OBJECTIVE To analyze the difference of genotypes and hearing phenotypes in infants with biallelic allele variant in GJB2,and to provide reference for clinical practice. METHODS One hundred and forty-two subjects with biallelic allele variant in GJB2 were recruited in Beijing Tongren Hospital from August 2012 to March 2024. All subjects received universal newborn hearing screening(UNHS),neonatal deafness genetic screening and audiological tests. The subjects were divided into three groups according to the genotypes:T/T groups(truncated/truncated mutations,59 cases),T/NT group(truncated/non-truncated mutations,50 cases) and NT/NT group(non-truncated/non-truncated mutations,33 cases). Three groups of genotypes,newborn hearing screening results,age at first diagnosis and hearing diagnosis results were analyzed. RESULTS The homozygous mutation of c.235delC/c.235delC was the dominant in T/T group(57.63％),the compound heterozygous mutation of c.235delC/c.109G>A was the dominant in T/NT group(74.00％),and the homozygous mutation of c.109G>A/c.109G>A was the dominant in NT/NT group(96.97％). The overall refer rate of UNHS was 80.28％,and the refer rate of T/T group was 89.83％,which was significantly higher than that of T/NT group 70.00％(P=0.009). The age of first diagnosis of 142 cases was (3.70±1.56) months,there was no significant difference between the three groups(P>0.05). In 142 cases,104 cases with hearing loss accounted for 73.24％,38 cases with normal hearing accounted for 26.76％. The proportion of confirmed hearing loss in T/T group was 100.00％,which was significantly higher than that in T/NT group 52.00％(P<0.001) and NT/NT group 57.58％(P<0.001). In side of hearing loss,of the 104 patients with hearing loss,86 cases(82.69％) had bilateral hearing loss and 18 cases(17.31％) had unilateral hearing loss. The proportion of bilateral hearing loss in T/T group was 100.00％,which was significantly higher than that in T/NT group 57.69％(P<0.001) and NT/NT group 63.16％(P<0.001). Among 190 ears of 104 patients with hearing loss,the degree of hearing loss was predominantly mild to moderate(63.16％),followed by profound(24.74％) and severe(12.10％). Among them,the T/T group was mainly marked by severe to profound hearing loss(58.47％),while both the T/NT group and the NT/NT group were mainly characterized by mild hearing loss(58.54％ and 74.19％),and the differences among the three groups were statistically significant(P<0.001). CONCLUSION In the T/T group,all patients were diagnosed as bilateral hearing loss at first diagnosis,and was mainly severe and profound hearing loss. The bilateral and unilateral hearing loss were 52.00％ and 57.58％ in the T/NT group and NT/NT group at first diagnosis respectively,and was mainly mild hearing loss.

Objective To investigate the relationship and predictive value of blood urea nitrogen(BUN)levels with the risk of in-hospital mortality in patients with septic shock.Methods Clinical data of 328 patients diagnosed with septic shock from January 1,2018 to September 30,2023 in Shenzhen Second People's Hospital were retrospectively collected.The primary outcome indicator was in-hospital death in patients with septic shock.Simple logistic regression analyses was used to explore the correlation between BUN and in-hospital death in patients with septic shock;multiple logistic regression analyses model was used to explore the quantitative relationship between BUN and in-hospital death in septic shock,sensitivity analyses was utilized to test the stability of the results.Results Simple logistic regression analyses suggested that BUN was a risk factor for in-hospital mortality in patients with septic shock.Multiple logistic regression analyses showed a positive correlation between BUN and in-hospital mortality in patients with septic shock:the risk of in-hospital mortality in patients with septic shock was increased by 3.3%for every 1 mmol/L increase in BUN(OR=1.033,P<0.01);after adjusting for different vari-ables,the risk of in-hospital death increased by 2.9%(OR=1.029,P<0.05)and 3.2%(OR=1.032,P<0.05)for each 1 mmol/L increase in BUN,respectively.Sensitivity analyses further confirmed the stability of the results(OR=1.04,P<0.05).Conclusion There is a positive correlation between BUN levels and in-hospital death in patients with septic shock,and it has a predictive value for the risk of in-hospital death in patients with septic shock.

