Patients with sudden deafness encounter greater psychological challenges and communication barriers after experiencing sudden hearing loss， and traditional medical models often fail to adequately address their unique needs. This paper analyzed the current situation of emotional and behavioral changes in patients with sudden deafness， and the gap between their expectations and the reality of medical care. From the perspective of narrative medicine， the theory and characteristics of the reconstruction of the doctor-patient relationships in patients with sudden deafness were explored. The results showed that narrative medicine can enhance patients’ emotional resonance and understanding， improve the efficiency and quality of doctor-patient communication， promote the formulation of personalized treatment plans， and enhance treatment adherence and satisfaction. Based on these results， strategies and pathways for the reconstruction of doctor-patient relationships for patients with sudden deafness were proposed， including building empathetic bridges and tapping into mechanisms of emotional resonance within narrative medicine； optimizing communication strategies and promoting the application of narrative techniques in doctor-patient dialogues； connecting narrative pathways and advocating the exploration of stories and strategies in personalized treatments； as well as facilitating treatment adherence and making full use of the psychodynamic effects of narrative medicine. Narrative medicine， as a patient-centered medical practice， can effectively promote the reconstruction of doctor-patient relationships， enhance treatment effectiveness， and offer a more humane treatment experience for patients.

Objective:To improve the understanding of patients with diffuse large B-cell lymphoma (DLBCL) with pulmonary cryptococcosis.Methods:The clinical data of 1 DLBCL patient with pulmonary cryptococcosis in the Central Hospital of Fengxian District of Shanghai in May 2023 were retrospectively analyzed, and the relevant literatures were reviewed.Results:This 75-year-old female patient was asymptomatic after 2 cycles of R-CHOP chemotherapy. The high-resolution CT of lung showed that lung nodules were progressively enlarged. Antibacterial treatment was ineffective. Pulmonary cryptococcosis was confirmed by bronchoalveolar lavage fluid (BALF) targeted high-throughput sequencing (tNGS) and cryptococcus capsular antigen (CrAg) detection. The central nervous system was not involved. And the long-term adequate-dose fluconazole was prescribed for 6 months, and the treatment against lymphoma was given synchronously. The lung nodule lesions reduced after antifungal therapy for 1 month. The lung nodules disappeared after the follow-up of 6 months after completion of final chemotherapy. The evaluation of lymphoma indicated complete remission.Conclusions:Pulmonary cryptococcosis occurs insidiously and shows no specific symptoms; its imaging manifestations are variable and routine anti-infection is ineffective. Immunochemotherapy for lymphoma patients is a high-risk factor for cryptococcal infection. tNGS and CrAg testing for BALF are effective methods of the confirmed diagnosis. The early and long-term adequate-dose antifungal treatment is the key to preventing the recurrence or progression.

BACKGROUND:Protein is one of the essential nutrients for the human body and is a key component of human cell tissue.Protein supplementation can promote the synthesis of myofibrillar protein and play a key role in strength training.However,the interaction mechanism and signaling pathway between protein and exercise are still unclear.OBJECTIVE:To explore the mechanism of interaction between exercise and protein,and to optimize the benefits of protein supplementation on exercise performance.METHODS:Using"sports,proteins,amino acids,polypeptide,interaction mechanisms,signaling pathway"as Chinese and English search terms,we searched WanFang Data,CNKI,VIP,and PubMed databases respectively.Articles were screened according to the inclusion criteria,and finally 73 articles were included in the review.RESULTS AND CONCLUSION:Current research on protein supplementation promoting exercise performance mainly focuses on promoting muscle growth,endurance improvement,and body recovery through protein supplementation,but there are differences in the existing experimental results.The interaction mechanism between protein molecules and proteins in the body is not yet clear.The research on the interaction mechanism between exercise and peptides is still in its infancy.Exercise can stimulate the full absorption of external protein intake,which can affect the mechanism of protein molecules in the body.Supplementing peptide nutrition can more accurately affect the body's state,thus better eliminating the phenomena of"sub-health"and"modern diseases."Therefore,studying the interaction mechanism between exercise and proteins is particularly important,delving into the specific mechanisms by which amino acids act on the body,and further exploring the interaction mechanism between exercise and peptides.

A 57-year-old male patient with ulcerative colitis for more than 8 years was treated with mesalazine sustained-release granules 0.5 g thrice daily orally in the early stages of the disease, and the patient′s condition was improved. Chest CT scan showed no abnormalities in both lungs. The patient stopped taking the medication intermittently due to the remission of the condition over the course of 8 years, and due to the recurrence and worsening of symptoms, the dosage of mesalazine sustained-release granules was increased 3 times to 1 g orally, 4 times a day. At the first time, the patient experienced skin itching after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 3 days. Afterwards, the dosage was reduced to 0.5 g thrice daily orally, and the patient′s skin itching did not recur. At the second time, the patient experienced skin itching on the trunk and limbs, chest tightness, and coughing 1 week after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 2 days. At the third time, the patient experienced skin itching, chest tightness, and cough after taking increased dose of mesalazine for 1 day, which relieved after stopping the medication for 1 day. Laboratory tests showed no abnormalities in blood routine and C-reactive protein. High resolution CT scan of the chest revealed patchy ground glass opacities in both lungs, linear opacities in the lower lobes of both lungs, and cystic translucent opacities in the pleura of both lungs. Allergic pneumonia caused by mesalazine was considered.

