Initial steps on the analysis of the underlying pharmacological mechanisms of Wendan decoction on sudden deafness using network pharmacology and molecular docking

Background:Despite its widespread therapeutic use and effectiveness,the underlying pharmacologic mechanisms of Wendan decoction(WDD)and how it works to treat sudden deafness(SD)remain unclear.In this study,the pharmacological mechanisms of WDD underlying SD were analyzed using network pharmacology and molecular docking.Methods:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)was employed to identify the active compounds and target genes of WDD,and genes associated with SD were screened on five databases.RGUI conducted Gene Ontology(GO)functional and the Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.A compound-target network was established using Cytoscape,and the STRING database created a protein-protein interaction(PPI)network to identify the key compounds and targets.Subsequently,a network of crucial compound-target was generated for further molecular docking analysis.For molecular docking simulations of the macromolecular target proteins and their matching ligand molecules,AutoDock Vina and AutoDockTool were utilized.Results:TCMSP identified 162 active target genes and 36 active compounds for WDD.The active target genes were compared with the 2271 genes associated with SD to identify 70 intersecting active target genes linked to 34 active compounds.The GO functional enrichment and KEGG pathway enrichment analyses were undertaken,and compound–target,and PPI networks were built.The key compounds and protein targets were identified and integrated to form a key compound–target network.Eventually,molecular docking was performed to investigate the interactions of the protein targets with their respective compounds.Conclusion:This study highlights the mechanisms of multi-compounds,targets,and pathways of WDD acting on SD and provides further evidence of crucial compounds and their matching target proteins of WDD acting on SD.

Outcomes of treatment of sudden deafness using different Protocols:a retrospective analysis of 104 cases

Objective To compare different treatment protocols for sudden deafness(SD), for the purpose of identifying an appropriate approach to SD. Methods A total of 104 patients with diagnosis of sudden hearing loss treated from Jan 2006 to December 2008 were included in this study, of which 31 received the typical pharmaceutical treatment (groupⅠ), 40 received the typical pharmaceutical treatment plus polarized liquid (GroupⅡ) and 33 received the hyperbaric oxygen in addition to the treatment included in Group Ⅱ(Group Ⅲ). Results The total improvement rate (67.74%, 62.50% and 75.76% for Groups Ⅰ, Ⅱ and Ⅲ respectively) was not statistically different between the three groups (P > 0.05). Conclusion The three treatment protocols are similar when judged by the treatment outcomes in SD, neither being superior to the others. The two important factors that appear to influence treatment outcomes are the audiogram pattern and duration of hearing loss before seeking treatment. Patients with upsloping or peak-type audiograms and treated within 7 days from the onset have better prognosis than others.

Concurrent symptoms and disease conditions in sudden deafness

Objective To study concomitant symptoms and disease conditions in sudden deafness. Methods Clinical data of 418 cases of sudden deafness treated in this department from 2000 to 2007 were reviewed. Results Of the 418 cases, 201 were males and 217 were females. Right ear was involved in 184 cases and left ear in 191 cases. Bilateral involvement was seen in 43 cases. The average age was 44.1 years. Tinnitus was reported in 369 cases (88.3%) either before or after hearing loss, of which 64.5% was of low pitch, 27.1% of high pitch and 8.4% of mixed tones. Constant tinnitus was reported in 83% of the cases, and muffled feelings in 33.3% of the cases. Hearing loss was the only complaint in 221 cases (52.9%). Dizziness was reported in 77 cases (18.4%) and vertigo attacks in 120 cases (28%). Hypertension, coronary artery disease and diabetes were found in 19.6% of 418 cases and hyperlipidemia in 54.5% of 211 cases. CT and / or MRI data were available in 147 cases, with positive findings in 18 cases (12.3%): 2 with acoustic neuroma (1.36%); 4 with emphraxis in the basal ganglia, cerebellum, temporal lobe or parietal lobe, and 12 with poor pneumatization of ipsior contralateral mastoid cells. Conclusion In this case series of sudden deafness, low-pitch constant tinnitus was a common complaint. Most of the studied cases presented with simple hearing loss. Vertigo attacks were more common than dizziness in this group of patients. The most common concomitant disorder was hyperlipidemia, especially high triglycerides. Imaging studies are important in managing sudden deafness in ruling out acoustic neuroma and other intracranial diseases.

Traditional Chinese Medicine Nursing Protocols for Sudden Deafness( Sudden Sensorineural Hearing Loss)

Sudden deafness is one of the commonest acute symptoms in otolaryngology.In recent years,the incidence of sudden deafness is on the rise all over the world,but its etiology is still unclear,and the prognosis is greatly different.Traditional Chinese medicine(TCM)believes that the onset of sudden deafness is related to the liver,gallbladder,heart and triple energizer meridians.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of sudden deafness.

