To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework.

Objective:To summarize and analyze the clinical characteristics of patients with sudden sensorineural hearing loss（SSHL） accompanying diabetes mellitus, to explore whether diabetes affects the treatment outcomes during hospitalization, and to identify the factors influencing the efficacy of SSHL patients with diabetes. Methods:A retrospective analysis was conducted on clinical data from 939 patients with SSHL. The baseline characteristics, and onset conditions of the diabetes group（79 cases） and the non-diabetes group（860 cases） were compared. Propensity score matching（PSM） was applied in a 1︰ 2 ratio to match initial hearing levels with baseline characteristics such as age, sex, and BMI, resulting in 73 diabetes cases and 144 non-diabetes cases for treatment efficacy comparison. For the analysis of prognostic factors, a logistic regression model was established based on the treatment outcomes of 217 patients with SSHL. Results:The proportion of SSHL patients accompanying diabetes was 8.40%（79/939）. Compared to non-diabetic patients, those with diabetes were older（median age of 53 years in the diabetes group and 39 years in the non-diabetes group） and had a higher proportion of hypertension（43.04% vs 12.67%）, with significant difference observed（P<0.05）. After PSM, the treatment efficacy during hospitalization was better in the diabetes group than in the non-diabetes group（58.90% vs 47.92%）, although the difference was not statistically significant（P>0.05）. The prognosis of patients with SSNHL accompanied by diabetes was analyzed using a multivariate logistic regression model that included age, HDL-C, and INR as variables; however, no statistically significant differences were found（P>0.05）. Conclusion:Patients with SSHL accompanying diabetes are generally older with a higher incidence of hypertension. The presence of diabetes does not affect the treatment outcomes during hospitalization.
Humans ; Propensity Score ; Retrospective Studies ; Hearing Loss, Sensorineural/therapy* ; Hearing Loss, Sudden/therapy* ; Middle Aged ; Diabetes Mellitus ; Male ; Female ; Prognosis ; Adult ; Logistic Models ; Diabetes Complications ; Aged ; Treatment Outcome

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Background Hebei Province is located in the North China Plain. In view of the influence of geological background and the acute and chronic hazards caused by excessive drinking water toxicological indicators, coupled with the large coverage of water supply in urban areas and the existence of self-built water supply facilities, it is necessary to understand the drinking water sanitation status in urban areas and conduct health risk assessment. Objective To investigate main indicators affecting the compliance rate of drinking water quality in urban areas of Hebei and evaluate the chronic non-carcinogenic risks of 11 chemicals. Methods The collection, preservation, and testing of 14299 samples of finished water, tap water, and secondary water supply in urban areas of Hebei Province from 2017 to 2021 were conducted following the Standard examination methods for drinking water (GB/T 5750—2006). A total of 11 chemicals were evaluated according to the Hygienic standards for drinking water (GB 5749—2006). The chronic non-carcinogenic risks of the 11 chemicals in drinking water by oral exposure were assessed using the four-step health risk assessment model developed by the United States Environmental Protection Agency and the Technical guide for environmental health risk assessment of chemical substances (WS/T 777—2021). Results From 2017 to 2021, the compliance rates of arsenic, cadmium, hexavalent chromium, lead, mercury, selenium, cyanide, chloroform, and carbon tetrachloride in drinking water in urban areas of Hebei Province were all 100.00%, and fluoride and nitrate (N) were the main indicators affecting water quality compliance, with compliance rates of 97.68% and 99.53% respectively. The compliance rate of fluoride increased year by year (χ²=178.06, P<0.05), and the concentration showed a downward trend (χ²=563.49, P<0.05). The compliance rate of fluoride in water samples during the wet season was higher than that during the dry season (χ²=5.06, P<0.05). The median concentrations of fluoride and nitrate in drinking water in urban areas of Hebei Province from 2017 to 2021 were 0.36 mg·L⁻¹ and 3.32 mg·L⁻¹, with hazard quotients of 0.15 and 0.05, respectively, both less than 1, suggesting no chronic non-carcinogenic risks, and no significant gender difference was found. The hazard quotient of maximum fluoride concentration was 1.65, which was greater than 1, suggesting chronic non-carcinogenic risks. The chronic non-carcinogenic risks associated with the maximum concentrations of the remaining 10 chemical indicators were all within an acceptable range. Conclusions Nine toxicological indicators in drinking water in urban areas of Hebei Province from 2017 to 2021, except for fluoride and nitrate, are within the national standards. Fluoride and nitrate are the main toxicological indicators that affect the overall compliance rate of water quality, and the chronic non-carcinogenic risks associated with maximum concertration of nitrate and 95% concentration of fluoride are at an acceptable level.

