BACKGROUND:The immune response is strongly associated with the pathological development of Parkinson's disease.Studies have shown that the major histocompatibility complex plays a key role in immune response.OBJECTIVE:To summarize the mechanism of major histocompatibility complex regulation of immune response and the effect on the pathological markerα-synuclein of Parkinson's disease.METHODS:"Parkinson's disease,the major histocompatibility complex,innate immunity,adaptive immunity,microglia,T cell,B cell,α-syn,inflammation,MHC-Ⅰ,MHC-Ⅱ"were used as search terms to search the literature in PubMed database.Finally,92 articles were included for reading analysis.RESULTS AND CONCLUSION:(1)Congenital immune response is involved in the occurrence and development of Parkinson's disease,and the change of microglia's pro-inflammatory and anti-inflammatory phenotypes may aggravate the degenerative changes of Parkinson's disease.(2)The phenotype and function of T cells are related to the progression of Parkinson's disease.Regulatory T cells promote the activation of anti-inflammatory microglia and inhibit Th subgroup.B-cell-mediated humoral immunity can clear pathological α-synuclein,and its specific mechanism needs further study.(3)The major histocompatibility complex is closely related to the occurrence of innate and adaptive immunity,and thus affects the inflammation of Parkinson's disease.(4)α-Synuclein can regulate the activation of microglia and the expression of major histocompatibility complex,which leads to inflammatory changes in Parkinson's disease.(5)α-Synuclein is closely related to the immune response of Parkinson's disease and has become an important target for the treatment of Parkinson's disease.

Objective:To investigate the factors influencing sound localization in patients with unilateral sudden sensorineural hearing loss, so as to provide the reference for hearing rehabilitation of patients with unilateral sudden hearing loss.Methods:This study was a cross-sectional study that retrospectively analyzed the clinical data and audiological examination results of 228 patients with unilateral sudden sensorineural hearing loss(103 males and 125 females; aged from 18 to 80 years, with an average age of 46.2 years; 107 cases in the left ear and 121 cases in the right ear; 8 cases of low-frequency decline type, 42 cases of high-frequency decline type, 92 cases of flat decline type, and 86 cases of total deafness type)at the Eye and ENT Hospital of Fudan University from June 2023 to April 2024. The minimum audible angle (MAA) was calculated by the angle discrimination test of 1000 Hz and 4000 Hz warble tones, which were recorded as MAA 1 000 and MAA 4 000 according to the frequency of the given sound stimulus. The root mean square error (RMSE) was calculated by the angle recognition test with daily natural sounds as the stimulus sound. Using SPSS 27.0 statistical software, correlation and multiple regression analysis were used to research the clinical factors affecting the ability of sound localization in patients with unilateral sudden sensorineural hearing loss. Results:The mean MAA 1 000, MAA 4 000, RMSE of patients with unilateral sudden deafness were (53.97±29.14)°, (46.34±28.87)° and (30.06±13.64)°, respectively. Univariate analysis of variance revealed that there were significant differences between different classifications of sudden sensorineural hearing loss for sound localization tests (MAA 1 000: F=6.338, P<0.001,MAA 4 000: F=14.334, P<0.001,RMSE: F=49.918, P<0.001), post-hoc analysis observed that all significant contrasts were included the type of total deafness and low-frequency deafness. Correlation analysis showed the age of subjects in this study was weak positively correlated to the MAA 1 000 ( r=0.165, P=0.013), the duration of sudden sensorineural hearing loss was weak negatively related to RMSE ( r=-0.144, P=0.030), there were significant positive relationships between the threshold of PTA, PTA 1kHz, PTA 4kHz for the affected side, as well as the binaural PTA difference and sound localization test (MAA 1 000,MAA 4 000,RMSE) (all P<0.001). The multiple regression analysis showed the age and the binaural PTA difference for the affected side were the significant factors for the MAA 1 000 and MAA 4 000, the binaural PTA difference was the significant factors for the RMSE. The R 2 of multivariable linear regression model for MAA 1 000, MAA 4 000 and RMSE results in unilateral sudden deafness patients were 0.149, 0.207 and 0.553, respectively. Conclusion:Age, the hearing of the affected side, and binaural PTA difference are the significant factors for sound localization ability in patients with unilateral sudden sensorineural hearing loss, hearing compensation of the affected ear for these patients is hopeful to enhance the sound localization ability.

