Intratympanic vs systemic use of steroids as first-line treatment for sudden hearing loss:A meta-analysis of randomized,controlled trials

Background Sudden sensorineural hearing loss(SSNHL)is a common disease in otology,and steroids play an important role in its treatment.Steroids can be administered systemically or locally,and the efficacies of different administration routes remain controversial.Methods We searched the Cochrane,EMBASE,PubMed,Web of Science,CNKI,Wanfang and Weipu databases for randomized controlled trials(RCTs)on glucocorticoid treatments for SSNHL to compare the efficacy of topical and systemic steroid administration.The Review Manager 5.4 software was used for synthesis of data:the rate of reported hearing improvement and change in pure-tone audiometry(PTA).Results In all the included studies,when intratympanic administration was compared to systemic therapies,the risk difference(RD)using reported hearing improvement as an outcome measure was 0.08(95%CI:0.01–0.14,I2=45%).Using PTA changes as an outcome measure in 4 studies,the mean difference(MD)was 10.43 dB(95%CI:3.68–17.18,I2=81%).Hearing improvement RD was also compared among different types of steroid,recovery criteria,follow-up times and diagnostic criteria,and showed no significant differences exception for recovery criteria(>10 dB)(RD-0.06,95%CI:0.14-0.2,I2=0%).Conclusion As the initial treatment for SSNHL,topical steroids seem to be superior to systemic steroid administration,especially in patients with contraindications to systemic steroids usage.However,further verification based on high-quality research is needed.

In situ localization of BiVO_(4) onto two-dimensional MXene promoting photoelectrochemical nitrogen reduction to ammonia

The existing industrial ammonia synthesis usually adopts the Haber-Bosch process,which requires harsh conditions of high temperature and high pressure,and consumes high energy.Under this circumstance,photoelectrochemical(PEC)catalysis is regarded as a promising method for N_(2) reduction reaction(NRR),but bears problems of low efficiency and yield.Thus,exploring active catalysts remains highly desirable.In this work,BiVO_(4)@MXene hybrids have been facilely synthesized by a hydrothermal route.The heterojunctions by the in situ growth of BiVO_(4) onto two-dimensional(2D)MXene greatly increase the NRR efficiency:under photoelectric conditions,the optimized NH_(3) yield is 27.25µg h^(-1) cm^(-2),and the Faraday efficiency achieves 17.54% at−0.8 V relative to the reversible hydrogen electrode(RHE),which are higher than most state-of-the-art NRR(photo)electrocatalysts.The mechanism speculation shows the enhanced light absorption range and the heterojunction formation largely promote the separation and the transfer efficiency of photogenerated carriers,thereby improving the PEC catalytic ability.Therefore,this work provides a hybrid route to combine the advantages of photo and electric catalysis for effective artificial nitrogen fixation.