Objective To investigate the expression of serum microRNA-204-5p(miR-204-5p)in patients with sudden deafness(SD)and its relationship with cochlear function and hearing prognosis.Methods A to-tal of 113 SD patients admitted to this hospital from October 2020 to October 2023 were selected as the case group.According to the hearing prognosis of SD patients,they were divided into a poor prognosis group(n=43)and a good prognosis group(n=70).Another 95 healthy people who underwent the physical examination were selected as the control group.Real-time fluorescent quantitative PCR and enzyme-linked immunosorbent assay were used to detect serum levels of miR-204-5p and endothelin-1(ET-1),and the relationship between them and cochlear function was analyzed.Automatic hemorheology instrument was used to detect the hemo-dynamic parameters.Multivariate Logistic regression was used to analyze the influencing factors of hearing prognosis in SD patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive val-ue of serum miR-204-5p in hearing prognosis of SD patients.Results The serum levels of miR-204-5p and ET-1 and hemodynamic parameters including plasma viscosity(PV),low-shear viscosity(LSV)and whole blood high-shear viscosity(HSV)in the case group were significantly higher than those in the control group(P<0.05).The incidence of cochlear dysfunction in the miR-204-5p high expression group was higher than that in the miR-204-5p low expression group(P<0.05).The levels of serum miR-204-5p,ET-1,PTA,HSV,LSV and PV in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).HSV,LSV,PV,miR-204-5p and ET-1 were related factors affecting the hearing prognosis of SD patients(P<0.05).The area under the curve of serum miR-204-5p,ET-1 combined with hemodynamic pa-rameters to predict the hearing prognosis of SD patients was 0.976.It was better than that of each individual diagnosis(Zfive combination-HSV=3.464,Zfive combination-LSV=3.014,Zfive combination-PV=3.741,Zfive combination-miR-204-5p=3.476,Zfive combination-ET-1=2.829,P=0.001,0.003,<0.001,0.001,0.005).The sensitivity and specificity of combined prediction were 95.35%and 88.57%,respectively.Conclusion Serum miR-204-5p level is significantly in-creased in SD patients,which is closely related to cochlear function and hearing prognosis.Serum miR-204-5p and ET-1 levels combined with hemodynamic indicators have higher predictive efficiency for hearing prognosis in SD patients.

Adolescent depression is increasingly recognized as a serious mental health disorder with distinct clinical and molecular features. Using single-nucleus RNA sequencing, we identified cell-specific transcriptomic changes in the nucleus accumbens (NAc), particularly in astrocytes, of adolescent macaques exhibiting depressive-like behaviors. The level of diacylglycerol kinase beta was significantly reduced in neurons and glial cells of depressed macaques, while FKBP5 levels increased in glial cells. Disruption of GABAergic synapses and disruption of D-glutamine and D-glutamate metabolism were linked to depressive phenotypes in medium spiny neurons (MSNs) and subtypes of astrocytes. Communication pathways between astrocytes and D1/D2-MSNs were also disrupted, involving factors like bone morphogenetic protein-6 and Erb-B2 receptor tyrosine kinase-4. Bulk transcriptomic and proteomic analyses corroborated these findings, and FKBP5 upregulation was confirmed by qRT-PCR, western blotting, and immunofluorescence in the NAc of rats and macaques with chronic unpredictable mild stress. Our results highlight the specific roles of different cell types in adolescent depression in the NAc, offering potential targets for new antidepressant therapies.
Animals ; Nucleus Accumbens/metabolism* ; Male ; Transcriptome ; Depression/genetics* ; Astrocytes/metabolism* ; Neurons/metabolism* ; Rats

Objective To develop an exercise rehabilitation program for the patients with upper limb lymphedema in order to provide standardised guidance for specialised management and nursing practice,and to promote the recovery of patients.Methods With the evidence-based methods,domestic and international literaturs were retrieved and the quality of the papers was evaluated.A research team was established to discuss and draft an initial version of the rehabilitation program for the patients with upper limb lymphedema.Delphi method was used to conduct two rounds of consultation with 15 experts in lymphedema between June and September 2023.According to the expert opinions,the exercise rehabilitation program for patients with upper limb lymphedema was finalised after screening and modification of the indicators.Results The final version of the exercise rehabilitation program for patients with upper limb lymphedema includes four tier-1 indicators(routine upper limb rehabilitation exercises,aerobic exercise,anti-resistance exercise and respiratory training),15 tier-2 indicators,and 33 tier-3 indicators.The positive response rate in both rounds of expert consultation was 100.00%,with the authority coefficient at 0.95.In the second round of expert consultation,it was founds that the importance of tier-3 indicators was from 3.93 to 5.00,with the rationality from 4.13 to 5.00 and the feasibility from 3.53 to 4.93.The coefficient of variation in tier-1 and tier-2 indicators was 0.00-0.17 and 0.07-0.23,respectively.The coefficients of variation of per tier-3 indicator in importance,rationality and feasibility were from 0.00 to 0.22,0.00 to 0.22 and 0.05 to 0.22,respectively.The Kendall's coefficient of concordance(W)for tier-1 and tier-2 indicators was 0.490 and 0.387,respectively.The Kendall's W of per tier-3 indicator in importance,rationality and feasibility was 0.427,0.311 and 0.530,respectively,with statistically significant differences(P<0.001).Conclusion The exercise rehabilitation program developed in this study is scientific,comprehensive and highly targeted.It provides a theoretical basis and practical guidance for exercise rehabilitation and nursing care of the patients with upper limb lymphedema.

