Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.

Objective:To explore the value and clinical significance of percutaneous CO 2 monitoring in non-invasive positive pressureventilator in the treatment of severe obstructive sleep apnea (OSA) in children. Methods:Retrospective analysis was conducted on 38 children with severe OSA, who were treated in Henan Children′s Hospital from August 2023 to December 2024. All of the enrolled children were diagnosed by polysomnography(PSG), treated with non-invasive positive pressure ventilator (NPPV) according to the standard treatment plan, and continuously monitored with TcpCO 2. Arterial blood gas was analyzed before and after pressure titration and TcpCO 2 changes were compared between awake and sleep with arterial blood gas PaCO 2. The sleep parameters, parameters related to arterial blood gas, and the relationship between TcpCO 2 and alveolar hypoventilation in children were analyzed. The cut-off value of alveolar hypoventilation factors were estimated. Statistical analysis was performed using the SPSS 27.0 software. Results:(1)The difference between awake TcpCO 2 and sleep TcpCO 2 was statistically significant[(42.52±3.56)mmHg vs.(51.09±4.07)mmHg, P<0.001), and the difference between sleep TcpCO 2 and morning PaCO 2 was statistically significant[(51.09±4.07)mmHg vs. (40.83±5.34)mmHg, P<0.001]. (2) There was no significant difference in related indicators among different gender children, but the difference in BMI values between preschool and school age children was significant[(18.03±4.96)kg/m 2vs.(25.21±5.25)kg/m 2, t=-4.08, P<0.001]. (3) Obstructive apnea hypopnea index(OAHI), oxygen desaturation index (ODI), and TcpCO 2 were independent risk factors for alveolar hypopnea, but there was no correlation between BMI and whether alveolar hypoventilation.(4).OAHI, ODI, and TcpCO 2 were predictive of the presence of alveolar hypoventilation. When the OAHI exceeded 54.7events/h, ODI exceeded 72.1 events/h, and TcpCO 2 exceeded 56.5 mmHg, the children were more likely to have alveolar hypoventilation. Conclusion:Transcutaneous carbon dioxide, OAHI and ODI can effectively predict whether children have alveolar hypoventilation, which is helpful for clinical treatment.

BACKGROUND: Without timely and effective rehabilitation, hearing loss may profoundly affect human life quality. China has a large population of hearing-impaired individuals, which imposes a heavy health burden on society. Moreover, this population is projected to increase rapidly owing to China's aging society. METHODS: We used data from a population-representative epidemiological investigation of hearing loss and ear diseases in four Chinese provinces. We estimated the national prevalence using multiple linear regression of the age-group proportions and prevalence in 31 provinces with clustering analysis. We used years lived with disability (YLDs) to analyze the disease burden and forecasted the prevalence of hearing loss by 2060 in China. RESULTS: An estimated 115 million people had moderate-to-complete hearing loss in 2015 across the 31 provinces of China (8.4% of 1.37 billion people). Of these, 85.7% were older than age 50 years (99 million people) and 2.4% were younger than 20 years old (2.8 million people). Of all YLDs attributable to hearing loss, 68.9% were attributable to moderate-to-complete cases. By 2060, a projected 242 million people in China will have moderate-to-complete hearing loss, a 110.0% increase from 2015. CONCLUSIONS The hearing loss prevalence in China is high. Population aging and socioeconomic factors substantially affect the prevalence and severity of hearing loss and the disease burden. The prevalence and severity of hearing loss are unevenly distributed across different provinces. Future public health policies should take these trends and regional variations into account.
Humans ; China/epidemiology* ; Hearing Loss/epidemiology* ; Prevalence ; Middle Aged ; Male ; Female ; Adult ; Aged ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Aged, 80 and over ; Cost of Illness