A 57-year-old male patient with ulcerative colitis for more than 8 years was treated with mesalazine sustained-release granules 0.5 g thrice daily orally in the early stages of the disease, and the patient′s condition was improved. Chest CT scan showed no abnormalities in both lungs. The patient stopped taking the medication intermittently due to the remission of the condition over the course of 8 years, and due to the recurrence and worsening of symptoms, the dosage of mesalazine sustained-release granules was increased 3 times to 1 g orally, 4 times a day. At the first time, the patient experienced skin itching after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 3 days. Afterwards, the dosage was reduced to 0.5 g thrice daily orally, and the patient′s skin itching did not recur. At the second time, the patient experienced skin itching on the trunk and limbs, chest tightness, and coughing 1 week after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 2 days. At the third time, the patient experienced skin itching, chest tightness, and cough after taking increased dose of mesalazine for 1 day, which relieved after stopping the medication for 1 day. Laboratory tests showed no abnormalities in blood routine and C-reactive protein. High resolution CT scan of the chest revealed patchy ground glass opacities in both lungs, linear opacities in the lower lobes of both lungs, and cystic translucent opacities in the pleura of both lungs. Allergic pneumonia caused by mesalazine was considered.

BACKGROUND:Protein is one of the essential nutrients for the human body and is a key component of human cell tissue.Protein supplementation can promote the synthesis of myofibrillar protein and play a key role in strength training.However,the interaction mechanism and signaling pathway between protein and exercise are still unclear.OBJECTIVE:To explore the mechanism of interaction between exercise and protein,and to optimize the benefits of protein supplementation on exercise performance.METHODS:Using"sports,proteins,amino acids,polypeptide,interaction mechanisms,signaling pathway"as Chinese and English search terms,we searched WanFang Data,CNKI,VIP,and PubMed databases respectively.Articles were screened according to the inclusion criteria,and finally 73 articles were included in the review.RESULTS AND CONCLUSION:Current research on protein supplementation promoting exercise performance mainly focuses on promoting muscle growth,endurance improvement,and body recovery through protein supplementation,but there are differences in the existing experimental results.The interaction mechanism between protein molecules and proteins in the body is not yet clear.The research on the interaction mechanism between exercise and peptides is still in its infancy.Exercise can stimulate the full absorption of external protein intake,which can affect the mechanism of protein molecules in the body.Supplementing peptide nutrition can more accurately affect the body's state,thus better eliminating the phenomena of"sub-health"and"modern diseases."Therefore,studying the interaction mechanism between exercise and proteins is particularly important,delving into the specific mechanisms by which amino acids act on the body,and further exploring the interaction mechanism between exercise and peptides.

Objective To investigate the predictive value of color Doppler ultrasound parameters for fetal growth restriction (FGR) induced by hypertensive disorders of pregnancy in high-altitude regions. Methods Pregnant women with gestational hypertension who were treated between July 2020 and June 2022 at the Affiliated Hospital of Qinghai University (with altitude of 2, 300 meters, were divided into group A1 with 19 cases and group A2 with 51 cases according to occurrence of FGR), Yushu People's Hospital (with altitude of 3, 700 meters, were divided into group B1 with 25 cases and group B2 with 47 cases according to occurrence of FGR), and Civil Aviation Clinical Medical College of Peking University (plain region, control group with 71 cases) were enrolled in this study. All pregnant women in each group underwent fetal color Doppler ultrasound examination of the middle cerebral artery (MCA) and umbilical artery (UA) blood flow parameters, including pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D), peak systolicvelocity (PSV), and cerebroplacental ratio (CPR) at 28 weeks of gestation were detected. Multivariate Logistic regression analysis was performed to identify independent risk factors for FGR in pregnant women with gestational hypertension. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of color Doppler parametersfor FGR. Results The UA blood flow parameters (PI, RI, S/D, PSV) of the fetuses in groups A1, A2, B1, and B2 were significantly higher than those in the control group, while the MCA blood flow parameters (PI, RI, S/D, PSV) and CPR were significantly lower (P < 0.05). Among the five groups, group B1 had the highest UA blood flow parameters (PI, RI, S/D, PSV) and the lowest MCA blood flow parameters (PI, RI, S/D, PSV) and CPR (P < 0.05). Multivariate Logistic regression analysis revealed that high altitude of residence and umbilical cord abnormalities were independent risk factors for FGR in pregnant women with gestational hypertension (P < 0.05). ROC curve analysis showed that the areas under the curves for the combined prediction of FGR in pregnant women with gestational hypertension at altitudes of 2, 300 meters and 3, 700 meters using color Doppler multi-parameters were 0.906 and 0.917, respectively, indicating a significantly higher predictive performance compared to individual parameter (P < 0.05). Conclusion Color Doppler ultrasound parameters of UA and MCA bloodflow during the second trimester of pregnancy demonstrate good predictive value for FGR induced by hypertensive disorders of pregnancy in high-altitude regions at different altitudes, and the predictive performance is even higher when multiple parameters are combined.

