Objective:To combine the conventional audiometric curves and extended high frequency audiometric curves of patients with sensorineural deafness to form a full-frequency audiometric curve and to perform typing, so as to comprehensively understand the hearing status of patients with sensorineural deafness.Methods:This study was a cross-sectional study. The study subjects included 249 patients with sensorineural hearing loss who visited the Otolaryngology-Head and Neck Surgery outpatient clinic of the PLA General Hospital between July 2019 and December 2020. Among them, 146 were male and 103 were female, aged 11 to 80 years. The cases included 123 with mild hearing loss, 70 with moderate hearing loss, 32 with moderately severe hearing loss, 17 with severe hearing loss, 6 with profound hearing loss, and 1 with total deafness. According to the national standard GB/T16403-1996, conventional pure-tone audiometry (125-8 000 Hz) was performed on the 249 patients with sensorineural hearing loss to obtain their conventional-frequency hearing curves, which were then classified. Extended high-frequency pure-tone threshold testing (9 000-20 000 Hz) was conducted using extended high-frequency headphones, specifically including eight frequencies: 9 000, 10 000, 11 200, 12 500, 14 000, 16 000, 18 000, and 20 000 Hz. Ultimately, the full-frequency hearing curves (125-20 000 Hz) of each patient were obtained. The K-means clustering analysis method was used to classify the hearing curves based on their characteristics, and the results of the K-means clustering analysis were partially adjusted through manual screening.Results:The conventional hearing curves of all 249 patients were consistent with sensorineural hearing loss. The detection rates for extended high frequencies (9 000, 10 000, 11 200, 12 500, 14 000, 16 000, 18 000, and 20 000 Hz) were 96.79% (241/249), 94.38% (235/249), 87.95% (219/249), 78.31% (195/249), 65.46% (163/249), 22.09% (55/249), 10.84% (27/249), and 0.80% (2/249), respectively. The conventional-frequency hearing curves of the patients could be classified into the following types: low-frequency descending type (50/249, 20.08%), conventional-frequency steep descending type (78/249, 31.33%), conventional-frequency gradual descending type (58/249, 23.29%), conventional-frequency flat type (25/249, 10.04%), conventional-frequency 4 000 Hz notch type (30/249, 12.05%), and other types (8/249, 3.21%). By incorporating extended high-frequency hearing data, the full-frequency hearing curves of 235 patients were further classified into the following types based on different characteristics: full-frequency hill type (32/235, 13.62%), full-frequency ascending type (28/235, 11.91%), full-frequency 8 000 Hz notch type (14/235, 5.96%), full-frequency steep descending type (82/235, 34.89%), full-frequency gradual descending type (34/235, 14.47%), full-frequency shoulder-raising type (7/235, 2.98%), full-frequency shoulder-dropping type (25/235, 10.64%), full-frequency flat type (8/235, 3.40%), and other full-frequency types (5/235, 2.13%).Conclusions:Compared to the classification based on conventional-frequency hearing curves, the full-frequency hearing curves of patients with sensorineural hearing loss provide a more comprehensive representation of their overall hearing status. Patients with the same conventional-frequency hearing curve classification may exhibit different full-frequency hearing curve types, suggesting potential differences in the location and extent of pathological damage within their auditory systems.

