Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

Objective: To evaluate the safety and efficacy of therapeutic whole blood exchange combined with lymphoplasmapheresis in the treatment of refractory autoimmune hemolytic anemia (AIHA). Methods: A retrospective analysis was performed on the clinical data of AIHA patients who underwent therapeutic whole blood exchange combined with lymphoplasmapheresis at our hospital from March 2022 to May 2025. Efficacy was assessed by comparing changes in hemoglobin, platelet count, and bilirubin levels before and after treatment. Safety was evaluated by analyzing vital signs before and after the procedure, parameters during the exchange, and adverse reactions. Results: A total of 12 AIHA patients were enrolled, completing 19 exchange procedures. The number of procedures per patient ranged from 1 to 3. The median treatment duration was 67 (65-73) minutes, with a median exchange volume of 2 025 (1 851-2 121) mL, comprising 4.5 (4-6) units of red blood cells and 1 350 (1 200-1 400) mL of plasma. Ten patients achieved partial remission, one achieved complete remission, and one showed no response, yielding an response rate of 91% (11/12). After a single session, hemoglobin increased significantly by 17.58±9.85 g/L (P<0.01), while platelets counts decreased by 45 (17.5, 79)×10 /L (P<0.05), and both systolic and diastolic blood pressure showed a significant elevation (P<0.05). However, no statistically significant differences were observed in total bilirubin, indirect bilirubin, white blood cell count, or heart rate. During the procedures, 4 adverse reactions occurred in 3 patients: one child experienced severe heart rate fluctuation twice consecutively, and two adults developed plasma allergies. All reactions resolved spontaneously without pharmacological intervention. Conclusion: The combination of therapeutic whole blood exchange and lymphoplasmapheresis appears to be a safe and effective treatment for refractory AIHA patients.

Background:With the increasing diversity of biological agents,the first-line biological agents for moderate-to-severe Crohn's disease(CD)and ulcerative colitis(UC)requires more precise positioning.Aims:To systematically evaluate the efficacy and safety of infliximab(IFX)and ustekinumab(UST)as first-line options for moderate-to-severe CD and UC.Methods:Randomized controlled trials(RCTs)on IFX and UST in treatment of moderate-to-severe CD and UC were retrieved from CNKI,Wanfang data,VIP,Chinese Science Citation Database and PubMed,Web of Science,Embase,ClinicalTrials,Cochrane Library from the date of database establishment to December 2023.An indirect meta-analysis was conducted to compare the efficacy and safety of IFX and UST in treatment of moderate-to-severe CD and UC.Results:Eleven RCTs were enrolled.No significant differences in clinical remission and maintenance rates of moderate-to-severe CD were found between IFX group and UST group(P>0.05),and no significant differences in serious adverse events and serious infection rates were found between these two groups(P>0.05).No significant differences in clinical remission and maintenance rates of moderate-to-severe UC were found between IFX group and UST group(P>0.05),and no significant differences in serious adverse events and serious infection rates were found between these two groups(P>0.05).Conclusions:Both IFX and UST can be served as first-line biological therapy for patients with moderate-to-severe CD.In view of the fact that IFX can increase the risk of tuberculosis,UST is recommended as first-line therapy for moderate-to-severe CD.For moderate-to-severe UC,IFX is an effective and safe first-line biological therapy,and UST can be served as an alternative.

The liver's remarkable regenerative capacity is crucial to restore its function, which can be compromised in cases of severe or chronic liver injury. Thus, the search of new methods to promote liver regeneration is of great clinical importance. In recent years, the gut microbiota is an emerging field of research that attracts the scientific community. The gut microbiota not only affects the integrity of digestive system but also exerts a significant impact on liver function via the so-called " gut-liver axis". Increasing evidence suggests that an imbalance in gut microbiota is associated with the development of various liver diseases, and modulation of gut microbiota might be a potential cure for liver diseases. Research into the role of gut microbiota in liver regeneration not only help us understand the pathogenesis of liver diseases but also facilitate the development of new therapeutic strategies.

