Objective:To assess the clinical features and effectiveness of antiviral therapy in newborns with sensorineural hearing loss (SNHL) caused by congenital congenital cytomegalovirus (cCMV) infection, and to speculate the risk factors for poor hearing outcomes.Methods:A multicenter prospective cohort study wasconducted, enrolling 176 newborns diagnosed with cCMV at four research centers in Zhejiang Province from March 1, 2021, to April 30, 2024. Clinical characteristics at birth were recorded and hearing was followed up. The children were divided into groups based on their condition at birth, specifically into asymptomatic, mild symptom, and moderate to severe symptom groups. Additionally, they were divided into SNHL and normal hearing groups based on the results of air conduction brainstem audiometry at birth. And they were also divided into treatment and untreated groups according to antiviral treatment. Mann Whitney U test, and chi square test were used for inter group comparison to analyze the differences in clinical features between different disease groups, and to analyze the effects of clinical features, antiviral therapy, and other factors on hearing improvement. Logistic regression analysis was employed to identify the risk factors influencing hearing outcomes. Results:Among the cohort of 176 children diagnosed infection with cCMV, 90 cases were male and 86 cases were female. Of these, 79 cases were asymptomatic, 12 cases classified as mild cCMV and 85 cases as moderate to severe cCMV. Fifty cases belonged to SNHL group, with different degrees of severity, including 30 cases of mild, 9 cases of moderate, 5 cases of severe, and 6 cases of extremely severe SNHL. Among the 121 cases in the normal hearing group, 2 cases (1.7%) exhibited late-onset hearing loss despite having normal hearing at birth. Among 81 cases (46.0%) who completed the hearing follow-up, 71 cases (87.7%) had good hearing outcomes and 10 cases (12.3%) had poor hearing outcomes. Among the 81 children, 29 cases (35.8%) had SNHL at birth. During follow-up, the hearing threshold improved in 19 cases (65.5%), remained stable in 7 cases (24.1%) and progressed in 3 cases (10.3%). A total of 26 cases in the treatment group and 55 cases in the untreated group completed the hearing follow-up assessment. The rate of hearing improvement in the treatment group was found to be higher compared to the untreated group (13 cases (50.0%) vs. 6 cases (10.9%), χ2=15.00, P<0.01), with individuals in the treatment group having a 4.58 times greater likelihood of experiencing hearing improvement ( RR=4.58,95% CI 1.96-10.70, P<0.05). However, no statistically significant difference was observed in hearing outcomes between the antiviral treatment group and the untreated group ( RR=0.90, 95% CI 0.57-1.41, P=0.517). Multivariate analysis further confirmed SNHL ( OR=11.58, 95% CI 2.10-63.93, P=0.005) and preterm birth ( OR=4.98, 95% CI 1.06-23.41, P=0.042) as independent risk factors for poor hearing outcomes. Conclusions:SNHL resulting from cCMV infection presents symptoms at birth and can be improved by antiviral therapy. Poor hearing outcomes are associated with SNHL and prematurity.