Objective To study the prognostic factors of progressive hearing loss among children with large vestibular aqueduct syndrome(LVAS).Methods The clinical data of 49 children(95 ears)with LVAS who re-ceived at least two hearing tests from January 2017 to January 2023 in our hospital were retrospectively analyzed,and they were divided into two groups according to the progression of hearing loss:the stable group(55 ears)and the progressive group(40 ears).The effects for progressive hearing loss of initial age,gender,laterality,imaging features,audiometric data,and incomplete partition type Ⅱ(IP-Ⅱ)and SLC26A4(type A,B,C,D)genotypes were analyzed by univariate and multivariate Cox regression analysis.The potential prognostic factors were further verified by Kaplan-Meier survival analysis.Results Each dB decrease in the initial average hearing threshold in-creased the expected hazard by 7.03％(P=0.02).Incomplete partition type Ⅱ(IP-Ⅱ)was associated with 5.11 hazard ratio(95％CI,1.81 to 14.45,P=0.002).Genotype C was associated with 6.13 hazard ratio for progressive hearing loss(95％CI,2.07 to 18.13,P=0.001).Conclusion The initial average hearing threshold,IP-Ⅱ,and SLC26A4 genotype C were significant effect factors of progressive hearing loss in patients with LVAS.This could predict the progression of hearing loss in children with LVAS and help identify patients at high risk for progressive hearing loss.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

Objective Baseline investigation was conducted on the current situation of intravenous infusion treatment in a Class Ⅲ Grade A children's hospital in Hu'nan Province, and the quality improvement was carried out according to the investigation results, and explored the quality improvement effect. Methods The baseline investigation on intravenous infusion treatment was conducted in a Class Ⅲ Grade A children's hospital in Hu'nan Province in September 2016. A total of 558 children from 18 clinical departments were selected as research subjects by random number table method. Quality improvement was carried out according to the survey results. A total of 1 088 cases of children undergoing intravenous treatment were investigated for the second round in September 2017. The infusion site, puncture tool, catheter fixation, catheter related complications, catheter maintenance and connection mode were compared before and after quality improvement. Results The selection of infusion sites before and after quality improvement meets the requirements. The usage rate of indwelling needle increased from 88.5% to 94.4%, and the usage rate of spiral joint increased from 56.6% to 73.8%. Both the differences were statistically significant (χ2=78.38, 50.0;P＜0.05). After quality improvement, the incidence of catheter missing was decreased from 92.5% to 82.5% when nurses performed catheter maintenance, with statistical significance (χ2=30.1,P＜0.05). Conclusions By practicing standards for clinical venous treatment, strengthening training, and carrying out process quality control, the quality of work for nursing staff in the selection of infusion tools and the control of complications of indwelling catheters has been significantly improved.

Patients with systemic lupus erythematosus (SLE)are susceptible to influenza virus infection due to autoimmune disorder,use of glucocorticoids and the immunosuppressive agents.Influenza virus infection affects the disease stability,and the mortality of influenza virus infection in SLE patients is 5 times higher than that in general people infected by influenza virus.Vaccination is the most effective measure to prevent influenza virus infection.There is lack of studies on the influenza immunization in SLE patients in China,so this paper reviews prevention effect and safety of inoculation,the immune response to vaccine as well as the factors influencing immune response in influenza vaccination for SLE patients.

OBJECTIVE:To compare the efficacy and safety of Jinkui shenqi pill versus Shengjing capsule in the treatment of oligoasthenozoosperimia under behavioral intervention. METHODS:98 patients with oligoasthenozoosperimia were randomly divid-ed into Shengjing capsule group(49 cases)and Jinkui shenqi pill(49 cases). All patients received intervention treatment(cognitive intervention,psychological intervention,diet intervention and exercise intervention,etc.). Based on it,Shengjing capsule group re-ceived 1.6 g Shengjing capsules,orally,3 times a day;Jinkui shenqi pill group received 6 g Jinkui shenqi pill,orally,twice a day. They were treated for 3 months. Clinical efficacy,semen quality (semen volume,sperm concentration,sperm motility rate, sperm motility)and sex hormone levels [testosterone(T),follicle stimulating hormone(FSH),luteinizing hormone(HLH),pro-gesterone(P),prolactin(PRL)] before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RE-SULTS:The total effective rate in Shengjing capsule group was significantly higher than Jinkui shenqi pill group,with statistical significance(P<0.05). Before treatment,there were no significant differences in semen quality and sex hormone levels(P>0.05). After treatment,semen quality in 2 groups was significantly higher than before,semen volume and sperm motility in Shengjing cap-sule group were higher than Jinkui shenqi pill group,with statistical significances(P<0.05). T levels in 2 groups were significant-ly higher than before,while Shengjing capsule group was lower than Jinkui shenqi pill group,with statistical significances (P<0.05);and there were no significant differences in FSH,HLH,P and PRL before and after treatment in 2 groups(P>0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Under behavioral interven-tion,Shengjing capsule has better efficacy than Jinkui shenqi pill in the treatment of oligoasthenozoosperimia,it can significantly improve semen quality,while Jinkui shenqi pill is better in terms of improving sex hormone levels;and both show good safety.