Objective:To combine the conventional audiometric curves and extended high frequency audiometric curves of patients with sensorineural deafness to form a full-frequency audiometric curve and to perform typing, so as to comprehensively understand the hearing status of patients with sensorineural deafness.Methods:This study was a cross-sectional study. The study subjects included 249 patients with sensorineural hearing loss who visited the Otolaryngology-Head and Neck Surgery outpatient clinic of the PLA General Hospital between July 2019 and December 2020. Among them, 146 were male and 103 were female, aged 11 to 80 years. The cases included 123 with mild hearing loss, 70 with moderate hearing loss, 32 with moderately severe hearing loss, 17 with severe hearing loss, 6 with profound hearing loss, and 1 with total deafness. According to the national standard GB/T16403-1996, conventional pure-tone audiometry (125-8 000 Hz) was performed on the 249 patients with sensorineural hearing loss to obtain their conventional-frequency hearing curves, which were then classified. Extended high-frequency pure-tone threshold testing (9 000-20 000 Hz) was conducted using extended high-frequency headphones, specifically including eight frequencies: 9 000, 10 000, 11 200, 12 500, 14 000, 16 000, 18 000, and 20 000 Hz. Ultimately, the full-frequency hearing curves (125-20 000 Hz) of each patient were obtained. The K-means clustering analysis method was used to classify the hearing curves based on their characteristics, and the results of the K-means clustering analysis were partially adjusted through manual screening.Results:The conventional hearing curves of all 249 patients were consistent with sensorineural hearing loss. The detection rates for extended high frequencies (9 000, 10 000, 11 200, 12 500, 14 000, 16 000, 18 000, and 20 000 Hz) were 96.79% (241/249), 94.38% (235/249), 87.95% (219/249), 78.31% (195/249), 65.46% (163/249), 22.09% (55/249), 10.84% (27/249), and 0.80% (2/249), respectively. The conventional-frequency hearing curves of the patients could be classified into the following types: low-frequency descending type (50/249, 20.08%), conventional-frequency steep descending type (78/249, 31.33%), conventional-frequency gradual descending type (58/249, 23.29%), conventional-frequency flat type (25/249, 10.04%), conventional-frequency 4 000 Hz notch type (30/249, 12.05%), and other types (8/249, 3.21%). By incorporating extended high-frequency hearing data, the full-frequency hearing curves of 235 patients were further classified into the following types based on different characteristics: full-frequency hill type (32/235, 13.62%), full-frequency ascending type (28/235, 11.91%), full-frequency 8 000 Hz notch type (14/235, 5.96%), full-frequency steep descending type (82/235, 34.89%), full-frequency gradual descending type (34/235, 14.47%), full-frequency shoulder-raising type (7/235, 2.98%), full-frequency shoulder-dropping type (25/235, 10.64%), full-frequency flat type (8/235, 3.40%), and other full-frequency types (5/235, 2.13%).Conclusions:Compared to the classification based on conventional-frequency hearing curves, the full-frequency hearing curves of patients with sensorineural hearing loss provide a more comprehensive representation of their overall hearing status. Patients with the same conventional-frequency hearing curve classification may exhibit different full-frequency hearing curve types, suggesting potential differences in the location and extent of pathological damage within their auditory systems.

OBJECTIVES: To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression. METHODS: A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression. RESULTS: The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05). CONCLUSIONS In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.
Humans ; Adolescent ; Female ; Male ; Depression/psychology* ; Psychotherapy/methods* ; Fear/psychology* ; Prospective Studies ; Surveys and Questionnaires

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human’s health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumulates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human’s health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumulates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

ObjectiveTo collect and screen records concerning the spleen and stomach diseases and syndromes in ancient books of traditional Chinese medicine （TCM） using an automated framework and to systematically explore the concept evolution of spleen and stomach diseases and syndromes using the visualization method. MethodA total of 1 224 kinds of ancient book data in the Ancient Books of Traditional Chinese Medicine Database （V2.1） were analyzed using the automated testing tool Selenium WebDriver with the Python 3.8 programming language and the etree library of Lxml for automatic collection and statistics of the "book title" "author" "classification" "dynasty" "completion time"， and "informative abstract". After being checked and collated， the collected data were visually analyzed with Tableau （V2020.1.3） for figuring out the concept evolution of spleen and stomach diseases and syndromes in the past dynasties from the perspectives of symptoms and signs， etiology and pathogenesis， principle-method-recipe-medicinal， and prognosis. ResultA total of 7 203 clauses were automatically collected from 989 ancient books. It was found that in the pre-Qin period， there were few ancient books related to the spleen and stomach diseases and syndromes， and the understandings were confined to the superficial symptoms or signs and the basic etiology and pathogenesis. From the Han to Sui and Tang dynasties， the related concepts gradually increased and the descriptions about the manifestations are more detailed than those in previous dynasties. The etiology， diagnosis， and treatment system of the spleen and stomach diseases and syndromes were further perfected. In the Song， Jin， and Yuan dynasties， such concepts as independent signs，symptoms， as well as nature and location of spleen and stomach diseases and syndromes were enriched. In the Ming and Qing dynasties， a TCM syndrome differentiation and treatment system for spleen and stomach diseases and syndromes was formed， and the related concepts were gradually simplified and unified. ConclusionThe concepts of spleen and stomach diseases and syndromes have undergone an evolution from simplicity to complexity and then back to simplicity. There are numerous ancient books discussing the concepts of spleen and stomach diseases and syndromes， exhibiting a fluctuating yet rising trend with time. The automated framework enables the construction of a lightweight database of spleen and stomach diseases and syndromes. Based on data visualization， the concept evolution of the spleen and stomach diseases and syndromes from ancient times to the present has been efficiently uncovered， which is conducive to tracing the origin and development of spleen and stomach diseases and syndromes in TCM. This has provided reference for related research of spleen and stomach diseases in modern Chinese medicine.