Objective:To understand the level of self-advocacy in young female breast cancer patients and analyze its influencing factors, so as to provide reference for clinical intervention.Methods:A total of 250 young female breast cancer patients from Puyang People′s Hospital and Puyang Oilfield General Hospital from May 2021 to June 2022 were selected as research objects by convenience sampling method. A cross-sectional survey was conducted using the general information questionnaire, Female Self-Advocacy in Cancer Survivorship, Cancer Distress Scales for Adolescent and Young Adults and Family Resilience Assessment Scale. Multiple stepwise linear regression was used to analyze the influencing factors of self-advocacy in young women with breast cancer.Results:A total of 235 young female breast cancer patients completed the survey. The total score for self-advocacy was (77.04 ± 12.76) points, the total score of psychological distress was (108.25 ± 18.36) points, and the total score of family resilience was (112.93 ± 25.20) points. Self-advocacy was negatively correlated with psychological distress ( r=-0.548, P<0.001), and positively correlated with family resilience ( r=0.596, P<0.001). Education level, personality type, family monthly income, perceived economic pressure, work status, fertility, intimate relationship, diagnosis time, psychological distress and family resilience were the influencing factors of self-advocacy of young female breast cancer patients ( R2=0.595, F=35.31, P<0.01). Conclusions:The level of self-advocacy of young female breast cancer patients should be further improved. Medical staff should take targeted measures according to influencing factors to improve their self-advocacy level.

Objective:To investigate the effects and significance of α-synuclein(α-syn)on the expression level of β-arrestin 2 in Parkinson's disease(PD)in a mouse model.Methods:Twenty-eight C57BL/6J mice with similar motor skills were randomly divided into a model group and a control group, with 14 mice in each group.A PD model was established by injecting preformed fibrils of α-syn into the striatum of the brain, and behavioral changes were monitored after 4 weeks.The expression levels of α-syn, the dopamine receptor(DR), tyrosine hydroxylase(TH), inflammatory factors, β-arrestin 2 and the nuclear transcription factor-κB(NF-κB)signaling pathway-related proteins were determined by Western blotting.The interaction between α-syn and β-arrestin 2 was detected by fluorescence resonance energy transfer(FRET), and the regulation of α-syn on β-arrestin 2 transcriptional activation was detected by the dual luciferase report assay.Results:After 4 weeks of modeling, compared with the control group, the average movement speed of mice in the model group was significantly reduced( t=9.415, P<0.001), the movement track was sparse and concentrated around the open field, and the time needed to climb the pole was significantly prolonged( t=16.412, P<0.001). Compared with the control group, the relative expression of α-synin in astrocytes in the model group increased significantly, the relative expressions of D1DR and TH decreased significantly[(1.14±0.18) vs.(0.53±0.16), (0.67±0.13) vs.(1.15±0.11), (0.46±0.05) vs.(0.81±0.06)]( t=9.810, 10.917 and 17.356, all P<0.001), the relative expression of tumor necrosis factor-α, interleukin-1β, interleukin-6 and NF-κB signaling pathway-related proteins increased significantly( t=3.583, 4.284, 5.396, 11.747, 16.375 and 18.294, all P<0.001), and the relative expression of β-arrestin 2 protein[(0.42±0.11) vs.(1.33±0.14)]in astrocytes decreased significantly( t=19.795, P<0.001). The FRET results suggested a possible direct interaction between α-syn and β-arrestin 2.The results of the dual luciferase report assay showed that the transcription activity of β-arrestin 2 was significantly increased after α-syn gene knockout. Conclusions:The α-syn may induce inflammation in astrocytes by activating the NF-κB signaling pathway and participate in the pathogenesis of PD by reducing dopamine biosynthesis and inhibiting its physiological function through negative regulation of β-arrestin 2.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with autosomal dominant late-onset non-syndromic hearing loss (NSHL). METHODS: Clinical data of the pedigree were collected. Genomic DNA was extracted from peripheral blood samples of the proband and other family members. Trio whole exome sequencing was carried out for 19 396 genes to identify potential pathogenic variants. Sanger sequencing was carried out to verify the candidate variant in the pedigree. RESULTS: The proband and his father were found to carry a c.1183+1delG p.? variant of the DFNA5 gene. The variant was confirmed to be co-segregating with the disease phenotype in the pedigree. CONCLUSION The c.1183+1delG p.? variant of the DFNA5 gene probably underlay the late onset NSHL in this pedigree. Above finding has enabled accurate genetic counseling for this pedigree.
Age of Onset ; China ; Hearing Loss, Sensorineural/genetics* ; Humans ; Male ; Mutation ; Pedigree ; Receptors, Estrogen/genetics*

