Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.
Humans ; Male ; Female ; Retrospective Studies ; Prognosis ; Adult ; Middle Aged ; Vertigo/diagnosis* ; Hearing Loss, Sensorineural/diagnosis* ; Young Adult ; Hearing Loss, Sudden/diagnosis* ; Adolescent ; Aged ; Vestibular Evoked Myogenic Potentials

Objective To explore the effect of hyperbaric oxygen combined with synchronous brain bionic electrical stimulation on patients with stroke-related sleep disorders.Methods From November,2023 to November,2024,a total of 68 stroke patients with stroke-related sleep disorders ad-mitted to Huashan Hospital,Fudan University were selected.They were randomly divided into control group(n=34)and experimental group(n=34).The control group received routine hyperbaric oxygen therapy,while the ex-perimental group received routine hyperbaric oxygen therapy combined with synchronous brain bionic electrical stimulation inside the chamber,for four weeks.Pittsburgh Sleep Quality Index(PSQI),sleep-monitoring wrist-bands,Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess the outcomes before and after treatment..Results Four patients in the control group and one in the experimental group dropped out.After treatment,the scores of each factors of PSQI decreased in both groups(t>2.693,P<0.05),and were lower in the experimental group than in the control group(t>2.699,P<0.01),expect hypnotic drug use(P>0.05);the total sleep time,deep sleep time and rapid eye movement sleep time became longer in both groups(|t|>7.270,P<0.001),and they were longer in the experimental group than in the control group(|t|>5.712,P<0.001);the scores of SAS and SDS decreased in both groups(t>9.530,P<0.001),and they were less in the experimental group than in the control group(t>4.740,P<0.001).Conclusion Synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber could effectively prolong the total sleep time,deep sleep time and rapid eye movement time of patients with stroke-related sleep disorders,re-lieve anxiety and depression after stroke,and improve sleep quality.

Objective To explore the effect of hyperbaric oxygen combined with synchronous brain bionic electrical stimulation on patients with stroke-related sleep disorders.Methods From November,2023 to November,2024,a total of 68 stroke patients with stroke-related sleep disorders ad-mitted to Huashan Hospital,Fudan University were selected.They were randomly divided into control group(n=34)and experimental group(n=34).The control group received routine hyperbaric oxygen therapy,while the ex-perimental group received routine hyperbaric oxygen therapy combined with synchronous brain bionic electrical stimulation inside the chamber,for four weeks.Pittsburgh Sleep Quality Index(PSQI),sleep-monitoring wrist-bands,Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess the outcomes before and after treatment..Results Four patients in the control group and one in the experimental group dropped out.After treatment,the scores of each factors of PSQI decreased in both groups(t>2.693,P<0.05),and were lower in the experimental group than in the control group(t>2.699,P<0.01),expect hypnotic drug use(P>0.05);the total sleep time,deep sleep time and rapid eye movement sleep time became longer in both groups(|t|>7.270,P<0.001),and they were longer in the experimental group than in the control group(|t|>5.712,P<0.001);the scores of SAS and SDS decreased in both groups(t>9.530,P<0.001),and they were less in the experimental group than in the control group(t>4.740,P<0.001).Conclusion Synchronous brain bionic electrical stimulation in hyperbaric oxygen chamber could effectively prolong the total sleep time,deep sleep time and rapid eye movement time of patients with stroke-related sleep disorders,re-lieve anxiety and depression after stroke,and improve sleep quality.

OBJECTIVE: To establish a rapid detection and genotyping method for SARS-CoV-2 Omicron BA.4/5 variants using CRISPPR-Cas12a gene editing technology. METHODS: We combined reverse transcription-polymerase chain reaction (RT-PCR) and CRISPR gene editing technology and designed a specific CRISPPR RNA (crRNA) with suboptimal protospacer adjacent motifs (PAM) for rapid detection and genotyping of SARS- CoV-2 Omicron BA.4/5 variants. The performance of this RT- PCR/ CRISPPR-Cas12a assay was evaluated using 43 clinical samples of patients infected by wild-type SARS-CoV-2 and the Alpha, Beta, Delta, Omicron BA. 1 and BA. 4/5 variants and 20 SARS- CoV- 2-negative clinical samples infected with 11 respiratory pathogens. With Sanger sequencing method as the gold standard, the specificity, sensitivity, concordance (Kappa) and area under the ROC curve (AUC) of RT-PCR/CRISPPR-Cas12a assay were calculated. RESULTS: This assay was capable of rapid and specific detection of SARS- CoV-2 Omicron BA.4/5 variant within 30 min with the lowest detection limit of 10 copies/μL, and no cross-reaction was observed in SARS-CoV-2-negative clinical samples infected with 11 common respiratory pathogens. The two Omicron BA.4/5 specific crRNAs (crRNA-1 and crRNA-2) allowed the assay to accurately distinguish Omicron BA.4/5 from BA.1 sublineage and other major SARS-CoV-2 variants of concern. For detection of SARS-CoV-2 Omicron BA.4/5 variants, the sensitivity of the established assay using crRNA-1 and crRNA-2 was 97.83% and 100% with specificity of 100% and AUC of 0.998 and 1.000, respectively, and their concordance rate with Sanger sequencing method was 92.83% and 96.41%, respectively. CONCLUSION By combining RT-PCR and CRISPPR-Cas12a gene editing technology, we successfully developed a new method for rapid detection and identification of SARS-CoV-2 Omicron BA.4/5 variants with a high sensitivity, specificity and reproducibility, which allows rapid detection and genotyping of SARS- CoV-2 variants and monitoring of the emerging variants and their dissemination.
Humans ; COVID-19 ; CRISPR-Cas Systems ; Genotype ; Reproducibility of Results ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2/genetics* ; RNA ; COVID-19 Testing

