Objective:To assess the sound localization ability of patients with unilateral sudden hearing loss during the early period of treatment, to explore its changing characteristics and to analyze influencing factors.Methods:A total of 22 patients with unilateral sudden sensorineural hearing loss, with onset within 3 days, who were hospitalized at Shandong Provincial ENT Hospital between January and April 2024, were collected in this study. The cohort included 13 males and 9 females, with a mean age of 36.5 years. Among them, 10 suffered in the right ear and 12 in the left ear. Additionally, 15 healthy individuals (8 males and 7 females, mean age 29.2 years) were selected as controls. Pure tone audiometry and sound localization tests were reviewed on the first day, third day, fifth day of admission; the third week after onset, and the pure tone average and the root-mean-square error(RMSE) were used as indicators, respectively. The improvement of the ability of sound localization and pure tone average were assessed by correlation analyses using SPSS, version 27.0, and multiple regression analysis was employed to explore effects that might influence sound localization ability.Results:The pure tone threshold and sound localization ability on the third week of onset were improved compared with those on the initial three instances(the first, third, and fifth days of admission). 9 of the 22 patients (40.91%, 9/22) presented normal sound localization ability whereas their hearing loss had not recurred yet. The Spearman correlation analysis revealed a significant positive correlation between the improvement of sound localization ability and hearing improvement ( r=0.57, P<0.001). Meanwhile, multiple regression analysis showed that hearing threshold was a significant factor for sound localization when there was audible frequency. Vice versa, at this circumstance, ages and vertigo were significant factors. Conclusions:For most of the patients with unilateral sudden hearing loss, ability of sound localization improves with the decrease of hearing threshold. Notably, some patients can restore normal levels of sound localization for white noise, even in the presence of hearing loss at certain frequencies, by relying on binaural acoustic cues provided by residual hearing.

Objective:To investigate the role of endoplasmic reticulum stress(ERS)-related long non-coding RNA(lnc RNA)Gm9795 in the progression of hepatocellular carcinoma(HCC).Methods:This retrospective cohort study included 80 HCC patients who underwent routine surgical procedures at Nanjing Jiangning Hospital from 2014 to 2020.Colecting clinical datas from all patients and using real-time fluorescence quantitative PCR to detect the expression level of Gm9795 in 80 patients'cancer and adjacent tissues,as well as in HCC cells(HepG2,Hep3B,HCCLM3,and Huh7).The correlation between Gm9795 expression and overall survival time and recurrence free survival time of HCC patients was analysised.Constructing HCCLM3 cells overexpressing Gm9795 through lentiviral infection,and constructing Huh7 cells silencing Gm9795 expression through liposome transfection.The proliferation ability of cells was evaluated using CCK-8 assay and colony formation assay,while the migration and invasion ability of cells were detected using Transwell assay.Identification of Gm9795 specific binding protein by mass spectrometry(MS).The effect of overexpressing or silencing Gm9795 expression on the expression of C/EBP homologous protein(CHOP)gene was detected by Western blotting.The CHOP gene was simultaneously transferred into HCCLM3 cells overexpressing Gm9795,and the effects of up-regulating CHOP expression level on the proliferation,migration,and invasion of HCCLM3 cells were evaluated using CCK-8 assay,colony formation assay,and Transwell assay.Results:Compared with adjacent tissues,the expression level of Gm9795 was significantly up-regulated in HCC tissues(P<0.001).The expression levels of Gm9795 in all HCC cells were significantly higher than in normal hepatocytes LO2(all P<0.05).Higher expression levels of Gm9795 were associated with aggressive clinical pathological features,including tumor size,multiple tumors,Barcelona Clinic Liver Cancer(BCLC)staging,and portal vein tumor thrombus(all P<0.05).The results of multivariate analysis showed that high expression level of Gm9795 was an independent prognostic factor for overall survival and recurrence free survival in HCC patients(both P<0.05).The higher expression of Gm9795 was significantly correlated with shorter overall survival and recurrence free survival in the cohort(both P<0.01).Compared with the Vector group,the proliferation,migration,and invasion of HCCLM3 cells were significantly enhanced in the Gm9795 overexpression group(all P<0.01);Compared with the siNC group,the proliferation,migration,and invasion of Huh7 cells were significantly reduced in the siGm9795-1 and siGm9795-2 groups(all P<0.01).CHOP was identified as a Gm9795 specific binding protein by MS.Compared with the Gm9795+Vector group,the Gm9795+CHOP group showed significant reductions in proliferation,migration,and invasion of HCCLM3 cells(all P<0.01).Conclusions:Gm9795 is up-regulated in HCC tissues,and the high expression of Gm9795 is an independent prognostic factor for the overall survival of HCC patients.Gm9795 promotes the proliferation and invasion of HCC cells in vitro,and its mechanism may be related to the inhibition of ERS mediated by CHOP signaling pathway.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To assess the sound localization ability of patients with unilateral sudden hearing loss during the early period of treatment, to explore its changing characteristics and to analyze influencing factors.Methods:A total of 22 patients with unilateral sudden sensorineural hearing loss, with onset within 3 days, who were hospitalized at Shandong Provincial ENT Hospital between January and April 2024, were collected in this study. The cohort included 13 males and 9 females, with a mean age of 36.5 years. Among them, 10 suffered in the right ear and 12 in the left ear. Additionally, 15 healthy individuals (8 males and 7 females, mean age 29.2 years) were selected as controls. Pure tone audiometry and sound localization tests were reviewed on the first day, third day, fifth day of admission; the third week after onset, and the pure tone average and the root-mean-square error(RMSE) were used as indicators, respectively. The improvement of the ability of sound localization and pure tone average were assessed by correlation analyses using SPSS, version 27.0, and multiple regression analysis was employed to explore effects that might influence sound localization ability.Results:The pure tone threshold and sound localization ability on the third week of onset were improved compared with those on the initial three instances(the first, third, and fifth days of admission). 9 of the 22 patients (40.91%, 9/22) presented normal sound localization ability whereas their hearing loss had not recurred yet. The Spearman correlation analysis revealed a significant positive correlation between the improvement of sound localization ability and hearing improvement ( r=0.57, P<0.001). Meanwhile, multiple regression analysis showed that hearing threshold was a significant factor for sound localization when there was audible frequency. Vice versa, at this circumstance, ages and vertigo were significant factors. Conclusions:For most of the patients with unilateral sudden hearing loss, ability of sound localization improves with the decrease of hearing threshold. Notably, some patients can restore normal levels of sound localization for white noise, even in the presence of hearing loss at certain frequencies, by relying on binaural acoustic cues provided by residual hearing.

