Objective:To explore the perioperative precautions, rehabilitation effect, and affecting factors in cochlear implantation (CI) among patients with hereditary syndromic hearing loss.Methods:This was a retrospective cohort study. 47 patients diagnosed as hereditary syndromic deafness were treated in the Department of Otolaryngology-Head and Neck Surgery of the Chinese PLA General Hospital from 2010 to 2021, including 26 males and 21 females, aged 0.9-25 years. All patients received unilateral or bilateral CI. Clinical manifestation combined with genetic testing was used to diagnose syndromic hearing loss. The risks and precautions of CI in these patients were summarized from preoperative imaging, intraoperative observations, and postoperative complications. Single factor linear regression and multiple linear regression models in SPSS 26.0 software were used to evaluate the effects of various factors on auditory and speech rehabilitation after CI for syndromic hearing loss. The postoperative outcomes were analyzed through aided hearing thresholds, categories of auditory performance (CAP) scale, and speech intelligibility rate (SIR) scale.Results:Thirteen kinds of syndromes, totally 47 cases, including CHARGE (20 cases), Waardenburg (9 cases), Autosomal dominant deafness-onychodystrophy (DDOD, 4 cases), Pendred (3 cases), Noonan Syndrome with Multiple Lentigines (NSML, 2 cases), Branchio-Oto-Renal (BOR, 2 cases), Bart-Pumphery (1 case), Perrault (1 case), Kabuki (1 case), Frontometaphyseal dysplasia type 2 (FMD 2, 1 case), Mandibulofacial dysostosis Guion-Almeida type (MFDGA, 1 case), Coffin-Siris (1 case), and 10q26.12-q26.3 del (1 case), were enrolled. The perioperative special management included the following measures. For patients with cardiac and/or cartilage development issues, preoperative assessments of cardiac function and/or laryngeal cartilage development were performed to minimize anesthetic risks. For patients with mild intellectual disability and/or an auditory neuropathy phenotype, preoperative communication with the patients′ families was conducted to explain the limitations of CI and assist in setting reasonable expectations. For syndromic hearing loss patients who commonly present with inner ear malformations, facial nerve anomalies, and/or intraoperative cerebrospinal fluid leakage, appropriate electrodes were selected prior to surgery, intraoperative facial nerve monitoring and careful cerebrospinal fluid leak repair were conducted, respectively. For patients with NSML accompanied by coagulation issues, the postoperative compression bandaging duration was extended to reduce the risk of hematoma formation. The daily duration of cochlear implant use, the presence of cochlear malformation, and developmental delay were independent factors influencing postoperative CAP scores. The daily duration of cochlear implant use, developmental delay, and unilateral or bilateral CI were independent factors influencing postoperative SIR scores.Conclusions:Hereditary syndrome deafness is a rare disease that affects multiple organs and causes extensive functional impairment. Before CI, a comprehensive evaluation of major affected organ functions is required to assess anesthetic and surgical risks. Genetic diagnosis not only identifies the molecular etiology of patients with syndromic hearing loss and reveals rare phenotypes, but also aids in prognostic evaluation. The main factors affecting CI outcomes in patients with syndromic hearing loss include the presence of cochlear malformations, developmental delays, daily duration of cochlear implant use, and bilateral implantation status.