Hepatosteatosis is characterized by abnormal accumulation of triglycerides(TG),leading to prolonged and chronic inflammatory infiltration.To date,there is still a lack of effective and economical therapies for hepatosteatosis.Oridonin(ORI)is a major bioactive component extracted from the traditional Chinese medicinal herb Rabdosia rubescens.In this paper,we showed that ORI exerted significant protective ef-fects against hepatic steatosis,inflammation and fibrosis,which was dependent on LXRα signaling.It is reported that LXRα regulated lipid homeostasis between triglyceride(TG)and phosphatidylethanol-amine(PE)by promoting ATCL and EPT1 expression.Therefore,we implemented the lipidomic strategy and luciferase reporter assay to verify that ORI contributed to the homeostasis of lipids via the regulation of the ATGL gene associated with TG hydrolysis and the EPT1 gene related to PE synthesis in a LXRα-dependent manner,and the results showed the TG reduction and PE elevation.In detail,hepatic TG overload and lipotoxicity were reversed after ORI treatment by modulating the ATCL and EPT1 genes,respectively.Taken together,the data provide mechanistic insights to explain the bioactivity of ORI in attenuating TG accumulation and cytotoxicity and introduce exciting opportunities for developing novel natural activators of the LXRα-ATGL/EPT1 axis for pharmacologically treating hepatosteatosis and metabolic disorders.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective::To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta (PA).Methods::This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. According to the intraoperative findings after delivery, the study population was divided into PA and non-PA groups. We compared the pregnancy outcomes between the two groups, used multivariate logistic regression to analyze the risk factors for placental accreta.Results::For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage (236/10,205, 2.31% vs. 283/869, 32.57%), severe postpartum hemorrhage (89/10,205, 0.87% vs. 186/869, 21.75%), diffuse intravascular coagulation (3/10,205, 0.03% vs. 4/869, 0.46%), puerperal infection (33/10,205, 0.32% vs. 12/869, 1.38%), intraoperative bladder injury (1/10,205, 0.01% vs. 16/869, 1.84%), hysterectomy (130/10,205, 1.27% vs. 59/869, 6.79%), and blood transfusion (328/10,205,3.21 % vs. 231/869,26.58%) was significantly increased in the PA group ( P < 0.05). At the same time, the neonatal birth weight (3250.00 (2950.00-3520.00) g vs. 2920.00 (2530.00-3250.00) g), the probability of neonatal comorbidities (245/10,205, 2.40% vs. 61/869, 7.02%), and the rate of neonatal intensive care unit admission (817/10,205, 8.01% vs. 210/869, 24.17%) also increased significantly ( P < 0.05). Weight (odds ratio ( OR)= 1.03, 95% confidence interval ( CI): 1.01-1.05)), parity ( OR= 1.18, 95% CI: 1.03-1.34), number of miscarriages ( OR= 1.31, 95% CI: 1.17-1.47), number of previous cesarean sections ( OR= 2.57, 95% CI: 2.02-3.26), history of premature rupture of membrane ( OR= 1.61, 95% CI: 1.32-1.96), previous cesarean-section transverse incisions ( OR= 1.38, 95% CI: 1.12-1.69), history of placenta previa ( OR= 2.44,95% CI: 1.50-3.96), and the combination of prenatal hemorrhage ( OR= 9.95,95% CI: 8.42-11.75) and placenta previa ( OR= 91.74, 95% CI: 74.11-113.56) were all independent risk factors for PA. Conclusion::There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Objective:To evaluate the efficacy of combination of toy and cartoon video-assisted admission in preventing agitation during recovery from general anesthesia in preschool children.Methods:Totally 96 children who undergoing elective surgery from July 2018 to October 2019 in Guangzhou Women and Children′s Medical Center were divided into experimental group ( n=48) and control group ( n=48). Two groups were admitted to the general preoperative waiting room for 60 minutes before the operation, and children in the experimental group recieved toy and cartoon video combination intervention, while children in the control group were subjected to routine nursing intervention. The children′s agitation was assessed by using Pediatric Anesthesia Emergence Delirium Scale (PAED) when children entered the post-anesthesia care unit (PACU), 10 minutes after in PACU and leave PACU. In addition, the vital signs such as blood pressure, heart rate, respiratory rate of the two groups were also recorded. Results:The emergence time and duration of PACU stay in the experimental group were (17.19±1.76) minutes and (22.47±2.36) minutes, significantly shortern than in the control group (18.36±2.19) minutes and (23.82±2.62) minutes, the difference was statistically significant ( t values were 2.760, 2.546, P<0.05). 10 minutes after in PACU and out of PACU, the PAED scores, systolic pressure, heart rate, respiratory rate was [7.56±1.86, 4.60±1.19, (108.12±10.19)mmHg, (102.72±8.55) mmHg, (112.91±6.10) times/minute, (106.39±6.75) times/minute, (18.87±1.98) times/minute, (17.49±1.68) times/minute], significantly lower than those in the control group [13.40±1.47, 6.71±2.21, (116.73±14.17)mmHg, (107.62±12.44) mmHg, (121.07±8.07) times/minute, (114.69±5.78) times/minute, (20.96±1.86) times/minute, (18.47±1.63) times/minute], the difference was statistically significant ( t values were 2.162-16.332, P<0.05). Conclusion:Toy and cartoon video combine-assisted admission can reduce the agitation and stable vital signs during recovery from general anesthesia in preschool children.

