OBJECTIVE To compare and analyze the clinical efficacy and safety of postauricular versus intratympanic dexamethasone injection in the treatment of sudden sensorineural hearing loss （SSNHL） with all frequency loss. METHODS A retrospective study was conducted on 150 patients with SSNHL with all frequency loss who were treated at the Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang University of Chinese Medicine between June 1， 2020， and May 31， 2025. According to different injection routes， the patients were divided into the intratympanic group （intratympanic injection， n ＝78） and the postauricular group （postauricular injection， n ＝72）. The differences in hearing threshold indicators and auditory outcomes before and after treatment， tinnitus/vertigo indicators， coagulation function indicators before and after treatment， as well as adverse reactions during treatment were compared between the two groups. RESULTS After treatment， both groups demonstrated significant reductions in the mean speech-frequency threshold and the mean hearing threshold compared with baseline （ P ＜0.05）， whereas no statistically significant differences were observed between the two groups （ P ＞0.05）. Therapeutic outcomes varied significantly across different degrees of hearing loss in each group （intratympanic group： P ＝0.005； postauricular group： P ＜0.001）. Moreover， a significant linear trend relationship was observed between the degree of hearing loss and treatment efficacy grades （ P ＜0.001）， indicating that the more severe the hearing loss， the poorer the treatment outcome （ P ＜0.05）. Notably， the intratympanic group demonstrated superior efficacy compared with the postauricular group in patients with severe and profound hearing loss （ P ＜0.05）. Among patients presenting with vertigo prior to treatment， the postauricular group exhibited a significantly higher response rate than the intratympanic group （ P ＜0.05）， while no statistically significant difference was observed between the two groups in patients with tinnitus （ P ＞0.05）. Regarding coagulation parameters， fibrinogen （FIB） levels and activated partial thromboplastin time decreased or shortened significantly follo wing therapy （ P ＜0.05）， whereas thrombin time （TT） and prothrombin time were significantly prolonged （ P ＜0.05）. Moreover， the postauricular group showed lower FIB levels and longer TT values compared with the intratympanic group （ P ＜0.05）. No significant differences were identified between the two groups in the incidence of gastrointestinal reactions， bleeding manifestations， hepatic or renal dysfunction， or allergic reactions （ P ＞0.05）； however， vestibular adverse reactions occurred more frequently in the intratympanic group （ P ＜0.05）. CONCLUSIONS Compared with intratympanic injection， postauricular dexamethasone injection combined with conventional treatment regimens achieved comparable efficacy in overall hearing improvement in SSNHL patients with all frequency loss. However， the postauricular injection shows potential advantages in vertigo relief， enhancing treatment response in patients with varying degrees of hearing loss， regulating of coagulation function， and declucing of vestibular adverse reactions， while the intratympanic injection may be more suitable for patients with severe hearing loss.

Objective To investigate the effects of auricular point seed-pressing and earpoint scraping on sleep quality,sleep structure index and neurotransmitter in patients with sleep disorders in neurology department.Methods A total of 110 patients with sleep disorders treated in the Department of Neurology at Nanjing Hospital Affiliated to Nanjing Medical University from June 2022 to June 2024 were selected as the study subjects.The patients were randomly divided into an observation group and a control group using a random number table,with 55 cases in each group.The control group was treated with Estazolam Tablets,while the observation group received auricular point seed-pressing therapy combined with ear scraping therapy.The treatment course lasted for 4 weeks.After treatment,the clinical efficacy of the two groups was evaluated.Changes in the Pittsburgh Sleep Quality Index(PSQI)scores were observed before and after treatment,as well as sleep structure indicators,including total sleep time(TST),sleep latency(SL),arousal index(AI),non-rapid eye movement sleep time(NREM)[light sleep stage(S1),light to moderate sleep stage(S2),moderate sleep stage(S3),deep sleep stage(S4)],actual sleep time(AST),sleep efficiency(SE),and rapid eye movement sleep time(REM).The serum levels of norepinephrine(NE),5-hydroxytryptamine(5-HT),and gamma-aminobutyric acid(GABA)were compared before and after treatment,as well as changes in the Quality of Life Scale(SF-36)scores.The safety and incidence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate in the observation group was 96.61%(53/55),while it was 81.82%(45/55)in the control group.The efficacy of the observation group was superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,the PSQI scores of both groups were significantly improved(P＜0.05),and the observation group showed significantly better improvement in PSQI scores compared to the control group,with a statistically significant difference(P＜0.05).