Objective:To explore the perioperative precautions, rehabilitation effect, and affecting factors in cochlear implantation (CI) among patients with hereditary syndromic hearing loss.Methods:This was a retrospective cohort study. 47 patients diagnosed as hereditary syndromic deafness were treated in the Department of Otolaryngology-Head and Neck Surgery of the Chinese PLA General Hospital from 2010 to 2021, including 26 males and 21 females, aged 0.9-25 years. All patients received unilateral or bilateral CI. Clinical manifestation combined with genetic testing was used to diagnose syndromic hearing loss. The risks and precautions of CI in these patients were summarized from preoperative imaging, intraoperative observations, and postoperative complications. Single factor linear regression and multiple linear regression models in SPSS 26.0 software were used to evaluate the effects of various factors on auditory and speech rehabilitation after CI for syndromic hearing loss. The postoperative outcomes were analyzed through aided hearing thresholds, categories of auditory performance (CAP) scale, and speech intelligibility rate (SIR) scale.Results:Thirteen kinds of syndromes, totally 47 cases, including CHARGE (20 cases), Waardenburg (9 cases), Autosomal dominant deafness-onychodystrophy (DDOD, 4 cases), Pendred (3 cases), Noonan Syndrome with Multiple Lentigines (NSML, 2 cases), Branchio-Oto-Renal (BOR, 2 cases), Bart-Pumphery (1 case), Perrault (1 case), Kabuki (1 case), Frontometaphyseal dysplasia type 2 (FMD 2, 1 case), Mandibulofacial dysostosis Guion-Almeida type (MFDGA, 1 case), Coffin-Siris (1 case), and 10q26.12-q26.3 del (1 case), were enrolled. The perioperative special management included the following measures. For patients with cardiac and/or cartilage development issues, preoperative assessments of cardiac function and/or laryngeal cartilage development were performed to minimize anesthetic risks. For patients with mild intellectual disability and/or an auditory neuropathy phenotype, preoperative communication with the patients′ families was conducted to explain the limitations of CI and assist in setting reasonable expectations. For syndromic hearing loss patients who commonly present with inner ear malformations, facial nerve anomalies, and/or intraoperative cerebrospinal fluid leakage, appropriate electrodes were selected prior to surgery, intraoperative facial nerve monitoring and careful cerebrospinal fluid leak repair were conducted, respectively. For patients with NSML accompanied by coagulation issues, the postoperative compression bandaging duration was extended to reduce the risk of hematoma formation. The daily duration of cochlear implant use, the presence of cochlear malformation, and developmental delay were independent factors influencing postoperative CAP scores. The daily duration of cochlear implant use, developmental delay, and unilateral or bilateral CI were independent factors influencing postoperative SIR scores.Conclusions:Hereditary syndrome deafness is a rare disease that affects multiple organs and causes extensive functional impairment. Before CI, a comprehensive evaluation of major affected organ functions is required to assess anesthetic and surgical risks. Genetic diagnosis not only identifies the molecular etiology of patients with syndromic hearing loss and reveals rare phenotypes, but also aids in prognostic evaluation. The main factors affecting CI outcomes in patients with syndromic hearing loss include the presence of cochlear malformations, developmental delays, daily duration of cochlear implant use, and bilateral implantation status.

Objective To explore the effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)combined with chemotherapy on progres-sion-free survival(PFS)in advanced non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutation.Methods A total of 110 advanced NSCLC patients with EGFR mutation in our hospital from January 2019 to April 2021 were selected as research objects.Ac-cording to different therapeutic plans,they were divided into group A with 37 cases(anlotinib chemo-therapy),group B with 32 cases(icotinib chemotherapy)and group C with 41 cases(anlotinib plus icotinib and chemotherapy).The short-term effect,levels of vascular growth factors before and after treatment,and the incidence of adverse reactions were compared among the three groups.After 2 years of follow-up,survival curve was drawn by Kaplan-Meier method,and survival rate and PFS were compared in three groups by Log-rank.Results The objective response rate(ORR)was 68.29％in the group C,which was significantly higher than 43.24％in the group A and 40.62％in the group B(P＜0.05);after treatment,levels of serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)and platelet-derived growth factor(PDGF)in the group C were significantly lower than those in the group A and the group B(P＜0.05);the total incidence of adverse reac-tions was 29.27％in the group C,which showed no significant differences when compared to 24.32％in the group A and 25.00％in the group B(P＞0.05).By the time of the last follow-up,the 2-year overall survival rate was 74.29％in the group C,which was significantly higher than 51.09％in the group A and 45.03％in the group B(Log-rank x2=6.478,P=0.039);the medi-an PFS in the group A,the group B and the group C was 9.0,8.6 and 13.2 months respectively,and differences were statistically significant(Log-rank x2=6.264,P=0.043).Conclusion For the advanced NSCLC patients with EGFR mutations,combination medication of EGFR-TKI com-bined with chemotherapy can effectively increase ORR,reduce levels of serum vascular growth fac-tors,prolong the PFS,and the safety is good.