Objective:To identify the genetic causes of adverse pregnancy outcomes in five families and provide a basis for rational guidance on genetic and reproductive counseling.Methods:A retrospective analysis was conducted on five families with a history of adverse pregnancy outcomes, where one partner was found to have a cryptic balanced translocation. These cases were identified among pregnant women who underwent invasive prenatal diagnosis at the Department of Medical Genetics and Prenatal Diagnosis, Wuxi Maternity and Child Health Care Hospital, from January 2016 to June 2023. Conventional G-banding karyotyping and chromosomal microarray analysis (CMA) were performed on affected children/fetus samples. Chromosome G-banding and fluorescence in situ hybridization (FISH) were used for parental tracing. Genetic counseling was provided for all cases, and the pregnancy outcomes were followed up. Descriptive analysis was applied in this study. Results:Case 1 involved an eldest son with unexplained intellectual disability, and the CMA results showed an 8.6 Mb deletion in the 4p16.3p16.1 region and a 1.0 Mb duplication in the 7q36.3 region. Unbalanced translocations were detected in the current pregnancies of the other four cases, which were a 6.1 Mb duplication in the 14q32.2q32.33 region with a 1.6 Mb deletion in the 21q22.3 region (Case 2), a 10.8 Mb duplication in the 6q25.3q27 region with a 1.2 Mb deletion in the 15q26.3 region (Case 3), a 1.0 Mb duplication in the 5p15.33 region with a 2.9 Mb deletion in the 6q27 region (Case 4), and a 3.2 Mb deletion in the 1q44 region with a 4.8 Mb duplication in the 19p13.3 region (Case 5). FISH confirmed that either the husband or the wife in each of the five families was a carrier of a cryptic balanced translocation. Further CMA testing on amniotic fluid samples from previous terminated pregnancies of Cases 3 and 4 also indicated unbalanced translocations. Both the current pregnancy of Case 1 and the subsequent pregnancy of Case 2 gave birth to healthy babies after non-abnormal prenatal diagnosis and genetic counseling. Cases 3 to 5 are currently preparing for pregnancy.Conclusion:Advances and combined application of genetic technologies will be conducive to improving the diagnosis of cryptic balanced translocations in some families with adverse pregnancy outcomes, providing a sound basis for genetic counseling in future pregnancy.

Objective This paper aims to address the challenges of hospital equipment management by implementing the life cycle management system in the medical laboratories of public hospitals.Methods Based on the three principles of standard-ization,refinement,and dynamism,this paper conducted data tracking and managed equipment analysis with specifications dur-ing the processes of planning,discussion,procurement,acceptance,operation,maintenance,performance evaluation,scrap-ping,and updating.Results After implementing life cycle management,the average risk level significantly decreased compared to pre-implementation(P＜0.05).Budget implementation efficiency increased by 14.53％from 2019 to 2023.The investment payback period was controlled within 2 years.Conclusion The application of the life cycle management system to equipment management in medical laboratories of public hospitals is of great significance for the high-quality development of hospitals.

Objective:To develop a health behavior guidance program for stroke rehabilitation patients based on the adaptive leadership framework (ALF) .Methods:Relevant stroke health behavior guidelines were systematically retrieved, screened, included, and recommendations extracted from domestic and international websites. The initial draft of the health behavior guidance program for stroke rehabilitation patients was developed in light of the ALF. From January to March 2022, the draft was refined through two rounds of Delphi expert consultation, resulting in the finalized health behavior guidance program.Results:A total of 10 guidelines were included, and 73 guideline recommendations were extracted. These recommendations were categorized into six dimensions and 25 specific items. In both rounds of expert consultation, 15 questionnaires were distributed and all were returned, yielding an effective recovery rate of 100.00%, with an expert authority coefficient greater than 0.8. Based on expert feedback and group discussions, the final program included eight dimensions and 31 items, adding sleep management and regular health consultations to the original six dimensions.Conclusions:The health behavior guidance program for stroke rehabilitation patients, based on the ALF, introduces a new perspective on nursing by reasonably dividing adaptive and technical problems. This approach aligns with clinical practice in China, providing scientific and practical value for promoting health behaviors and offering a new perspective for health education in stroke patients.