Based on best track data of tropical cyclones（TCs） from the Japan Meteorological Agency, the characteristics of suddenly reversed TCs（SRTCs）, which have turning angles usually approaching 180°, are statistica...Based on best track data of tropical cyclones（TCs） from the Japan Meteorological Agency, the characteristics of suddenly reversed TCs（SRTCs）, which have turning angles usually approaching 180°, are statistically analyzed from 1949 to 2011 over the western North Pacific Ocean. The typical large-scale circulation patterns of SRTCs are investigated using reanalysis data and dynamical composite analysis. Results show that turnings mainly occur in low latitudes between 10°N and 20°N,and mainly west of 135°E. The majority of SRTCs reach their peak intensity at, or slightly before, the turning time and subsequently decrease at some variable rate. Specifically, SRTCs are divided into four types, each containing two groups（i.e.eight groups in total） in terms of the moving-direction changes. The moving speed of all SRTC types except the south–north type decreases to its lowest during the 24 h, corresponding to a significant reduction in the primary steering components.According to the analysis of the 13 typical flow patterns found in this study, we suggest that sudden track changes are caused by the reversal steering flow. The original balance of the background flow patterns are broken up by new systems, e.g. binary TCs or dispersion-induced anticyclones. Additionally, sudden track changes are often due to double ridge variations of the subtropical high or weakened/strengthened high pressure in the east and west, respectively.展开更多
In this paper,to simulate the three dimensional turbulent flow in suddenly expanded rectangular duct numerically,the SIMPLEC algorithm is employed to solve the incompressible Navier-Stckes equation with k-εturbulenc...In this paper,to simulate the three dimensional turbulent flow in suddenly expanded rectangular duct numerically,the SIMPLEC algorithm is employed to solve the incompressible Navier-Stckes equation with k-εturbulence model.The numerical resulis show well the three dimensional turbulent flow field in the rectangular duct behind the sudden expansion cross-section. and agree.fairly well with the experimental result of the length of the main circumfluence.The numerical method of this paper can be applied to numerical analysis of this kind of turbulent flow.展开更多
ON January 16, 1993, I received a letter from Shan Jiazhi, professor of gynecology and obstetrics at Shandong Provincial Hospital. In his letter, Shan informed me that a woman would soon give birth to quadruplets and ...ON January 16, 1993, I received a letter from Shan Jiazhi, professor of gynecology and obstetrics at Shandong Provincial Hospital. In his letter, Shan informed me that a woman would soon give birth to quadruplets and asked me to quickly come to the hospital. In his office, Professor Shan produced two X-rays of the lying-in woman. "This woman, Su Lixin, is a worker with the Jinan No. 1 Machine Tool Factory. Since she was hospitalized, we’ve applied modern comprehensive measures to control the occurrence of complications and have striven for international standards for the gestational period reaching or surpassing 37 weeks." He then told me that in the United States,展开更多
BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.展开更多
Objective:To analyze the necessity and effectiveness of vestibular rehabilitation training instruction in the treatment of sudden deafness accompanied by vertigo.Methods:Sixty medical staff who learned the treatment m...Objective:To analyze the necessity and effectiveness of vestibular rehabilitation training instruction in the treatment of sudden deafness accompanied by vertigo.Methods:Sixty medical staff who learned the treatment methods for sudden deafness accompanied by vertigo(vestibular rehabilitation training)from January 2024 to February 2025 were selected as the research subjects.They were divided into two groups according to the time of study:the control group,who participated in the training teaching first,and the observation group,who participated later.Each group had 30 people.The control group received conventional training,while the observation group underwent continuous quality improvement.The effects and assessment results of different teaching methods were compared.Results:The theoretical and practical assessment scores of medical staff in the observation group were higher than those in the control group(p<0.05);the satisfaction of medical staff in the observation group with the teaching mode was higher than that in the control group(p<0.05).Conclusion:Vestibular rehabilitation training has significant effects on sudden deafness accompanied by vertigo.Training medical staff not only enhances their understanding of training methods but also enables them to provide specialized guidance to patients,improving their vertigo condition.展开更多
