Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.
Humans ; Male ; Female ; Retrospective Studies ; Prognosis ; Adult ; Middle Aged ; Vertigo/diagnosis* ; Hearing Loss, Sensorineural/diagnosis* ; Young Adult ; Hearing Loss, Sudden/diagnosis* ; Adolescent ; Aged ; Vestibular Evoked Myogenic Potentials

Metabolic dysfunction-associated steatotic liver disease (MASLD), the most prevalent chronic liver condition globally, lacks adequate and effective therapeutic remedies in clinical practice. Recent studies have increasingly highlighted the close connection between the ubiquitin-proteasome system (UPS) and the progression of MASLD. This relationship is crucial for understanding the disease's underlying mechanism. As a sophisticated process, the UPS govern protein stability and function, maintaining protein homeostasis, thus influencing a multitude of elements and biological events of eukaryotic cells. It comprises four enzyme families, namely, ubiquitin-activating enzymes (E1), ubiquitin-conjugating enzymes (E2), ubiquitin-protein ligases (E3), and deubiquitinating enzymes (DUBs). This review aims to delve into the array of pathways and therapeutic targets implicated in the ubiquitination within the pathogenesis of MASLD. Therefore, this review unveils the role of ubiquitination in MASLD while spotlighting potential therapeutic targets within the context of this disease.

Acute liver injury (ALI) serves as a critical precursor and major etiological factor in the progression and ultimate manifestation of various hepatic disorders. The prevention and treatment of ALI is still a serious global challenge. Given the limited therapeutic options for ALI, exploring novel targeted therapeutic agents becomes imperative. The potential therapeutic efficacy of inhibiting RIPK2 is highlighted, as it may provide significant benefits by attenuating the MAPK pathway and NF-κB signaling. Herein, we propose a CMD-OPT model, a two-stage molecular optimization tool for the rapid discovery of RIPK2 inhibitors with optimal properties. Compound RP20, which targets the ATP binding site, demonstrated excellent kinase specificity, ideal oral pharmacokinetics, and superior therapeutic effects in a model of APAP-induced ALI, positioning RP20 as a promising preclinical candidate. This marks the first application of RIPK2 inhibitors in ALI treatment, opening a novel therapeutic pathway for clinical applications. These results highlight the efficacy of the CMD-OPT model in producing lead compounds from known active molecules, showcasing its significant potential in drug discovery.

Objective:To provide a reference for the hierarchical management of clinical nurses in top three hospitals, the hierarchical management evaluation system was conducted and evaluated in the present study.Methods:On the context of three-dimensional structure theory of medical quality, the Delphi method was applied to conduct two rounds of correspondence consultation among 23 nursing experts, and then related indexes were established based on the evaluation results and recommendations.Results:An evaluation system for hierarchical management of clinical nurse in top three hospitals was finally constructed, which included 3 first-grade and 19 second-grade indexes. The effective recovery rate of the two rounds of expert questionnaires and authority Cr of two rounds of expert consultation were 100% and 0.915, respectively. The Kendall coefficients of concordance for significance and operability of the first-grade and second-grade indexes were 0.353/0.515 and 0.344/0.469, respectively ( P<0.01). Conclusions:The hierarchical management of clinical nurses in top three hospitals constructed based on three-dimensional structure theory has reliability and feasibility.

This article interprets the " Screening for and Managing the Person with Frailty in Primary Care: Guidelines " developed in 2020 by the International Conference on Frailty and Sarcopenia Research (ICFSR) . This article also analyzes the characteristics of frailty assessment tools and management strategies for frail elderly in order to provide new ideas for the assessment and management of frail elderly in China, and achieve healthy aging of the elderly.

Objective:To investigate the quality of life of senior women with urinary incontinence and to explore its influencing factors.Methods:A convenient sampling method was used to select 152 senior women with urinary incontinence in Fuzhou Hot-Spring Street Community, Dongjie Street Community and Old-age Care Institutions from June 2017 to September 2017. The quality of life of elderly women with urinary incontinence were observed and the influencing factors were analyzed via International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) and Incontinence Quality of Life Scale (I-QOL).Results:The quality of life of senior women with urinary incontinence was (98.7±12.2) points. The scores of the three dimensions including restrictive behavior, social activity limitation and psychological impact were 34.5±4.4 and 41.4±5.4 and 20.8 ± 3.5, respectively. There were 4 factors that influencing the quality of life of patients, namely, the severity of urinary incontinence, the type of urinary incontinence, diabetes and the frequency of leaking urine ( P<0.01). Conclusions:Urinary incontinence has a certain negative impact on the quality of life of patients, and its influencing factors are complex. Individualized care measures should be taken based on the influencing factors to improve the quality of life of patients.

