Objectives:To investigate the outcomes of cochlear implantation in Mandarin-speaking cochlear implant (CI) users with single-sided deafness (SSD).Methods:This study was a single-center prospective cohort study. Eleven Mandarin-speaking adult SSD patients who underwent CI implantation at Capital Medical University Beijing Tongren Hospital from August 2020 to October 2021 were recruited, including 6 males and 5 females, with the age ranging from 24 to 50 years old. In a sound field with 7 loudspeakers distributed at 180°, we measured root-mean-square error(RMSE)in SSD patients at the preoperative, 1-month, 3-month, 6-month, and 12-month after switch-on to assess the improvement of sound source localization. The Mandarin Speech Perception (MSP) was used in the sound field to test the speech reception threshold (SRT) of SSD patients under different signal-to-noise locations in a steady-state noise under conditions of CI off and CI on, to reflect the head shadow effect(S SSDN NH), binaural summation effect(S 0N 0) and squelch effect(S 0N SSD). The Tinnitus Handicap Inventory (THI) and the Visual Analogue Scale (VAS) were used to assess changes in tinnitus severity and tinnitus loudness in SSD patients at each time point. The Speech, Spatial and Qualities of Hearing Scale(SSQ) and the Nijmegen Cochlear Implantation Scale (NCIQ) were used to assess the subjective benefits of spatial speech perception and quality of life in SSD patients after cochlear implantation. SPSS 19.0 software was used for statistical analysis. Results:SSD patients showed a significant improvement in the poorer ear in hearing thresholds with CI-on compared with CI-off; The ability to localize the sound source was significantly improved, with statistically significant differences in RMSE at each follow-up time compared with the preoperative period ( P<0.05). In the S SSDN NH condition, which reflects the head shadow effect, the SRT in binaural hearing was significantly improved by 6.5 dB compared with unaided condition, and the difference was statistically significant ( t=6.25, P=0.001). However, there was no significant improvement in SRT between the binaural hearing condition and unaided conditions in the S 0N 0 and S 0N SSD conditions ( P>0.05). The total score of THI and three dimensions were significant decreased ( P<0.05). Tinnitus VAS scores were significantly lower in binaural hearing compared to the unaided condition ( P<0.001). The total score of SSQ, and the scores of speech and spatial dimensions were significant improved in binaural hearing compared to the unaided condition ( P<0.001). There was no statistical difference in NCIQ questionnaire scores between preoperative and postoperative ( P>0.05), and only the self-efficacy subscore showed a significant increase( Z=-2.497, P=0.013). Conclusion:CI could help Mandarin-speaking SSD patients restore binaural hearing to some extent, improve sound localization and speech recognition in noise. In addition, CI in SSD patients could suppress tinnitus, reduce the loudness of tinnitus, and improve subjective perceptions of spatial hearing and quality of life.

Thrombolytic therapy plays a vital role in reperfusion strategy for ST-segment elevation myocardial infarction(STEMI)patients.Previous Chinese expert consensus focused on pre-hospital thrombolysis therapy in STEMI patients was published in 2018 which tremendously promoted pre-hospital thrombolysis therapy.In recent years,plenty of research progress and results of clinical trials have been released in following areas such as STEMI reperfusion strategy,anti-platelet/anti-coagulants therapy,contemporary facilitated percutaneous coronary intervention,and so on.Meanwhile,the COVID-19 pandemic makes timely reperfusion for STEMI patients even more challenging.Therefore,this consensus has been proposed aiming to summarize recent progress in STEMI thrombolysis therapy and to provide practical & evidence-based instructions conforming to national conditions.We hope this consensus will contribute to the emergency management and long-term prognosis of STEMI patients.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective:To investigate the efficacy of the novel bone cement bridging screw system combined with percutaneous vertebroplasty (PVP) in the treatment of symptomatic chronic osteoporotic vertebral fractures (SCOVF) with intravertebral vacuum cleft (IVC).Methods:A retrospective case series study was used to analyze the clinical data of 27 patients with SCOVF admitted to Honghui Hospital affiliated to Xi′an Jiaotong University from August 2016 to August 2018, including 6 males and 21 females; age 69-88 years [(75.2±4.9)years]. All patients were treated by the novel bone cement bridging screw combined with PVP. The operation time, amount of bone cement injected and occurrence of bone cement leakage or displacement were recorded. The vertebral body index (VBI), vertebral body angle (VBA), two-segment Cobb angle (BCA), visual analogue score (VAS) and Oswestry disability index (ODI) were compared