Objective:To observe the expression level of β-arrestin 1/2 in mice with Parkinson's disease(PD)and its relationship with pathogenesis of PD.Methods:PD model was prepared by using 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine hydrochloride(MPTP). The mice were killed at 3 days after the last administration and the brain tissue was taken for observing brain histopathological changes.The colocalization of β-arrestin1/2 with microglia was detected by using immunofluorescence double-labeling of β-arrestin1/2 and microglia.Tyrosine hydroxylase(TH)and Iba-1 were used to label cells, and then the loss of dopaminergic neurons and the activation of microglia were observed by immunohistochemistry.Results:As compared with the blank control group, the relative expression level of β-arrestin1 protein in brain tissue of PD mice was increased significantly, while the relative expression level of β-arrestin2 protein was decreased significantly( t=11.535, 9.948, both P=0.000), and β-arrestin1/2 shared cell localization with microglia.After MPTP induced PD, the number of Th + neurons in SNc area of midbrain was decreased significantly in β-arrestin1 + /+ group and β-arrestin1 -/- group( t=4.098, 3.571, P=0.000, 0.001), while the number of Iba-1 + cells in SNc area of midbrain was increased significantly( t=10.097、6.448, both P=0.000). After MPTP induced PD, the number of Th + neurons in SNc area of midbrain was decreased significantly in β-arrestin2 + /+ group and β-arrestin2 -/- group( t=3.512, 5.237, P=0.001, 0.000), while the number of Iba-1 + cells in SNc area of midbrain was increased significantly( t=5.816、8.402, P=0.000). Compared with β-arrestin1 + /+ group, the expressions of TRAF6, NF-κB and COX-2 in mouse microglia were significantly increased in β-arrestin1 -/- group( t=5.324, 5.837, 9.350, all P=0.0000). Compared with β-arrestin2 + /+ group, the expressions of TRAF6, NF-κB and COX-2 in mouse microglia were significantly down-regulated in β-arrestin2 -/- group( t=5.094, 6.318, 9.466, all P=0.000). Conclusions:The expression of β-arrestin1 is up-regulated and β-arrestin2 is down-regulated in brain tissue of PD mice.β-arrestin1/2 may affect the proliferation and activation of microglia and the loss of dopaminergic neurons through TRAF6/NF-κB/COX-2 pathway, and participate in the pathological process of PD.

Objective    To analyze the protective mechanism of spinal cord ischemia-reperfusion injury mediated by N-methyl-D-aspartate (NMDA) receptor. Methods    A total of 42 SD rats were randomly assigned to 4 groups: a non-blocking group (n=6), a saline group (n=12), a NMDA receptor blocker K-1024 (25 mg/kg) group (n=12) and a voltage-gated Ca2+ channel blocker nimodipine (0.5 mg/kg) group (n=12). The medications were injected intraperitoneally 30 min before ischemia. The neural function was evaluated. The neuronal histologic change of spinal cord lumbar region, the release of neurotransmitter amino acids and expression of spinal cord neuronal nitric oxide synthase (nNOS) were compared. Results    At 8 h after reperfusion, the behavioral score of the K-1024 group was 2.00±0.00 points, which was statistically different from those of the saline group (5.83±0.41 points) and the nimodipine group (5.00±1.00 points, P<0.05). Compared with the saline group and nimodipine group, K-1024 group had more normal motor neurons (P<0.05). There was no significant difference in glutamic acid concentration in each group at 10 min after ischemia (P=0.731). The nNOS protein expression in the K-1024 group was significantly down-regulated compared with the saline group (P<0.01). After 8 h of reperfusion, the expression of nNOS protein in the K-1024 group was significantly up-regulated compared with the saline group (P<0.05). Conclusion    K-1024 plays a protective role in spinal cord ischemia by inhibiting NMDA receptor and down-regulating nNOS protein expression; during the reperfusion, K-1024 has a satisfactory protective effect on spinal cord function, structure and biological activity of nerve cells.