Current State of Clinical Studies on Diagnosis and Treatment of Sudden Deafness in China

Objective To evaluate the current status of clinical studies on diagnosis and treatment of sudden deafness (SD) in China by retrospective reviewing articles on SD published in Chinese journals in the past 5 years. Special attention is given to whether the diagnosis and treatment standards established in 1996 by the otolaryngology branch of Chinese Medical Association (the'1996 standard') were followed. Methods The terms of 'Sudden deafness' and 'treatment' were used as the keywords in searching articles published between 2000 and 2004 in the Chinese biomedicine literature database and Chinese journal network. Principles of evidence-based medicine were applied in reviewing the articles. Results Two hundreds and thirty- four articles were identified, including 176 between 2000 and 2002 and 58 between 2003 and 2004. Among the 176 articles published between 2000 and 2002, effects of medications were studies in 126 articles, of which only 26 (20.6%) followed the'1996 standards'. Eighty-nine (70.6%) were reported based on controlled clinical trials (CCT) and 36 (28.5%) met the criteria of randomized controlled trails (RCT). Of the 58 articles published between 2003 and 2004, drug effects were evaluated in 25 articles, which were all based on the '1996 standards'. However, there lacked placebo control, follow-up data or statistical analysis in these papers. Only 6 articles reported side-effects from pharmacological treatment. Conclusions While a significant number of articles on SD were published in the past 5 years, the '1996 standards' were followed only in a small number of them. The standards may not be appropriate in guiding research and need to be modified for improved guidance to SD management. Multi-center, RCTs should be a crucial part in studies on SD.

Diuretic Agents in Treatment of Sudden Deafness

Objective To study the role of diuretic agents in treating sudden deafness (SD) and explore the possibility of endolymphatic hydrops as a potential cause of SD. Methods Twenty-eight SD cases were reviewed. In 23 cases, treatment was initiated with routine agents. Diuretic agents were later added in 8 of these cases that failed to respond to routine treatment agents. Diuretic agents were included in the initial treatment in the rest 5 cases. In total, 13 cases received diuretics in addition to routine treatment agents and 15 cases received conventional treatment only. Results In the 8 cases who received diuretics after failed conventional treatments, 4 showed hearing improvement, whereas all 5 cases in which diuretics were included in the initial treatment demonstrated hearing improvement. Conclusion These results suggest a possible role of endolymphatic hydrops in the pathophysiologic course of SD. Diuretics should be considered when clear indications exist with no conflicts to other medical conditions.

Cochlear and Vestibular Functional Study in Patients with Sudden Deafness and Lyme Disease

Lyme disease (LD) and idiopathic sudden deafness (ISD) are supposed to be different diseases with different aetiologies. In an attempt to confirm this assumption, 10 patients with confirmed LD and 12 patients with ISD were consecutively included into the study. Further to the laboratory and audio logical investigation, a low frequency sound (LFS) stimulation on posturography was performed and evaluated. Patients with ISD had higher pure tone average (PTA) than patients with LD (PTA ISD/LD was 72 decibel (dB)/23 dB). There was no difference of vertigo between LD and ISD patients. Patients with ISD have more body sway velocity during the first stimulation than patients with LD. We conclude that the cochlear organ is more affected in ISD patients than in patients with LD. However, the vestibular organ seems to be affected in both diseases. ISD and LD are two different disease entities with different aetiologies but with common otological clinical signs.

Experimental study of transient cochlear ischemia as a cause of sudden deafness

The etiology of sudden deafness or idiopathic sudden sensorineural hearing loss(ISSHL) remains unclear. Over the past 15 years, we have investigated the mechanisms of ischemic-induced hearing loss using a gerbil model of transient cochlear ischemia. In the gerbil, cochlear ischemia can be induced by occluding the bilateral vertebral arteries simultaneously at the neck, because the posterior communicating arteries of the Circle of Willis close spontaneously around 1 mo after birth. When 15 min ischemia was loaded on this animal, permanent hearing loss of about 25 d B and the death of hair cells, especially inner hair cells were induced. These pathological changes were mainly due to lack of an energy source, glutamate excitotoxicity, and the production of free radicals, especially superoxide and nitrous oxide species. Ischemic damage could be prevented by various procedures, such as cooling the cochlea, intratympanic administration of insulin-like growth factor 1 or AM-111(an anti-apoptotic agent), and systemic administration of prednisolone(steroid), edarabone(free radical scavenger), ginsenoside Rb1(Kanpo), hematopoietic stem cells, glia-cell derived neurotrophic factor, and liposome-encapsulated hemoglobin(artificial red blood cells). We also found that the cochlea was protected by the ischemic tolerance, indi-cating that minor cochlear ischemia alleviates or prevents inner ear damage in subsequent severe cochlear ischemia. As ISSHL usually occurs suddenly, with no preceding sign or symptom, we suggest that most ISSHL cases are caused by circulatory disturbance, probably at the stria vascularis.

