Animal models of cochlear implant: Classification and update

Cochlear implantation(CI)is currently recognized as the most effective treatment for severe to profound sensorineural deafness and is considered one of the most successful neural prostheses.Since its inception in 1961,cochlear implantation has expanded its range of applications to encompass younger newborns,older people,and individuals with unilateral hearing loss.In addition,it has improved its surgical methods to minimize the occurrence of complications.Furthermore,notable advancements have been made in the design of electrodes,techniques for speech processing,and software for programming.Nevertheless,inflammation,fibrosis,and even ossification are observed in the cochlea of nearly all cochlear implant(CI)patients.These tissue responses might have a negative impact on the performance of the implants,residual hearing,and the results of post-operative CI rehabilitation.Animal models are significant translational tools that offer essential preclinical data for possible therapeutics.Thus,this study concentrates on the existing animal models used for cochlear implantation,highlights the advancements made in research,and offers insights into potential future research areas.

Effi cacy of partial and complete resuscitative endovascular balloon occlusion of the aorta in the hemorrhagic shock model of liver injury

BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)can temporarily control traumatic bleeding.However,its prolonged use potentially leads to ischemia-reperfusion injury(IRI).Partial REBOA(pREBOA)can alleviate ischemic burden;however,its security and eff ectiveness prior to operative hemorrhage control remains unknown.Hence,we aimed to estimate the effi cacy of pREBOA in a swine model of liver injury using an experimental sliding-chamber ballistic gun.METHODS:Twenty Landrace pigs were randomized into control(no aortic occlusion)(n=5),intervention with complete REBOA(cREBOA)(n=5),continuous pREBOA(C-pREBOA)(n=5),and sequential pREBOA(S-pREBOA)(n=5)groups.In the cREBOA and C-pREBOA groups,the balloon was inflated for 60 min.The hemodynamic and laboratory values were compared at various observation time points.Tissue samples immediately after animal euthanasia from the myocardium,liver,kidneys,and duodenum were collected for histological assessment using hematoxylin and eosin staining.RESULTS:Compared with the control group,the survival rate of the REBOA groups was prominently improved(all P<0.05).The total volume of blood loss was markedly lower in the cREBOA group(493.14±127.31 mL)compared with other groups(P<0.01).The pH was significantly lower at 180 min in the cREBOA and S-pREBOA groups(P<0.05).At 120 min,the S-pREBOA group showed higher alanine aminotransferase(P<0.05)but lower blood urea nitrogen compared with the cREBOA group(P<0.05).CONCLUSION:In this trauma model with liver injury,a 60-minute pREBOA resulted in improved survival rate and was effective in maintaining reliable aortic pressure,despite persistent hemorrhage.Extended tolerance time for aortic occlusion in Zone I for non-compressible torso hemorrhage was feasible with both continuous partial and sequential partial measures,and the significant improvement in the severity of acidosis and distal organ injury was observed in the sequential pREBOA.

The acceptance of traditional Chinese medicine among patients with Parkinson's disease:A hospital survey

Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of life.To some extent,traditional Chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD patients.The purpose of this study was to investigate the attitude,acceptance,and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital.Methods:A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023.A self-report questionnaire was developed to investigate PD patients’attitudes and acceptance of TCM based on the questionnaire.Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM therapy.Results:A total of 397 patients completed the questionnaire,of which 78.09%were willing to be treated with TCM and 21.91%indicated that they were not willing to use TCM.Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime.These included education level of a bachelor’s degree(odds ratio[OR)=8.554;95%confidence interval[CI]:4.112–17.794;P<0.001,vs junior high school education),living in an urban setting(OR=8.022;95%CI:4.577–14.060;P<0.001,vs rural),having other underlying diseases(OR=5.126;95%CI:3.078–8.537;P<0.001,vs none),having previously used TCM(OR=3.083;95%CI:1.852–5.134;P<0.001,vs not used),believing that TCM therapy is safe(OR=3.530;95%CI:1.446–8.616;P=0.006,vs not thought),believing that TCM therapy is effective(OR=3.859;95%CI:1.482–10.047;P=0.006,vs not understood),and being willing to discuss ongoing TCM therapy with an attending physician(OR=62.468;95%CI:30.350–128.574;P<0.001,vs not informed).Conclusion:This study initially investigated the acceptance,attitude,and independent predictors of TCM use among PD patients.To expand the prevalence of TCM use among patients with PD,we recommend to broadening the public outreach for TCM via contemporary means of Internet and broadcast communication,enhancing access to TCM services in rural communities,and strengthening the communication between doctors and patients.

