Objective:This study aimed to evaluate the therapeutic effect of intratympanic injection of ganglioside in patients with refractory sudden deafness. Methods:A total of 120 patients with sudden deafness, aged 18-65 years, whose onset was within 11-42 days, failed to respond to conventional treatment, and had an average hearing threshold（500-4 000 Hz）>60 dB were selected. They were prospectively and randomly divided into a control group of 61 cases and an experimental group of 59 cases. The control group was treated according to the recommended protocol of the Chinese Medical Association（postauricular injection of methylprednisolone）, while the experimental group was treated with intratympanic injection of monosialotetrahexosylganglioside sodium+postauricular injection of methylprednisolone. Both groups were simultaneously administered oral ginkgo biloba extract and citicoline tablets. Hearing was re-examined two weeks after the completion of treatment, and the therapeutic effects of the two different treatment methods were compared and analyzed. Results:The effective rate was 29.51% in the control group and 54.24% in the experimental group（P<0.01）. The average hearing threshold improved by 11.57 dB HL in the control group and 22.50 dB HL in the experimental group（P<0.05）. Conclusion:The combination of postauricular injection of methylprednisolone and intratympanic injection of ganglioside is more effective than postauricular injection of methylprednisolone alone in the treatment of refractory sudden deafness. The earlier the treatment, the better the therapeutic effect.
Humans ; Middle Aged ; Hearing Loss, Sudden/drug therapy* ; Adult ; Prospective Studies ; Young Adult ; Aged ; Adolescent ; Male ; Female ; Injection, Intratympanic ; Gangliosides/administration & dosage* ; Methylprednisolone/therapeutic use* ; Treatment Outcome

Objective To evaluate the diagnostic value of prostate health index(PHI)and prostate health index density(PHID)in identifying intermediate-to high-risk prostate cancer(PCa).Methods Clinical data of 160 treatment-na?ve patients with highly suspected PCa,who underwent initial prostate biopsy in our hospital during Jul.2022 and Feb.2024,were retrospectively analyzed.Data included age,body mass index(BMI),prostate volume(PV),total prostate-specific antigen(tPSA),free PSA(fPSA),[-2]proPSA(p2PSA),PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiver operating characteristic(ROC)curve and multivariate logistic regression analysis were employed to assess the diagnostic performance of PHI and PHID in predicting PCa and identifying intermediate-to high-risk PCa.Results There were statistically significant differences in tPSA,p2PSA,PHI and PHID between the negative and positive groups,as well as among the low-,medium-and high-risk groups(P＜0.01).Both PHI and PHID demonstrated good diagnostic performance in predicting PCa(AUC=0.820 8 and 0.875 7,respectively;all P＜0.001),and in identifying intermediate-to high-risk PCa(AUC=0.838 0 and 0.878 3,respectively;all P＜0.001).Compared to the baseline model,the incorporation of PHI and PHID individually into the multivariate model significantly improved the screening performance for PCa(AUC=0.910 and 0.898,respectively;all P＜0.001).Conclusion PHI and PHID exhibit high diagnostic efficacy in screening PCa,particularly in identifying intermediate-to high-risk disease.

Objective To study influencing factors of hypoproteinemia in maintenance hemodialysis pa-tients.Methods A multicenter study was conducted.We selected 397 maintenance hemodialysis patients hos-pitalized at five hospitals of Wenzhou Kangning Hospital Group from April to June 2024 as study subjects.Pa-tients'general data and laboratory test results were collected.Logistic regression combined with the CHAID decision tree model was used to analyze indicators of hypoproteinemia in patients.Results Among 397 main-tenance hemodialysis patients,92 had hypoproteinemia(hypoproteinemia group),with a prevalence of 23.17%;others were assigned to the normal protein group.Statistically significant differences existed between groups in gender,age,occupation,education level,diabetes,vascular access type,insurance type,weight,Hb,blood calcium,blood phosphorus,blood potassium,blood glucose,parathyroid hormone,creatinine,blood urea,and cholesterol(P<0.05).Logistic regression showed occupation,insurance type,diabetes,Hb,and creatinine were independent influencing factors(P<0.05).The CHAID decision tree model identified age as the root node.Conclusion Occupation,insurance type,diabetes,Hb,age,and creatinine are important influencing fac-tors for hypoproteinemia in maintenance hemodialysis patients.Logistic regression combined with decision tree analysis can play complementary roles.