Objective:To investigate the quality of life of senior women with urinary incontinence and to explore its influencing factors.Methods:A convenient sampling method was used to select 152 senior women with urinary incontinence in Fuzhou Hot-Spring Street Community, Dongjie Street Community and Old-age Care Institutions from June 2017 to September 2017. The quality of life of elderly women with urinary incontinence were observed and the influencing factors were analyzed via International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and Incontinence Quality of Life Scale (I-QOL).Results:The quality of life of senior women with urinary incontinence was (98.7±12.2) points. The scores of the three dimensions including restrictive behavior, social activity limitation and psychological impact were 34.5±4.4 and 41.4±5.4 and 20.8 ± 3.5, respectively. There were 4 factors that influencing the quality of life of patients, namely, the severity of urinary incontinence, the type of urinary incontinence, diabetes and the frequency of leaking urine ( P<0.01). Conclusions:Urinary incontinence has a certain negative impact on the quality of life of patients, and its influencing factors are complex. Individualized care measures should be taken based on the influencing factors to improve the quality of life of patients.

OBJECTIVE:To evaluate the effectiveness and safety of repaglinide combined with metformin versus glimepiride combined with metformin in the treatment of type 2 diabetes mellitus (T2DM),and to provide evidence-based reference for the clinic. METHODS:Retrieved from CJFD, VIP, Wanfang database, PubMed, Embase, Medline and Cochrane Library, randomized controlled trials (RCTs) about therapeutic efficacy (HbA1c, FPG, 2 hPG) and safety (the incidence of ADR,hypoglycemia and gastrointestinal reaction)of repaglinide combined with metformin(trial group)versus glimepiride combined with metformin(control group)in the treatment of T2DM were collected. Meta-analysis was performed by using Rev Man 5.2 statistical software after data extraction and quality evaluation with Cochrane systematic evaluation manual. RESULTS:A total of 12 RCTs were included,involving 957 patients. Results of Meta-analysis showed that the decrease of 2 hPG in trial group was significantly better than control group,with statistical significance [MD=-0.70,95％CI(-1.02,-0.38),P<0.001]. There was no statistical significance in the decrease of HbA1c [MD=0.00,95％CI(-0.24,0.25),P=0.98] or FPG [MD=0.10,95％CI(-0.17,0.36),P=0.47],the incidence of ADR [OR=0.54,95％CI(0.28,1.06),P=0.07],hypoglycemia [OR=0.52,95％CI(0.13,2.06),P=0.35] or gastrointestinal reactions [OR=0.60,95％CI(0.15,2.41),P=0.47] between 2 groups. CONCLUSIONS:Repaglinide combined with metformin is better than glimepiride combined with metformin in reducing 2 hPG,but both of them have similar safety.