BACKGROUND Managing refractory sudden sensorineural hearing loss(RSSHL)in patients with diabetes mellitus(DM)presents significant therapeutic challenges,highlighting the importance of identifying effective treatment s...BACKGROUND Managing refractory sudden sensorineural hearing loss(RSSHL)in patients with diabetes mellitus(DM)presents significant therapeutic challenges,highlighting the importance of identifying effective treatment strategies.AIM To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM.METHODS This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024,all receiving routine treatment.Participants were categorized into the control group(40 cases),receiving an intratympanic injection of methylprednisolone sodium succinate(MPSS),and the research group(44 cases),treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group.The efficacy,adverse reactions(tympanic membrane perforation,middle ear infections,burning sensation,vertigo,and tinnitus),blood glucose(BG)[fasting BG(FBG),2-hour postprandial BG(2hPBG),and glycosylated hemoglobin(HbA1c)],hearing thresholds at different frequencies(250 Hz,500 Hz,and 1000 Hz),serum biochemical indexes[interleukin(IL)-6,C-reactive protein(CRP),and procalcitonin(PCT)],and quality of life assessed by the short-form 36 item health survey(SF-36)were comparatively analyzed.RESULTS The research group demonstrated a markedly higher total effectiveness rate(81.82%vs 60.00%,P=0.027)and a comparable incidence of total adverse reactions than the control group.Further,the research group exhibited notably reduced FBG,2hPBG,HbA1c,IL-6,CRP,and PCT post-treatment(P<0.01),which were lower compared with the pre-treatment levels and the control group(P<0.05),as well as reduced hearing thresholds at different frequencies(250 Hz,500 Hz,and 1000 Hz,P<0.05).Furthermore,the post-treatment SF-36 scores of the research group in terms of energy,social functioning,role functioning,physical functioning,mental health,and overall health were all significantly improved than the pre-treatment levels and the control group(P<0.05).CONCLUSION The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions,which has a health promotion value.展开更多
Sudden cardiac death(SCD)is one of the most devastating sequelae of myocardial diseases and can be the initial symptom in younger athletes or middle-aged busi-nesspeople.An implantable cardioverter defibrillator(ICD)p...Sudden cardiac death(SCD)is one of the most devastating sequelae of myocardial diseases and can be the initial symptom in younger athletes or middle-aged busi-nesspeople.An implantable cardioverter defibrillator(ICD)prevents SCD and dramatically reduces the arrhythmic events in these patients;hence,the risk strati-fication for the SCD is important.In survivors of out-of-hospital cardiac arrest,identification of its etiologies is required to select the appropriate treat-ments following ICD installation.Cardiac magnetic resonance imaging(MRI)is useful for evaluating the morphology and function of the heart and for tissue character-ization,MRI can therefore be used to stratify the risk of SCD associated with various myocardial diseases and leads to primary prevention using ICD.MRI can predict arrhythmic events,which suggest the progression of myocardial damage,following secondary prevention.In this review,we provide a clinical and MRI focused update and MRI protocol for the primary and secondary prevention of SCD.We summarize the contribution and limitations of cardiac MRI for pre-vention SCD using ICD implantation.展开更多
Objectives:Sudden sensorineural hearing loss(SSNHL)is a sudden onset condition of unknown etiology,often accompanied by tinnitus and vertigo,significantly affecting patients'quality of life.While some individuals ...Objectives:Sudden sensorineural hearing loss(SSNHL)is a sudden onset condition of unknown etiology,often accompanied by tinnitus and vertigo,significantly affecting patients'quality of life.While some individuals experience spontaneous recovery,the unpredictability of treatment outcomes and potential complications pose clinical challenges.Recent studies suggest a potential link between thyroid hormone levels-particularly free triiodothyronine(FT3)and thyroid-stimulating hormone(TSH)-and both the pathogenesis and prognosis of SSNHL.However,the precise mechanisms remain unclear.This study aims to investigate the correlation between thyroid hormone abnormalities and hearing recovery in SSNHL patients,providing insights to enhance diagnostic and therapeutic approaches.Methods:This prospective observational study included 66 SSNHL patients admitted to the Affiliated Hospital of Qingdao University between April 2024 and February 2025.Serum TSH and FT3 levels were measured using chemiluminescence immunoassay,while hearing function was evaluated through pure-tone audiometry following standard guidelines.The“posttreatment hearing gap(PTHG)”was introduced as a quantitative measure of treatment efficacy.All patients received comprehensive treatment,including glucocorticoid therapy and hyperbaric oxygen therapy,and were classified into