Objective To explore the differences between community-based population-wide early screening combined with two-way referral model and the traditional opportunistic screening model for early diagnosis of early-stage prostate cancer.Methods From August 2022 to April 2024,12815high-risk elderly males within the Fifth People's Hospital of Shanghai,Fudan University healthcare al-liance underwent population-wide prostate-specific antigen(PSA)screening across five community health centers.Among them,1005 cases with PSA＞4.0ng/ml were identified and referred via a two-way referral model to the Fifth People's Hospital of Shanghai,Fudan University for further evaluation.Prostate biopsies were performed on 445 eligible patients who consented(mean age was 65.6±6.8 years),and clinical data were collected as the community-based population-wide early screening combined with two-way referral mod-el group(Group A).During the same period,4600high-risk elderly males with lower urinary tract symptoms underwent opportunistic PSA screening at the Fifth People's Hospital of Shanghai,Fudan University identifying 700 cases with abnormal PSA levels.Biopsies were performed on 270 eligible patients who consented(mean age was 64.8±6.4 years),and clinical data were collected as the traditional op-portunistic screening model group(Group B).Baseline characteristics,positive rate of prostate cancer,clinical stages,and pathological grades were compared between the two groups.Results There were no statistically significant differences in age,PSA levels,family his-tory,body mass index(BMI),marital status and education level between the groups.There were 160 positive cases in Group A,the pos-itive rate was 35.9％,while there were 90 positive cases in Group B,the positive rate was 33.3％,with no significant statistical differ-ence(P=0.652).In Group A,100 cases(62.5％of diagnosed cases)were classified as clinical stage ≤T2N0M0,compared to 35 ca-ses(38.9％)in Group B,showing a significant statistical difference(P=0.023).Group A had 105 cases(65.6％of diagnosed cases)with International Society of Urological Pathology(ISUP)grade ≤3,while Group B had 30 cases(33.3％),showing a significant statis-tical difference(P=0.002).Conclusion Community-based population-wide early screening combined with two-way referral model showed no difference in the positive rate of prostate cancer compared to traditional opportunistic screening but exhibited advantages in diag-nosing early-stage prostate cancer.Wider adoption of this model may improve the current status of delayed staging and poor prognosis a-mong prostate cancer patients in China.

Objective To evaluate the diagnostic value of prostate health index(PHI)and prostate health index density(PHID)in identifying intermediate-to high-risk prostate cancer(PCa).Methods Clinical data of 160 treatment-na?ve patients with highly suspected PCa,who underwent initial prostate biopsy in our hospital during Jul.2022 and Feb.2024,were retrospectively analyzed.Data included age,body mass index(BMI),prostate volume(PV),total prostate-specific antigen(tPSA),free PSA(fPSA),[-2]proPSA(p2PSA),PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiver operating characteristic(ROC)curve and multivariate logistic regression analysis were employed to assess the diagnostic performance of PHI and PHID in predicting PCa and identifying intermediate-to high-risk PCa.Results There were statistically significant differences in tPSA,p2PSA,PHI and PHID between the negative and positive groups,as well as among the low-,medium-and high-risk groups(P＜0.01).Both PHI and PHID demonstrated good diagnostic performance in predicting PCa(AUC=0.820 8 and 0.875 7,respectively;all P＜0.001),and in identifying intermediate-to high-risk PCa(AUC=0.838 0 and 0.878 3,respectively;all P＜0.001).Compared to the baseline model,the incorporation of PHI and PHID individually into the multivariate model significantly improved the screening performance for PCa(AUC=0.910 and 0.898,respectively;all P＜0.001).Conclusion PHI and PHID exhibit high diagnostic efficacy in screening PCa,particularly in identifying intermediate-to high-risk disease.

Objective To explore the differences between community-based population-wide early screening combined with two-way referral model and the traditional opportunistic screening model for early diagnosis of early-stage prostate cancer.Methods From August 2022 to April 2024,12815high-risk elderly males within the Fifth People's Hospital of Shanghai,Fudan University healthcare al-liance underwent population-wide prostate-specific antigen(PSA)screening across five community health centers.Among them,1005 cases with PSA＞4.0ng/ml were identified and referred via a two-way referral model to the Fifth People's Hospital of Shanghai,Fudan University for further evaluation.Prostate biopsies were performed on 445 eligible patients who consented(mean age was 65.6±6.8 years),and clinical data were collected as the community-based population-wide early screening combined with two-way referral mod-el group(Group A).During the same period,4600high-risk elderly males with lower urinary tract symptoms underwent opportunistic PSA screening at the Fifth People's Hospital of Shanghai,Fudan University identifying 700 cases with abnormal PSA levels.Biopsies were performed on 270 eligible patients who consented(mean age was 64.8±6.4 years),and clinical data were collected as the traditional op-portunistic screening model group(Group B).Baseline characteristics,positive rate of prostate cancer,clinical stages,and pathological grades were compared between the two groups.Results There were no statistically significant differences in age,PSA levels,family his-tory,body mass index(BMI),marital status and education level between the groups.There were 160 positive cases in Group A,the pos-itive rate was 35.9％,while there were 90 positive cases in Group B,the positive rate was 33.3％,with no significant statistical differ-ence(P=0.652).In Group A,100 cases(62.5％of diagnosed cases)were classified as clinical stage ≤T2N0M0,compared to 35 ca-ses(38.9％)in Group B,showing a significant statistical difference(P=0.023).Group A had 105 cases(65.6％of diagnosed cases)with International Society of Urological Pathology(ISUP)grade ≤3,while Group B had 30 cases(33.3％),showing a significant statis-tical difference(P=0.002).Conclusion Community-based population-wide early screening combined with two-way referral model showed no difference in the positive rate of prostate cancer compared to traditional opportunistic screening but exhibited advantages in diag-nosing early-stage prostate cancer.Wider adoption of this model may improve the current status of delayed staging and poor prognosis a-mong prostate cancer patients in China.

