Objective:This study aimed to evaluate the therapeutic effect of intratympanic injection of ganglioside in patients with refractory sudden deafness. Methods:A total of 120 patients with sudden deafness, aged 18-65 years, whose onset was within 11-42 days, failed to respond to conventional treatment, and had an average hearing threshold（500-4 000 Hz）>60 dB were selected. They were prospectively and randomly divided into a control group of 61 cases and an experimental group of 59 cases. The control group was treated according to the recommended protocol of the Chinese Medical Association（postauricular injection of methylprednisolone）, while the experimental group was treated with intratympanic injection of monosialotetrahexosylganglioside sodium+postauricular injection of methylprednisolone. Both groups were simultaneously administered oral ginkgo biloba extract and citicoline tablets. Hearing was re-examined two weeks after the completion of treatment, and the therapeutic effects of the two different treatment methods were compared and analyzed. Results:The effective rate was 29.51% in the control group and 54.24% in the experimental group（P<0.01）. The average hearing threshold improved by 11.57 dB HL in the control group and 22.50 dB HL in the experimental group（P<0.05）. Conclusion:The combination of postauricular injection of methylprednisolone and intratympanic injection of ganglioside is more effective than postauricular injection of methylprednisolone alone in the treatment of refractory sudden deafness. The earlier the treatment, the better the therapeutic effect.
Humans ; Middle Aged ; Hearing Loss, Sudden/drug therapy* ; Adult ; Prospective Studies ; Young Adult ; Aged ; Adolescent ; Male ; Female ; Injection, Intratympanic ; Gangliosides/administration & dosage* ; Methylprednisolone/therapeutic use* ; Treatment Outcome

Objective To analyze the acupoint selection rule of acupuncture and moxibustion in the treatment of gastrointestinal dysfunction associated with sepsis,thereby providing a reference for clinical treatment.Methods A systematic search was conducted in several databases,including China national knowledge infrastructure(CNKI),China Science Periodical Database,Chinese Science and Technology Journal Database,Chinese Biomedical literature database(CBM),Wanfang Data,and VIP Database,from the inception of the databases until September 30,2023.The collected literature was organized in an Excel database and subjected to descriptive analysis.Association rule analysis and cluster analysis were performed using SPSS 26.0 and SPSS Modeler 18.0 software.Results Finally,35 acupuncture and moxibustion prescriptions in 35 articles were selected for frequency statistics.The results showed 33 acupoints were used to treat gastrointestinal dysfunction in sepsis,with an overall frequency of use of 176 acupoints.The top 10 acupoints used by acupuncture and moxibustion for the treatment of gastrointestinal dysfunction in sepsis from high to low were Zusanli,Tianshu,Shangjuxu,Zhongwan,Neiguan,Xiajuxu,Guanyuan,Qihai,Shangwan,Xiawan.The top 3 were Zusanli(16.5%),Tianshu(13.6%),Shangjuxu(11.9%).The most commonly used meridians were the Foot Yangming Stomach Meridian(52.8%),Ren Meridian(23.9%),and Foot Taiyin Spleen Meridian(8.0%).The main sites for acupoint selection were the lower limbs(44.9%)and abdomen(41.5%).The most commonly used acupoints were combined acupoints below specific acupoints(35.2%),followed by recruited acupoints(27.8%).The results of high-frequency acupoint correlation analysis showed that the acupoints with the highest comprehensive support were Zusanli,Tianshu,Zhongwan,and Shangjuxu.Cluster analysis identified 5 effective clusters(Quchi acupoint-Sanyinjiao acupoint-Neiting acupoint-Daheng acupoint-Jiaji acupoint-Yinlingquan acupoint-Shangwan acupoint-Xiawan acupoint,Guanyuan acupoint-Qihai acupoint-Neiguan acupoint-Xiajuxu acupoint,Tianshu acupoint-Shangjuxu acupoint,Zhongwan acupoint,Zusanli acupoint)and 4 commonly used acupoint combinations(Guanyuan acupoint-Qihai acupoint-Neiguan acupoint-Xiajuxu acupoint,Tianshu acupoint-Shangjuxu acupoint,Zhongwan acupoint,Zusanli acupoint).Conclusions Acupuncture treatment for gastrointestinal dysfunction in sepsis is mainly based on the treatment of"spleen and stomach",with local acupoint selection and acupoint selection along the meridian as the main approach.It emphasizes the application of specific acupoints,especially the Xiahe and Mu acupoints.