Objective To explore the effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)combined with chemotherapy on progres-sion-free survival(PFS)in advanced non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutation.Methods A total of 110 advanced NSCLC patients with EGFR mutation in our hospital from January 2019 to April 2021 were selected as research objects.Ac-cording to different therapeutic plans,they were divided into group A with 37 cases(anlotinib chemo-therapy),group B with 32 cases(icotinib chemotherapy)and group C with 41 cases(anlotinib plus icotinib and chemotherapy).The short-term effect,levels of vascular growth factors before and after treatment,and the incidence of adverse reactions were compared among the three groups.After 2 years of follow-up,survival curve was drawn by Kaplan-Meier method,and survival rate and PFS were compared in three groups by Log-rank.Results The objective response rate(ORR)was 68.29％in the group C,which was significantly higher than 43.24％in the group A and 40.62％in the group B(P＜0.05);after treatment,levels of serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)and platelet-derived growth factor(PDGF)in the group C were significantly lower than those in the group A and the group B(P＜0.05);the total incidence of adverse reac-tions was 29.27％in the group C,which showed no significant differences when compared to 24.32％in the group A and 25.00％in the group B(P＞0.05).By the time of the last follow-up,the 2-year overall survival rate was 74.29％in the group C,which was significantly higher than 51.09％in the group A and 45.03％in the group B(Log-rank x2=6.478,P=0.039);the medi-an PFS in the group A,the group B and the group C was 9.0,8.6 and 13.2 months respectively,and differences were statistically significant(Log-rank x2=6.264,P=0.043).Conclusion For the advanced NSCLC patients with EGFR mutations,combination medication of EGFR-TKI com-bined with chemotherapy can effectively increase ORR,reduce levels of serum vascular growth fac-tors,prolong the PFS,and the safety is good.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

Objective Find abnormal changes of plasma lipid metabolism-related proteins before 20 weeks of gestation in patients with hypertensive disorder of pregnancy(HDP), and preliminarily investigate the role of plasma apolipoprotein C4 elevation in HDP. Methods A nested case-control study was used. The plasma were collected from pregnant women who underwent routine prenatal examination in Guangzhou Women and Children's Medical Center from November 2014 to March 2017. Label-free mass spectrometry was used to detect the differences in plasma lipid metabolism-related proteins before 20 weeks of gestation between 12 pairs of HDP patients and normal controls, and different 48 pairs of samples were used for verification. The protein with the most significant difference multiples was screened to study its effects on monolayer permeability and nitric oxide secretion of endothelial cells. One-way ANOVA was used for comparison between groups, and P<0.05 was considered as statistically significant difference. Results Compared with the control, the lipid metabolism-related proteins, APOC4, Fatty acid-binding protein 4 (FABP4), Apolipoprotein E (APOE), Apolipoprotein C3 (APOC3) and Beta-2-glycoprotein 1(APOH) raised to 1.94, 1.82, 1.59, 1.55 and 1.38 times, phospholipid transfer protein (PLTP) decreased to 0.78 times in plasma before 20 weeks of pregnancy of patients with HDP (t value were 2.499, 2.497, 2.081, 2.098, 2.426 and 2.564, respectively, P<0.05). Cell experiments results showed that 50 ng / ml APOC4 significantly increased 20％ HUVEC single layer cell permeability to FITC-labeled dextran (F=455.4, P<0.01), and significantly decreased the level of nitric oxide in the supernatant of HUVEC culture by 25％ (F=61.92, P<0.01). Conclusions Before diagnosis, plasma protein levels involved in lipid metabolism in HDP patients have been changed, resulting in abnormal lipid metabolism. APOC4 can increase the permeability of vascular endothelial cells, inhibit endothelial source of NO secretion, cause endothelial dysfunction.

BACKGROUND:Deep vein thrombosis occurred during waiting period before operation affects the prognosis of calcaneal fractures. Therefore, it has important clinical significance for its accurate diagnosis. The staging of thrombosis during waiting period before operation for calcaneal fractures is rarely reported. OBJECTIVE:To detect the incidence and risk factors of deep vein thrombosis in patients with calcaneal fracture by ultrasound elastography imaging after staging diagnosis of thrombosis. METHODS:Al objects were included in the study from patients with calcaneal fractures waiting for surgery in the Qinghai University Affiliated Hospital between 2008 and 2015. Patients received preoperative duplex ultrasonography. Those with thrombosis received ultrasound elastography. The incidence of thrombosis was calculated. According to medical records, age, sex, body mass index and history of smoking were col ected. The correlation between thrombosis and above factors was analyzed by multiple Logistic regression analysis. RESULTS AND CONCLUSION:(1) One hundred and forty-nine patients were final y included. Of these, 22 (14.8%) were found to affect deep vein thrombosis in the lower limb. The incidence of acute thrombosis was 9.4%. (2) Multiple Logistic regression analysis suggested that age (P=0.009, OR=1.063, 95%confidence interval (CI) 1.010–1.117), body mass index (P=0.019, OR=1.302, 95%CI 1.124–1.430), history of smoking (P=0.017, OR=5.124, 95%CI 1.347-18.359), and operation waiting time (P=0.000, OR=5.190, 95%CI 1.396–19.266) were risk factors of acute lower extremity deep venous thrombosis. (3) These results suggest that the incidences of preoperative deep vein thrombosis and acute deep vein thrombosis are very high. The risk assessment of acute deep vein thrombosis should be taken according to the patient’s age, smoking history, body mass index, as wel as the time waiting for surgery. The corresponding diagnosis and treatment program should be given to patients with thrombosis.