Objective:The expression of endothelial growth factor-A (VEGF-A), chemokine [monocyte chemoattractant protein-1(MCP-1) and RANTES] in stenosis of autologous arteriovenous fistula (AVF) in hemodialysis patients and their correlation with basic fibroblast growth factor (b-FGF).Methods:From March 2018 to April 2019, 90 patients with end-stage renal disease were enrolled in this study. All patients were given the first autologous AVF surgery, and 45 patients with AVF loss were in group Ⅰ, 45 patients with normal AVF were in group Ⅱ. The thickness and area of intima and media were measured. The expression of growth factors was detected by immunohistochemistry. The correlation between serum b-FGF and the expression of growth factors was analyzed.Results:The thickness ratio and area ratio of intima to media in group Ⅰ were larger than those in group Ⅱ ( P<0.05). VEGF-A, MCP-1 and RANTES were strongly positive in group Ⅰ and weakly positive in group Ⅱ. The expression levels of serum b-FGF, serum and tissue VEGF-A, MCP-1 and RANTES in group Ⅰ were significantly higher than those in group Ⅱ ( P<0.05). Serum b-FGF levels in group Ⅰ were positively correlated with serum levels of VEGF-A, MCP-1 and RANTES ( r=0.794, 0.523, 0.576, P<0.05), while serum b-FGF levels in group Ⅱ were not significantly correlated with serum levels of VEGF-A, MCP-1 and RANTES ( P>0.05). Conclusions:Serum b-FGF may play an important role in venous intimal hyperplasia by mediating the over expression of VEGF-A, MCP-1 and RANTES.

ObjectiveTo explore the correlation between butylphthalide and plasma brain-type creatine kinase isoenzyme (CK-BB),endothelin (ET),calcitonin gene related peptide (CGRP) in patients with acute cerebral infarction (ACI).MethodsSixty patients with ACI were divided into treatment group and control group with 30 cases each by random digits table method.Both groups received normal treatment continuously for 7 days,and butylphthalide of 200 mg was added to treatment group for 3 times per day.The levels of plasma CK-BB,ET and CGRP of two groups before and after treatment were measured and compared.ResultsThe levels of plasma CK-BB,ET of two groups both decreased significantly after treatment,but CGRP rose obviously.It showed significant differences before and after treatment of both groups (P ＜0.01 or ＜ 0.05).The levels of plasma CK-BB,ET of treatment group after treatment were lower than those of control group in the same period [(216.48±36.95) U/L vs.(333.07±54.03) U/L,(83.33±26.48)ng/L vs.(98.46±31.46) ng/L,P ＜ 0.05 ].The level of plasma CGRP of treatment group after treatment was significantly higher than that of control group in the same period [ (44.16±13.28 ) ng/L vs.(36.42±12.31 )ng/L,P ＜ 0.05 ].ConclusionButylphthalide can reduce the plasma enzyme activity,balance ET and CGRP,extend the cerebral arteries to antagonize ET,improve cerebral ischemia and cerebral hypoxia,which can protect brain cells and endothelial cells.

Objective To establish an otitis media with effusion model in rat,and provide a pure physical approach of animal model for researching the otitis media with effusion.Methods Twenty-four clean grade male SD rats were selected.Only the right ears were used for the model group,the contralateral ears were used as the control group.The animal model of otitis media with effusion was established by blocking eustachian tube with cork stopper through the right side mandible,the hearing was evaluated by ABR and tympanogram configurations,the pathologic changes of middle ear and eustachian tube mucous membrane were examined by light microscopy.Results Twenty out of 24 ears of rats' of hearing threshold increased from 34.25?5.45 dB to 57.63?5.46 dB (P