effective and ineffective groups based on hearing recovery outcomes.Results:No significant differences in gender or comorbidities(tinnitus,ear fullness,dizziness)were observed between the abnormal thyroid function group(n=45)and the normal thyroid function group(n=21)(all p>0.05).Similarly,initial TSH and FT3 levels did not differ significantly among patients with varying degrees of hearing impairment(mild,moderate,severe)(p>0.05).However,during treatment,ΔFT3 demonstrated a significant negative correlation with PTHG(r=-0.739,p=0.002),suggesting that a greater increase inΔFT3 is associated with improved hearing recovery.Additionally,TSH levels showed a significant positive correlation withΔFT3(p<0.05).Conclusions:Abnormal thyroid function in SSNHL patients was not associated with the severity of hearing loss.However,dynamic changes in FT3 during treatment showed a significant correlation with therapeutic efficacy,suggesting that monitoringΔFT3 may have clinical value in prognostic assessment.Nonetheless,this study had a limited sample size,and the potential influence of hormone therapy on thyroid function was not accounted for.Therefore,the role of thyroid hormones in SSNHL warrants further validation through large-scale prospective studies and mechanistic investigations.展开更多
Background Sudden sensorineural hearing loss(SSNHL)is a rapid condition of hearing impairment,typically occurring over 72 hours and affecting the inner ear or auditory nerve pathways.The etiology of SSNHL remains larg...Background Sudden sensorineural hearing loss(SSNHL)is a rapid condition of hearing impairment,typically occurring over 72 hours and affecting the inner ear or auditory nerve pathways.The etiology of SSNHL remains largely idiopathic,with potential causes including viral infections,vascular occlusions,and autoimmune disorders.Traditional treatment primarily involves systemic corticosteroids,but their efficacy is inconsistent,leading to exploring alternative and adjunctive therapies such as intratympanic steroid(ITS)injections.Objective This Systematic Review and Meta-Analysis intends to determine the effectiveness of ITS injections as an initial treatment,combined therapy,or salvage treatment for SSNHL compared to systemic steroids alone.Methods An inclusive study was performed through the PubMed,Scopus,Web of Science,and Cochrane Library databases,encompassing publications published from 2015 to 2024.Case-control studies,cohort studies,randomized controlled trials(RCTs),and systematic reviews were included.Two separate reviewers read the studies and extracted data on steroid administration methods,study outcomes,and risk of bias(ROB)using the Cochrane Collaboration Tool and RevMan 5.4.Results The review included 12 studies with varied designs,including prospective RCTs,systematic reviews,and retrospective analyses.Combined ITS and systemic steroid therapy showed superior hearing recovery compared to systemic steroids alone in several studies.ITS alone demonstrated variable efficacy,with some studies indicating benefits,particularly as a salvage therapy.ROB assessment revealed variability in methodological rigor,with studies like those of Li&Ding et al.(2020)and Devantier et al.(2022)showing low risk,while others exhibited higher risks,particularly in random sequence generation and allocation concealment.Conclusion The findings suggest that ITS injections,particularly when combined with systemic steroids,can enhance hearing recovery in SSNHL patients.However,variability in study outcomes and methodological quality underscores the need for standardized protocols and further high-quality RCTs.This analysis underscores the prospective advantages of ITS therapy while stressing the need for stringent study designs to enhance SSNHL treatment methodologies.展开更多
This article investigates the approaching control for fixed-wing Unmanned Aerial Vehi-cle(UAV)aerial recovery in the presence of pre-specified performance requirements,complex air-flows,maneuvering flight of transport...This article investigates the approaching control for fixed-wing Unmanned Aerial Vehi-cle(UAV)aerial recovery in the presence of pre-specified performance requirements,complex air-flows,maneuvering flight of transport aircraft,and different initial deviations.First,a novelcontrol-oriented Six-Degree-Of-Freedom(6-DOF)UAV model considering airflow disturbancesis established for better consistency with the actual UAV system.Then,to achieve satisfactory per-formance in the approaching process,a Flexible Appointed-time Prescribed Performance Control(FAPPC)algorithm,with the features of user-specified time convergence,no overshoot,indepen-dence from the initial value,and singularity-free,is proposed.Specifically,to solve the singularityissue encountered by the existing PPC methods in dealing with sudden disturbances,an adaptiveadjustment signal is introduced in FAPPC to perceive the threat of increasing error and relax thepreset boundaries appropriately.Moreover,minimum learning parameter-based neural networkestimators are developed to approximate unknown lumped disturbances at a low computationalcost.Finally,the stability of the closed system is analyzed via Lyapunov synthesis,and the effective-ness and advantages of the proposed control scheme are demonstrated via simulation andHardware-In-the-Loop(HIL)experimental validation.展开更多