Objective:To investigate the role of endoplasmic reticulum stress(ERS)-related long non-coding RNA(lnc RNA)Gm9795 in the progression of hepatocellular carcinoma(HCC).Methods:This retrospective cohort study included 80 HCC patients who underwent routine surgical procedures at Nanjing Jiangning Hospital from 2014 to 2020.Colecting clinical datas from all patients and using real-time fluorescence quantitative PCR to detect the expression level of Gm9795 in 80 patients'cancer and adjacent tissues,as well as in HCC cells(HepG2,Hep3B,HCCLM3,and Huh7).The correlation between Gm9795 expression and overall survival time and recurrence free survival time of HCC patients was analysised.Constructing HCCLM3 cells overexpressing Gm9795 through lentiviral infection,and constructing Huh7 cells silencing Gm9795 expression through liposome transfection.The proliferation ability of cells was evaluated using CCK-8 assay and colony formation assay,while the migration and invasion ability of cells were detected using Transwell assay.Identification of Gm9795 specific binding protein by mass spectrometry(MS).The effect of overexpressing or silencing Gm9795 expression on the expression of C/EBP homologous protein(CHOP)gene was detected by Western blotting.The CHOP gene was simultaneously transferred into HCCLM3 cells overexpressing Gm9795,and the effects of up-regulating CHOP expression level on the proliferation,migration,and invasion of HCCLM3 cells were evaluated using CCK-8 assay,colony formation assay,and Transwell assay.Results:Compared with adjacent tissues,the expression level of Gm9795 was significantly up-regulated in HCC tissues(P<0.001).The expression levels of Gm9795 in all HCC cells were significantly higher than in normal hepatocytes LO2(all P<0.05).Higher expression levels of Gm9795 were associated with aggressive clinical pathological features,including tumor size,multiple tumors,Barcelona Clinic Liver Cancer(BCLC)staging,and portal vein tumor thrombus(all P<0.05).The results of multivariate analysis showed that high expression level of Gm9795 was an independent prognostic factor for overall survival and recurrence free survival in HCC patients(both P<0.05).The higher expression of Gm9795 was significantly correlated with shorter overall survival and recurrence free survival in the cohort(both P<0.01).Compared with the Vector group,the proliferation,migration,and invasion of HCCLM3 cells were significantly enhanced in the Gm9795 overexpression group(all P<0.01);Compared with the siNC group,the proliferation,migration,and invasion of Huh7 cells were significantly reduced in the siGm9795-1 and siGm9795-2 groups(all P<0.01).CHOP was identified as a Gm9795 specific binding protein by MS.Compared with the Gm9795+Vector group,the Gm9795+CHOP group showed significant reductions in proliferation,migration,and invasion of HCCLM3 cells(all P<0.01).Conclusions:Gm9795 is up-regulated in HCC tissues,and the high expression of Gm9795 is an independent prognostic factor for the overall survival of HCC patients.Gm9795 promotes the proliferation and invasion of HCC cells in vitro,and its mechanism may be related to the inhibition of ERS mediated by CHOP signaling pathway.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To investigate the effect of drospirenone and ethinylestradiol in the treatment of ovulation induction in patients with premature ovarian insufficiency (POI).Methods:A randomized controlled clinical study analyzed the clinical data of 130 POI patients who underwent assisted reproductive treatment at the Department of Reproductive Medicine, Department of Obstetrics and Gynecology, the Seventh Medical Center and Department of Obstetrics and Gynecology, the Sixth Medical Center of Chinese people's Liberation Army General Hospital from December 2021 to November 2022. The subject-centered randomization method was used to conceal the allocation, and there was no blinding. The patients in experimental group was given drospirenone and ethinylestradiol as pretreatment, while control group was not treated. The main observation indicator of the follicle recovery growth rate and the secondary observation indicators of estradiol and follicle-stimulating hormone (FSH) levels before and after pretreatment, the number of eggs retrieved, the proportion of eggs retrieved, and other embryo laboratory-related indicators were compared between the two groups.Results:The recovery rate of follicular growth in the experimental group was significantly higher than that in control group, and the difference was statistically significant [50.77% (33/65) vs. 15.38% (10/65), P<0.001, rate difference =35.38%, 95% CI: 19.44%-48.98%]. The levels of FSH [17.70 (8.15, 27.00) U/L] decreased significantly and estradiol [24.00 (15.00, 90.47) ng/L] increased significantly in the experimental group after preconditioning with spironolone ethinylestradiol compared with those before preconditioning [30.30 (25.95, 48.05) U/L, P<0.001; 15.00 (15.00, 24.00) ng/L, P<0.001], the differences were statistically significant. Conclusion:The spironolone ethinylestradiol can effectively inhibit the level of FSH and increase the level of estradiol in patients with POI, and increase the probability of ovarian growth and development during ovulation induction therapy.