Sudden deafness as a prodrome of cerebellar artery infarction:Three case reports

BACKGROUND To summarize the clinical characteristics of acute cerebral infarction(ACI)in patients with sudden deafness(SD)as the first symptom,improve the awareness of the disease,and help diagnosis and treatment.CASE SUMMARY From 2019 to 2020,three patients with ACI with SD as the first symptom were admitted to our hospital.Pure tone audiometry,head magnetic resonance imaging(MRI),vertebral artery and carotid artery B-ultrasound,head and neck computed tomography angiography,and other examinations were performed.Following the treatment of SD,hearing and dizziness were not significantly improved.Then,the patients developed symptoms of related cranial nerve injury,and brain MRI showed cerebral infarction in the cerebellopontine angle area.All three cases were transferred to the neurology department for relevant conservative treatment.CONCLUSION Patients with ACI with SD as the first symptom usually attend the otolaryngology clinic.Here a diagnosis of SD,which is based on an audiological examination,is made and the corresponding treatment is administered.To reduce the misdiagnosis of this disease,close attention should be paid to the changes in the patient's clinical symptoms and related auxiliary examinations should be performed,such as brain MRI and cerebrovascular imaging.Otolaryngologists should pay attention to the type and severity of hearing loss,the accompanying symptoms,age,high-risk factors for cerebral infarction,and related cranial nerve symptoms in patients with SD.If the patient's early brain MRI does not show abnormalities,monitoring remains essential.The head MRI should be analyzed quickly based on the changes in the symptoms of the patient,to make an accurate diagnosis and provide the timely and correct treatment for the patients.

Expression relationship and significance of miR-155 and HDAC2 in peripheral blood mononuclear cells of patients with sudden deafness

Objective:To investigate the expressions of microRNA-155 (miR-155) and histone deacetylase 2 (HDAC2) in peripheral blood mononuclear cells (PBMC) of patients with sudden deafness (SSNHL) and their clinical significances.Methods:112 patients with SSNHL who were treated in our hospital from February 2017 to September 2018 were selected as the study subjects, and they were referred to as sudden deafness group, and another 115 healthy examinees in the same period were compared and studied as normal group. The relative expression levels of miR-155, HDAC2, ICAM-1, TNF-α and interleukin-8 (IL-8) in PBMC of all subjects were detected by real-time fluorescence quantitative analysis (qRT-PCR). Pearson method was used to analyze the relationships between miR-155, HDAC2 and the expressions of ICAM-1, TNF-α, IL-8, and miR-155 and the expression of HDAC2 in PBMC of SSNHL patients. Logistic regression analysis was used to analyze the risk factors of SSNHL. The predictive diagnostic values of miR-155 and HDAC2 in PBMC for SSNHL were evaluated. Results:The relative expression levels of miR-155, ICAM-1, TNF-α and IL-8 in PBMC of sudden deafness group were significantly higher than those of normal group (P<0.05), while the relative expression levels of HDAC2 were significantly lower than those of normal group (P<0.05). In SSNHL patients, miR-155 were positively correlated with the expression levels of ICAM-1, TNF-α and IL-8 (P<0.05). The expression level of HDAC2 was negatively correlated with the expression levels of TNF-α and IL-8 (P<0.05). The expression level of miR-155 in PBMC of SSNHL patients was negatively correlated with HDAC2 (P<0.05). MiR-155, ICAM-1, TNF-α and IL-8 were risk factors for SSNHL (P<0.05), while HDAC2 was protective factor for SSNHL (P<0.05). The areas under curve (AUC) of miR-155 and HDAC2 in PBMC for SSNHL diagnosis were 0.855 and 0.835 respectively, the truncation values of which were 1.449 and 0.959 respectively, at this moment, the sensitivities were 75.0% and 81.3% respectively, and the corresponding specificities were 86.1% and 70.1% respectively. The AUC of combined diagnosis of SSNHL was 0.927, and the sensitivity and specificity were 86.7% and 85.3% respectively.Conclusions:The expressions of miR-155 is high and HDAC2 is low in PBMC of SSNHL patients, which are negatively correlated, and both of them may participate in the occurrence and development of SSNHL through mutual influence, which is a risk factor of SSNHL. The combination of the two can effectively improve the predictive diagnostic value of SSNHL.