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)mutations are influenced by random and uncontrollable factors,and the risk of the next widespread epidemic remains.Dual-target drugs that synergistically act on two targets exhibit strong therapeutic effects and advantages against mutations.In this study,a novel computational workflow was developed to design dual-target SARS-CoV-2 candidate inhibitors with the Envelope protein and Main protease selected as the two target proteins.The drug-like molecules of our self-constructed 3D scaffold database were used as high-throughput molecular docking probes for feature extraction of two target protein pockets.A multi-layer perceptron(MLP)was employed to embed the binding affinities into a latent space as conditional vectors to control conditional distribution.Utilizing a conditional generative neural network,cG-SchNet,with 3D Euclidean group(E3)symmetries,the conditional probability distributions of molecular 3D structures were acquired and a set of novel SARS-CoV-2 dual-target candidate inhibitors were generated.The 1D probability,2D joint probability,and 2D cumulative probability distribution results indicate that the generated sets are significantly enhanced compared to the training set in the high binding affinity area.Among the 201 generated molecules,42 molecules exhibited a sum binding affinity exceeding 17.0 kcal/mol while 9 of them having a sum binding affinity exceeding 19.0 kcal/mol,demonstrating structure diversity along with strong dual-target affinities,good absorption,distribution,metabolism,excretion,and toxicity(ADMET)properties,and ease of synthesis.Dual-target drugs are rare and difficult to find,and our"high-throughput docking-multi-conditional generation"workflow offers a wide range of options for designing or optimizing potent dual-target SARS-CoV-2 inhibitors.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutations are influenced by random and uncontrollable factors, and the risk of the next widespread epidemic remains. Dual-target drugs that synergistically act on two targets exhibit strong therapeutic effects and advantages against mutations. In this study, a novel computational workflow was developed to design dual-target SARS-CoV-2 candidate inhibitors with the Envelope protein and Main protease selected as the two target proteins. The drug-like molecules of our self-constructed 3D scaffold database were used as high-throughput molecular docking probes for feature extraction of two target protein pockets. A multi-layer perceptron (MLP) was employed to embed the binding affinities into a latent space as conditional vectors to control conditional distribution. Utilizing a conditional generative neural network, cG-SchNet, with 3D Euclidean group (E3) symmetries, the conditional probability distributions of molecular 3D structures were acquired and a set of novel SARS-CoV-2 dual-target candidate inhibitors were generated. The 1D probability, 2D joint probability, and 2D cumulative probability distribution results indicate that the generated sets are significantly enhanced compared to the training set in the high binding affinity area. Among the 201 generated molecules, 42 molecules exhibited a sum binding affinity exceeding 17.0 kcal/mol while 9 of them having a sum binding affinity exceeding 19.0 kcal/mol, demonstrating structure diversity along with strong dual-target affinities, good absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties, and ease of synthesis. Dual-target drugs are rare and difficult to find, and our "high-throughput docking-multi-conditional generation" workflow offers a wide range of options for designing or optimizing potent dual-target SARS-CoV-2 inhibitors.

Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.

Objective:To explore the value and clinical significance of percutaneous CO 2 monitoring in non-invasive positive pressureventilator in the treatment of severe obstructive sleep apnea (OSA) in children. Methods:Retrospective analysis was conducted on 38 children with severe OSA, who were treated in Henan Children′s Hospital from August 2023 to December 2024. All of the enrolled children were diagnosed by polysomnography(PSG), treated with non-invasive positive pressure ventilator (NPPV) according to the standard treatment plan, and continuously monitored with TcpCO 2. Arterial blood gas was analyzed before and after pressure titration and TcpCO 2 changes were compared between awake and sleep with arterial blood gas PaCO 2. The sleep parameters, parameters related to arterial blood gas, and the relationship between TcpCO 2 and alveolar hypoventilation in children were analyzed. The cut-off value of alveolar hypoventilation factors were estimated. Statistical analysis was performed using the SPSS 27.0 software. Results:(1)The difference between awake TcpCO 2 and sleep TcpCO 2 was statistically significant[(42.52±3.56)mmHg vs.(51.09±4.07)mmHg, P<0.001), and the difference between sleep TcpCO 2 and morning PaCO 2 was statistically significant[(51.09±4.07)mmHg vs. (40.83±5.34)mmHg, P<0.001]. (2) There was no significant difference in related indicators among different gender children, but the difference in BMI values between preschool and school age children was significant[(18.03±4.96)kg/m 2vs.(25.21±5.25)kg/m 2, t=-4.08, P<0.001]. (3) Obstructive apnea hypopnea index(OAHI), oxygen desaturation index (ODI), and TcpCO 2 were independent risk factors for alveolar hypopnea, but there was no correlation between BMI and whether alveolar hypoventilation.(4).OAHI, ODI, and TcpCO 2 were predictive of the presence of alveolar hypoventilation. When the OAHI exceeded 54.7events/h, ODI exceeded 72.1 events/h, and TcpCO 2 exceeded 56.5 mmHg, the children were more likely to have alveolar hypoventilation. Conclusion:Transcutaneous carbon dioxide, OAHI and ODI can effectively predict whether children have alveolar hypoventilation, which is helpful for clinical treatment.

OBJECTIVE To investigate the therapeutic effect of autologous costal cartilage transplantation with anterior/posterior split of cricoid cartilage on laryngotracheal stenosis in children.METHODS A retrospective analysis of 12 cases of laryngotracheal stenosis in children treated with anterior/posterior split of cricoid cartilage combined with T-tube implantation in Beijing Children's Hospital Affiliated to Capital Medical University in recent years.There were 5 males and 7 females,aged from 2 years and 6 months to 16 years and 9 months,with an average age of 8 years and 9 months.There were 2 cases of grade Ⅱ stenosis,9 cases of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.All cases underwent tracheotomy before operation.The course of disease ranged from 4 months to 6 years,with an average of 3 years.RESULTS Of the 12 patients,10(83.3％)were cured,and the tracheotomy cannula was successfully removed to restore normal breathing and pronunciation function.There were 2 cases of extubation failure,including 1 case of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.CONCLUSION The etiology of laryngotracheal stenosis in children is complex and difficult to treat.Anterior/posterior split costal cartilage transplantation combined with T-tube implantation through internal/external cervical approach can achieve good therapeutic effect in the treatment of laryngotracheal stenosis in children.