preoperatively, at day 1 after operation and at the last follow-up. The results of the MOS 36-item short form health survey (SF-36) and Odom′s criteria were compared preoperatively and at the last follow-up to evaluate pain relief and neurological recovery.Results:All patients were followed up for 36-48 months [(40.2±3.7)months]. The operation time was 37-70 minutes [(49.6±10.8)minutes], with the amount of bone cement injected for 3-6 ml [(34.7±0.9)ml]. Intraoperative bone cement leakage occurred in 4 patients (15%), among which 3 had lateral vertebral leakage and 1 superior intervertebral disc leakage. There was no bone cement displacement during the postoperative period to the last follow-up. The VBI, VBA, BCA, VAS and ODI were (43.1±5.9)%, (21.0±2.6)°, (45.0±6.3)°, 7.6 (7.0, 8.0)points, (79.9±7.6)% preoperatively, were (78.7±2.6)%, (12.7±2.1)°, (26.1±4.7)°, 3.2 (3.0, 4.0)points, (50.0±9.3)% at day 1 after operation, and were (78.0±2.3)%, (13.2±2.4)°, (27.1±4.9)°, 2.0 (2.0, 2.0)points, (22.9±5.1)% at the last follow-up. There were significant differences in above five measures at day 1 after operation and at the final follow-up in comparison with the preoperative values (all P<0.05), and their values measured at day 1 after operation and at the final follow-up were also significantly different (all P<0.05). The SF-36 score in physical function, role physical, body pain, vitality and social function was 45.2 (40.0, 50.0)points, 28.7 (25.0, 50.0)points, 15.9 (10.0, 22.0)points, 48.3 (40.0, 60.0)points, 29.2 (25.0, 37.5)points preoperatively, significantly different from 78.0 (75.0, 85.0)points, 75.0 (75.0, 75.0)points, 68.1 (64.0, 74.0)points, 62.0 (55.0, 70.0)points, 34.7 (25.0, 37.5)points at the last follow-up (all P<0.05). However, there were no significant differences in SF-36 before operation and at the last follow-up in dimensions of general health, emotional function and mental health (all P>0.05). According to Odom′s criteria, 19 patients were graded as excellent, 7 good, 1 fair and 0 poor, with an excellent and good rate of 96%. Conclusion:For SCOVF patients with IVC, the novel bone cement bridging screw system combined with PVP has advantages of no displacement of bone cement, satisfactory fixation, significant pain relief and satisfactory functional recovery.

OBJECTIVE: To identify whether naringenin plays a protective role during thoracic aneurysm formation in Marfan syndrome. METHODS: To validate the effect of naringenin, Fbn1^C1039G/+ mice, the mouse model of Marfan syndrome, were fed with naringenin, and the disease progress was evaluated. The molecular mechanism of naringenin was further investigated via in vitro studies, such as bioluminescence resonance energy transfer (BRET), atomic force microscope and radioligand receptor binding assay. RESULTS: Six-week-old Fbn1^C1039G/+ mice were fed with naringenin for 20 weeks. Compared with the control group, naringenin significantly suppressed the aortic expansion [Fbn1^C1039G/+ vs. Fbn1^C1039G/++naringenin: (2.49±0.47) mm, n=18 vs. (1.87±0.19) mm, n=22, P < 0.05], the degradation of elastin, and the expression and activity of matrix metalloproteinase 2 (MMP2) and MMP9 in the ascending aorta of Fbn1^C1039G/+ mice. Besides, treatment with naringenin for 6 weeks also attenuated the disease progress among the 20-week-old Fbn1^C1039G/+ mice with established thoracic aortic aneurysms [Fbn1^C1039G/+ vs. Fbn1^C1039G/++naringenin: (2.24±0.23) mm, n=8 vs. (1.90±0.17) mm, n=8, P < 0.05]. To understand the underlying molecular mechanisms, we examined the effects of naringenin on angiotensin Ⅱ type 1 receptor (AT1) signaling and transforming growth factor-β (TGF-β) signaling respectively, which were the dominant signaling pathways contributing to aortopathy in Marfan syndrome as previously reported. The results showed that naringenin decreased angiotensin Ⅱ (Ang Ⅱ)-induced phosphorylation of protein kinase C (PKC) and extracellular regulating kinase 1/2 (ERK1/2) in HEK293A cell overexpressing AT1 receptor. Moreover, naringenin inhibited Ang Ⅱ-induced calcium mobilization and uclear factor of activated T-cells (NFAT) signaling. The internalization of AT1 receptor and its binding to β-arrestin-2 with Ang Ⅱ induction were also suppressed by naringenin. As evidenced by atomic force microscope and radioligand receptor binding assay, naringenin inhibited Ang Ⅱ binding to AT1 receptor. In terms of TGF-β signaling, we found that feeding the mice with naringenin decreased the phosphorylation of Smad2 and ERK1/2 as well as the expression of TGF-β downstream genes. Besides, the serum level of TGF-β was also decreased by naringenin in the Fbn1^C1039G/+ mice. Furthermore, we detected the effect of naringenin on platelet, a rich source of TGF-β, both in vivo and in vitro. And we found that naringenin markedly decreased the TGF-β level by inhibiting the activation of platelet. CONCLUSION Our study showed that naringenin has a protective effect on thoracic aortic aneurysm formation in Marfan syndrome by suppressing both AT1 and TGF-β signaling.