Acute flaccid paralysis and neurogenic respiratory failure associated with enterovirus D68 infection in children: Report of two cases

BACKGROUND Acute flaccid paralysis(AFP)and neurogenic respiratory failure rarely occur in children.At the end of 2018,some children with such symptoms were admitted to our hospital.In this study,we aimed to assess two children with AFP and neurogenic respiratory failure associated with enterovirus D68(EV-D68).CASE SUMMARY Two children admitted to our hospital presented with symptoms and imaging results different from those of acute disseminated encephalomyelitis and hand,foot,and mouth disease.Their main symptoms were AFP and neurogenic respiratory failure.Magnetic resonance imaging showed severe inflammatory injury mainly to the anterior horn cells of the spinal cord.Blood and cerebrospinal fluid samples were collected to assess for pathogens,including bacteria,tuberculosis,cryptococcus,herpes virus,and coxsackie virus,and the results were negative.At the beginning,the two cases were not assessed for EV-D68 in the nasopharyngeal,blood,and cerebrospinal fluid specimens.About 2 mo later,EVD68 was detected in the stool sample of one of the cases.The symptom of AFP was caused by injury to the anterior horn cells at levels C5-L5 of the spinal cord,while neurogenic respiratory failure was at levels C3-C5.CONCLUSION We should pay attention to the detection and diagnosis of EV-D68 and make efforts to develop antivirus drugs and vaccines.

Internal fixation and unicompartmental knee arthroplasty for an elderly patient with patellar fracture and anteromedial osteoarthritis:A case report

BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.

Experimental study on the relationship between traumatic stress and tumor growth,proliferation,and metastasis

Objective This study aimed to investigate the relationship between traumatic stress and tumor growth,proliferation,and metastasis.Methods A scalding method was used as an injurious factor to induce traumatic stress in Wistar rats.The rats were randomly divided into three groups—the control group,mild-scald group,and severe-scald group,with 14 rats in each group.Wistar rats were used to subculture the Walker-256 cell line for the generation of tumor ascites.Tumor cells from the ascites were cultured and used to establish a rat subcutaneous xenograft model.After 7 days,the mild-burn group and the severe-burn group were subjected burns to 10%and 15%of their backs,respectively.Blood was taken from the tail vein of rats at different times to detect changes in blood cortisol,IL-1β,and TNF-αlevels.Pathological specimens were collected 14 days later,and immunohistochemistry was performed to examine vascular endothelial growth factor(VEGF),proliferating cell nuclear antigen(PCNA),E-cadherin,and vimentin.Results Cortisol,IL-1βand TNF-αlevels were significantly higher in the scalding groups than in the control group.Tumor examination was performed after 14 days.The changes in tumor size showed that the tumor volume in the control group(0.593±0.195 cm3)and the mild-scald group(0.782±0.344 cm3)were not significantly different.However,the tumor volume was significantly larger in the severeburn group(1.806±0.838 cm3)than in the control and the mild-burn groups(P<0.05).Tumor tissue immunohistochemistry showed that the percentage of cells expressing PCNA in the control group,mildscald group,and severe-scald group was 57.1%,71.4%and 85.7%,respectively,and the differences among the groups were statistically significant.The number of VEGF-positive cells in the mild-and severescald groups was significantly higher than those of the control group(P<0.05).The number of E-cadherinpositive cells in the tumor tissues was significantly lower in the severe-scald group than that in the control and mild-scald groups.Vimentin showed the opposite trend in the tumor tissue,and the differences were statistically significant(P<0.05).Conclusion Different degrees of a traumatic response in tissues caused by scalding can cause a corresponding stress response in the body.The release of inflammatory mediators;increase in VEGF,PCNA and vimentin in the tumor tissue;and decrease in E-cadherin lead to a change in tumor tissue growth and metastasis.Traumatic stress is associated with tumor growth,proliferation,and metastasis.

