OBJECTIVE To investigate the differences in audiological characteristics and speech recognition rates between vestibular schwannoma(VS)patients presenting with sudden sensorineural hearing loss(SSNHL)as first symptom and patients with idiopathic sudden deafness(ISD),in order to provide a reference for clinical diagnosis and differential diagnosis.METHODS A retrospective analysis was conducted on 60 patients with VS presenting as SSNHL(VS group),and 60 patients with unilateral ISD(SD group).Pure-tone thresholds,audiogram configurations,and speech recognition scores were compared between the two groups.Statistical analyses were performed using t-test,Mann-Whitney U test,and chi-square test.RESULTS Hearing loss in the VS group was mainly distributed in the moderate to profound range,and the proportion of descending-type audiograms was significantly higher than that in the SD group(χ2=13.97,P=0.002 9).In contrast,the SD group was predominantly characterized by mild to moderate hearing loss and flat-type audiograms.Regarding speech recognition,the VS group showed significantly poorer monosyllabic recognition(38.6%±40.4%)and sentence recognition(53.4%±42.0%)compared with the SD group(59.0%±37.8%,75.8%±36.0%,P<0.01).Notably,some VS patients exhibited complete loss of speech recognition even before the pure-tone average reached the level of total deafness.CONCLUSION VS patients presenting with SSNHL showed significant differences in audiogram configurations and speech recognition compared with those with ISD.A marked decline in speech recognition,combined with a typical descending-type audiogram,may serve as important clinical indicators,suggesting that early imaging examinations should be performed to confirm the diagnosis.

To establish an immunochromatographic method for rapid detection of caprine enterovir-us(CEV),the monoclonal antibody against CEV VP1 protein was used as gold-labeled monoclonal antibodies,and the purified rabbit-derived polyclonal antibody of CEV-VP1 and sheep anti-mouse IgG were used as the detection line and quality control line,respectively.The colloidal gold immu-nochromatographic test strips for CEV were prepared according to the principle of double antibody sandwich,evaluated,and applied for clinical specimen detection.The results showed that the meth-od specifically recognized CEV without cross-reaction with bovine enterovirus and bovine viral di-arrhea virus.The minimum detection limit of the method was 102.49 TCID50/mL and had good re-producibility.The prepared test strips had a shelf life of three months kept at 4 ℃.Detection of clin-ical samples using the immunochromatographic test strips showed 100％coincidence rate with RT-PCR method.In conclusion,the colloidal gold immunochromatographic test strips for detection of the emerging CEV with good specificity,sensitivity and repeatability,which provides a new techni-cal means easily used for the rapid detection/diagnosis and epidemiological investigation on CEV infection.

Objective To establish a rat model of ovarian endometriosis(EMS)using the horn reversion method,to provide an ideal animal model for exploring the pathogenesis and treatment of EMS.Methods Fifty SPF-grade female SD rats were divided randomly into five groups:a sham group,and 1,2,3,and 4 weeks after surgery groups,respectively(n=10 rats per group).Apart from the sham group,an ovarian-type EMS model was established in the other groups by the uterine horn refracture method,and the modeling success rate,and ectopic foci volume and mass were observed in each group.The morphology of ectopic foci was observed by hematoxylin-eosin(HE),and expression of proliferating cell nuclear antigen(PCNA),Ki67,epithelial cadherin(E-cadherin),and neural cadherin(N-cadherin)in the uterus and ectopic foci tissues were detected by immunohistochemistry.The model was further evaluated and the degree of cell proliferation and epithelial mesenchymal transformation at different times after modeling were analyzed.Results The modeling success rates in the 1,2,3,and 4 weeks after surgery groups were 80%,90%,100%,and 100%,respectively(P＞0.05).The volume and mass of the ectopic foci were significantly greater in the 3 and 4 weeks after surgery groups compared with the 1 and 2 weeks after surgery groups(P＜0.01).HE staining showed endometrial epithelial cells,mesenchymal cells and a few glands in the ectopic foci tissues.Immunohistochemical staining showed that expression levels of Ki67,PCNA,and N-cadherin in uterus tissues were significantly higher(P＜0.05,P＜0.01)in all the model groups compared with the sham group,while expression levels of E-cadherin were significantly lower(P＜0.05,P＜0.01).Expression levels of Ki67,PCNA,and N-cadherin in the uterus and ectopic foci tissues were significantly higher(P＜0.05,P＜0.01)in the 2,3,and 4 weeks after surgery groups compared with the 1 week after surgery group,while expression levels of E-cadherin were significantly lower(P＜0.05,P＜0.01).Conclusion The uterine horn reversion method can be used to establish an ovarian EMS model in rats.Ectopic lesions can be observed 1 week after surgery.The success rate of modeling increases with modeling time,stabilizing at 3 weeks postoperatively.Ki67,PCNA,and N-cadherin were significantly expressed in the uterus and ectopic foci tissues,and their expression levels increased with modeling time,while E-cadherin expression in the uterus and ectopic foci tissues decreased with modeling time.These results showed good modeling success of the EMS rat model,suggesting that it could be used as a stable EMS modeling method.