Quantum interferometric power(IP), a discordlike measure, plays an important role in quantum metrology. We study the dynamics of IP for two-qubit X-shape states under different noisy environments. Our study shows that...Quantum interferometric power(IP), a discordlike measure, plays an important role in quantum metrology. We study the dynamics of IP for two-qubit X-shape states under different noisy environments. Our study shows that IP exhibits sudden change, and one side quantum channel is enough for the occurrence of a sudden change of IP. In particular, we show that the initial state having no sudden change of quantum discord exhibits a sudden change of IP under the dynamics of amplitude noise, but the converse is not true. Besides, we also investigate the dynamics of IP under two different kinds of composite noises. Our results also confirm that sudden change of IP occurs under such composite noises.展开更多
BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores ...BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.展开更多
Wellens’ syndrome is defined by specific T-wave inversions in the precordial leads of the electrocardiogram (ECG),which are indicative of acute anterior myocardial ischemia caused by severe proximal stenosis of the l...Wellens’ syndrome is defined by specific T-wave inversions in the precordial leads of the electrocardiogram (ECG),which are indicative of acute anterior myocardial ischemia caused by severe proximal stenosis of the left anterior descending (LAD)artery.If not promptly treated,approximately 75%of patients with Wellens’ syndrome may experience extensive anterior wall myocardial infarction or sudden cardiac death within days to weeks.^([1,2]) Although the characteristic ECG changes associated with Wellens’syndrome are highly suggestive of LAD occlusion,there are rare instances in which similar ECG alterations are observed in the absence of LAD stenosis,a phenomenon referred to as pseudo-Wellens’ syndrome.The precise pathophysiological mechanisms underlying this syndrome remain unclear.Here,we present a patient with a myocardial bridge who presented a typical Wellens’ECG pattern.展开更多
Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most...Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most severe manifestations are cardiovascular,arising from tumor propagation through the venous system into the inferior vena cava(IVC),right heart,and pulmonary arteries,mimicking thromboembolic disease.[2,3]This can lead to pulmonary embolism(PE),right heart obstruction,and even sudden cardiac death.[4]Diagnosis is challenging,often delayed by misdiagnosis as conventional PE.We present two cases of IVL initially presenting with PE,highlighting the critical cardiovascular implications and diagnostic pitfalls.展开更多
Based on the number of asthmatic children in the Children's Hospital of Yulin City,the monitoring data of daily pollen concentration,and routine meteorological and environmental monitoring data of Yulin City from ...Based on the number of asthmatic children in the Children's Hospital of Yulin City,the monitoring data of daily pollen concentration,and routine meteorological and environmental monitoring data of Yulin City from 2020 to 2022,the meteorological and environmental conditions of a thunderstorm asthma event in Yulin City in northern Shaanxi on September 9,2022 were analyzed.The results show that the strong convective weather was accompanied by a strong thunderstorm,lightning,gusts,short-time heavy precipitation and small hail,and the convective activity lasted for nearly 7 h.The short-term abrupt change of allergenic substances such as artemisia pollen caused by lightning,gusts and precipitation,the sudden drop in temperature,the inversion near the surface and the stimulation of cold air were the key meteorological conditions for the subsequent outbreak of asthma.In early September in 2022,the daily average pollen concentration in Yulin City was up to 1067.9 particles/1000 mm^(2),which was 113.3%and 41.2%higher than that of the same period in 2021 and 2020,respectively.The day before the thunderstorm,the pollen concentration soared to 2680 particles/1000 mm^(2),reaching the maximum of the year.The synergistic effect of the thunderstorm event and the sharp increase in pollen concentration on the previous day provided the background of heavy pollen pollution for this outbreak of thunderstorm asthma.O_(3)concentration was consistently high on the day of thunderstorm and the day before,and the peaks of O_(3)and PM 10 concentration appeared subsequently in the afternoon of the day,which became the background of air pollution for the asthma outbreak.展开更多