MOOC,a Massive Open Online Course,is a new curriculum model,which is having a significant impact on higher medical education in China.The paper discussed the feasibility and theoretical basis of MOOC platform-Coursera which was applied to M-learning for medical students,and tried to explore the way to benefit higher medical education reform.

BACKGROUNDHyperglycemia may accelerate liver fibrosis. Currently, there is no effective treatment for liver fibrosis induced by type 2 diabetes. The study aim was to investigate whether RhoA/Rho kinase (ROCK) pathway is involved in liver fibrosis in the rats with type 2 diabetes and define the protective effects of fasudil on livers.

METHODSA rat model of type 2 diabetes was established by high fat diet combined with streptozotocin (30 mg/kg, intraperitoneal injection). Animals were randomly assigned to 3 groups: control rats, untreated diabetic rats that received vehicle and fasudil-treated diabetic rats that received ROCK inhibitor fasudil hydrochloride hydrate (10 mg/kg per day, intraperitoneal injection, for 14 weeks). The morphological features of liver were observed by HE staining. Accumulation of collagen in livers was determined by Masson staining and the measurement of hydroxyproline. The mRNA expression of transforming growth factor-β1 (TGFβ1), connective tissue growth factor (CTGF), type-I, and type-III procollagen was assessed with real-time polymerase chain reaction. The phosphorylation of myosin phosphatase target subunit-1 (MYPT1) and the protein levels of TGFβ1 and α-smooth muscle actin (a-SMA) were evaluated by Western blotting.

RESULTSCompared with control rats, untreated diabetic rats showed higher values of collagen and hydroxyproline in livers (P < 0.01), the phosphorylation of MYPT1 and the protein levels of TGFβ1 and α-SMA were increased (P < 0.01), and the mRNA expression of TGFβ1, CTGF, type-I, and type-III procollagen was upregulated (P < 0.01); compared with untreated diabetic rats, treatment with fasudil signifcantly reduced values of collagen and hydroxyproline (P < 0.01), and decreased the phosphorylation of MYPT1 and the levels of TGFβ1 and α-SMA (P < 0.01), concomitant with the downregulation of TGFβ1/CTGF, type-I, and type-III procollagen mRNA expression (P < 0.01).

CONCLUSIONSFasudil ameliorates liver fibrosis in rats with type 2 diabetes at least partly by inhibiting TGFβ1/CTGF pathway and α-SMA expression. Inhibition of RhoA/ROCK may be a novel therapeutic target for liver fibrosis in diabetic non-alcoholic steatohepatitis.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; analogs & derivatives ; therapeutic use ; Animals ; Connective Tissue Growth Factor ; metabolism ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Liver Cirrhosis ; drug therapy ; enzymology ; metabolism ; Protein Kinase Inhibitors ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism ; rho-Associated Kinases ; antagonists & inhibitors

The serum level of CXCL10 was determined in both patients with Graves' disease (GD) and normal control subjects.Serum CXCL10 levels in untreated and relapsed GD groups were higher compared with the remission group and control group( P＜0.01 ).A significant difference was observed between the former two GD groups (P＜0.01 ),but no difference was found between latter two groups( P＞0.05 ).Serum CXCL10 levels were positively correlated with FT3 and FT4,and negatively correlated with TSH by multiple linear regression analysis( P＜0.01 ).