Effect of batroxobin combine with ginkgo-damole injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness

Objective: To study the effects of combined use of Batroxobin and Ginkgo Leaf Extract and Dipyridamole Injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness. Methods: A total of 94 patients with sudden deafness in our hospital were selected, and divided them into control group and observation group randomly, 47 cases in each group. All patients were given 10BU batroxobin injection intravenous drip after admission every other day;And the patients of observation group were given intravenous drip of 30ml ginkgo-damole injection, 1 time a day. The hemodynamics, coagulation function, fibrinolytic function and related factors were detected and compared between the two groups before and after treatment. Results: Before treatment, there was no statistical difference in hemodynamics, coagulation function, fibrinolytic function and related factors between the two groups;After treatment, the levels of WBV and PV in the control group was (5.21±0.58) mPa/s and (1.78±0.32) mPa/s, and the observation group was (4.13±0.47) mPa/s and (1.31±0.26) mPa/s, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of PT, APTT, TT and PF was (19.22±3.98) s, (43.57±9.88) s, (15.64±3.27) s and (58.22±10.58) μg/L, and the observation group was (23.97±4.82) s, (52.49±10.38) s, (20.59±4.15) s and (41.03±8.46) μg/L, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The levels of Fib, D-dimer and FDP was (4.52±0.93) g/L, (6.53±1.88) mg/L and (8.17±2.34)μg/mL, and the observation group was (3.13±0.75 g/L, (9.75±2.14) mg/L, (13.52±2.58) μg/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups;The serum levels of ET, NO and SOD was (66.92±5.87) ρg/mL, (48.75±7.61) μmol/L, (95.01±12.38) NU/mL, and the observation group was (63.97±5.24) ρg/mL, (43.11±6.83) μmol/L, (104.79±13.15) NU/mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups. Conclusion: The treatment of patients with sudden deafness using batroxobin combine with ginkgo-damole injection, can improve the hemodynamics, coagulation function, fibrinolytic function of patients, decrease the serum levels of ET and NO, improve the levels of SOD, the effect is curative, it's worthy of clinical application.

Clinical Efficacy of Hyperbaric Oxygen Therapy at Different Pressures in the Treatment of Sudden Deafness

Objective:To analyze the efficacy of hyperbaric oxygen at different pressures in the treatment of sudden deafness.Methods:Eighty-two patients with sudden deafness treated in the Affiliated Hospital of Hebei University from September 2019 to September 2021 were selected as the research subjects.The patients were randomly divided into study group 1 and study group 2,and they were treated with hyperbaric oxygen on the basis of routine treatment,in which the pressure used was 1.8 ATA and 2.2 ATA,respectively.Oxygen was delivered via the pressure stabilizing mask for 60 minutes.The patients received two courses of treatment,each lasting 10 days.The changes in hearing(pure tone audiometry)and the clinical efficacy of both the groups were compared before and after treatment.The data obtained were statistically analyzed using SPSS 19.0.Results:The total effective rate of study group 1 was 90.00%,while that of study group 2 was 76.19%.The differences between the two groups were statistically significant(p<0.05).Conclusion:For patients with sudden deafness treated with hyperbaric oxygen,the clinical efficacy of 1.8 ATA is more significant than that of 2.2 ATA.

The Clinical Effects of Hyperbaric Oxygen in the Treatment of Sudden Deafness

Objective:To observe the clinical effect of hyperbaric oxygen in the treatment of sudden deafness.Methods:Ninety-six patients with sudden deafness diagnosed by the otolaryngology department were divided into 2 groups which comprised of 48 patients in the conventional treatment group and the other 48 patients in the hyperbaric oxygen treatment group.Both groups were treated with methylcobalamin,vitamin B1,and ginkgo biloba extract.The patients in the hyperbaric oxygen treatment group were given hyperbaric oxygen therapy of 2.0 ATA once a day.Each course of treatment lasted 10 days and after two courses of treatment,the clinical efficacies of the two groups were compared.Results:After two courses of treatment,the effect of treatment in the hyperbaric oxygen treatment group was significantly better than that of the conventional treatment group.Conclusion:Hyperbaric oxygen therapy can effectively improve the hearing level of patients with sudden deafness and the overall effective rate of treatment.

Challenging situation of coronary artery anomaly associated with ischemia and/or risk of sudden death

Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.