Hospital biosecurity capacitation:Analysis and recommendations for the prevention and control of COVID-19

The outbreak of the coronavirus disease 2019(COVID-19)in December 2019 highlighted several concerns regarding hospital biosafety capacitation in the People’s Republic of China,although the epidemic is now under control.This study examined the primary problems related to hospital biosecurity,including the absence of a hospital emergency system,inadequate management and control of nosocomial infection,limited hospital laboratory capacity,and poor hospital admission capacity.Accordingly,this study puts forward the following countermeasures and suggestions for hospitals to deal with future biosecurity events,such as a major epidemic:first,biosecurity management systems and emergency response mechanisms in hospitals need to be set up;second,the investment and guarantee mechanisms for hospital biosecurity construction should be improved;third,the capacity building of biosecurity incident management requires special attention in general hospitals;and finally,comprehensive plans need to be developed for the integrated construction of medical treatment and prevention facilities through diseasecontrol systems.

Eligibility of C-BIOPRED severe asthma cohort for type-2 biologic therapies

To the Editor:Patients with severe persistent asthma experience greater morbidity with more impairment in quality of life despite higher use of health care resources and being treated with existing asthma treatments such as inhaled corticosteroids and b-agonists,and sometimes oral corticosteroid(OCS)therapy.Type-2(T2)high asthma has been identified as a phenotype that responds to targeted T2 biologic therapies such as anti-IgE,anti-interleukin(IL)5,or anti-IL5Ra and anti-IL4Ra monoclonal antibodies,which are currently available in Europe and North America,and are currently introduced in the rest of the world.[1]

Clinical significance,molecular characterization,and immune microenvironment analysis of coagulation-related genes in clear cell renal cell carcinoma

Background:Numerous studies have revealed a tight connection between tumor development and the coagulation system.However,the effects of coagulation on the prognosis and tumor microenvironment(TME)of clear cell renal cell carcinoma(ccRCC)remain poorly understood.Methods:We employed the consensus clustering method to characterize distinct molecular subtypes associated with coagulation patterns.Subsequently,we examined variations in the overall survival(OS),genomic profiles,and TME characteristics between these subtypes.To develop a prognostic coagulation-related risk score(CRRS)model,we utilized the least absolute shrinkage and selection operator Cox regression and stepwise multivariate Cox regression analyses.We also created a nomogram to aid in the clinical application of the risk score,evaluating the relationships between the CRRS and the immune microenvironment,responsiveness to immunotherapy,and targeted treatment.The clinical significance of PLAUR and its biological function in ccRCC were also further analyzed.Results:There were significant differences in clinical features,prognostic stratification,genomic variation,and TME characteristics between the two coagulation-related subtypes.We established and validated a CRRS using six coagulation-related genes that can be employed as an effective indicator of risk stratification and prognosis estimation for ccRCC patients.Significant variations in survival outcomes were observed between the high-and low-risk groups.The nomogram was proficient in predicting the 1-,3-,and 5-year OS.Additionally,the CRRS emerged as a novel tool for evaluating the clinical effectiveness of immunotherapy and targeted treatments in ccRCC.Moreover,we confirmed upregulated PLAUR expression in ccRCC samples that was significantly correlated with poor patient prognosis.PLAUR knockdown notably inhibited ccRCC cell proliferation and migration.Conclusion:Our data suggested that CRRS may be employed as a reliable predictive biomarker that can provide therapeutic benefits for immunotherapy and targeted therapy in ccRCC.

