tympanic membrane without malformations of auricle and external auditory canal, and thick bony plate covered the oval window of the HRCT imaging, CAOW should be highly suspected, which could be confirmed by the exploratory tympanotomy.

Objective To explore the differences in clinical characteristics of sudden sensorineural hearing loss(SSNHL)between patients with coronavirus disease 2019(COVID-19)and those without-COVID-19.Methods 31 SSNHL patients with COVID-19 who were hospitalized in a department during the COVID-19 epidemic period(from December 2022 to January 2023)were included as the study group,and 12 SSNHL patients without COVID-19 who received treatment during the non-COVID-19 epidemic period(from December 2021 to January 2022)were co-llected as the control group.Two groups of patients received standardized treatment,and their clinical characteristics and prognosis were compared.Clinical characteristics of SSNHL patients with COVID-19 during the COVID-19 epidemic period were analyzed.Results The time interval from patients developed COVID-19 to the onset of SSNHL in the study group was 3-30 days.The time interval from onset to consultation were 3(1,7)days and 5(4,6)days in the study group and the control group,respectively,with no significant difference(P＞0.05).The average age of patients in the study group was(44.16±13.54)years,which was higher than that of the control group(35.23±9.24)years,and the difference was statistically significant(P＜0.05).The hearing at damaged fre-quency of the study group improved by 6.5(0.5,24.5)dB after therapy,which was lower than that of the control group(36.0[27.0,38.0]dB),with statistically significant difference(P＜0.05).There was a negative correlation of the interval of consultation with the average improvement level of hearing at damaged frequency(r=-0.318,P=0.033).The longer the interval,the less the hearing improvement and the worse the therapeutic effect.Corre-lation analysis was further conducted on the time interval from development of COVID-19 to SSNHL onset and the time interval of consultation in patients in the study group,which showed no correlation(r=-0.337,P=0.059).There was no statistically significant difference in the types and degree of SSNHL between two groups of patients(both P＞0.05).After standardized treatment,the rate of ineffective patients in the study group was 56.25％,which was higher than that in the control group(15.38％),and the difference was statistically significant(P＜0.05).Conclusion After adjusting the COVID-19 prevention and control policies,there are more hospitalized COVID-19 patients with SSNHL,with a higher proportion in patients of older age,with poorer efficacy,and inef-fective treatment.The earlier the treatment for SSNHL patients,the better the effect can achieve.COVID-19 may be a potential inducement and/or etiological factor of SSNHL,and further research is needed.

Objective:To construct and validate a three-level early warning model of moderate to severe ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technology.Methods:A case-control study was conducted. Totally 10 181 infertility patients who underwent in vitro fertilization treatment in Reproductive Medicine Center, Women and Children's Medical Center Affiliated to Guangzhou Medical University from April 2013 to April 2023 were retrospectively analyzed and divided into modeling group (8 145 cases) and validation group (2 036 cases) by random number table method. The clinical data of the two groups were analyzed, and the risk factors affecting the occurrence of moderate and severe OHSS after oocytes retrieval were screened by multi-factor logistic regression analysis. The early warning model was established and the column diagram was drawn at three nodes which were before ovarian stimulation, before trigger and 3 d after oocyte retrieval. The receiver operating characteristic (ROC) curve and calibration curve were used to verify the models. Results:The antral follicle count (AFC, OR=1.045, 95% CI: 1.020-1.071, P<0.001), anti-Müllerian hormone (AMH)>3.36 μg/L ( OR=7.135, 95% CI: 2.084-24.432, P=0.002) and number of cycles ( OR=0.149, 95% CI: 0.022-1.026, P=0.049) were included in the pre-stimulation prediction model. AFC ( OR=1.046, 95% CI: 1.018-1.074, P=0.001), AMH>3.36 μg/L ( OR=5.780, 95% CI: 1.661-20.116, P=0.006), gonadotropin releasing hormone-agonist protocols ( OR=3.895, 95% CI=1.913-7.931, P<0.001), estrogen peak≥18 350 pmol/L ( OR=2.258, 95% CI: 1.092-4.666, P=0.028), the number of follicles with a diameter of ≥10 mm>20 ( OR=2.377, 95% CI: 1.092-5.172, P=0.029) were included in the pre-trigger prediction model. AMH>3.36 μg/L ( OR=8.374, 95% CI: 2.417-29.019, P=0.001), estrogen peak≥18 350 pmol/L ( OR=3.947, 95% CI: 1.533-10.167, P=0.004), total number of oocytes retrived ( OR=1.042, 95% CI: 0.996-1.090, P=0.025), abdominal distension ( OR=60.181, 95% CI: 22.515-160.854, P<0.001), fresh transplantation ( OR=21.766, 95% CI: 7.119-66.544, P<0.001), human chorionic gonadotropin trigger ( OR=17.752, 95% CI: 3.993-78.924, P<0.001) were included in the prediction model of 3 d after oocyte retrieval. The areas under ROC curves of the three models were 0.830 (95% CI: 0.782-0.878), 0.859 (95% CI: 0.812-0.906) and 0.948 (95% CI: 0.919-0.977), respectively. The areas under ROC curves of the validation groups of the three models were 0.922 (95% CI: 0.880-0.965), 0.936 (95% CI: 0.886-0.986), and 0.971 (95% CI: 0.938-0.999), respectively. The calibration curve indicated that the early-warning evaluation model has good stability. Conclusion:The three-level early warning model of moderate and severe OHSS has good differentiation, reliable predictability and clinical practicability, which is conducive to the dynamic and continuous assessment of the risk of moderate and severe OHSS, adjustment of treatment plan at any time, and timely adoption of effective preventive measures.