BACKGROUND:Currently,the pathogenesis of Parkinson's disease is not clear.Relevant studies have shown that α-synuclein and mitochondria are closely related to the pathogenesis of Parkinson's disease.It mainly involves oxidative stress,mitochondrial complex damage,calcium homeostasis,mitochondrial dynamics and mitochondrial quality control.OBJECTIVE:To review the association between α-synuclein and mitochondrial damage in Parkinson's disease.METHODS:The first author searched more than 50 documents from CNKI and WanFang databases from 2010 to 2024 using the keywords of"Parkinson's disease,mitochondrial damage and mechanism,α-synuclein"in Chinese as well as more than 750 documents from PubMed between 2010 and 2024 using the keywords of"Parkinson's disease,alpha-synuclein,mitochondria,oxidative stress,calcium homeostasis,mitophagy,mitochondrial dynamics,mitochondrial protein introduction"in English.Finally,70 documents were included for review.RESULTS AND CONCLUSION:Recent studies have confirmed the important role of mitochondrial dysfunction in the pathophysiology of Parkinson's disease,and the interaction between α-synuclein and mitochondria is a particularly significant factor in the pathogenesis of Parkinson's disease.The cascade of events that begin with naturally unfolded α-synuclein and eventually form mature fibril is collectively known as α-synuclein aggregation.The toxicity of aggregation accumulates in dopaminergic neurons and then disrupts mitochondrial function,thereby triggering Parkinson's disease.Therefore,the underlying mechanism of this bidirectional relationship between α-synuclein and mitochondrial dysfunction may provide new insights into the pathophysiology of Parkinson's disease.

Objective:To investigate the factors influencing sound localization in patients with unilateral sudden sensorineural hearing loss, so as to provide the reference for hearing rehabilitation of patients with unilateral sudden hearing loss.Methods:This study was a cross-sectional study that retrospectively analyzed the clinical data and audiological examination results of 228 patients with unilateral sudden sensorineural hearing loss(103 males and 125 females; aged from 18 to 80 years, with an average age of 46.2 years; 107 cases in the left ear and 121 cases in the right ear; 8 cases of low-frequency decline type, 42 cases of high-frequency decline type, 92 cases of flat decline type, and 86 cases of total deafness type)at the Eye and ENT Hospital of Fudan University from June 2023 to April 2024. The minimum audible angle (MAA) was calculated by the angle discrimination test of 1000 Hz and 4000 Hz warble tones, which were recorded as MAA 1 000 and MAA 4 000 according to the frequency of the given sound stimulus. The root mean square error (RMSE) was calculated by the angle recognition test with daily natural sounds as the stimulus sound. Using SPSS 27.0 statistical software, correlation and multiple regression analysis were used to research the clinical factors affecting the ability of sound localization in patients with unilateral sudden sensorineural hearing loss. Results:The mean MAA 1 000, MAA 4 000, RMSE of patients with unilateral sudden deafness were (53.97±29.14)°, (46.34±28.87)° and (30.06±13.64)°, respectively. Univariate analysis of variance revealed that there were significant differences between different classifications of sudden sensorineural hearing loss for sound localization tests (MAA 1 000: F=6.338, P<0.001,MAA 4 000: F=14.334, P<0.001,RMSE: F=49.918, P<0.001), post-hoc analysis observed that all significant contrasts were included the type of total deafness and low-frequency deafness. Correlation analysis showed the age of subjects in this study was weak positively correlated to the MAA 1 000 ( r=0.165, P=0.013), the duration of sudden sensorineural hearing loss was weak negatively related to RMSE ( r=-0.144, P=0.030), there were significant positive relationships between the threshold of PTA, PTA 1kHz, PTA 4kHz for the affected side, as well as the binaural PTA difference and sound localization test (MAA 1 000,MAA 4 000,RMSE) (all P<0.001). The multiple regression analysis showed the age and the binaural PTA difference for the affected side were the significant factors for the MAA 1 000 and MAA 4 000, the binaural PTA difference was the significant factors for the RMSE. The R 2 of multivariable linear regression model for MAA 1 000, MAA 4 000 and RMSE results in unilateral sudden deafness patients were 0.149, 0.207 and 0.553, respectively. Conclusion:Age, the hearing of the affected side, and binaural PTA difference are the significant factors for sound localization ability in patients with unilateral sudden sensorineural hearing loss, hearing compensation of the affected ear for these patients is hopeful to enhance the sound localization ability.