A histological examination of corneal epithelium after iontophoresis with different riboflavin solutions

To the Editor:Currently,from a pathological point of view,corneal collagen crosslinking(CXL)with riboflavin is the only new therapy for controlling keratoconus progression.Riboflavin,as a photosensitizer,can be activated after the ultraviolet radiation in the cornea and prevent it from damaging intraocular organizations.Therefore,the concentration of riboflavin in the corneal stroma must be maintained at a sufficient level during the treatment.[1]Riboflavin,a type of water-soluble macromolecule,is resistant to permeating the corneal epithelial barrier.Thus,de-epithelial eye-dripping was adopted conventionally with complications such as inevitable pain,long recovery time,potential risk of infection,and so on;transepithelial corneal CXL is increasingly becoming a research hotspot.It is thus critically important to improve the transepithelial penetration of riboflavin.Although iontophoresis was reported,it had a slightly higher effect with no clear mechanism analysis.[2,3,4]Corneal epithelium is lipophilic and hydrophobic,and hydrophilic drugs enter corneal stroma via intercellular pathways.In this study,permeability effects of riboflavin in different solvents into the cornea via iontophoresis were compared,and the changes of corneal epithelial cell layer organizations were analyzed to examine the solvent components that are most beneficial to iontophoresis and investigate the underlying mechanism of the penetration effect.

中国新诊断胶质母细胞瘤患者实际治疗方案与Stupp方案的一致性比较

目的评估中国新诊断胶质母细胞瘤(glioblastoma multiforme,GBM)患者实际接受的治疗方案与指南推荐的Stupp方案的一致性。方法纳入202例新诊断GBM患者,评估实际接受的治疗方案与Stupp方案一致的患者比例,以及不符合Stupp方案的原因。结果研究发现,仅15.8%的GBM患者接受了与Stupp方案一致的治疗。治疗方案的不一致主要是由于同步放化疗阶段替莫唑胺剂量>75 mg/m^(2)(58/120;48.3%)和治疗持续时间<42 d(84/120;70.0%),以及辅助治疗阶段替莫唑胺剂量<150 mg/m^(2)(89/101;88.1%)。接受符合Stupp方案治疗的患者的中位总生存期(27.09 vs 18.21个月)和无进展生存期(14.27 vs 12.10个月)更长。结论需要提高中国GBM患者实际接受的治疗方案与Stupp方案的一致性。

Clinical characteristics of sudden hearing loss during pregnancy

Objective:The objective of this study was to explore the clinical characteristics and management of sudden hearing loss(HL)during pregnancy,thus better guiding the clinical practice.Methods:The clinical and follow-up data of 17 patients(17 ears)with sudden HL during pregnancy were analyzed retrospectively(the observe group).Twelve nonpregnant female patients(12 ears)with sudden HL of similar clinical characteristics were selected as the control group.The prognosis of the two groups was compared.All the patients were followed up after delivery,and two of them were readmitted to the hospital 1–2 months after delivery.Results:The observe group had better improvement in hearing and a higher response rate compared to the control group.The pure tone hearing and speech recognition rate of patients could still be improved after the readmitted treatment,and the hearing could partially recover spontaneously during follow-up.The laboratory indicators that affect the inflammatory response and coagulation pathway were significantly different between the two groups.Conclusions:The hearing condition of sudden HL during pregnancy is severe,and the prognosis of these patients is better than nonpregnant patients of similar clinical characteristics.Postpartum treatment is still effective,and some patients showed self-healing with time during follow-up.The inflammatory response and coagulation function may affect the hearing of patients through a metabolic pathway.

Effects of acupuncture on functional gastrointestinal disorders:special effects,coeffects,synergistic effects in terms of single or compatible acupoints

OBJECTIVE:To investigate how the“special effect”/“coeffect”/“synergistic effect”can achieve a positive result using an“acupuncture prescription”for functional gastrointestinal disorders(FGIDs)in clinical practice,based on the characteristics of single/compatible acupoints and acupuncture techniques.METHODS:According to the search strategy,we searched six electronic bibliographic databases and provided a summary for this overview.RESULTS:A large body of evidence has shown that acupuncture has positive effects in the treatment of FGIDs.However,the“prescription”intervention involved different single acupoints,compatible acupoints and acupoints based on expert consensus.CONCLUSIONS:The core acupoints,including Tianshu(ST25),Zusanli(ST36),and Shangjuxu(ST37),emphasize the application of special acupoints,meridian points and nerve segments,and the two-way regulatory effect found in this study is often used as the basis of acupoint selection and acupoint prescription for acupuncture treatment of FGIDs.

