According to the World Health Organization's world report on hearing, nearly 2.5 billion people worldwide will suffer from hearing loss by 2050, which may contribute to a severe impact on individual life quality and national economies. Sensorineural hearing loss (SNHL) occurs commonly as a result of noise exposure, aging, and ototoxic drugs, and is pathologically characterized by the impairment of mechanosensory hair cells of the inner ear, which is mainly triggered by reactive oxygen species accumulation, inflammation, and mitochondrial dysfunction. Though recent advances have been made in understanding the ability of cochlear repair and regeneration, there are still no effective therapeutic drugs for SNHL. Chinese herbal medicine which is widely distributed and easily accessible in China has demonstrated a unique curative effect against SNHL with higher safety and lower cost compared with Western medicine. Herein we present trends in research for Chinese herbal medicine for the treatment of SNHL, and elucidate their molecular mechanisms of action, to pave the way for further research and development of novel effective drugs in this field.

ObjectiveTo evaluate the therapeutic effect of stewed Polygoni Multiflori Radix on androgenic alopecia （AGA） and study the treatment mechanism. MethodNinety-nine SPF-grade male C57BL/6J mice were randomized into control， model， positive drug （finasteride， 0.65 mg·kg^-1）， low （0.78 g·kg^-1）， medium （1.56 g·kg^-1）， and high （3.12 g·kg^-1）-dose stewed Polygoni Multiflori Radix， and Polygoni Multiflori Radix Praeparata groups by the random number table method. The mouse model of AGA was constructed by subcutaneous multi-point injection of testosterone propionate diluent for 60 days， and the mice were administrated with corresponding drugs by gavage from day 11. The therapeutic effects of stewed Polygoni Multiflori Radix and Polygoni Multiflori Radix Praeparata on AGA were evaluated by newly hair area， hair length， hair weight in the hair removal area， and hematoxylin-eosin staining. Enzyme-linked immunosorbent assay was employed to determine the levels of testosterone （T）， dihydrotestosterone （DHT）， and 5α-reductase （5-AR） in the skin tissue of mice. Western blot was employed to determine the expression levels of key proteins in the Wnt/β-catenin signaling pathway. ResultCompared with the control group， the model group （after 60 days of modeling） showed reductions in the newly hair area， hair length and weight in the back hair removal area， and ratio of hair follicles containing melanin to total hair follicles （P<0.05， P<0.01）， elevated levels of T， DHT， and 5-AR， up-regulated expression level of glycogen synthase kinase-3β （GSK-3β） （P<0.05， P<0.01）， and down-regulated expression levels of β-catenin， phospho-glycogen synthase kinase-3β （p-GSK-3β）， and p-GSK-3β/GSK-3β （P<0.05， P<0.01） in the skin tissue. Compared with the model group， the positive drug， low-， medium-， and high-dose stewed Polygoni Multiflori Radix， and low-， medium-， and high-dose Polygoni Multiflori Radix Praeparata improved the newly hair area and hair length of mice （P<0.01）， and stewed Polygoni Multiflori Radix and Polygoni Multiflori Radix Praeparata at low and medium doses improved the weight of newly formed hair in mice （P<0.05， P<0.01）. The positive drug， low-， medium-， and high-dose stewed Polygoni Multiflori Radix， and low- and high-dose Polygoni Multiflori Radix Praeparata increased the ratio of hair follicles containing melanin to total hair follicles in the skin tissue （P<0.05， P<0.01）. Compared with Polygoni Multiflori Radix Praeparata at the same doses， the medium and high doses of stewed Polygoni Multiflori Radix increased the ratio of melanin-containing hair follicles to total hair follicles （P<0.05）. Compared with the model group， stewed Polygoni Multiflori Radix lowered the levels of T and DHT， down-regulated the expression level of GSK-3β （P<0.01）， and up-regulated the expression levels of β-catenin， p-GSK-3β， and p-GSK-3β/GSK-3β （P<0.05， P<0.01） in the skin tissue of the mice. ConclusionStewed Polygoni Multiflori Radix can ameliorate androgenic alopecia in mice by reducing the androgen level and promoting Wnt/β-catenin signaling.