Objective To observe the value of changes of neutrophil-to-lymphocyte ratio(NLR)before and after the first interventional treatment of hepatocellular carcinoma(HCC)for predicting patient's overall survival(OS).Methods Totally 92 HCC patients who underwent the first time TACE or TACE+hepatic artery infusion chemotherapy(HAIC)were retrospectively enrolled.The patients were divided into NLR ratio(NLRR)＜1.29 group(n=54)and≥1.29 group(n=38)based on the ratio of NLR after to before treatment,also ΔNLR＜0.87 group(n=60)and≥0.87 group(n=32)based on the difference of NLR after and before treatment.Clinical data were compared between groups,survival analysis was performed,and the value of NLRR and ΔNLR for predicting OS were analyzed.Results No significant difference of clinical data was found between NLRR＜1.29 and≥1.29 groups,nor between ΔNLR＜0.87 and≥0.87 groups(all P＞0.05).The median OS of 92 patients was 30.90 months,which in NLRR＜1.29 group(55.10 months)was longer than that in NLRR≥1.29 group(22.30 months,P=0.005),while in ΔNLR＜0.87 group(55.10 months)was longer than that in ΔNLR≥0.87 group(14.20 months,P=0.003).Cox regression analysis showed that the maximum diameter of tumor≥5 cm,distant metastasis,ascites,NLRR≥1.29 and ΔNLR≥0.87 were all independent risk factors of OS(all P＜0.05).Taken 1.29 and 0.87 as the best cut-off value,respectively,the area under the curve of NLRR and ΔNLR for predicting OS was 0.620 and 0.610,respectively.Conclusion NLRR and ΔNLR were helpful for predicting OS of HCC patient after the first interventional treatment.

Objective To investigate the role of CCCTC-binding factor(CTCF)in the development of oxaliplatin(OXA)-induced gastric cancer drug-tolerant cells(DTCs)and to preliminarily elucidate its underlying mechanisms.Methods The DTCs model of gastric cancer was established by treating MGC803 cells with OXA.Overexpression and knockdown of CTCF in MGC803 cells were performed to observe their effects on the formation of DTCs in gastric cancer.Additionally,Bcl2-like protein 1(BCL2L1)was knocked down in CTCF-overexpressing cells,and its impact on DTCs formation was evaluated.Flow cytometry was used to analyze the effects of varying CTCF/BCL2L1 expression levels on the apoptosis of gastric cancer cells under OXA treatment.Immunohistochemistry(IHC)was employed to detect the expression levels of CTCF/BCL2L1 in gastric cancer tissues,and the therapeutic outcomes of neoadjuvant chemotherapy in patients with different CTCF/BCL2L1 expression levels were assessed.Results Gastric cancer DTCs can be obtained following a regimen of continuous treatment of MGC803 cells with a specific concentration of oxaliplatin(OXA,1.5 μmol/L)for 5 days,followed by an additional 5-day culture period post-treatment cessation.The upregulation of CTCF has been shown to facilitate the formation of DTCs in gastric cancer,whereas its downregulation inhibits this process(P<0.05).In MGC803 gastric cancer cells,the expression level of BCL2L1 is positively correlated with that of CTCF.Knockdown of BCL2L1 in MGC803 cells overexpressing CTCF can reverse the pro-DTC formation effect of CTCF(P<0.05).Overexpression of CTCF confers resistance to OXA-induced apoptosis in gastric cancer cells,and this anti-apoptotic effect can be reversed by BCL2L1 knockdown in MGC803 cells overexpressing CTCF(P<0.05).In the tumor tissues of the majority of gastric cancer patients,the expression levels of BCL2L1 are positively correlated with those of CTCF,and the efficacy of neoadjuvant chemotherapy is notably reduced in patients with high expression of the CTCF/BCL2L1 axis compared to those with low expression(P<0.05).Conclusion CTCF promotes the formation of OXA-related gas-tric cancer DTCs by upregulating BCL2L1 expression and inhibiting apoptosis,making the CTCF/BCL2L1 axis a potential therapeutic target for DTCs in gastric cancer.