tRF-Gln-CTG-026 ameliorates liver injury by alleviating global protein synthesis

tsRNAs(tRNA-derived small RNAs),as products of the stress response,exert considerable influence on stress response and injury regulation.However,it remains largely unclear whether tsRNAs can ameliorate liver injury.Here,we demonstrate the roles of tsRNAs in alleviating liver injury by utilizing the loss of NSun2(NOP2/Sun domain family,member 2)as a tsRNAs-generating model.Mechanistically,the loss of NSun2 reduces methyluridine-U5(m^(5)U)and cytosine-C5(m^(5)C)of tRNAs,followed by the production of various tsRNAs,especially Class I tsRNAs(tRF-1s).Through further screening,we show that tRF-Gln-CTG-026(tG026),the optimal tRF-1,ameliorates liver injury by repressing global protein synthesis through the weakened association between TSR1(pre-rRNA-processing protein TSR1 homolog)and pre-40S ribosome.This study indicates the potential of tsRNA-reduced global protein synthesis in liver injury and repair,suggesting a potential therapeutic strategy for liver injury.

Acute pancreatitis may be a pathogenic factor of fulminant type 1 diabetes mellitus

To the Editor:Fulminant type 1 diabetes mellitus(FT1DM)is characterized by a rapid loss ofβ-cell functions,negative antibody to islet cells,ketoacidosis,and elevated pancreatic enzymes.[1]In a nationwide survey in Japan,elevated pancreatic enzymes and abdominal pain were found in 98%and 70%of patients with ketoacidosisonset FT1DM,respectively.However,abdominal computed tomography(CT)showed no abnormalities.The increased pancreatic enzymes were related to diabetic ketoacidosis.Several Japanese scholars have reported that FT1DM appeared after acute pancreatitis(AP).So far,no such cases have been reported in China.Here,we report two cases of FT1DM following AP,review previous cases,and speculate the relationship between AP and FT1DM.Informed consents were obtained from both patients.

Brain development in newborns and infants after ECMO

Background Extracorporeal membrane oxygenation(ECMO)not only significantly improves survival rates in severely ill neonates but also is associated with long-term neurodevelopmental issues.To systematically review the available literature on the neurodevelopmental outcomes of neonates and infants who have undergone ECMO treatment,with a focus on motor deficits,cognitive impairments,sensory impairments,and developmental delays.This review aims to understand the incidence,prevalence,and risk factors for these problems and to explore current nursing care and management strategies.Data sources A comprehensive literature search was performed across PubMed,EMBASE,and Web of Science using a wide array of keywords and phrases pertaining to ECMO,neonates,infants,and various facets of neurodevelopment.The initial screening involved reviewing titles and abstracts to exclude irrelevant articles,followed by a full-text assessment of potentially relevant literature.The quality of each study was evaluated based on its research methodology and statistical analysis.Moreover,citation searches were conducted to identify potentially overlooked studies.Although the focus was primarily on neonatal ECMO,studies involving children and adults were also included due to the limited availability of neonate-specific literature.Results About 50%of neonates post-ECMO treatment exhibit varying degrees of brain injury,particularly in the frontal and temporoparietal white matter regions,often accompanied by neurological complications.Seizures occur in 18%–23%of neonates within the first 24 hours,and bleeding events occur in 27%–60%of ECMO procedures,with up to 33%potentially experiencing ischemic strokes.Although some studies suggest that ECMO may negatively impact hearing and visual development,other studies have found no significant differences;hence,the influence of ECMO remains unclear.In terms of cognitive,language,and intellectual development,ECMO treatment may be associated with potential developmental delays,including lower composite scores in cognitive and motor functions,as well as potential language and learning difficulties.These studies emphasize the importance of early detection and intervention of potential developmental issues in ECMO survivors,possibly necessitating the implementation of a multidisciplinary follow-up plan that includes regular neuromotor and psychological evaluations.Overall,further multicenter,large-sample,long-term follow-up studies are needed to determine the impact of ECMO on these developmental aspects.Conclusions The impact of ECMO on an infant’s nervous system still requires further investigation with larger sample sizes for validation.Fine-tuned management,comprehensive nursing care,appropriate patient selection,proactive monitoring,nutritional support,and early rehabilitation may potentially contribute to improving the long-term outcomes for these infants.