Objective To explore the difference of transfer RNA-derived small RNA(tsRNA)expression profile before and after acute myocardial infarction(AMI)and the diagnostic value of tsRNA for AMI.Methods Age-and weight-matched male C57 mice(8-10 weeks)were randomly divided into MI group and Sham group,with 4 in each group.AMI model was surgically induced in mice in MI group.After 24 h of modeling,RNA was extracted from left ventricular myocardial tissue.After removing modifications,total RNA of each sample was sequentially ligated to 3'and 5'small RNA adapters.Subsequently,reverse transcription PCR was performed.cDNA was then synthesized and amplified.The amplified products corresponding to the size of 15-40 nt RNA were screened to construct a library for sequencing.The sequencing results were compared with the mature tRNA and tRNA precursor sequences in GtRNAdb database.Differentially expressed tsRNA profiles before and after AMI were obtained.The alterations of the cleaved patterns of tRNA corresponding to the same codon before and after AMI were analyzed.According to the profile of differentially expressed tsRNA before and after AMI,tsRNA only abundantly expressed in MI group were selected and verified in myocardial tissue and plasma of mice to explore the potential of these tsRNAs as diagnostic markers of AMI.Results tsRNA profile showed good repeatability within the same group and great distinctiveness between the different groups.After AMI occurred,the cleaved patterns of a variety of tRNAs changed,including tRNA Asn-GTT,Glu-TTC,Gly-ACC,Gly-GCC,His-GTG,Ile-AAT,Ile-GAT,Pro-TGG,Ser-AGA,and Trp-CCA.Compared with the Sham group,268 tsRNAs significantly up-regulated and 1 228 tsRNAs down-regulated in MI group,and 64 tsRNAs were uniquely expressed in MI group.tRF-Gly-CCC-2-31,tiRNA-Val-CAC-1-32,tiRNA-Val-AAC-2-32,tiRNA-Glu-TTC-2-32,and tiRNA-Lys-TTT-1-34 were specifically expressed in cardiac tissue on the 1st day post AMI.Among them,tiRNA-Val-AAC-2-32 and tiRNA-Lys-TTT-1-34 showed specifically abundant levels in plasma from MI group and dynamically changed with AMI duration.Conclusions The expression profile of tsRNA is significantly different before and after AMI.tiRNA-Val-AAC-2-32 and tiRNA-Lys-TTT-1-34 are uniquely highly expressed in myocardial tissue and plasma from AMI mice,and might have the potential as diagnostic markers of AMI.

Objective:To investigate the diagnosis and strategy of individualized functional rhinoplasty based on the overall evaluation of the nasal cavity as a integration.Methods:A prospective study was carried out in the patients who underwent endoscopic functional rhinoplasty at the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University from February 2018 to August 2021. The overall evaluation of the internal and external structure and function of the nasal cavity was performed before surgery, and the individualized surgical strategies were developed. According to the surgical strategy, nasal septum correction, inferior turbinate ablation, inferior turbinate fracture displacement, inferior turbinate submucous resection, dorsal extended cartilage graft, crooked nose correction, prosthesis or autologous cartilage implantation, hump reduction and osteotomy were performed to adjust the nasal function and aesthetics. Internal nasal valve (INV) angle, INV collapse grade, INV cross-sectional area, and external nasal valve effectiveness (ENVE) index were used to evaluate the structure of nasal valve area. Nasal obstruction symptom assessment (NOSE) scale and nasal resistance [including total nasal resistance (RT), nasal resistance differential ratio (R 1r)] was used to evaluate nasal ventilation function. Facial clinimetric evaluation questionnaire rhinoplasty module (FACE-Q RM), rhinoplasty outcome evaluation (ROE) scale, external nasal subunit measurement was used to evaluate nasal appearance, and self-rating depression scale (SDS) and self-rating anxiety scale (SAS) was used to evaluate psychological status. Finally, the correlation between patient satisfaction and subjective and objective parameters were analyzed. The data before and after operation were compared by paired t-test. Correlation was tested by Pearson analysis. Results:A total of 50 patients were included, including 18 males and 32 females, ranging in age from 23 to 52 years, mean age 35.7 years. All patients had symptoms of nasal congestion, of which 28 cases with crooked nose deformity, 12 cases with nasal valve stenosis, 6 cases with saddle nose deformity, and 4 cases with hump nose. Compared with preoperative, postoperative INV angle was significantly increased, INV collapse grade was decreased, INV cross-sectional area was increased, ENVE index was increased ( P<0.05). After operation, the NOSE score decreased, and nasal resistance showed that RT and R 1r decreased, indicating that nasal congestion symptoms were relieved significantly ( P<0.05). The postoperative FACE-Q RM and ROE scores increased, indicating that patients’ nasal appearance satisfaction increased ( P<0.05), external nasal subunit measurement showed that the upper nasal alar width and lower nasal alar angle were reduced ( P<0.05), the measured value of residual structure has no significant change. Postoperative SDS and SAS scores were significantly lower than preoperative ones, and the difference was statistically significant ( P<0.05).Overall satisfaction was improved( P<0.05). Pearson correlation analysis showed that patient satisfaction was positively correlated with INV angle, INV cross-sectional area, ENVE index, and subjective nasal shape score (FACE-Q RM, ROE), and negatively correlated with INV collapse grade, NOSE score, and nasal resistance measurement, but had no correlation with external nasal subunit measurement. Conclusion:Combined with the overall evaluation of nasal structure, nasal ventilation function and external nasal aesthetics, it is beneficial to develop the diagnosis and treatment strategy of individualized functional rhinoplasty, so as to improve patient satisfaction.