(3)After treatment,the sleep structure indicators in the observation group,including TST,SL,AI,S1,S2,S3,S4,AST,SE,and REM,were significantly improved,and the differences were statistically significant compared to the control group(P＜0.05).(4)After treatment,the serum levels of NE,5-HT,and GABA in both groups were significantly improved,and the observation group showed significantly better improvement in these levels compared to the control group,with a statistically significant difference(P＜0.05).(5)After treatment,the SF-36 scores of both groups were significantly improved,and the observation group showed significantly better improvement in SF-36 scores compared to the control group,with a statistically significant difference(P＜0.05).(6)The total incidence of adverse reactions in the observation group was 0.00%(0/55),while it was 10.91%(6/55)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Auricular point seed-pressing therapy combined with ear scraping therapy for the treatment of sleep disorders at the Department of Neurology can significantly improve patients'sleep quality,enhance sleep structure-related indicators,regulate neurotransmitter levels,thereby improving patients'quality of life with high safety and efficacy.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Cancer is a highly deadly disease, with breast cancer, cervical cancer, endometrial cancer, and ovarian cancer being the most prevalent in women. However, traditional cancer treatments present challenges due to their strong toxic side effects and adverse reactions. Numerous studies have demonstrated that natural products derived from various plants possess therapeutic and preventive properties against cancer. These phytochemicals have been extensively investigated as a potential alternative to conventional chemotherapy drugs, owing to their safety and efficacy. This article provides a comprehensive review of the recent advances in the chemoprevention and mechanisms of phytochemicals against the four major female cancers. The focus will be on how these phytochemicals regulate cancer cell proliferation, apoptosis, invasion, and metastasis to impede cancer progression. Given their extensive clinical applications, phytochemicals hold great promise in the field of cancer treatment. It hopes that this review will inspire more researchers to explore the potential of these natural compounds in combating female cancers.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Objective To establish an artificial intelligence (AI)-assisted platform for detection of parasite eggs, and to evaluate its detection efficiency and accuracy, so as to provide technical supports for elimination of parasitic diseases. Methods A total of 1 003 slides of Enterobius vermicularis, horkworm, Trichuris trichiura, Clonorchis sinensis, Taenia, Ascaris lumbricoides, Schistosoma japonicum, Paragonimus westermani and Fasciolopsis buski eggs were collected, and converted into digital images with an automatated scanning microscope to create a dataset. Based on the Object Detection platform on the Baidu Easy DL model, an AI-assisted platform for detection of parasite eggs was created through procedures of uploading, labeling, training, evaluation and optimization. Then, 70% of the datasets were randomly selected for model training, and the precision, recall and average accuracy were calculated to evaluate the effectiveness of platform for recognition of parasite eggs. In addition, the platform was deployed on the computer and smart phone terminals for use. Results An AI-assisted platform for detection of parasite eggs was successfully created. If the platform was deployed using the public cloud application programming interface (API), the average accuracy, precision and recall of the platform were 93.42%, 92.55% and 89.32% for recognition of parasite eggs. If the platform was deployed using the offline software development kit (SDK), the average accuracy, precision and recall of the platform were 92.97%, 94.78% and 87.63% for recognition of parasite eggs. In addition, the precision of the platform was 97.00% and 96.23% for identification of Taenia and C. sinensis eggs, respectively. Conclusions The AI-assisted platform for detection of parasite eggs has been successfully created, which is high in the accuracy for recognition of parasite eggs and convenient in use. This platform may provide a powerful technical support for parasitic disease diagnosis.