A non-surgical suturing strategy for rapid cardiac hemostasis

As the central organ of the human body,once the heart is damaged,it will cause devastating damage to the circulation system of the whole body,often leading to rapid death.Currently,the only treatment option to stop bleeding in penetrating cardiac injuries is surgical suturing,which is extremely complex and risky.In addition,it is difficult to implement this kind of treatment in battlefields with poor medical conditions.Therefore,there is an urgent need to develop an effective cardiac hemostasis strategy.In this work,we propose a two-step hemostasis strategy that can effectively stop bleeding for penetrating heart injuries.That is,cardiac hemostatic plug(CHP)is made from the nanocomposite(polylactic acid/gelatin/absorbable hemostatic particles,PLA/GEL/AHP)with high biosafety,excellent hemostatic performance,and degradability which is used to block cardiac bleeding,and then wound surface is sealed by in-situ electrospun medical glue fibers(N-octyl-2-cyanoacrylate,interfacial toughness:221±23 J·m−2),thus completing cardiac hemostasis(porcine heart with 1 cm diameter penetrating wound).The hemostasis process is simple and quick(<2 min).In addition,it is worth mentioning that we have also proposed a new composite method based on solution blow spinning that is suitable for doping various functional particles,and the PLA/GEL/AHP composite nanofiber membrane prepared by this method is also a promising hemostatic material.

Extranodal Rosai Dorfman disease mimicking multiple liver metastases

A 59-year-old female patient was admitted to our center complaining of upper abdominal pain,fatigue,and intermittent fever for the past 4 months.Her cancer antigen 125(CA125)level was 143.8 U/mL.The computed tomography(CT)scan showed multiple low-density foci in the liver with arterial enhancement,suggestive of liver metastases(Figure 1A).Meanwhile,the positron emission tomography(PET)/CT scan demonstrated multiple FDG avid lesions in the liver with multiple enlarged lymph nodes in the left supraclavicular,mediastinal,supradiaphragmatic,hilar,and retroperitoneal regions,suggestive of liver and lymph nodal metastases(Figure 1B).

Entity and relation extraction with rule-guided dictionary as domain knowledge

Entity and relation extraction is an indispensable part of domain knowledge graph construction,which can serve relevant knowledge needs in a specific domain,such as providing support for product research,sales,risk control,and domain hotspot analysis.The existing entity and relation extraction methods that depend on pretrained models have shown promising performance on open datasets.However,the performance of these methods degrades when they face domain-specific datasets.Entity extraction models treat characters as basic semantic units while ignoring known character dependency in specific domains.Relation extraction is based on the hypothesis that the relations hidden in sentences are unified,thereby neglecting that relations may be diverse in different entity tuples.To address the problems above,this paper first introduced prior knowledge composed of domain dictionaries to enhance characters’dependence.Second,domain rules were built to eliminate noise in entity relations and promote potential entity relation extraction.Finally,experiments were designed to verify the effectiveness of our proposed methods.Experimental results on two domains,including laser industry and unmanned ship,showed the superiority of our methods.The F1 value on laser industry entity,unmanned ship entity,laser industry relation,and unmanned ship relation datasets is improved by+1%,+6%,+2%,and+1%,respectively.In addition,the extraction accuracy of entity relation triplet reaches 83%and 76%on laser industry entity pair and unmanned ship entity pair datasets,respectively.