Objective:To investigate the influence of changes in the cognitive load of anesthesia residents on the teaching effectiveness of high-fidelity scenario simulation.Methods:Eighty-seven anesthesia residents in a grade-A tertiary hospital from February to November 2022 were divided into groups A, B, and C according to the random number method. Three cases were selected from the anesthesia crisis resource teaching case library for high-fidelity simulation training for the three groups, respectively, using the crossover design to control the order of the cases. Each round of training consisted of pre-training instruction, simulation teaching, and post-training summarization and analysis. After three rounds of simulation teaching, cognitive load, anxiety status, test scores, and non-technical skills were evaluated for all the study participants. SPSS 20.0 was used to perform analysis of variance with repeated measures and Pearson's correlation analysis.Results:All the three groups showed significantly higher cognitive load and anxiety scores during the first-round simulation training than during the second-round and third-round simulation trianing. The test scores were significantly lower in the first round [(87.07±5.66), (88.38±5.41), (89.07±6.17)] than in the second round [(95.69±2.29), (96.10±2.08), (96.07±2.60)] and the third round [(96.34±1.45), (96.38±1.50), (96.17±1.73); all P<0.05]. The non-technical skill scores were also significantly lower in the first round [(37.24±7.58), (38.69±7.27), (39.24±8.74)] than in the second round [(46.17±5.55), (47.07±5.59), (47.59±6.74)] and the third round [(47.17±5.21), (48.48±5.38), (48.24±6.83); all P<0.05]. For simulations with the same cases, the trainees showed significantly higher cognitive load and anxiety scores and significantly lower test scores and non-technical skill scores in the first round than in the second and third rounds ( P<0.05). Conclusions:Anesthesia residents have higher levels of cognitive load and anxiety in the first scenario simulation training, which can reduce learning outcomes, and repeated simulation training can reduce trainees' cognitive load and anxiety.

Objective This study was to explore factors related to early radial artery occlusion(RAO)associated transradial approach(TRA).Methods Patients who underwent the TRA from July 2021 to Jan 2024 were included in our study.Patients were divided into radial artery occlusion group and non-radial artery occlusion group.The data of general demography,the number of radial artery punctures attempts,and whether add heparin to the Antispasmodic Agents were recorded to assess the incidence and predictors of RAO.Results A total of 543 patients were included in the study.All patients underwent ultrasound evaluation 24h after DSA.Among them,32 cases experienced RAO,while 511 cases did not experienced RAO.The occurrence rate of RAO was significantly higher in patients without addition of heparin to the antispasmodic agents for the prevention of radial artery spasm,those with more than 3 radial artery puncture attempts and those using either an 11 cm short sheath,or Cordis puncture needles(all P<0.05).Multiple logistic analysis showed that addition of heparin to the Antispasmodic Agents(OR=0.076,95% CI:0.018～0.321,P<0.001),less than 3 radial artery puncture attempts(OR=0.245,95% CI:0.111～0.541,P<0.001),using an 16 cm longer sheath(OR=0.195,95% CI:0.067～0.564,P=0.003),using an Terumo puncture needles(OR=0.325,95% CI:0.148～0.717,P=0.005)could reduce the incidence of RAO.Conclusions Anticoagulation with intrathecal heparin,application of trocar to improve the success rate of puncture,and the use of a 16 cm long sheath can significantly reduce the incidence of early RAO after DSA.

Objective:To explore the effect of discharge preparation service based on timing theory on the care readiness and benefit finding of caregivers for elderly dementia patients.Methods:From January 2021 to December 2022, 100 caregivers of elderly dementia patients from the Neurology Department and Rehabilitation Department of Jingjiang People's Hospital were selected as the subject by convenient sampling. Caregivers were divided into a control group and a study group based on their enrollment time, with 50 cases in each group. The control group received routine nursing, while the study group was treated with discharge preparation services based on timing theory. The effect was evaluated using the Caregiver Preparedness Scale (CPS) and Caregiver Benefit Finding Questionnaire.Results:After intervention, the CPS score of the study group was (22.80±2.83), which was higher than the control group's (17.92±2.60), and the difference was statistically significant ( P<0.05). After three months of discharge, the score of the Caregiver Benefit Finding Questionnaire in the study group was (117.50±6.25), which was higher than the control group's (109.98±9.89), and the difference was also statistically significant ( P<0.05) . Conclusions:The discharge preparation service based on timing it right can improve the care readiness and benefit finding of caregivers for elderly dementia patients.

OBJECTIVE: To explore the genetic basis for a child with Rothmund-Thomson syndrome (RTS). METHODS: The child has featured poikeloderma, short stature, cataract, sparse hair and skeletal malformation. Peripheral blood samples of the child and her family members were collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing. RESULTS: The child was found to harbor compound heterozygous variants of the RECQL4 gene, namely c.1048_1049delAG and c.2886-1G>A, among which c.2886-1G>A was unreported previously. According to the ACMG guidelines, the c.1048_1049delAG was predicted to be pathogenic (PVS1+PM3_Strong+PM2), while the c.2886-1G>A was predicted to be likely pathogenic (PVS1+PM2). CONCLUSION The compound heterozygous variants of the RECQL4 gene probably underlay the pathogenesis of RTS in this patient. Above finding has enriched the mutational spectrum of the RECQL4 gene.
Child ; Family ; Female ; Humans ; Mutation ; RecQ Helicases/genetics* ; Rothmund-Thomson Syndrome/genetics* ; Whole Exome Sequencing