AIM:To investigate the role of ClC-3 chloride channel in the promotion of radio sensitization of na-sopharyngeal carcinoma CNE-2Z cells by dihydroartemisinin(DHA).METHODS:MTT was used to detect the inhibito-ry effect of DHA on the viability of CNE-2Z cells and normal nasopharyngeal epithelial NP69-SV40T cells,the radio sensi-tization effect of DHA on CNE-2Z cells was detected by cloning assay,the expression of ClC-3 protein was detected by Western blot,the expression of ClC-3 protein was down-regulated by siRNA technology,and the chlorine current of cells was recorded by whole cell patch-clamp technology.RESULTS:(1)Compared with NP69-SV40T cells,DHA selective-ly inhibited the proliferation of CNE-2Z cells,with IC10 values of(13.020±4.831)μmol/L and(5.244±1.050)μmol/L,respectively(P＜0.01).(2)The results of clonal formation experiments showed that DHA had a radio sensitizing effect on CNE-2Z cells,with a radio sensitization ratio of 1.9.(3)DHA could activate the chlorine channel of CNE-2Z cells and produce an outward chlorine current,but had no effect on the chlorine channel of NP69-SV40T cells.(4)DHA promoted the expression of ClC-3 chloric channel protein in CNE-2Z cells(P＜0.01).(5)Chlorine channel blocker NPPB could in-hibit the radio sensitizing effect of DHA on CNE-2Z cells by 1.84 times,and also inhibited the chlorine current activated by DHA.(6)the down-regulation of CNE-2Z ClC-3 protein could inhibit the radio sensitization effect of DHA on CNE-2Z cells by 4.19 times,and the activation of chlorine current by DHA on CNE-2Z cells was no longer produced.CONCLU-SION:DHA has a radio sensitizing effect on nasopharyngeal carcinoma CNE-2Z cells,which is likely to be related to the activation of ClC-3 chloride channel.

Background:Identifying missed diagnoses of polyps is significant in reducing the incidence of colorectal cancer.Until now,the role of repeat colonoscopy during colorectal polypectomy in reducing themissed diagnoses of polyps is sparsely studied.Aims:To analyze the value of repeat colonoscopy during colorectal polypectomy in reducing themissed diagnoses of polyps.Methods:One hundred and forty-six patients in the first affiliated hospital of Ningbo University who underwent polypectomy were consecutively recruited for repeat colonoscopy from January 2020 to January 2021.The number,size,and location of missed polyps were recorded and analyzed during colorectal polypectomy.Univariate logistic regression analysis was used to analyze the independent risk factors of missed polyps.Results:There were 86 males and 60 females among the 146 enrolled patients,which aged(55.54±10.51)years.The overall missed polyps'rate was 27.17%.We found that all missed polyps were sessile polyps and<10 mm in size,the difference was significant in the left colon.Univariate logistic regression analysis showed that the endoscopist' experience was an independent risk factor for missed polyps.Conclusions:Endoscopist'experience was an independent risk factor for missed polyps.Repeat colonoscopy could reduce the missed polyps.

Objective:To investigate the changes of various cytokines and coagulation function in B cell acute lymphoblastic leukemia(ALL) patients with different CRS scores during CD19-CAR-T cell immunotherapy.Methods:87 patients with B-ALL hospitalized in the First Affiliated Hospital of Soochow University and 30 normal controls were enrolled into this study from July 2018 to October 2020. The age of the patients was 32(20, 56) years old and 36(41.4%) were female. All these coagulation indicators, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, fibrinogen (Fg) were analyzed by automatic blood coagulation in B-ALL patients before and after treated with CAR-T cell. The ratio of CD19-CAR-T cells and the expression of IL-6, IL-10, IFN-γ, TFN-α, IL-2, IL-4, and IL-17A were analyzed using flow cytometry. The patients′ clinical parameters were detected, and the CRS classification of severity was made according to the standard of consensus.Results:Patients with CRS>3 had prolonged PT and APTT, increased D-dimer, and decreased fibrinogen ( P<0.05). The levels of cytokines of IFN-γ, IL-6, and IL-10 were significantly higher in patients with CRS>3 than that in controls ( P<0.05).The D-dimer level is positively correlated with IL-10. Conclusion:Patients with severe CRS grading have significant coagulation dysfunction in CD19-CAR-T cell immunotherapy. Cytokines IFN-γ, IL-6, and IL-10 may affect coagulation function and CRS grading during CD19-CAR-T cell immunotherapy.