BACKGROUND:Currently,the pathogenesis of Parkinson's disease is not clear.Relevant studies have shown that α-synuclein and mitochondria are closely related to the pathogenesis of Parkinson's disease.It mainly involves oxidative stress,mitochondrial complex damage,calcium homeostasis,mitochondrial dynamics and mitochondrial quality control.OBJECTIVE:To review the association between α-synuclein and mitochondrial damage in Parkinson's disease.METHODS:The first author searched more than 50 documents from CNKI and WanFang databases from 2010 to 2024 using the keywords of"Parkinson's disease,mitochondrial damage and mechanism,α-synuclein"in Chinese as well as more than 750 documents from PubMed between 2010 and 2024 using the keywords of"Parkinson's disease,alpha-synuclein,mitochondria,oxidative stress,calcium homeostasis,mitophagy,mitochondrial dynamics,mitochondrial protein introduction"in English.Finally,70 documents were included for review.RESULTS AND CONCLUSION:Recent studies have confirmed the important role of mitochondrial dysfunction in the pathophysiology of Parkinson's disease,and the interaction between α-synuclein and mitochondria is a particularly significant factor in the pathogenesis of Parkinson's disease.The cascade of events that begin with naturally unfolded α-synuclein and eventually form mature fibril is collectively known as α-synuclein aggregation.The toxicity of aggregation accumulates in dopaminergic neurons and then disrupts mitochondrial function,thereby triggering Parkinson's disease.Therefore,the underlying mechanism of this bidirectional relationship between α-synuclein and mitochondrial dysfunction may provide new insights into the pathophysiology of Parkinson's disease.

BACKGROUND:The immune response is strongly associated with the pathological development of Parkinson's disease.Studies have shown that the major histocompatibility complex plays a key role in immune response.OBJECTIVE:To summarize the mechanism of major histocompatibility complex regulation of immune response and the effect on the pathological markerα-synuclein of Parkinson's disease.METHODS:"Parkinson's disease,the major histocompatibility complex,innate immunity,adaptive immunity,microglia,T cell,B cell,α-syn,inflammation,MHC-Ⅰ,MHC-Ⅱ"were used as search terms to search the literature in PubMed database.Finally,92 articles were included for reading analysis.RESULTS AND CONCLUSION:(1)Congenital immune response is involved in the occurrence and development of Parkinson's disease,and the change of microglia's pro-inflammatory and anti-inflammatory phenotypes may aggravate the degenerative changes of Parkinson's disease.(2)The phenotype and function of T cells are related to the progression of Parkinson's disease.Regulatory T cells promote the activation of anti-inflammatory microglia and inhibit Th subgroup.B-cell-mediated humoral immunity can clear pathological α-synuclein,and its specific mechanism needs further study.(3)The major histocompatibility complex is closely related to the occurrence of innate and adaptive immunity,and thus affects the inflammation of Parkinson's disease.(4)α-Synuclein can regulate the activation of microglia and the expression of major histocompatibility complex,which leads to inflammatory changes in Parkinson's disease.(5)α-Synuclein is closely related to the immune response of Parkinson's disease and has become an important target for the treatment of Parkinson's disease.

Objective To explore imaging manifestations of crossed ectopic fused kidney.Methods Data of 12 patients with crossed ectopic fused kidney were retrospectively analyzed,and the imaging manifestations of crossed ectopic fused kidney were observed.Results L type crossed ectopic fused kidney was detected in 5 cases,while inferior ectopic type(Ii type),S-shaped type and lump type(O type)ectopic fused kidney was found each in 2 cases,respectively,and doughnut or disc type(C-C type)ectopic fused kidney was noticed in 1 case.The ectopic fused kidney presented with empty one side renal cavity,while the morphology and position of the contralateral kidney were generally normal in all 12 cases,which crossed the midline and fused with the contralateral in situ kidney,including right to left crossed ectopic fusion in 8 cases and left to right crossed ectopic fusion in 4 cases.The ureters of the crossing kidney went across the midline,opened into the bladder trigone on the contralateral side in 11 cases or prostate in 1 case.Combined reproductive system abnormalities were found in 3 cases,including unicornous uterus,bicornuate uterus and cryptorchidism each in 1 case.Two cases were found complicated with abnormal inferior vena cava,including 1 case of both side inferior vena cava and 1 case of left inferior vena cava.Conclusion The imaging manifestations of crossed ectopic fused kidney had characteristics.Complete displaying of reveal fused kidney,ureteral course and opening was helpful to accurate diagnosis and classification of crossed ectopic fused kidney.