Objective To investigate the effects of gut microbiota regulation combined with exercise rehabilitation on non-motor symptoms and neurological function in Parkinson's disease patients.Methods A total of 154 Parkinson's disease patients admitted to our hospital from January 2022 to January 2024 were selected as the subjects of the study.Using a random number table,these 154 patients were evenly divided into a control group and a treatment group,with 77 patients in each group.Both groups received standard treatments,but the control group also underwent exercise rehabilitation therapy,while the treatment group received probiotic supplementation and exercise rehabilitation therapy.The effectiveness of the two groups was then compared.Results Following the 12 weeks,24 weeks therapeutic regimen,The treatment group showed significantly better outcomes(P<0.05).Clinically meaningful reductions were observed in Hoehn-Yahr staging,alongside decreased scores on standardized instruments assessing psychiatric symptoms HAMA,HAMD,SCOPA-AUT,UPDRS Ⅰ-IV and PDSS(P<0.05).Concurrently,the study group exhibited enhanced MMSE(P<0.05).Fecal microbiome analyses revealed a favorable ecological shift characterized by increased colonization of beneficial genera Bifidobacterium and Lactobacillus,with concomitant suppression of pathobionts Enterococcus and Enterobacteriaceae.Gait analysis revealed increased step length,speed,and frequency in the treatment group(P<0.05).Conclusion Patients with Parkinson's disease who received probiotics combined with exercise rehabilitation treatment could effectively improve non-motor symptoms and neurological function,while promoting the balance of intestinal flora,and reduce clinical symptoms.

Objective To investigate the effects of gut microbiota regulation combined with exercise rehabilitation on non-motor symptoms and neurological function in Parkinson's disease patients.Methods A total of 154 Parkinson's disease patients admitted to our hospital from January 2022 to January 2024 were selected as the subjects of the study.Using a random number table,these 154 patients were evenly divided into a control group and a treatment group,with 77 patients in each group.Both groups received standard treatments,but the control group also underwent exercise rehabilitation therapy,while the treatment group received probiotic supplementation and exercise rehabilitation therapy.The effectiveness of the two groups was then compared.Results Following the 12 weeks,24 weeks therapeutic regimen,The treatment group showed significantly better outcomes(P<0.05).Clinically meaningful reductions were observed in Hoehn-Yahr staging,alongside decreased scores on standardized instruments assessing psychiatric symptoms HAMA,HAMD,SCOPA-AUT,UPDRS Ⅰ-IV and PDSS(P<0.05).Concurrently,the study group exhibited enhanced MMSE(P<0.05).Fecal microbiome analyses revealed a favorable ecological shift characterized by increased colonization of beneficial genera Bifidobacterium and Lactobacillus,with concomitant suppression of pathobionts Enterococcus and Enterobacteriaceae.Gait analysis revealed increased step length,speed,and frequency in the treatment group(P<0.05).Conclusion Patients with Parkinson's disease who received probiotics combined with exercise rehabilitation treatment could effectively improve non-motor symptoms and neurological function,while promoting the balance of intestinal flora,and reduce clinical symptoms.