Objective: To construct evaluation index system of training effectiveness for new recruiting nurses based on the theory of Kirkpatrick Model. Methods: The draft of evaluation index system of training effectiveness for new recruiting nurses was drawn up through literature survey and interview method first, and then it was constructed by using Delphi method and statistical analysis. Results: Through two rounds of expert consultations, the experts′ suggestions were revised and summarized, and then the evaluation index system was constructed, including 4 grade I indexes, 14 grade Ⅱindexes, and 56 grade Ⅲ indexes. The positive coefficients of the two rounds of expert consultation were 96.15% and 100.00%, respectively, with authoritative coefficient of 0.877. The Kendall Harmony Coefficients of importance and operability of grade I, Ⅱ, and Ⅲ indexes were 0.640, 0.378, 0.296, and 0.707, 0.515, 0.416, respectively (P< 0.01). Conclusions The enthusiasm, authority level and coordination degree of the experts were all at a high level. The evaluation index system of training effectiveness for new recruiting nurses was of high importance and operability.

Objective To reduce the incidence of falls in elderly patients and improve the quality of nursing safety using tracing method. Methods The tracking methodology was used to formulate fall prevention system and implement tracking path. The tracking centered on patients with high risk of fall and included three aspects: mastery degree of nurses on fall prevention system, participation degree of patients and the implementation of first class quality control. The comparison of tracking result analysis of two quarters in 2016 helped to find out the main reason of the occurrence of falls in elderly patients, make targeted improvement measures and evaluate the effect. Results After the continuous improvement of using tracking methodology, the scores of inspection results and the mastery degree of all nurses on fall core competence in the second quarter were significantly improved when compared to the first quarter (t=23.18, 17.25;P< 0.01); the incidence of falls decreased from 13 cases (6.5%) in the first quarter to 4 cases (2.0%) in the second quarter, while patients' satisfaction degree increased from 85.5% in the first quarter to 98.5% in the second quarter with statistically significant differences between two quarters (χ2=6.38, 14.72; P< 0.01). Conclusions The application of tracing method can effectively reduce the incidence of falls in elderly patients. The method is beneficial to the long-term management of nursing quality, simple, feasible, easy to use, and worthy promoting.

Objective To investigate bacterial vaginosis (BV)and vulvovaginal candidiasis (VVC)in women and to analyze its related factors.Methods The conditions of Physical examina-tion of 1967 female patients in the region from 2011 to 2013 were analyzed,and questionnaire was used to explore the relevant factors that affect the occurrence of BV and VVC.Results There were 282 patients with vulvovaginal yeast disease with the detection rate of 14.34%(282 /1967);231 patients were detected with bacterial vaginosis with 11.74% of detection rate (231 /1967);The higher detection rate of vulvovaginal candidiasis occurred among 25 to 35 year old and there was no significant difference in the occurrence of BV (P >0.05);Logistic analysis revealed that abortion was the risk factors that affect the treatment of VVC and BV;The man cooperated with the treatment and used condoms as protective factor as the safe factor.Conclusion VVC and BV are associated with vaginal microflora imbalance,so the patients should pay attention to healthy hy-giene habits as well as focus on treatment of the partners to block cross-infection and ensure good treatment effect.

Objective To investigate bacterial vaginosis (BV)and vulvovaginal candidiasis (VVC)in women and to analyze its related factors.Methods The conditions of Physical examina-tion of 1967 female patients in the region from 2011 to 2013 were analyzed,and questionnaire was used to explore the relevant factors that affect the occurrence of BV and VVC.Results There were 282 patients with vulvovaginal yeast disease with the detection rate of 14.34%(282 /1967);231 patients were detected with bacterial vaginosis with 11.74% of detection rate (231 /1967);The higher detection rate of vulvovaginal candidiasis occurred among 25 to 35 year old and there was no significant difference in the occurrence of BV (P >0.05);Logistic analysis revealed that abortion was the risk factors that affect the treatment of VVC and BV;The man cooperated with the treatment and used condoms as protective factor as the safe factor.Conclusion VVC and BV are associated with vaginal microflora imbalance,so the patients should pay attention to healthy hy-giene habits as well as focus on treatment of the partners to block cross-infection and ensure good treatment effect.