Antibody-drug conjugates(ADCs)are commonly heterogeneous and require extensive assessment of exposure-efficacy and exposure-safety relationships in preclinical and clinical studies.In this study,we report the generation of a monoclonal antibody against monomethyl auristatin E(MMAE)and the development,validation,and application of sensitive and high-throughput enzyme-linked immunosor-bent assays(ELISA)to measure the concentrations of MMAE-conjugated ADCs and total antibodies(tAb,antibodies in ADC plus unconjugated antibodies)in cynomolgus monkey sera.These assays were suc-cessfully applied to in vitro plasma stability and pharmacokinetic(PK)studies of SMADC001,an MMAE-conjugated ADC against trophoblast cell surface antigen 2(TROP-2).The plasma stability of SMADC001 was better than that of similar ADCs coupled with PEG4-Val-Cit,Lys(m-dPEG24)-Cit,and Val-Cit linkers.The developed ELISA methods for the calibration standards of ADC and tAb revealed a correlation be-tween serum concentrations and the OD450 values,with R2 at 1.000,and the dynamic range was 0.3-35.0 ng/mL and 0.2-22.0 ng/mL,respectively;the intra-and inter-assay accuracy bias％ranged from-12.2％to-5.2％,precision ranged from-12.4％to-1.4％,and the relative standard deviation(RSD)was less than 6.6％and 8.7％,respectively.The total error was less than 20.4％.The development and validation steps of these two assays met the acceptance criteria for all addressed validation parameters,which suggested that these can be applied to quantify MMAE-conjugated ADCs,as well as in PK studies.Furthermore,these assays can be easily adopted for development of other similar immunoassays.

Objective:To observe any effects of electroacupuncture (EA) at acupoints CV23 and GV16 in activating c-Fos genes in the brain regions related to swallowing.Methods:Twenty C57 mice were randomly divided into a blank group, an EA at CV23 group, an EA at GV16 group and an EA at CV23+ GV16 group, each of 5. All except the mice in the blank group were given EA at the relevant acupoints CV23 or GV16 or both, respectively, for 15min. Samples were collected from all of the groups 50min after the EA treatment, and immunofluorescence staining was used to quantify the expression of the c-Fos gene in the brain regions controlling swallowing.Results:In the nucleus tractus solitarii the average number of c-Fos positive cells of the CV23 group was (445.1±43.14)/mm 2, significantly higher than the (297.47±25.54)/mm 2 of the GV16 group. No significant differences were observed in the average number of c-Fos positive cells in parabrachial nucleus. In the primary motor cortex the average number of c-Fos positive cells in the GV16 group was significantly higher than in the other two groups. In the primary sensory cortex the CV23+ GV16 group had a significantly higher average number. Conclusions:EA at the CV23 most strongly activates the c-Fos gene in the nucleus tractus solitarii. For c-Fos activation in the primary motor cortex GV16 is the most effective point. For c-Fos activation in the primary sensory cortex, EA at CV23 and GV16 together is recommended. These results may guide the selection of acupoints in treating dysphagia.

Objective:To analyze the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Hainan Province, so as to provide basis for diagnosis, treatment, prevention and control of the disease.Methods:Clinical data of 93 patients with tsutsugamushi disease in the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2019 were collected. Epidemiological data, clinical manifestations, examination results, treatment and outcome of the patients were retrospectively analyzed.Results:Of totally 93 patients with tsutsugamushi disease, 48 were male and 45 were female, with an average age of 50.73 years old. The peak time of onset was from June to October, with 46 cases (49.46%). Seventy cases (75.27%) were farmers, and 84 cases (90.32%) had a clear history of field work or grassland contact before onset. The clinical manifestations were fever (93/93, 100.00%), eschar or ulcer (42/93, 45.16%), headache (65/93, 69.89%), chills (60/93, 64.52%), rash (35/93, 37.63%), lymphadenopathy (51/93, 54.84%) and fatigue (40/93, 43.01%). Laboratory examination results: eosinophil reduced (74/93, 79.57%), platelet reduced (32/93, 34.41%); alanine aminotransferase, C reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) were increased in 81.72% (76/93), 97.85% (91/93), 20.43% (19/93) and 72.04% (67/93) of the patients, respectively. Eighty-four cases (90.32%) had abnormal results of chest imaging. All patients were cured by doxycycline.Conclusions:Tsutsugamushi disease is prevalent in summer and autumn in Hainan. It has various clinical manifestations. Doxycycline is an effective treatment drug. It is suggested that the relevant departments should strengthen the training of clinical diagnosis and treatment of tsutsugamushi disease by local clinicians to reduce the misdiagnosis rate.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all <0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all <0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all <0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all <0.01). CONCLUSIONS The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.
Anxiety ; diagnosis ; Betacoronavirus ; Coronavirus Infections ; prevention & control ; psychology ; Depression ; diagnosis ; Fatigue ; diagnosis ; Health Personnel ; psychology ; Humans ; Mental Health ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control ; psychology