Objective:To explore the effect of occupational aluminum (Al) exposure on workers' overall cognitive level and speech function.Methods:In July 2019, by using cluster sampling method, the group of 232 exposed to Al from an Al plant in Shanxi Province were selected as the exposed group, and the group of 228 not exposed to Al were selected as the control group. The blood Al concentration was determined by inductively coupled plasma mass spectrometry (ICP-MAS) . The exposed group was divided into high exposure group and low exposure group according to the median ( M) concentration of Al in serum. The general cognitive function and speech function were evaluated with the Montreal Cognitive Assessment Scale (MoCA) , and the differences in the general cognitive function and speech function between the groups were compared, and non-conditional logistic regression was used to analyze the possible influencing factors of mild cognitive impairment (MCI) . Results:There were significant differences in age, working age, education and drinking status between Al exposed group and control group ( P<0.05) . The total MoCA score, animal naming tese (ANT) score and category fluency repetition (CFT) score in Al exposure group were lower than control group and the differences were statistically significant ( P<0.05) . The full rate of ANT was lower than that of CFT in Al exposure group ( P<0.05) . The total MoCA score, ANT score and CFT score in the high exposure group were significantly lower than those in the control group ( P<0.05) . The score of MoCA, ANT and CFT in high exposure group were lower than those in low exposure group between the level of serum aluminum>60 μg/L group and ≤60 μg/L group ( P<0.05) . Logistic regression analysis showed that working age, serun Al concentration, ANT score, CFT score and SR score were the possible influencing factors of MCI in occupational Al exposure workers ( P<0.05) . Conclusion:Occupational Al exposure can lead to impaired speech function of workers, the higher the ANT score, CFT score and SR score, the lower working age and serum Al concentration, the lower risk of MCI.

Objective:To explore the effect of occupational aluminum (Al) exposure on workers' overall cognitive level and speech function.Methods:In July 2019, by using cluster sampling method, the group of 232 exposed to Al from an Al plant in Shanxi Province were selected as the exposed group, and the group of 228 not exposed to Al were selected as the control group. The blood Al concentration was determined by inductively coupled plasma mass spectrometry (ICP-MAS) . The exposed group was divided into high exposure group and low exposure group according to the median ( M) concentration of Al in serum. The general cognitive function and speech function were evaluated with the Montreal Cognitive Assessment Scale (MoCA) , and the differences in the general cognitive function and speech function between the groups were compared, and non-conditional logistic regression was used to analyze the possible influencing factors of mild cognitive impairment (MCI) . Results:There were significant differences in age, working age, education and drinking status between Al exposed group and control group ( P<0.05) . The total MoCA score, animal naming tese (ANT) score and category fluency repetition (CFT) score in Al exposure group were lower than control group and the differences were statistically significant ( P<0.05) . The full rate of ANT was lower than that of CFT in Al exposure group ( P<0.05) . The total MoCA score, ANT score and CFT score in the high exposure group were significantly lower than those in the control group ( P<0.05) . The score of MoCA, ANT and CFT in high exposure group were lower than those in low exposure group between the level of serum aluminum>60 μg/L group and ≤60 μg/L group ( P<0.05) . Logistic regression analysis showed that working age, serun Al concentration, ANT score, CFT score and SR score were the possible influencing factors of MCI in occupational Al exposure workers ( P<0.05) . Conclusion:Occupational Al exposure can lead to impaired speech function of workers, the higher the ANT score, CFT score and SR score, the lower working age and serum Al concentration, the lower risk of MCI.