Spinal subarachnoid hemorrhage(SSAH)is a relatively uncommon but significant cause of acute and progressive neurological impairment.It represents less than 1.5%of all instances of bleeding within the subarachnoid spac...Spinal subarachnoid hemorrhage(SSAH)is a relatively uncommon but significant cause of acute and progressive neurological impairment.It represents less than 1.5%of all instances of bleeding within the subarachnoid space.[1]The early stages of SSAH often present atypical clinical symptoms,making diagnosis challenging and potentially leading to treatment delays,which further result in irreversible neurological damage.Lower back pain is a common complaint in the emergency department(ED).[2]Common causes include overuse resulting in back strain.展开更多
基金supported by the National Natural Science Foundation of China (Grant Nos. 41230421, 41005029 and 41105065)the National Public Benefit (Meteorology) Research Foundation of China (Grant No. GYHY201106004)
文摘Based on best track data of tropical cyclones（TCs） from the Japan Meteorological Agency, the characteristics of suddenly reversed TCs（SRTCs）, which have turning angles usually approaching 180°, are statistically analyzed from 1949 to 2011 over the western North Pacific Ocean. The typical large-scale circulation patterns of SRTCs are investigated using reanalysis data and dynamical composite analysis. Results show that turnings mainly occur in low latitudes between 10°N and 20°N,and mainly west of 135°E. The majority of SRTCs reach their peak intensity at, or slightly before, the turning time and subsequently decrease at some variable rate. Specifically, SRTCs are divided into four types, each containing two groups（i.e.eight groups in total） in terms of the moving-direction changes. The moving speed of all SRTC types except the south–north type decreases to its lowest during the 24 h, corresponding to a significant reduction in the primary steering components.According to the analysis of the 13 typical flow patterns found in this study, we suggest that sudden track changes are caused by the reversal steering flow. The original balance of the background flow patterns are broken up by new systems, e.g. binary TCs or dispersion-induced anticyclones. Additionally, sudden track changes are often due to double ridge variations of the subtropical high or weakened/strengthened high pressure in the east and west, respectively.
文摘In this paper,to simulate the three dimensional turbulent flow in suddenly expanded rectangular duct numerically,the SIMPLEC algorithm is employed to solve the incompressible Navier-Stckes equation with k-εturbulence model.The numerical resulis show well the three dimensional turbulent flow field in the rectangular duct behind the sudden expansion cross-section. and agree.fairly well with the experimental result of the length of the main circumfluence.The numerical method of this paper can be applied to numerical analysis of this kind of turbulent flow.
文摘ON January 16, 1993, I received a letter from Shan Jiazhi, professor of gynecology and obstetrics at Shandong Provincial Hospital. In his letter, Shan informed me that a woman would soon give birth to quadruplets and asked me to quickly come to the hospital. In his office, Professor Shan produced two X-rays of the lying-in woman. "This woman, Su Lixin, is a worker with the Jinan No. 1 Machine Tool Factory. Since she was hospitalized, we’ve applied modern comprehensive measures to control the occurrence of complications and have striven for international standards for the gestational period reaching or surpassing 37 weeks." He then told me that in the United States,
文摘BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
文摘Objective:To analyze the necessity and effectiveness of vestibular rehabilitation training instruction in the treatment of sudden deafness accompanied by vertigo.Methods:Sixty medical staff who learned the treatment methods for sudden deafness accompanied by vertigo(vestibular rehabilitation training)from January 2024 to February 2025 were selected as the research subjects.They were divided into two groups according to the time of study:the control group,who participated in the training teaching first,and the observation group,who participated later.Each group had 30 people.The control group received conventional training,while the observation group underwent continuous quality improvement.The effects and assessment results of different teaching methods were compared.Results:The theoretical and practical assessment scores of medical staff in the observation group were higher than those in the control group(p<0.05);the satisfaction of medical staff in the observation group with the teaching mode was higher than that in the control group(p<0.05).Conclusion:Vestibular rehabilitation training has significant effects on sudden deafness accompanied by vertigo.Training medical staff not only enhances their understanding of training methods but also enables them to provide specialized guidance to patients,improving their vertigo condition.