Objective To develop an exercise rehabilitation program for the patients with upper limb lymphedema in order to provide standardised guidance for specialised management and nursing practice,and to promote the recovery of patients.Methods With the evidence-based methods,domestic and international literaturs were retrieved and the quality of the papers was evaluated.A research team was established to discuss and draft an initial version of the rehabilitation program for the patients with upper limb lymphedema.Delphi method was used to conduct two rounds of consultation with 15 experts in lymphedema between June and September 2023.According to the expert opinions,the exercise rehabilitation program for patients with upper limb lymphedema was finalised after screening and modification of the indicators.Results The final version of the exercise rehabilitation program for patients with upper limb lymphedema includes four tier-1 indicators(routine upper limb rehabilitation exercises,aerobic exercise,anti-resistance exercise and respiratory training),15 tier-2 indicators,and 33 tier-3 indicators.The positive response rate in both rounds of expert consultation was 100.00%,with the authority coefficient at 0.95.In the second round of expert consultation,it was founds that the importance of tier-3 indicators was from 3.93 to 5.00,with the rationality from 4.13 to 5.00 and the feasibility from 3.53 to 4.93.The coefficient of variation in tier-1 and tier-2 indicators was 0.00-0.17 and 0.07-0.23,respectively.The coefficients of variation of per tier-3 indicator in importance,rationality and feasibility were from 0.00 to 0.22,0.00 to 0.22 and 0.05 to 0.22,respectively.The Kendall's coefficient of concordance(W)for tier-1 and tier-2 indicators was 0.490 and 0.387,respectively.The Kendall's W of per tier-3 indicator in importance,rationality and feasibility was 0.427,0.311 and 0.530,respectively,with statistically significant differences(P<0.001).Conclusion The exercise rehabilitation program developed in this study is scientific,comprehensive and highly targeted.It provides a theoretical basis and practical guidance for exercise rehabilitation and nursing care of the patients with upper limb lymphedema.

OBJECTIVE To evaluate the clinical effect of Bushen Yuyin Tiaochong Decoction in the treatment of diminished o-varian reserve(DOR)infertility with kidney-yin deficiency.METHODS 60 DOR infertility patients with kidney-yin deficiency from the gynecology outpatient department of the Second Affiliated Hospital of Jiangxi University of Chinese Medicine from October 2020 to April 2023 were selected and divided into the placebo group and the kidney-tonifying group using the random number table method,with 30 cases in each group.Patients in both groups were given oral treatment with dehydroepiandrosterone(DHEA).The placebo group was additionally given placebo.The Bushen Yuyin group was additionally given Bushen Yuyin Tiaochong Decoction.The treat-ment course for both groups was 3 months.Changes in TCM syndrome scores and reproductive life quality scores were observed before and after treatment.Changes in serum follicle-stimulating hormone(FSH),anti-Mullerian hormone(AMH)and estradiol(E2)levels in patients were detected by ELISA.The occurrence of adverse reactions during treatment was observed,and the pregnancy rates of the two groups of patients after treatment were recorded.RESULTS After treatment,the total TCM syndrome scores of patients in the Bushen Yuyin group were significantly reduced(P<0.01),which was better than that of the placebo group(P<0.01);the reproduc-tive life quality scores of patients in both groups were significantly increased(P<0.05,P<0.01),the Bushen Yuyin group was better than the placebo group(P<0.05);the number of AFC in the Bushen Yuyin group was significantly increased(P<0.01),which was better than the control group(P<0.01);the serum AMH levels of patients in both groups were significantly increased(P<0.05,P<0.01),and the Bushen Yuyin group was higher than that of the placebo group(P<0.01);the serum E2 level of patients in both groups was significantly decreased(P<0.05,P<0.01),the Bushen Yuyin group was lower than the placebo group(P<0.01);the serum FSH level of patients in Bushen Yuyin group was significantly decreased(P<0.01),which was better than that of the placebo group(P<0.01);the total pregnancy rate of the Bushen Yuyin group was better than that of the placebo group(P<0.05);no significant ad-verse reactions were observed in both groups during the treatment period.CONCLUSION Bushen Yuyin Tiaochong Decoction can significantly improve the pregnancy rate of DOR infertile patients,enhance ovarian function while reducing TCM syndrome scores,im-prove the quality of reproductive life,and is highly safe.

To summarize the nursing experience of a patient with lower limb lymphedema treated with latissimus dorsi lymph node flap transplantation combined with lymphatic vessel venous anastomosis. The main contents of nursing included refining the observation steps and accurately evaluating the blood supply of the skin flap; real time dynamic communication between medical WeChat images and text, and targeted treatment; implementing personalized disease management to prevent complications; adopting an integrated medical and nursing remote follow-up model to improve follow-up efficiency. After 20 days of careful nursing, the patient′s skin flap had good blood circulation and no vascular crisis or skin flap necrosis after surgery One week after surgery and 1 to 3 months of follow-up, the degree of swelling in the affected limb significantly decreased and the skin softened significantly.

Compared to the general population, there is a higher prevalence of epilepsy in individuals with cerebral palsy (CP). Epilepsy serves as an indicator of CP severity and has a significant impact on the early survival and future quality of life of children with CP. Therefore, it is crucial to investigate the shared mechanisms underlying CP and epilepsy. This study aims to summarize the comorbidity of CP and epilepsy from genetic factors, risk factors, and pathophysiological mechanisms, in order to provide a reference for further research.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.