Parkinson's disease (PD) is one of the hotspots in the research field of neurodegenerative diseases, and its pathogenesis is still controversial. Trace metal elements play an important role in normal growth and development of the human body. Metal ions can cross the blood-brain barrier and enter the brain, leading to α-synapnuclein aggregation, mitochondrial dysfunction, and degeneration of dopaminergic neurons, and then inducing the occurrence of PD. This article mainly reviewed the potential mechanisms of metal elements in PD, discussed the role of metabolic imbalance of common trace metals (copper, iron, manganese, and zinc) in PD, and put forward new insights into the treatment of PD.

Objective:To investigate the effect of mind mapping on the discharge readiness of patients undergoing first coronary stent implantation, so as to provide basis for seeking effective discharge guidance in clinical practice.Methods:One hundred patients who were hospitalized in the Department of Cardiology, the Second Affiliated Hospital of Dalian Medical University from December 2019 to August 2020 and who underwent coronary stent implantation for the first time were selected as the study objects. They were divided into the control group and the experimental group with 50 cases in each group by the random number table method. The control group was given routine discharge guidance, and the experimental group was given discharge guidance using mind mapping. Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale were used to compare the differences of discharge readiness and discharge guidance quality between the two groups after intervention.Results:The personal status, adaptability, predictive support and the total score of discharge readiness in the experimental group were (25.18 ± 3.79), (45.24 ± 3.63), (36.62 ± 3.63), (107.04 ± 8.92) points, which were all higher than those in the control group (23.34 ± 3.04), (41.68 ± 3.62), (35.14 ± 2.14), (100.16 ± 7.36) points, with statistically significant differences ( t values were -4.91--2.48, all P<0.05). The actual acquired content, guiding skills and results, total scores of discharge guidance quality of patients in the experimental group were (56.66 ± 6.06), (94.46 ± 4.33), (151.12 ± 8.26) points, which were all higher than those in the control group (45.38 ± 9.19), (89.44 ± 10.87), (134.82 ± 14.31) points, with statistically significant differences ( t values were -7.25, -3.03, -6.97, all P<0.05). Conclusions:Mind mapping can effectively improve the discharge preparation degree and discharge guidance quality of patients undergoing coronary stent implantation for the first time, and it is a simple and practical discharge guidance tool.

Objective:To understand the level of thirst distress in heart failure and analyze its influencing factors, in order to provide a theoretical basis for implementing the intervention measures to alleviate patients′ thirst distress.Methods:A total of 187 patients with heart failure who met the inclusion criteria from the First Affiliated Hospital and the Second Affiliated Hospital of Dalian Medical University from November 2019 to October 2020 were selected as the research objects. The General Information Questionnaire, Thirst Distress Scale-Heart Failure, Generalized Anxiety Disorder 7-item Scale, Patient Health Questionaire-9 and Brief Illness Perception Questionnaire were used to investigate heart failure patients. Multiple linear regression was used to explore the influencing factors of heart failure patients′ thirst distress.Results:The score of thirst distress in heart failure patients was (23.95 ± 4.21), multiple stepwise linear regression analysis showed that heart function grade, diuretic usage, anxiety, depression and disease perception were the influencing factors of thirst distress in patients with heart failure, which explained 41.9% of the thirst distress in heart failure patients.Conclusions:The thirst distress of heart failure patients is in the middle level, and its thirst distress is affected by many factors, clinical medical staff should pay attention to the severity of thirst distress in patients with heart failure, actively develop different intervention measures to reduce patients′ thirst sensation, and explore effective schemes to alleviate thirst distress in patients with heart failure.