Objective:To investigate the diagnosis and strategy of individualized functional rhinoplasty based on the overall evaluation of the nasal cavity as a integration.Methods:A prospective study was carried out in the patients who underwent endoscopic functional rhinoplasty at the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University from February 2018 to August 2021. The overall evaluation of the internal and external structure and function of the nasal cavity was performed before surgery, and the individualized surgical strategies were developed. According to the surgical strategy, nasal septum correction, inferior turbinate ablation, inferior turbinate fracture displacement, inferior turbinate submucous resection, dorsal extended cartilage graft, crooked nose correction, prosthesis or autologous cartilage implantation, hump reduction and osteotomy were performed to adjust the nasal function and aesthetics. Internal nasal valve (INV) angle, INV collapse grade, INV cross-sectional area, and external nasal valve effectiveness (ENVE) index were used to evaluate the structure of nasal valve area. Nasal obstruction symptom assessment (NOSE) scale and nasal resistance [including total nasal resistance (RT), nasal resistance differential ratio (R 1r)] was used to evaluate nasal ventilation function. Facial clinimetric evaluation questionnaire rhinoplasty module (FACE-Q RM), rhinoplasty outcome evaluation (ROE) scale, external nasal subunit measurement was used to evaluate nasal appearance, and self-rating depression scale (SDS) and self-rating anxiety scale (SAS) was used to evaluate psychological status. Finally, the correlation between patient satisfaction and subjective and objective parameters were analyzed. The data before and after operation were compared by paired t-test. Correlation was tested by Pearson analysis. Results:A total of 50 patients were included, including 18 males and 32 females, ranging in age from 23 to 52 years, mean age 35.7 years. All patients had symptoms of nasal congestion, of which 28 cases with crooked nose deformity, 12 cases with nasal valve stenosis, 6 cases with saddle nose deformity, and 4 cases with hump nose. Compared with preoperative, postoperative INV angle was significantly increased, INV collapse grade was decreased, INV cross-sectional area was increased, ENVE index was increased ( P<0.05). After operation, the NOSE score decreased, and nasal resistance showed that RT and R 1r decreased, indicating that nasal congestion symptoms were relieved significantly ( P<0.05). The postoperative FACE-Q RM and ROE scores increased, indicating that patients’ nasal appearance satisfaction increased ( P<0.05), external nasal subunit measurement showed that the upper nasal alar width and lower nasal alar angle were reduced ( P<0.05), the measured value of residual structure has no significant change. Postoperative SDS and SAS scores were significantly lower than preoperative ones, and the difference was statistically significant ( P<0.05).Overall satisfaction was improved( P<0.05). Pearson correlation analysis showed that patient satisfaction was positively correlated with INV angle, INV cross-sectional area, ENVE index, and subjective nasal shape score (FACE-Q RM, ROE), and negatively correlated with INV collapse grade, NOSE score, and nasal resistance measurement, but had no correlation with external nasal subunit measurement. Conclusion:Combined with the overall evaluation of nasal structure, nasal ventilation function and external nasal aesthetics, it is beneficial to develop the diagnosis and treatment strategy of individualized functional rhinoplasty, so as to improve patient satisfaction.

Hepatocellular carcinoma （HCC） is one of the common malignant tumors of the digestive tract and seriously threatens the life of patients due to a high incidence rate， a high degree of malignancy， strong invasion and metastasis， and poor prognosis. At present， the main methods for the prevention and treatment of HCC include drugs， surgery， and interventional treatment， but all of these methods have certain adverse reactions and side effects. As an important intracellular signal transduction pathway in the human body， the JAK/STAT signaling pathway mainly exerts an anti-HCC effect by regulating cell invasion， metastasis， proliferation， growth， apoptosis， autophagy， angiogenesis， inflammation/immune response， iron metabolism， and drug resistance. Therefore， targeting the JAK/STAT signaling pathway plays an important role in the prevention and treatment of the development and progression of HCC. Traditional Chinese medicine has attracted wide attention due to its advantages of multiple targets， pathways， components， and levels in the treatment of HCC， and many cell or animal experiments on traditional Chinese medicine in the treatment of HCC have shown that the JAK/STAT signaling pathway is an important target for the prevention and treatment of HCC， with the effects of improving liver function， reducing HCC recurrence， and improving immunity. Based on this， this article analyzes the mechanism of action of the JAK/STAT signaling pathway in HCC， as well as the intervention effect of traditional Chinese medicine monomers， traditional Chinese medicine extracts， and traditional Chinese medicine compounds on the JAK/STAT signaling pathway， in order to provide theoretical basis and reference for the prevention and treatment of HCC and the research and development of new traditional Chinese medicine drugs.