Objective To investigate the differences between subjective and objective sleep quality in recurrent depressive patients and the correlative factors. Methods Thirty-two cases of recurrent depressive patients(the recurrent group) and 32 cases of first episode depressive patients(the control group)who met the inclusion were recruited in this study. The subjectivesleep quality ,mood and objective sleep quality of patients were estimated by Pittsburgh sleep quality index(PSQI),Hamilton anxiety Scale(HAMA),Hamilton depression Scale(HAMD),respectively. O ne whole-night polysomnography (PSG) was recorded. Results On subjec-tivesleep quality,the total sleep time was shorter,the sleep latency was longer,and the sleep efficiency was lower in the recurrent group compared with the control group. On objectivesleep quality ,the wake times were increased , the NREM1 phase was longer,the NREM2 phase was shorter,the RME phase was longer,the proportion of REM phase was increased,and the latency of REM phase was shorter in the recurrent group compared with the control group(P<0.05,respectively). There were significant differences between the subjective and objective sleep quali-ty in both groups,while the differences in the recurrent group were more significant(P < 0.01). In the recurrent group,thedifference of the total time between the subjective and objective sleep was positively correlated with PSQI score,the duration of disease and the number of attacks(P < 0.05),while,the differences of the sleep latency and sleep efficiency between the subjective and objective sleep were both positively correlated withPSQI score and the HAMA-14 score,respectively(P<0.05). Conclusion There was a significant difference between the subjec-tive and objective sleep quality of patients with recurrent depression ,and the differences were related to the course of disease,the number of attack,PSQI score and HAMA-14 score.

Objective To evaluate the effect of two dosages of the dyclonine hydrochloride mucilage on removing bubbles in bowel preparation before colonoscopy. Methods Data of 774 patients who received colonoscopy from November 2015 to April 2016 in People's Hospital of Xinjiang Uygur Autonomous Region were randomly divided into groups A, B and C. As the control group, group A only used four boxes of polyethylene glycol ( PEG) for bowel preparation and drank 50 mL water after bowel preparation;group B was given 10 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG for bowel preparation;group C was given 20 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG. Intestinal cleanliness, intraluminal gas bubbles and satisfaction were graded by endoscopic physicians. Polyps of less than 5 mm were recorded and adverse reactions were observed. Results There were no significant differences in intestinal cleanliness among groups A, B and C (P>0. 05).The intraluminal gas bubbles grading, physician satisfaction and detection rate of polyps of less than 5 mm of groups B and C were significantly better than those of group A( P<0. 01) , and group C was superior to group B in these variables ( P<0. 01) . The proportion of levelⅠandⅡin foam evaluation in group C was higher than that in group B ( P<0. 01) . Conclusion Dyclonine hydrochloride mucilage can eliminate the bubbles inside the intestine, and the effect of 20 mL dyclonine hydrochloride mucilage for bowel preparation is superior to 10 mL.

Objective To investigate the effect of virtual simulation teaching method in the comprehensive experimental teaching.Methods In experimental teaching of nursing,simulation medical records were compiled,plans were implemented,experiment guidance materials were preliminarily formed and teaching effect was evaluated.Results The application of virtual simulation teaching in nursing comprehensive experiments reflected the comprehensiveness of teaching content,and the comprehensiveness of knowledge,ability and capacity.It could train students creative ability,exploring spirit,enhance the sense of professional and humane care consciousness,train the communication skills and strain capacity,make active teaching atmosphere,improve the quality of teaching.Conclusions This teaching method can make students achieve mastery through a comprehensive multi-disciplinary knowledge,improve the ability of solving practical problems,help nurses to develop the comprehensive professional quality.