Objective To explore perioperative nursing of elderly patients with intertrochanteric fracture combined with coronary heart disease.Methods A total of 120 femoral intertrochanteric fractures patients with coronary heart disease were selected as the research objects and were randomly divided into observation group (60 cases) with conventional nursing and control group (60 cases) with conventional nursing.Before and after nursing (postoperative 6 h) and after nursing (postoperative 14 d),the pain scores and grading of the patients in the two groups were compared by visual analogue scale (VAS).Before and after nursing,Hamilton Anxiety Scale (HAMA),Depression Scale (HRSD) and the Simple Coping Style Questionnaire (SCSQ) were used to evaluate the psychological status of the two groups.After 14 d of nursing,the Harris hip function score of the patients in the two groups were recorded and compared at discharge and after operation for 6 months.Results After nursing,the number of patients with mild pain of observation group was significantly higher than that of control group (P ＜ 0.05);The number of severe pain was significantly lower than that of the control group (P ＜ 0.01).After nursing,VAS scores of two groups were significantly lower than treatment before (P ＜ 0.05).VAS score of observation group was significantly lower than that of control group (P ＜ 0.05).HAMA,HRSD and SCSQ scores of observation group were significantly lower than nursing before (P ＜ 0.05).The HAMA,HRSD and SCSQ of observation group were significantly lower than that of control group (P ＜ 0.05).Harris hip score of observation group was significantly higher than that of control group at different time points (P ＜ 0.05).Conclusion Comprehensive,scientific and rational nursing should be given to elderly patients with intertrochanteric fracture combined with coronary heart disease during perioperative period.

Objective To explore perioperative nursing of elderly patients with intertrochanteric fracture combined with coronary heart disease.Methods A total of 120 femoral intertrochanteric fractures patients with coronary heart disease were selected as the research objects and were randomly divided into observation group (60 cases) with conventional nursing and control group (60 cases) with conventional nursing.Before and after nursing (postoperative 6 h) and after nursing (postoperative 14 d),the pain scores and grading of the patients in the two groups were compared by visual analogue scale (VAS).Before and after nursing,Hamilton Anxiety Scale (HAMA),Depression Scale (HRSD) and the Simple Coping Style Questionnaire (SCSQ) were used to evaluate the psychological status of the two groups.After 14 d of nursing,the Harris hip function score of the patients in the two groups were recorded and compared at discharge and after operation for 6 months.Results After nursing,the number of patients with mild pain of observation group was significantly higher than that of control group (P ＜ 0.05);The number of severe pain was significantly lower than that of the control group (P ＜ 0.01).After nursing,VAS scores of two groups were significantly lower than treatment before (P ＜ 0.05).VAS score of observation group was significantly lower than that of control group (P ＜ 0.05).HAMA,HRSD and SCSQ scores of observation group were significantly lower than nursing before (P ＜ 0.05).The HAMA,HRSD and SCSQ of observation group were significantly lower than that of control group (P ＜ 0.05).Harris hip score of observation group was significantly higher than that of control group at different time points (P ＜ 0.05).Conclusion Comprehensive,scientific and rational nursing should be given to elderly patients with intertrochanteric fracture combined with coronary heart disease during perioperative period.

Objective To evaluate the effect of the needle free injection system (INJEX30) and insulin pen on insulin absorption and glycemic control in diabetic patients.Methods A total of 30 diabetic patients on insulin therapy without obvious complications were enrolled in the study with average BMI of 25.24 kg/m2.A comparison study was carried out in those subjects with the INJEX30 and insulin pen at 1 st day and 5th day.After an overnight fasting of 8-10 h,a standard mixed meal(50 g bread,50 g egg and 250 ml milk) was given to each patient.Blood samples at 0,20,40,60 min of the standard mixed meal were collected to test plasma glucose,serum insulin and C peptide.Results No difference was shown in fasting plasma glucose,serum insulin and C peptide between the patients with the two injection methods.The area under the curve (AUC) of plasma glucose and serum C peptide was significantly lower after the INJEX30 injection than that after insulin pen injection [plasma glucose AUC (542 ± 172) min · mmol · L-1 vs (601 ±199) min· mmol · L-1,P ＜0.01; C peptide AUC (70 ±53) min · μg · L-1 vs (80 ±58) min · μg · L-1,P ＜0.01].The AUC of serum insulin was significantly higher after the INJEX30 injection than that after insulin pen injection [serum insulin AUC(5621 ± 3790) min · mIU · L-1 vs(4285 ± 3376) min · mIU · L-1,P ＜0.01].No difference was found in the AUC of serum insulin between the two injection methods in the patients with BMI below 25.24 kg/m2,while the AUC of serum insulin was significantly higher after the INJEX30 injection than the insulin pen injection in the patients with BMI above 25.24 kg/m2 [serum insulin AUC(6453 ± 4099) min · mIU · L-1 vs (4879 ± 3701) min · mIU · L-1,P ＜0.01].Conclusion The INJEX30 improves the serum insulin level which may lead to a beneficial effect on the glycemic control.Such effect is more obvious in the overweight patients.