Analysis of gravity wave activity during stratospheric sudden warmings in the northern hemisphere

Due to the significant changes they bring to high latitude stratospheric temperature and wind,stratospheric sudden warmings(SSWs)can have an impact on the propagation and energy distribution of gravity waves(GWs).The variation characteristics of GWs during SSWs have always been an important issue.Using temperature data from January to March in 2014−2016,provided by the Constellation Observing System for Meteorology,Ionosphere and Climate(COSMIC)mission,we have analyzed global GW activity at 15−40 km in the Northern Hemisphere during SSW events.During the SSWs that we studied,the stratospheric temperature rose in one or two longitudinal regions in the Northern Hemisphere;the areas affected extended to the east of 90°W.During these SSWs,the potential energy density(E_(p)of GWs expanded and covered a larger range of longitude and altitude,exhibiting an eastward and downward extension.The E_(p)usually increased,while partially filtered by the eastward zonal winds.When zonal winds weakened or turned westward,E_(p)began to strengthen.After SSWs,the E_(p)usually decreased.These observations can serve as a reference for analyzing the interaction mechanism between SSWs and GWs in future work.

Protocol of Investigation on Sudden Death at Autopsy, Including Molecular, Genetic and Toxicology Testing

The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

The sudden ocean warming and its potential influences on earlyfrozen landfast ice in the Prydz Bay, East Antarctica

The ocean conditions beneath the ice cover play a key role in understanding the sea ice mass balance in the polar regions.An integrated high-frequency ice-ocean observation system,including Acoustic Doppler Velocimeter,Conductivity-Temperature-Depth Sensor,and Sea Ice Mass Balance Array(SIMBA),was deployed in the landfast ice region close to the Chinese Zhongshan Station in Antarctica.A sudden ocean warming of 0.14℃(p<0.01)was observed beneath early-frozen landfast ice,from(−1.60±0.03)℃during April 16-19 to(−1.46±0.07)℃during April 20-23,2021,which is the only significant warming event in the nearly 8-month records.The sudden ocean warming brought a double rise in oceanic heat flux,from(21.7±11.1)W/m^(2) during April 16-19 to(44.8±21.3)W/m^(2) during April 20-23,2021,which shifted the original growth phase at the ice bottom,leading to a 2 cm melting,as shown from SIMBA and borehole observations.Simultaneously,the slowdown of ice bottom freezing decreased salt rejection,and the daily trend of observed ocean salinity changed from+0.02 d^(-1) during April 16-19,2021 to+0.003 d^(-1) during April 20-23,2021.The potential reasons are increased air temperature due to the transit cyclones and the weakened vertical ocean mixing due to the tide phase transformation from semi-diurnal to diurnal.The high-frequency observations within the ice-ocean boundary layer enhance the comprehensive investigation of the ocean’s influence on ice evolution at a daily scale.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid-to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.

Clinical characteristics and analysis of vestibular-evoked myogenic potentials in patients with sudden sensorineural hearing loss in different ages

BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studies analyzing vestibularevoked myogenic potentials(VEMPs)in SSHL patients across various age groups.AIM To investigate vestibular condition in SSHL patients across various age demographics.METHODS Clinical data of 84 SSHL patients were investigated retrospectively.Audiometry,cervical vestibular evoked myogenic potentials(c-VEMPs),and ocular vestibular evoked myogenic potentials(o-VEMPs)were conducted on these patients.Parameters assessed included the latencies of P1 and N1 waves,as well as the amplitudes of P1–N1 waves.Moreover,the study evaluated the influence of factors such as sex,affected side,configuration of hearing loss,and presence of accompanying vertigo.RESULTS Among the 84 SSHL patients,no significant differences were observed among the three groups in terms of gender,affected side,and the presence or absence of vertigo.Group II(aged 41–60 years)had the highest number of SSHL cases.The rates of absent o-VEMPs in the affected ears were 20.83%,31.58%,and 22.72%for the three age groups,respectively,with no statistically significant difference among them.The rates of absent c-VEMPs in the affected ears were 8.3%,34.21%,and 18.18%for the three age groups,respectively,with significant differences.In the unaffected ears,there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups.In the three age groups,no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1–P1 waves for c-VEMPs and o-VEMPs,either on the affected side or on the unaffected side,across the three age groups.CONCLUSION The extraction rate of VEMPs is more valuable than parameters.Regardless of the presence of vertigo,vestibular organs are involved in SSHL.Notably,SSHL patients aged 41–60 appear more susceptible to damage to the inferior vestibular nerve and saccule.