Objective:To analyze the clinical characteristics, treatment, and prognosis of ectopic bronchogenic cysts in children.Methods:A retrospective analysis was conducted on the data including the clinical characteristics, auxiliary examination and treatment of 21 children with ectopic bronchogenic cysts diagnosed pathologically at Children′s Hospital Affiliated to Zhengzhou University from July 2015 to December 2023. There were 16 males and 5 females, with a male-female ratio of 3.2∶1, and the age ranged from 4 days to 8 years old (median age 2 years and 8 months).Results:Among the 21 cases of ectopic bronchogenic cysts, 11 cases were found in the pharynx, with symptoms including dyspnea (4 cases), snoring during sleep (3 cases), and choking on milk(4 cases).Ten cases were found in the head, neck or anterior chest, 5 of these cases had infection history, and 5 showed progressive mass growth.Imaging and endoscopy showed 9 patients underwent preoperative color ultrasonography revealed cystic masses with well-defined boundaries. CT examination was performed on 13 patients, which showed round or nearly round masses with homogeneous density, smooth margins, and regular cyst walls. CT attenuation values ranged from 2 to 52 Hounsfield Units (HU). Four cystic lesions were assessed via MRI, 3 cases demonstrated long T1 and long T2 signals, while 1 case had a slight short T1 and long T2 signal, with high signal intensity on fat-suppressed images. Eleven cases of pharyngopharyngeal cysts were examined by electronic nasopharyngoscopy. The cysts appeared as spherical or ovoid masses with smooth surfaces, close to or slightly light in color with the surrounding tissue, with one cyst presenting with a bluish blue in the oropharynx. All 11 pharyngeal cysts were excised using low-temperature plasma under general anesthesia and intubation assisted by a nasal endoscope. The cysts were pulled and excised as completely as possible.Ten cases of neck and anterior chest cysts were completely excised. Postoperative histopathology confirmed bronchogenic cyst. Twenty-one children were followed up postoperatively for 4 months to 7 years without recurrence, except for 1 patient who was lost to follow-up.Conclusions:Ectopic bronchogenic cysts are uncommon and lack of typical imaging and clinical features.Combination of ultrasonography, CT and MRI is recommended for cases occuered in neck and anterior chest, while electronic nasopharyngoscopy complements pharyngeal evaluations. Surgical intervention is the preferred treatment choice for this disease.

Objective:To analyze the clinical characteristics and endoscopic surgical procedures of the second branchial cleft cyst type Ⅳ in children.Methods:A retrospective review was conducted on 15 pediatric cases with type Ⅳ second branchial cleft cysts treated at the Beijing Children′s Hospital affiliated with Capital Medical University and Henan Children′s Hospital from September 2019 to November 2023. All patients underwent excision via a two-person, three-hand endoscopic transoral approach. The cohort included 12 males and 3 females, with an age range of 10 months to 10 years and 5 months, and a median age of (59.20±32.05) months. The clinical data of initial symptoms, sides, imaging features, treatment methods, complications, length of hospital stay, prognosis and outcome were recorded and analyzed. SPSS 22.0 software was used for statistical analysis.Results:Of the 15 children, 13 cases presented with snoring as the primary symptom, 1 case with dysphagia, and 1 case was asymptomatic and was found unintentionally. The mean disease duration was (6.74±9.05) months (range, from 3 days-2 years). MRI revealed cystic lesions on the right side in 12 cases and on the left side in 3 cases, characterized by uniform long T2 signal, equal T1 or short T1 signal. The cysts appeared dumbbell-shaped in 10 cases with the pharyngeal constrictor muscle as the waist, the posterior outside of the mass was adjacent to the internal carotid artery. The remaining 5 cases showed an isolated cyst located inside the pharyngeal constrictor muscle. The intraoperative MRI findings were consistent. Partial cystectomy was performed in 10 cases near the internal carotid artery, leaving only the portion with a clear arterial pulse intact. Five cases with isolated cysts on the medial side of the pharyngeal constrictor muscle were totally removed. The average length of hospital stay was (4.53±0.52) days (4-5 days). All patients were followed up for 7-56 months [median (30±15.12) months] with no recurrence of symptoms observed.Conclusions:The second branchial cleft cyst type Ⅳ in children is characterized by prominent pharyngeal cystic mass, with snoring as a predominant initial symptom, MRI provides excellent diagnostic value. The two-person, third-hand endoscopic transoral approach for cyst excision is feasible, safe, and offers the benefits of minimal invasiveness and reduced hospitalization time.