Objective:To investigate the association between exposure to ambient air pollutants and pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), and to clarify the susceptible windows of exposure. Methods:A retrospective cohort study was conducted on 2 071 infertile women aged ≤40 years who underwent the first fresh cleavage stage embryo transfer in the Department of Reproductive Medicine of the First Affiliated Hospital of Harbin Medical University from January 2014 to December 2021. Patients were divided into heating season group and non-heating season group based on whether the start date of gonadotropin (Gn) was during the heating season or not, and baseline data and pregnancy outcomes were compared between the two groups. Daily average levels of six criteria air pollutants [fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), sulfur dioxide (SO 2), carbon monoxide (CO), ozone (O 3) max-8 h] in four discrete periods were obtained. The four discrete periods included period 1, 75 d prior to Gn start to Gn start; period 2, Gn start to oocyte retrieval; period 3, oocyte retrieval to day 3 embryo transfer; period 4, embryo transfer to serum human chorionic gonadotropin test. The primary outcome was ongoing pregnancy. A multiple logistic regression model was used to investigate the association between air pollutant exposure and pregnancy outcomes, adjusted for important confounders. Results:The biochemical pregnancy rate [51.7% (465/900)], the clinical pregnancy rate [45.2% (407/900)], the ongoing pregnancy rate [38.2% (344/900)], and the live birth rate [36.1% (325/900)] in the heating season group were significantly lower than those in the non-heating season group [56.3% (659/1 171), P=0.037; 51.2% (599/1 171), P=0.007; 44.3% (519/1 171), P=0.005; 41.3% (484/1 171), P=0.016]. A significant negative correlation was observed between SO 2 and NO 2 exposure and ongoing pregnancy in all four time windows. SO 2 increased by one interquartile range (IQR), corresponding to adjusted OR (a OR) and 95% CI were 0.92 (0.85-0.99), 0.92 (0.87-0.99), 0.93 (0.87-0.99) and 0.93 (0.87-0.99), respectively. An IQR increase in NO 2 was also significantly associated with decreased odds of ongoing pregnancy (a OR=0.83, 95% CI: 0.72-0.95; a OR=0.87, 95% CI: 0.77-0.97; a OR=0.90, 95% CI: 0.81-1.00; a OR=0.85, 95% CI: 0.77-0.95, respectively). During period 1 and period 4, we observed adverse effects of PM 10 exposure on ongoing pregnancy (a OR=0.86, 95% CI: 0.75-0.98; a OR=0.89, 95% CI: 0.80-1.00, respectively). In Period 1, PM 2.5 exposure was significantly associated with reduced odds for ongoing pregnancy with a OR=0.86, 95% CI: 0.75-0.99. In addition, NO 2 exposure was associated with a decreased likelihood of achieving clinical pregnancy across all exposure windows except for period 3. However, no associations were noted with CO and O 3. Conclusion:Ambient air pollution has detrimental effects on pregnancy outcomes in patients undergoing fresh embryo transfer. Notably, the adverse impacts were also observed during preantral-antral follicle transition stage before IVF/ICSI treatment. A significant negative association between NO 2 exposure and pregnancy outcomes was observed in almost all exposure windows, indicating that NO 2 may be the main air pollutant associated with adverse pregnancy outcomes.

Objective:To investigate the association between exposure to ambient air pollutants and pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), and to clarify the susceptible windows of exposure. Methods:A retrospective cohort study was conducted on 2 071 infertile women aged ≤40 years who underwent the first fresh cleavage stage embryo transfer in the Department of Reproductive Medicine of the First Affiliated Hospital of Harbin Medical University from January 2014 to December 2021. Patients were divided into heating season group and non-heating season group based on whether the start date of gonadotropin (Gn) was during the heating season or not, and baseline data and pregnancy outcomes were compared between the two groups. Daily average levels of six criteria air pollutants [fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), sulfur dioxide (SO 2), carbon monoxide (CO), ozone (O 3) max-8 h] in four discrete periods were obtained. The four discrete periods included period 1, 75 d prior to Gn start to Gn start; period 2, Gn start to oocyte retrieval; period 3, oocyte retrieval to day 3 embryo transfer; period 4, embryo transfer to serum human chorionic gonadotropin test. The primary outcome was ongoing pregnancy. A multiple logistic regression model was used to investigate the association between air pollutant exposure and pregnancy outcomes, adjusted for important confounders. Results:The biochemical pregnancy rate [51.7% (465/900)], the clinical pregnancy rate [45.2% (407/900)], the ongoing pregnancy rate [38.2% (344/900)], and the live birth rate [36.1% (325/900)] in the heating season group were significantly lower than those in the non-heating season group [56.3% (659/1 171), P=0.037; 51.2% (599/1 171), P=0.007; 44.3% (519/1 171), P=0.005; 41.3% (484/1 171), P=0.016]. A significant negative correlation was observed between SO 2 and NO 2 exposure and ongoing pregnancy in all four time windows. SO 2 increased by one interquartile range (IQR), corresponding to adjusted OR (a OR) and 95% CI were 0.92 (0.85-0.99), 0.92 (0.87-0.99), 0.93 (0.87-0.99) and 0.93 (0.87-0.99), respectively. An IQR increase in NO 2 was also significantly associated with decreased odds of ongoing pregnancy (a OR=0.83, 95% CI: 0.72-0.95; a OR=0.87, 95% CI: 0.77-0.97; a OR=0.90, 95% CI: 0.81-1.00; a OR=0.85, 95% CI: 0.77-0.95, respectively). During period 1 and period 4, we observed adverse effects of PM 10 exposure on ongoing pregnancy (a OR=0.86, 95% CI: 0.75-0.98; a OR=0.89, 95% CI: 0.80-1.00, respectively). In Period 1, PM 2.5 exposure was significantly associated with reduced odds for ongoing pregnancy with a OR=0.86, 95% CI: 0.75-0.99. In addition, NO 2 exposure was associated with a decreased likelihood of achieving clinical pregnancy across all exposure windows except for period 3. However, no associations were noted with CO and O 3. Conclusion:Ambient air pollution has detrimental effects on pregnancy outcomes in patients undergoing fresh embryo transfer. Notably, the adverse impacts were also observed during preantral-antral follicle transition stage before IVF/ICSI treatment. A significant negative association between NO 2 exposure and pregnancy outcomes was observed in almost all exposure windows, indicating that NO 2 may be the main air pollutant associated with adverse pregnancy outcomes.