基金Supported by 2023 Science and Technology Innovation Program(Key Laboratory of Sleep Respiratory Disorders)in Huai'an,No.HAP202304。
文摘BACKGROUND Managing refractory sudden sensorineural hearing loss(RSSHL)in patients with diabetes mellitus(DM)presents significant therapeutic challenges,highlighting the importance of identifying effective treatment strategies.AIM To analyze the therapeutic effectiveness of intratympanic injection plus retroauricular injection for RSSHL complicated with DM.METHODS This study included 84 patients with RSSHL complicated with DM from April 2021 to April 2024,all receiving routine treatment.Participants were categorized into the control group(40 cases),receiving an intratympanic injection of methylprednisolone sodium succinate(MPSS),and the research group(44 cases),treated with retroauricular MPSS injection the next day in addition to the treatment administered in the control group.The efficacy,adverse reactions(tympanic membrane perforation,middle ear infections,burning sensation,vertigo,and tinnitus),blood glucose(BG)[fasting BG(FBG),2-hour postprandial BG(2hPBG),and glycosylated hemoglobin(HbA1c)],hearing thresholds at different frequencies(250 Hz,500 Hz,and 1000 Hz),serum biochemical indexes[interleukin(IL)-6,C-reactive protein(CRP),and procalcitonin(PCT)],and quality of life assessed by the short-form 36 item health survey(SF-36)were comparatively analyzed.RESULTS The research group demonstrated a markedly higher total effectiveness rate(81.82%vs 60.00%,P=0.027)and a comparable incidence of total adverse reactions than the control group.Further,the research group exhibited notably reduced FBG,2hPBG,HbA1c,IL-6,CRP,and PCT post-treatment(P<0.01),which were lower compared with the pre-treatment levels and the control group(P<0.05),as well as reduced hearing thresholds at different frequencies(250 Hz,500 Hz,and 1000 Hz,P<0.05).Furthermore,the post-treatment SF-36 scores of the research group in terms of energy,social functioning,role functioning,physical functioning,mental health,and overall health were all significantly improved than the pre-treatment levels and the control group(P<0.05).CONCLUSION The above results indicate that intratympanic plus retroauricular injections of MPSS are effective in treating RSSHL complicated with DM without increasing the incidence of adverse reactions,which has a health promotion value.
文摘Sudden cardiac death(SCD)is one of the most devastating sequelae of myocardial diseases and can be the initial symptom in younger athletes or middle-aged busi-nesspeople.An implantable cardioverter defibrillator(ICD)prevents SCD and dramatically reduces the arrhythmic events in these patients;hence,the risk strati-fication for the SCD is important.In survivors of out-of-hospital cardiac arrest,identification of its etiologies is required to select the appropriate treat-ments following ICD installation.Cardiac magnetic resonance imaging(MRI)is useful for evaluating the morphology and function of the heart and for tissue character-ization,MRI can therefore be used to stratify the risk of SCD associated with various myocardial diseases and leads to primary prevention using ICD.MRI can predict arrhythmic events,which suggest the progression of myocardial damage,following secondary prevention.In this review,we provide a clinical and MRI focused update and MRI protocol for the primary and secondary prevention of SCD.We summarize the contribution and limitations of cardiac MRI for pre-vention SCD using ICD implantation.
文摘Objectives:Sudden sensorineural hearing loss(SSNHL)is a sudden onset condition of unknown etiology,often accompanied by tinnitus and vertigo,significantly affecting patients'quality of life.While some individuals experience spontaneous recovery,the unpredictability of treatment outcomes and potential complications pose clinical challenges.Recent studies suggest a potential link between thyroid hormone levels-particularly free triiodothyronine(FT3)and thyroid-stimulating hormone(TSH)-and both the pathogenesis and prognosis of SSNHL.However,the precise mechanisms remain unclear.This study aims to investigate the correlation between thyroid hormone abnormalities and hearing recovery in SSNHL patients,providing insights to enhance diagnostic and therapeutic approaches.Methods:This prospective observational study included 66 SSNHL patients admitted to the Affiliated Hospital of Qingdao University between April 2024 and February 2025.Serum TSH and FT3 levels were measured using chemiluminescence immunoassay,while hearing function was evaluated through pure-tone audiometry following standard guidelines.The“posttreatment hearing gap(PTHG)”was introduced as a quantitative measure of treatment efficacy.All patients received comprehensive treatment,including glucocorticoid therapy and hyperbaric oxygen therapy,and were classified into effective and ineffective groups based on hearing recovery outcomes.Results:No significant differences in gender or comorbidities(tinnitus,ear fullness,dizziness)were observed between the abnormal thyroid function group(n=45)and the normal thyroid function group(n=21)(all p>0.05).Similarly,initial TSH and FT3 levels did not differ significantly among patients with varying degrees of hearing impairment(mild,moderate,severe)(p>0.05).However,during treatment,ΔFT3 demonstrated a significant negative correlation with PTHG(r=-0.739,p=0.002),suggesting that a greater increase inΔFT3 is associated with improved hearing recovery.Additionally,TSH levels showed a significant positive correlation withΔFT3(p<0.05).Conclusions:Abnormal thyroid function in SSNHL patients was not associated with the severity of hearing loss.However,dynamic changes in FT3 during treatment showed a significant correlation with therapeutic efficacy,suggesting that monitoringΔFT3 may have clinical value in prognostic assessment.Nonetheless,this study had a limited sample size,and the potential influence of hormone therapy on thyroid function was not accounted for.Therefore,the role of thyroid hormones in SSNHL warrants further validation through large-scale prospective studies and mechanistic investigations.