Objective To explore the influencing factors of readmission within 90 days in frail patients with chronic obstructive pulmonary disease(COPD),construct an early warning model and evaluate its discrimination and effectiveness.Methods A total of 831 COPD patients with frailty were included and divided into the readmission group(290 cases)and the control group(541 cases)based on whether they were readmitted within 90 days after discharge.The electronic medical record data were collected and compared between the two groups of patients.Multivariate Logistic regression analysis was used to screen independent influencing factors for readmission within 90 days in COPD weak patients.A predictive model was established.The column chart was drawn.The discriminability of the predictive model was evaluated through receiver operating characteristic(ROC)curves.The clinical practicality and the predictive model calibration were evaluated through decision curves and calibration curves.Results The body mass index(BMI)of the readmission group was lower than that of the non readmission group,and the proportion of acute exacerbation of COPD hospitalizations≥2 times in the past year,the Edmonton frailty scale(REFS)score and the Chalson comorbidity index(CCI)were higher in the readmission group than those of the non readmission group(P＜0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.721,95%CI:0.636-0.818),the number of acute exacerbations of COPD hospitalizations in the past year(OR=3.040,95%CI:1.944-4.753),REFS score(OR=1.726,95%CI:1.486-2.005)and CCI score(OR=3.917,95%CI:3.079-4.983)were all independent influencing factors for readmission within 90 days in COPD frail patients(P＜0.05).Based on the results of multiple factor Logistic regression analysis,the column chart warning model was constructed.The AUC value of the ROC curve was 0.847(95%CI:0.820-0.874),the specificity was 87.20%and the sensitivity was 64.50%.The calibration curve of the predictive model was close to the diagonal,and the calibrationa degree was good.The decision curve suggested that the prediction model had clinical practicality.Conclusion The early warning model constructed based on the influencing factors of readmission hospitalization within 90 days in weak patients with COPD has good predictive effect and clinical practicability.

Objective:To investigate the clinical characteristics and prognostic significance of germline mutations in patients with myelodysplastic neoplasms (MDS) .Methods:Clinical data from 407 patients with MDS [male, 252; female, 155; median age, 64 (range, 19-85) years] diagnosed at the First Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The clinical features and prognostic effects of germline mutations were evaluated.Results:The prevalence of germline mutations in patients with MDS was 5.9% (24/407), peaking at 20.0% in the group aged 21-30 years. The spectrum of germline mutations comprised DDX41 (9 cases, 2.2%), TP53 (3 cases, 0.7%), and single cases of RUNX1, TET2, MPL, CBL, ATRX, CEBPA, ETV6, IDH1, KDM5C, SBDS, GNAS, and CTC1. Patients with germline mutations exhibited significantly lower peripheral WBC counts than those without (1.87×10 9/L vs 2.50×10 9/L, P=0.018), but showed comparable median overall survival (21.3 months vs 21.1 months, P=0.97). Patients with DDX41 germline mutations, compared with those with other germline mutations, had a significantly older median age (65 vs 54 years, P=0.010), lower WBC counts (1.51×10 9/L vs 2.31×10 9/L, P=0.040), increased mean corpuscular volume (111.80 fl vs 97.25 fl, P=0.003), and a higher prevalence of normal karyotypes (100.0% vs 53.3%, P=0.022). The most frequently co-occurring somatic mutations in DDX41 germline mutation carriers were ASXL1, TET2, and RUNX1. Conclusion:In this study, the detection rate of germline mutations in MDS patients was 5.9% (24/407), peaking at 20% in the group aged 21-30 years. DDX41 and TP53 were the most prevalent germline mutations. DDX41 mutation carriers displayed distinct clinical characteristics; however, germline mutations overall showed no significant prognostic effect.