Triple-negative breast cancer (TNBC) is a nasty disease with extremely high malignancy and poor prognosis. Annexin A3 (ANXA3) is a potential prognosis biomarker, displaying an excellent correlation of ANXA3 overexpression with patients' poor prognosis. Silencing the expression of ANXA3 effectively inhibits the proliferation and metastasis of TNBC, suggesting that ANXA3 can be a promising therapeutic target to treat TNBC. Herein, we report a first-in-class ANXA3-targeted small molecule (R)-SL18, which demonstrated excellent anti-proliferative and anti-invasive activities to TNBC cells. (R)-SL18 directly bound to ANXA3 and increased its ubiquitination, thereby inducing ANXA3 degradation with moderate family selectivity. Importantly, (R)-SL18 showed a safe and effective therapeutic potency in a high ANXA3-expressing TNBC patient-derived xenograft model. Furthermore, (R)-SL18 could reduce the β-catenin level, and accordingly inhibit the Wnt/β-catenin signaling pathway in TNBC cells. Collectively, our data suggested that targeting degradation of ANXA3 by (R)-SL18 possesses the potential to treat TNBC.

Hepatic fibrosis is a pathological reparative response of the liver to chronic injury and a crucial step in the progression of chronic liver disease， characterized mainly by the activation of hepatic stellate cells and diffuse deposition of extracellular matrix. Currently， there is no ideal specific drug for the treatment of liver fibrosis in clinical practice. In recent years， with the development and progress of traditional Chinese medicine （TCM） in the treatment of liver fibrosis， TCM has been widely recognized for its significant therapeutic effect and fewer adverse reactions. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway is an important pathway that affects the formation and development of liver fibrosis. It mainly plays a role in liver fibrosis by inhibiting the activation and proliferation of hepatic stellate cells， promoting their apoptosis， reducing oxidative stress in liver cells， decreasing the deposition of extracellular matrix， and enhancing liver cell autophagy. This article summarized the mechanisms by which Chinese medicinal monomers regulated the PI3K/Akt pathway to exert their effects on liver fibrosis and their synergistic effects with other signaling pathways， providing a theoretical basis and references for the development of new drugs for the treatment of liver fibrosis with TCM.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Objective:To investigate changes in skin microecological structures and functions between acute and remission phases in adult patients with severe atopic dermatitis (AD) .Methods:From October 2019 to November 2020, skin scale specimens were collected from 5 body sites (cheeks, cubital fossa, back of the hand, abdomen, lower limbs) of 4 adult patients with severe AD in the acute and remission phases, who visited the outpatient clinic of Guangzhou Institute of Dermatology. The next-generation high-throughput sequencing was performed for metagenomic sequencing to construct the microbial gene catalogue of these specimens, followed by gene annotation and bioinformatics analysis for each sample.Results:A total of 18 phyla, 37 classes, 73 orders, 142 families, 237 genera, and 331 species were identified in the skin specimens from the 4 patients with severe AD. The patients with AD in the remission phase showed significantly increased diversity of skin microbiota and markedly different relative abundance of skin microorganisms compared with those in the acute phase (both P < 0.05). At the microbial species level, Staphylococcus aureus showed the highest impact on the acute phase of AD, while Staphylococcus epidermidis, Moraxella osloensis, Francisella sp., Staphylococcus cohnii, Staphylococcus warneri, Malassezia globosa and Malassezia restricta were enriched in the remission phase of AD with the absolute value of the common logarithm of the linear discriminant analysis score > 2 (Kruksal-Wallis test, all P < 0.05). As KEGG pathway enrichment analysis showed, the differentially abundant genes were annotated into a total of 355 functional pathways, of which 38 pathways were significantly enriched (all P < 0.05), mainly involving Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism, nitrogen metabolism, metabolism of arginine and proline, biosynthesis and degradation of valine, leucine and isoleucine, fatty acid degradation, peroxisome proliferator-activated receptor signaling pathway, etc. Conclusion:The skin microecological structure significantly differed between the acute and remission phases among the patients with severe AD, which may be related to multiple functional pathways, such as Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism and nitrogen metabolism.