Objective: This study aims to investigate the willingness and influencing factors of COVID-19 vaccination among Chinese middle school students, and to provide a reference for promoting the implementation of COVID-19 vaccination among middle school students. Methods: An online survey was conducted among middle school students in Beijing, Anqing of Anhui Province, Xi an of Shaanxi Province and Shenzhen of Guangdong Province, and 9 153 participants were enrolled in the present study. Single factor analysis and multinomial Logistic regression was used to determine the related factors of COVID-19 vaccination willingness. Results: The prevalence of vaccine acceptance, vaccine hesitancy and vaccine refusal among middle school students were 60.05%, 31.59% and 8.36%, respectively. The results of Chi square analysis showed there were significant difference of COVID-19 vaccination willingness among sex, school residence, grade, region, vaccination willingness of surrounding classmates, vaccination willingness of others, fear of SARS-CoV-2 and risk of SARS-CoV-2 infection( χ 2=8.43-1 059.43, P <0.05). Multinomial Logistic regression analysis presented that, compared to "vaccine acceptance" group, those girls, non resident in school, living in Beijing or Anqing, disagree or uncertain with influenced by peers, disagree or uncertain with influenced by others, uncertain with fear of SARS-CoV-2, disagree or uncertain with having risk of SARS-CoV-2 infection were more likely to show vaccine hesitancy( OR =1.22,1.21,1.49,1.69,1.75,2.54,1.41,2.32,3.32,1.99,2.38, P <0.05). And those non boarding in school, living in Beijing or Xi an, disagree or uncertainty influenced by peers, disagree or uncertainty influenced by others, disagree with fear of SARS- CoV- 2, disagree or uncertainty in having risk of SARS-CoV-2 infection were more likely to show vaccine refusal ( OR =1.27, 2.29 ,1.46,3.88,2.37,2.31,1.47,2.14,4.24,1.47, P <0.05). Conclusion The willingness of COVID-19 vaccination among middle school students in four cities is low, and targeted interventions should be advocated to form herd immunity.

To explore the laterality of SN+ area in patients with PD under TCS，and to further analyze its correlation with clinical data，in order to have a more comprehensive understanding of Parkinson's disease.Methods 81 patients with Parkinson's disease were collected，and the differences between SN+O and SN+N，SN+L and SN+R under transcranial ultrasound，and the correlation between SN+O and S/M and clinical data in patients with EOPD and LOPD were analyzed.Nonparametric test was used for difference analysis and spearman correlation was used for correlation analysis.Results The SN+O of PD was significantly larger than that of SN+N，and there was no significant difference in SN+ between left and right substantia nigra.The SN+O of early-onset PD was negatively correlated with the age of onset.Conclusion The area of SN+ on both sides of Parkinson's disease was asymmetrical under transcranial ultrasound.SN+O in Parkinson's disease was significantly larger than that in SN+N.The larger S/M often occurred in patients with early-onset PD rather than in patients with late-onset PD.Subgroup analysis showed that the age of onset of EOPD was negatively correlated with SN+O.SN+O and S/M in Parkinson's disease are not affected by age，disease duration，severity，autonomic nervous dysfunction and depression，but their stability as biomarkers needs to be further studied.