This study investigated the association between a proximal promoter polymorphism of IFNGR1 (interferon-γ receptor α chain, IFNGR-α) and breast cancer susceptibility, as well as the prognostic value of its expression variation in breast cancer patients. A case-control study was conducted at the Sixth Medical Center of PLA General Hospital from June 2020 to June 2022. The study included 182 pathologically confirmed breast cancer patients as the breast cancer group, 177 non-tumor patients with benign breast lesions as the benign breast lesions group, and 229 healthy individuals as the normal control group. 2-3 ml EDTA anticoagulant whole blood samples were collected from all participants, and genomic DNA was extracted and stored for further analysis. Basic patient information was retrieved from the hospital′s electronic medical records by patients′ ID number. The proximal promoter sequence of IFNGR1 was obtained from NCBI, and sequencing primers were designed using Primer Premier 6.0. Sanger sequencing was employed to analyze the IFNGR1 promoter sequence in the three groups, and the results were compared with the Eukaryotic Promoter Database (EPD) sequence using Bioedit software. Statistical analysis was performed on single nucleotide polymorphisms (SNPs) in the IFNGR1 promoter. The TCGA database was utilized to assess the relationship between IFNGR1 expression levels and breast cancer patient survival. The findings revealed that the -56 TG genotype of the IFNGR1 promoter was significantly associated with increased breast cancer risk ( Z=2.73, P<0.05). Notably, IFNGR1 expression was lower in breast cancer group compared to normal control group ( P<0.05). Analysis of the TCGA database indicated that patients with high IFNGR1 expression had longer survival times than those with low expression ( HR=0.87, 95% CI:0.77-0.98, P<0.05). In summary, the IFNGR1 -56 TG genotype is associated with an increased risk of breast cancer, and there is a positive correlation between IFNGR1 expression levels and the survival of breast cancer patients.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

OBJECTIVE To explore the expression level of miR-196a in cervical cells infected with high-risk human papillomavirus(HPV)16 and 18.METHODS The Gene Expression Omnibus(GEO)was used to screen for dif-ferentially expressed miRNAs between HPV 16 or 18-positive cervical cancer cells and normal cervical cells.On-line biological software https://kmplot.com/analysis/was utilized to analyze the relationship between the most differentially expressed miRNA and the overall survival of cervical cancer patients.Cervical swab samples positive for HPV 16 or HPV 18,detected by real-time fluorescent quantitative polymerase chain reaction(qPCR)genoty-ping,were collected as the study subjects.Cervical swab samples from the same period of physical examination population that were negative for HPV 16 or HPV 18 by qPCR genotyping served as negative controls.The qRT-PCR method was employed to detect the level of miR-196a in cervical cells,with data processed via the 2-△△Ctmethod.RESULTS Differential analysis of the GSE86100 data revealed that miR-196a expression de-creased in HPV 16 or HPV 18-positive cervical cells(log2FC=-6.60,P＜0.001),while miR-3188 expression significantly increased(log2FC=6.22,P＜0.001).Using online analysis tools https://kmplot.com/analysis,it was found that cervical cancer patients with high miR-196a expression had a shorter overall survival compared to those with low m iR-196a expression(HR=1.87,95％CI:1.17-3.00,P=0.008).H owever,there was no cor-relation between miR-3188 and the overall survival of cervical cancer patients(HR=1.47,95％CI:0.92-2.37,P=0.110).The results of specific qRT-PCR testing showed that the expression levels of miR-196a in cervical cells positive for HPV 16 and HPV 18 were 0.93±0.09 and 0.51±0.07,respectively,which were lower than those in the normal control group(1.89±0.13)(P＜0.05),consistent with the sequencing analysis results CONCLUSIONS Infection of cervical cells with HPV 16 or HPV 18 can lead to decreased expression of miR-196a,and the expres-sion level of miR-196a is negatively correlated with the overall survival of cervical cancer patients.

This study investigated the association between a proximal promoter polymorphism of IFNGR1 (interferon-γ receptor α chain, IFNGR-α) and breast cancer susceptibility, as well as the prognostic value of its expression variation in breast cancer patients. A case-control study was conducted at the Sixth Medical Center of PLA General Hospital from June 2020 to June 2022. The study included 182 pathologically confirmed breast cancer patients as the breast cancer group, 177 non-tumor patients with benign breast lesions as the benign breast lesions group, and 229 healthy individuals as the normal control group. 2-3 ml EDTA anticoagulant whole blood samples were collected from all participants, and genomic DNA was extracted and stored for further analysis. Basic patient information was retrieved from the hospital′s electronic medical records by patients′ ID number. The proximal promoter sequence of IFNGR1 was obtained from NCBI, and sequencing primers were designed using Primer Premier 6.0. Sanger sequencing was employed to analyze the IFNGR1 promoter sequence in the three groups, and the results were compared with the Eukaryotic Promoter Database (EPD) sequence using Bioedit software. Statistical analysis was performed on single nucleotide polymorphisms (SNPs) in the IFNGR1 promoter. The TCGA database was utilized to assess the relationship between IFNGR1 expression levels and breast cancer patient survival. The findings revealed that the -56 TG genotype of the IFNGR1 promoter was significantly associated with increased breast cancer risk ( Z=2.73, P<0.05). Notably, IFNGR1 expression was lower in breast cancer group compared to normal control group ( P<0.05). Analysis of the TCGA database indicated that patients with high IFNGR1 expression had longer survival times than those with low expression ( HR=0.87, 95% CI:0.77-0.98, P<0.05). In summary, the IFNGR1 -56 TG genotype is associated with an increased risk of breast cancer, and there is a positive correlation between IFNGR1 expression levels and the survival of breast cancer patients.