文摘Background Sudden sensorineural hearing loss(SSNHL)is a rapid condition of hearing impairment,typically occurring over 72 hours and affecting the inner ear or auditory nerve pathways.The etiology of SSNHL remains largely idiopathic,with potential causes including viral infections,vascular occlusions,and autoimmune disorders.Traditional treatment primarily involves systemic corticosteroids,but their efficacy is inconsistent,leading to exploring alternative and adjunctive therapies such as intratympanic steroid(ITS)injections.Objective This Systematic Review and Meta-Analysis intends to determine the effectiveness of ITS injections as an initial treatment,combined therapy,or salvage treatment for SSNHL compared to systemic steroids alone.Methods An inclusive study was performed through the PubMed,Scopus,Web of Science,and Cochrane Library databases,encompassing publications published from 2015 to 2024.Case-control studies,cohort studies,randomized controlled trials(RCTs),and systematic reviews were included.Two separate reviewers read the studies and extracted data on steroid administration methods,study outcomes,and risk of bias(ROB)using the Cochrane Collaboration Tool and RevMan 5.4.Results The review included 12 studies with varied designs,including prospective RCTs,systematic reviews,and retrospective analyses.Combined ITS and systemic steroid therapy showed superior hearing recovery compared to systemic steroids alone in several studies.ITS alone demonstrated variable efficacy,with some studies indicating benefits,particularly as a salvage therapy.ROB assessment revealed variability in methodological rigor,with studies like those of Li&Ding et al.(2020)and Devantier et al.(2022)showing low risk,while others exhibited higher risks,particularly in random sequence generation and allocation concealment.Conclusion The findings suggest that ITS injections,particularly when combined with systemic steroids,can enhance hearing recovery in SSNHL patients.However,variability in study outcomes and methodological quality underscores the need for standardized protocols and further high-quality RCTs.This analysis underscores the prospective advantages of ITS therapy while stressing the need for stringent study designs to enhance SSNHL treatment methodologies.
基金funded by the National Natural Science Foundation of China(Nos.62173022,61673042)the Academic Excellence Foundation of Beihang University for Ph.D.Studentsthe Outstanding Research Project of Shen Yuan Honors College,Beihang University,China(No.230123104)。
文摘This article investigates the approaching control for fixed-wing Unmanned Aerial Vehi-cle(UAV)aerial recovery in the presence of pre-specified performance requirements,complex air-flows,maneuvering flight of transport aircraft,and different initial deviations.First,a novelcontrol-oriented Six-Degree-Of-Freedom(6-DOF)UAV model considering airflow disturbancesis established for better consistency with the actual UAV system.Then,to achieve satisfactory per-formance in the approaching process,a Flexible Appointed-time Prescribed Performance Control(FAPPC)algorithm,with the features of user-specified time convergence,no overshoot,indepen-dence from the initial value,and singularity-free,is proposed.Specifically,to solve the singularityissue encountered by the existing PPC methods in dealing with sudden disturbances,an adaptiveadjustment signal is introduced in FAPPC to perceive the threat of increasing error and relax thepreset boundaries appropriately.Moreover,minimum learning parameter-based neural networkestimators are developed to approximate unknown lumped disturbances at a low computationalcost.Finally,the stability of the closed system is analyzed via Lyapunov synthesis,and the effective-ness and advantages of the proposed control scheme are demonstrated via simulation andHardware-In-the-Loop(HIL)experimental validation.
基金Project supported by the National Natural Science Foundations of China (Grant Nos. 11675119,12275136,and 12075001)the Nankai Zhide Foundations。
文摘Quantum interferometric power(IP), a discordlike measure, plays an important role in quantum metrology. We study the dynamics of IP for two-qubit X-shape states under different noisy environments. Our study shows that IP exhibits sudden change, and one side quantum channel is enough for the occurrence of a sudden change of IP. In particular, we show that the initial state having no sudden change of quantum discord exhibits a sudden change of IP under the dynamics of amplitude noise, but the converse is not true. Besides, we also investigate the dynamics of IP under two different kinds of composite noises. Our results also confirm that sudden change of IP occurs under such composite noises.