Objective To explore the relationship between waist-hip ratio （WHR） and the risk of acute ischemic stroke （AIS） in elderly population and its clinical significance.Methods Demographic information，disease diagnosis and blood biochemical data of 8375 residents who were followed up in Huamu Community in 2019 were retrospectively analyzed. Patients were divided into AIS group（506 cases）and non AIS group（7869 cases）according to whether residents had newly developed AIS during the follow up period. The data between the two groups were compared to analyze the correlation between WHR and AIS. Multivariate binary Logistic regression was used to analyze the influence of WHR on the risk of AIS.Results In this study，the percentages of residents in the AIS group and non-AIS group were 6.04% （506/8375） and 93.96%（7869/8375） respectively. Mean WHR of residents in the AIS group and non-AIS group was（0.91±0.07）and （0.90±0.07）respectively，and the difference between the two groups was statistically significant（t=2.715，P=0.007）.There were statistical differences in age，BMI，waist circumference，WHR，meat diet，hypertension，diabetes，coronary heart disease，serum creatinine，low density lipoprotein and total cholesterol between 2 groups（P<0.05）.There were no significant differences in gender，systolic blood pressure，diastolic blood pressure，hip circumference，smoking history，drinking history，atrial fibrillation，platelets，hemoglobin，serum glutamic pyruvic transaminase，blood urea nitrogen，fasting blood glucose，high density lipoprotein and triglyceride between the two groups （P>0.05）.The correlation between WHR and AIS risk［OR（95%CI）P］was 5.07（1.31，19.57） 0.018 before，and 4.34 （1.08，17.39）0.038 after adjusting for confounding factors.Conclusions Elevated WHR increases the risk of AIS in elderly population.These findings have certain significance for advocating weight control and prevention of cerebrovascular diseases in elderly population.

BACKGROUND/AIMS: The current study aims to investigate the protective effects of Bifidobacterium infantis on the abnormal immune response to inflammatory bowel disease (IBD) in dextran sodium sulfate (DSS)-induced colitis. METHODS: Eight-week-old BALB/c mice were separated into five groups at random (control, DSS, DSS+B9 [B. infantis 1×10⁹ CFU], DSS+B8 [B. infantis 1×10⁸ CFU], and DSS+B7 [B. infantis 1×10⁷ CFU]). Colitis was induced by 5% DSS ad libitum for 7 days, at which time we assessed weight, the disease activity index (DAI) score, and the histological damage score. The nuclear transcription factor Foxp3 (a marker of Treg cells), cytokines interleukin-10 (IL-10) and transforming growth factor β1 (TGF-β1), and related proteins (programmed cell death ligand 1 [PD-L1] and programmed cell death 1 [PD-1]) were detected by an immunohistochemical method and Western blot. RESULTS: B. infantis increased weight, decreased DAI scores and histological damage scores, increased the protein expression of Foxp3 (p<0.05) and cytokines IL-10 and TGF-β1 in mouse colon tissue (p<0.05), and increased the expression of PD-L1 in the treatment groups relative to that in the DSS group (p<0.05). The effect of B. infantis on Foxp3 and PD-L1 was dose dependent in the treatment groups (p<0.05). PD-L1 was positively correlated with Foxp3, IL-10, and TGF-β1. CONCLUSIONS: In a mouse model of IBD, B. infantis can alleviate intestinal epithelial injury and maintain intestinal immune tolerance and thus may have potential therapeutic value for the treatment of immune damage in IBD.
Animals ; Bifidobacterium ; Blotting, Western ; Cell Death ; Colitis ; Colon ; Cytokines ; Dextrans ; Immune Tolerance ; Inflammatory Bowel Diseases ; Interleukin-10 ; Methods ; Mice ; Models, Theoretical ; Sodium ; T-Lymphocytes, Regulatory ; Transcription Factors ; Transforming Growth Factors