OBJECTIVE: To investigate the introduction of vegetables and fruits in 4-8 months old infants, and to describe the maternal and infants' characteristics associated with the introduction of vegetables and fruits. METHODS: Mother-infant dyads (n=228) were recruited from 12 to 16 weeks postpartum and formally entered the study at 4 months of age. Data collected via face to face interview at 4-8 months postpartum, including the timing and types of added vegetables and fruits, as well as a variety of maternal and infant characteristics (n=204). Rank sum test and multiple linear regression were used to analyze the maternal and infant characteristics related to the introduction of vegetables and fruits. RESULTS: The time of introducing vegetables was concentrated at the age of 7 months, and the time of adding fruits was mainly at 6 months. Fruits were added earlier than vegetables (P < 0.001), and the variety of the added fruits was higher than that of vegetables (P=0.045). 48% (n=98) of infants had no more than three types of fruits and vegetables at 8 months. Only 9.8% (n=20) had added more than 10 kinds of fruits and vegetables at 8 months. Green leafy vegetables were the most commonly added vegetable, and apple was the most popular fruit. Compared with women who were 35 years of age or younger, women beyond 35 years old introduced vegetables to their babies 0.6 months later. 4-month-old exclusively breastfed infants had vegetables 0.4 months later than mixed-fed infants. Women with a bachelor's degree or above added 2-3 more types of fruits and vegetables to their babies than those with junior high school education and below. CONCLUSION The adding time of fruits was earlier than that of vegetable. Apples and green leafy vegetables are commonly added. Women with lower educational backgrounds add fewer types of fruits and vegetables to their babies. Mothers who choose exclusive breastfeeding and those over 35 years of age at childbirth add vegetables to their babies later than others. They should be targeted for health promotion programs that aim to improve the intake of fruits and vegetables among infants.
Adult ; Beijing ; Breast Feeding ; Female ; Follow-Up Studies ; Fruit ; Humans ; Infant ; Infant, Newborn ; Vegetables

Zhachong Shisanwei Pills, composed of 13 Chinese medicinal materials, are used for treating the diseases such as hemiplegia, pain of muscles and bones, rheumatism, and joint pain. The chemical composition and pharmacodynamics of Zhachong Shisanwei Pills have not been reported. Ultra-performance liquid chromatography/quadrupole-time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS/MS) was employed to quickly identify the chemical components of Zhachong Shisanwei Pills, which was performed with Shim-pack GIST C_(18) column(4.6 mm×150 mm, 5 μm). The gradient elution was conducted with methanol-0.05% acetic acid as the mobile phase. Electrospray ionization mass spectrometry(ESI-MS) was carried out in both positive and negative ion modes. The compounds were identidied based on accurate relative molecular weight, fragment ion species, and the MS data of reference substances and in literature. In conclusion, a total of 98 compounds were identified, including 19 organic acids, 36 flavonoids, 13 volatile oils, 8 tannins, 5 2-(2-phenylethyl)chromones, 5 amino acids, 3 sesquiterpenoids, 3 alkaloids, and 2 other compounds. This study characte-rized the chemical components of Zhachong Shisanwei Pills rapidly for the first time, laying a foundation for further research on the pharmacodynamic material basis and quality evaluation.
Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Drugs, Chinese Herbal/chemistry* ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

BACKGROUND: It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011. METHODS: A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided). RESULTS: The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107). CONCLUSIONS: The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly. TRIAL REGISTRATION NUMBER NCT03620565, https://register.clinicaltrials.gov.
China ; Female ; Gynecologic Surgical Procedures/adverse effects* ; Humans ; Pelvic Floor/surgery* ; Pelvic Organ Prolapse/surgery* ; Surgical Mesh/adverse effects* ; Treatment Outcome ; Vagina