文摘BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.
基金supported by a grant from the Science and Technology Fund of Tianjin Municipal Education Commission(2021KJ216)。
文摘Wellens’ syndrome is defined by specific T-wave inversions in the precordial leads of the electrocardiogram (ECG),which are indicative of acute anterior myocardial ischemia caused by severe proximal stenosis of the left anterior descending (LAD)artery.If not promptly treated,approximately 75%of patients with Wellens’ syndrome may experience extensive anterior wall myocardial infarction or sudden cardiac death within days to weeks.^([1,2]) Although the characteristic ECG changes associated with Wellens’syndrome are highly suggestive of LAD occlusion,there are rare instances in which similar ECG alterations are observed in the absence of LAD stenosis,a phenomenon referred to as pseudo-Wellens’ syndrome.The precise pathophysiological mechanisms underlying this syndrome remain unclear.Here,we present a patient with a myocardial bridge who presented a typical Wellens’ECG pattern.
基金supported by the Capital Medical University Undergraduate Innovation Project 2025(XSKY20-25251).
文摘Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most severe manifestations are cardiovascular,arising from tumor propagation through the venous system into the inferior vena cava(IVC),right heart,and pulmonary arteries,mimicking thromboembolic disease.[2,3]This can lead to pulmonary embolism(PE),right heart obstruction,and even sudden cardiac death.[4]Diagnosis is challenging,often delayed by misdiagnosis as conventional PE.We present two cases of IVL initially presenting with PE,highlighting the critical cardiovascular implications and diagnostic pitfalls.
基金Supported by the People's Government of Yulin City(2023-SF-09)Yulin Meteorological Bureau(2024Y-02)Open Research Fund Project of Key Laboratory of Ecological Environment and Meteorology in the Qinling Mountains and Loess Plateau(2022Y-21).
文摘Based on the number of asthmatic children in the Children's Hospital of Yulin City,the monitoring data of daily pollen concentration,and routine meteorological and environmental monitoring data of Yulin City from 2020 to 2022,the meteorological and environmental conditions of a thunderstorm asthma event in Yulin City in northern Shaanxi on September 9,2022 were analyzed.The results show that the strong convective weather was accompanied by a strong thunderstorm,lightning,gusts,short-time heavy precipitation and small hail,and the convective activity lasted for nearly 7 h.The short-term abrupt change of allergenic substances such as artemisia pollen caused by lightning,gusts and precipitation,the sudden drop in temperature,the inversion near the surface and the stimulation of cold air were the key meteorological conditions for the subsequent outbreak of asthma.In early September in 2022,the daily average pollen concentration in Yulin City was up to 1067.9 particles/1000 mm^(2),which was 113.3%and 41.2%higher than that of the same period in 2021 and 2020,respectively.The day before the thunderstorm,the pollen concentration soared to 2680 particles/1000 mm^(2),reaching the maximum of the year.The synergistic effect of the thunderstorm event and the sharp increase in pollen concentration on the previous day provided the background of heavy pollen pollution for this outbreak of thunderstorm asthma.O_(3)concentration was consistently high on the day of thunderstorm and the day before,and the peaks of O_(3)and PM 10 concentration appeared subsequently in the afternoon of the day,which became the background of air pollution for the asthma outbreak.
基金National Natural Science Foundation of China(82472218)National Key Clinical Specialist Construction Project(Z155080000004)+4 种基金National Key Research and Development Program of China(2024YFC3044400)Noncommunicable Chronic Diseases-National Science and Technology Major Project(2023ZD0506502)the Science and Technology of Shanghai Committee(23Y31900100)Shen Kang Hospital Development Center Project for Technical Standardization Management and Promotion(SHDC22023239)Key Supporting Discipline of Shanghai Healthcare System(2023ZDFC0102).
文摘Spinal subarachnoid hemorrhage(SSAH)is a relatively uncommon but significant cause of acute and progressive neurological impairment.It represents less than 1.5%of all instances of bleeding within the subarachnoid space.[1]The early stages of SSAH often present atypical clinical symptoms,making diagnosis challenging and potentially leading to treatment delays,which further result in irreversible neurological damage.Lower back pain is a common complaint in the emergency department(ED).[2]Common causes include overuse resulting in back strain.