Objective To investigate the regulatory effect of Jiedu Huayu Tongfu prescription on intestinal homeostasis in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome, as well as its effect on endotoxin, inflammatory factors, and cellular immune function. Methods A total of 72 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from June 2019 to January 2021 and met the diagnostic and inclusion criteria were enrolled as subjects and then randomly divided into observation group and control group, with 36 patients in each group. In the treatment group, 2 patients were lost to follow-up, 2 patients were excluded, and 32 patients completed the study; in the control group, 2 patients were lost to follow-up, 1 patient was excluded, and 33 patients completed the study. In addition to the basic treatment including antiviral therapy and liver-protecting treatment, the patients in the observation group were given Jiedu Huayu Tongfu granules, and those in the control group were given oral administration of Bifidobacterium tetravaccine tablets; the course of treatment was 4 weeks for both groups. The 16S rDNA sequencing technique was used for sequencing of fecal flora, and the two groups were measured in terms of the changes in liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and albumin (Alb)], endotoxin (ET), levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and T lymphocyte subsets (CD3 + T, CD4 + T, CD8 + T, and CD4 + /CD8 + ) after treatment. For normally distributed continuous data with homogeneity of variance, the paired t -test was used for comparison within each group, and the independent samples t -test was used for comparison between two groups; the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data. The chi-square test was used for comparison of categorical data. Results The observation group had a significantly higher overall response rate than the control group (87.5% vs 60.6%, χ 2 =-2.299, P =0.022). After treatment, both groups had significant reductions in ALT, AST, and TBil and a significant increase in Alb (all P < 0.05), and compared with the control group, the observation group had a significantly greater reduction in TBil ( Z =-2.165, P =0.030). After treatment, both groups had significant improvements in the levels of CD3 + T, CD4 + T, and CD4 + /CD8 + , and the observation group had significantly greater improvements than the control group ( Z =-2.146, -2.940, and 3.157, P =0.032, 0.003, and 0.002). After treatment, both groups had significant reductions in the levels of TNF-α, IL-6, and ET, and the observation group had significantly greater reductions than the control group ( Z =-2.139, -1.982, and -2.062, P =0.032, 0.048, and 0.043). Both groups had an increase in the number of operational taxonomic units after treatment. As for the abundance of intestinal flora at the phylum level, the observation group had a significant increase in the abundance of Firmicutes and a significant reduction in the abundance of Bacteroidetes after treatment ( Z =-3.181 and -2.215, P =0.001 and 0.027); compared with the control group, the observation group had significantly greater increases in the abundance of Firmicutes and Cyanobacteria and significantly greater reductions in the abundance of Bacteroidetes, Cercozoa, and ε-Proteobacteria (all P < 0.05). At the genus level, the observation group had a significant increase in the abundance of Bifidobacterium after treatment ( Z =-2.045, P =0.041). The alpha-diversity analysis showed that the observation group had significant increases in Chao1 and Ace indices after treatment ( t =-4.263 and -3.328, P =0.001 and 0.005) and a significantly greater increase in Ace index than the control group ( t =2.292, P =0.030). The beta-diversity analysis showed that the two groups had a similar composition of flora without significant difference (all P > 0.05). Conclusion Jiedu Huayu Tongfu prescription, in combination with etiological and basic treatments, can alleviate clinical symptoms, reduce liver injury, and improve cellular immune function in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome. Jiedu Huayu Tongfu prescription can improve the imbalance of intestinal flora by increasing the abundance of the probiotic bacteria such as Firmicutes, Lactobacillus, and Bifidobacterium and the pathogenic bacteria such as Bacteroidetes and Cercozoa, and its effect in further improving liver and immune function may be associated with the regulation of intestinal microecology.