Angiotensin II/metabolism* ; Animals ; Aortic Aneurysm, Thoracic/prevention & control* ; Calcium/metabolism* ; Disease Models, Animal ; Elastin/metabolism* ; Fibrillin-1/metabolism* ; Flavanones ; Marfan Syndrome/metabolism* ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Mice ; Mice, Inbred C57BL ; Protein Kinase C/metabolism* ; Receptor, Angiotensin, Type 1/metabolism* ; Transforming Growth Factor beta/metabolism* ; Transforming Growth Factors/metabolism* ; beta-Arrestins/metabolism*

Vascular endothelial cells and oxidation reduction system play an important role in the pathogenesis of atherosclerosis (AS). If these conditions are disordered, it will inevitably lead to plaque formation and even rupture. Astragaloside IV (AsIV) and salvianolic acid B (Sal B) are the main active ingredients of Astragalus membranaceus and Salvia miltiorrhiza, respectively, and found to ameliorate vascular endothelial dysfunction and protect against oxidative stress in recent studies. However, it is still unknown if the combination of AsIV and Sal B (AsIV + Sal B) can inhibit the development of plaque through amplifying the protective effect of vascular endothelial cells and anti-oxidative stress effect. To clarify the role of AsIV + Sal B in AS, we observed the efficacy of each group (Control, Model, AsIV, Sal B, and AsIV + Sal B) by biomolecular assays, such as observing the pathological morphology of the aorta by oil red O staining, evaluating the level of oxidative stress and endothelial cells in the serum by the Elisa test, and analyzing the changes of all small molecule metabolites in liver tissue by UPLC-QTOF-MS. Results showed that AsIV, Sal B and AsIV + Sal B decreased the deposition of lipid in the arterial wall, so as to exert the effect of anti-oxidant stress and vascular endothelial protection, where the inhibitory effect of AsIV + Sal B was the most obvious. Metabonomics analysis showed that Sal B regulated the metabolic pathways of arginine and proline. AsIV regulated glycerol metabolism and saturated fatty acid biosynthesis metabolism. AsIV + Sal B is mainly related to the regulation of the citrate cycle (TCA cycle), alanine, aspartic acid, and glutamate metabolism, cysteine, and methionine metabolism. Succinic acid and methionine are synergistic metabolites that exert an enhancing effect when AsIV and Sal B were used in combination. In conclusion, we demonstrated that AsIV acompanied with Sal B can be successfully used for anti-oxidative stress and vascular endothelial protection of AS, and succinic acid and methionine are the synergistic metabolites.
Antioxidants ; Atherosclerosis ; Benzofurans ; Endothelial Cells ; Humans ; Methionine ; Saponins ; Succinic Acid ; Triterpenes

Objective:To analyze the epidemiological characteristics of a family and workplace clustering of COVID-19， identify the source of infection and the transmission chain， and provide evidence for prevention and control of COVID-19 pandemic. Method:Field epidemiological method was used to conduct the investigation of confirmed cases and close contacts in this cluster. Data were analyzed with descriptive method. Real-time fluorescent quantitative PCR （RT-PCR） was used to detect the novel coronavirus nucleic acid in the collected respiratory tract samples. Results:A total of 18 epidemiological related cases were collected including 16 confirmed cases and 2 cases of asymptomatic infections. The involved places included 1 beauty clinic workplace and 3 families. Seven cases were males and 11 cases were females， with the minimum， maximum and median age of 3， 65 and 32 years old， respectively. Among them， the employees attack rate was 9.80% （10/102）， the family attack rate was 7.70% （5/78）， and the customer attack rate was 0.58% （1/173）. Positive nucleic acid test result in the respiratory tract sample of asymptomatic infection lasted for more than 2 months. Conclusions:The cause of this clustered COVID-19 epidemic is that the workplace environment is relatively closed with clustering crowds， and the source of imported infection is not discovered in time， which lead to a point-source outbreak and spread through family close contacts and clustering.