Objective:To investigate the incidence of hypomineralized second primary molars (HSPM) and deciduous teeth caries in school-aged children of Kaifeng City, and to discuss the association between HSPM and deciduous teeth caries, providing scientific guidance for clinical prevention and treatment.Methods:A cross-sectional study was carried out on first-grade children aged 6-7 years in five primary schools chosen from the eastern, western, southern, northern, and central areas of Kaifeng City by cluster random sampling method. The European Academy of Pediatric Dentistry criteria was used for scoring HSPM. The International Caries Detection and Assessment System (ICDAS-Ⅱ) was used to evaluate caries status.Results:This cross-sectional study was with a sample of 913 children. The prevalence of HSPM was 8.76% (80/913), with 39 boys and 41 girls, the most common type of which was atypical caries [35.00% (28/80)]. Regarding the distribution of HSPM, the incidence in maxilla [6.13% (56/913)] showed no statistically significant difference with that in the mandible [5.70% (52/913)] (χ2=0.16, P=0.692). In terms of severity, 56 cases were severe and 24 cases were mild. The association between HSPM and deciduous teeth caries was analyzed. The results showed that 56 had caries on their second primary molars among the 80 HSPM children. Children with HSPM had an increased risk of second deciduous molar decay compared to non-HSPM children ( OR=1.94, 95 %CI: 1.18-3.19, P<0.05); meanwhile, the deciduous teeth of HSPM children were more prone to suffer caries than those of non-HSPM children ( OR=2.33, 95 %CI: 1.26-4.29, P<0.05). Conclusions:The HSPM prevalence in school-aged children of Kaifeng City was 8.76%. Child with HSPM was more likely to have deciduous teeth caries than non-HSPM child. Special attention should be paid to children with HSPM after the eruption of affected molars.

The National Institute for Health and Care Excellence(NICE)first updated its 2013 Health Technology Evaluations Guidelines in 2022,followed by further minor adjustments in 2023.This round of updates primarily focuses on five key areas:mea-suring the value of health technologies,understanding and improving the evidence base,structured decision-making,addressing challenging diseases and technologies,and ensuring consistency in methods across evaluation and review projects.It outlines the up-date process and major changes,providing an analysis of these key points with the aim of offering valuable insights and methodologi-cal references for health technology assessment in China.

Objective:To explore the level of unmet need during chemotherapy for gastric cancer patients, analyze its dynamic trajectory and impact on the economic toxicity of chemotherapy.Methods:Convenience sampling was used to select 385 gastric cancer patients who received chemotherapy from June 2022 to December 2023 at the First Affiliated Hospital of Zhengzhou University. The level of unmet need for patients' first chemotherapy cycle (C 1) , second chemotherapy cycle (C 2) and third chemotherapy cycle (C 3) and economic toxicity at the end of chemotherapy were investigated separately. The latent class growth model (LCGM) was used to analyze classes of unmet need trajectories and to compare differences in patient economic toxicity across classes. Results:Finally 368 patients completed all data collection, and the effective response rate of survey respondents was 95.58%. As chemotherapy progressed, patients' unmet need scores gradually increased, and the unmet need scores of C 1, C 2, and C 3 were (35.54±5.44) , (47.32±6.45) , and (58.19±11.81) , respectively, which were categorized into three latent classes of medium-low level rapid increase group, medium level gradual increase group, and medium level stable group. There were 122 cases (33.15%) in medium-low level rapid increase group, 167 cases (45.38%) in medium level gradual increase group, and 79 cases (21.47%) in medium level stable group. The lowest economic toxicity score was found in medium-low level rapid increase group, followed by medium level gradual increase group, and the highest in medium level stable group, and the difference in economic toxicity scores among the three groups was statistically significant ( P<0.05) . The percentage of patients with positive economic toxicity in the three groups was 45.90% (56/122) , 28.14% (47/167) , and 18.99% (15/79) , respectively, with a statistically significant difference ( P<0.05) . Conclusions:Unmet needs of patients during chemotherapy for gastric cancer show a moderate to high level and gradually increase with the course of chemotherapy. The trajectory can be divided into three latent classes of medium-low level rapid increase group, medium level gradual increase group, and medium level stable group. There are differences in economic toxicity for patients with different classes of unmet need trajectories, with patients in increase or rapid increase groups facing severe economic toxicity.

Objective To explore an epileptic seizure prediction method for patients with refractory epilepsy to improve the classification and prediction efficiency of epileptic electroencephalogram(EEG)signals.Methods The study used the long-term EEG database of patients with intractable epilepsy from Children's Hospital Boston(CHB-MIT).The EEG features of epileptic seizures and preictal periods were extracted from multiple dimensions such as EEG synchronization,complexity,and energy distribution,and then these features were input into the artificial neural network model for classification and identification,thereby achieving accurate prediction of epilepsy.The performance were optimized by adjusting the model parameters,and a comparative evaluation was conducted with existing deep learning models.Results The model proposed in this study showed an accuracy rate of 99.29％,a precision of 91.44％,a sensitivity of 96.46％,and a specificity of 99.46％.Compared with current epilepsy seizure prediction studies based on machine learning or deep learning frameworks,the model in this study improved its classification prediction capabilities and demonstrated higher prediction accuracy.Conclusion An effective prediction of epileptic seizures was achieved by manually extracting epileptic EEG features and constructing an artificial neural network model.The model demonstrated high accuracy and stability,providing reliable technique to support clinical treatment and prevention of epilepsy.