Objective:To investigate the effect of drospirenone and ethinylestradiol in the treatment of ovulation induction in patients with premature ovarian insufficiency (POI).Methods:A randomized controlled clinical study analyzed the clinical data of 130 POI patients who underwent assisted reproductive treatment at the Department of Reproductive Medicine, Department of Obstetrics and Gynecology, the Seventh Medical Center and Department of Obstetrics and Gynecology, the Sixth Medical Center of Chinese people's Liberation Army General Hospital from December 2021 to November 2022. The subject-centered randomization method was used to conceal the allocation, and there was no blinding. The patients in experimental group was given drospirenone and ethinylestradiol as pretreatment, while control group was not treated. The main observation indicator of the follicle recovery growth rate and the secondary observation indicators of estradiol and follicle-stimulating hormone (FSH) levels before and after pretreatment, the number of eggs retrieved, the proportion of eggs retrieved, and other embryo laboratory-related indicators were compared between the two groups.Results:The recovery rate of follicular growth in the experimental group was significantly higher than that in control group, and the difference was statistically significant [50.77% (33/65) vs. 15.38% (10/65), P<0.001, rate difference =35.38%, 95% CI: 19.44%-48.98%]. The levels of FSH [17.70 (8.15, 27.00) U/L] decreased significantly and estradiol [24.00 (15.00, 90.47) ng/L] increased significantly in the experimental group after preconditioning with spironolone ethinylestradiol compared with those before preconditioning [30.30 (25.95, 48.05) U/L, P<0.001; 15.00 (15.00, 24.00) ng/L, P<0.001], the differences were statistically significant. Conclusion:The spironolone ethinylestradiol can effectively inhibit the level of FSH and increase the level of estradiol in patients with POI, and increase the probability of ovarian growth and development during ovulation induction therapy.

Objective:To analyze the anti-drug resistance, molecular epidemiology and virulence gene distribution of non-A-F group serotype isolates of Salmonella enterica enteric subspecis, so as to provide epidemiological basis for clinical diagnosis and treatment.Methods:Serotyping, antimicrobial susceptibility test and whole genome sequencing were performed on 11 isolates of non-A-F group serotype isolates of Salmonella enterica enteric subspecies that were isolated from The Children′s Hospital, Zhejiang University School of Medicine between 2017 and 2020. The serotype, multilocus sequence typing and virulence gene of the whole genome sequencing results were analyzed. Results:In our hospital, the detection rate of non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low (1.13%). Among the 11 strains, there were 3 strains belong to Jangwani serotype, 2 strains of Hvittingfoss serotype, and Wandsworth, Pomona, Kedougou, Urbana, Poona and Kumasi serotypes have 1 strain each. Except for the two multi-drug resistant strains, the other strains were sensitive to most antibiotics, and the MICs were at low levels. A total of 9 ST types were detected in the 11 strains, the 3 Jangwani serotype strains were ST3918, and the other isolates were of different ST types. The phylogenetic tree shown that the three strains of Jangwani serotype were closely related. A total of 103 virulence genes were detected in the 11 strains, including 78 genes related to secretion system, 21 genes related to adherence, 2 genes related to magnesium uptake, 1 gene related to resistance to antimicrobial peptides and 1 gene related to typhoid toxin. Conclusions:The detection rate of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies was low, and the sensitivity of the isolates to common antibiotics was high. The ST types and genetic relationship showed diversity. Clinical laboratory should pay attention to the detection of the non-A-F group serotype isolates of Salmonella enterica enteric subspecies, and the changes in drug resistance and virulence genes of the isolates should be closely monitored.

Laboratory testing plays an important role in the diagnosis and treatment of patients with Novel Coronavirus pneumonia. However, the lack of understanding of the virus in the early stage led to great difficulties in biosafety protection for clinical laboratories. Based on the latest researches and findings about the virus, this paper provides some personal opinions on the biosafety prevention in clinical laboratorians under epidemic condition for the reference of laboratory workers.