Background Cochlear implants (CIs) restore hearing by directly stimulating spiral ganglion neurons (SGNs), yet auditory outcomes remain highly variable. Increasing evidence suggests that SGN survival alone incompletely predicts CI performance; instead, transcriptional programmes governing neuronal excitability/synaptic transmission, structural plasticity, trophic-metabolic support and injury/inflammation may better reflect neural functional competence.Methods We re-analysed publicly available cochlear transcriptomic datasets spanning development, adulthood and injury/degeneration. Primary resources included developmental FACS RNA-seq of hair cells and surrounding tissue, adult inner- and outer-hair-cell microarrays, and a noise-induced hearing loss (NIHL) RNA-seq cohort following mesenchymal stromal cell (MSC) therapy. We additionally analysed independent injury/degeneration datasets, including spatial transcriptomics of spiral ganglion regions after noise exposure and spiral ganglion RNA-seq after aminoglycoside-induced deafening. Guided by cochlear neuroscience literature and functional enrichment, we assembled gene modules for excitability, plasticity, trophic/metabolic support and injury/inflammation. Module activity was quantified using within-dataset standardized scores from normalized expression, avoiding cross-platform merging. We derived a Cochlear Neural Functional Competence (CNFC) score (Excitability + Trophic - Injury) and assessed robustness using a minimal 24-gene panel. External validation was performed in an independent purified SGN dataset, and CNFC was benchmarked against transcriptome-wide principal components.Results Developmental maturation was characterized by increasing excitability-associated transcripts alongside down-regulation of actin/cytoskeletal remodelling components. Adult hair cells displayed distinct trophic signatures. In the NIHL model, MSC therapy was associated with transcriptional suppression of excitatory receptor and channel genes, consistent with a shift in the injury/inflammation-excitability balance, although functional consequences remain to be established. Importantly, in independent injury/degeneration datasets, CNFC decreased in spiral ganglion neuronal regions after noise exposure and in deafened spiral ganglion. Across datasets, CNFC captured coherent trends and remained highly correlated with full-module scoring when reduced to the 24-gene panel.Conclusion CNFC is a transparent, hypothesis-generating framework for summarizing cochlear neuronal functional state from transcriptomic data, complementing traditional survival metrics. By prioritizing interpretable modules and standardized within-dataset scoring, CNFC supports cross-study integration and highlights candidate programmes for mechanistic testing.

Objective:This study aims to systematically explore the clinical characteristics of rapid eye movement（REM） -related obstructive sleep apnea（OSA） and objective polysomnography（PSG） indicators, and conduct an in-depth investigation into the specific manifestations of REM-OSA at different disease severity levels, and clarify the differences in clinical characteristics and PSG parameters between REM-OSA and non-rapid eye movement OSA（NREM-OSA）. It provides a scientific basis for optimizing the clinical diagnosis and treatment strategies of REM-OSA and improving patient prognosis. Methods:The clinical data of OSA patients who visited the Sleep Center of the Second Affiliated Hospital of Xian Jiaotong University from March 1, 2021, to April 1, 2025, completed all-night PSG, and met the inclusion criteria were retrospectively analyzed. OSA was classified into mild, moderate, and severe degrees according to the apnea-hypopnea index（AHI）, and grouped based on the REM-OSA diagnostic criteria. Sleep data were obtained through PSG monitoring, and demographic information, clinical symptoms, and comorbidity data were collected. In-depth exploration was carried out through different groupings to analyze the specific manifestations of REM-OSA at different disease stages. Results:The prevalence of REM-OSA was relatively high in mild and moderate OSA（49.4% and 36.2% respectively）, and only 3.9% in severe OSA. Demographic characteristics: The proportion of males with NREM-OSA was higher than that of REM-OSA in all degrees of OSA（mild: P=0.01; moderate: P=0.02; severe: P=0.01）. In severe OSA, the BMI, neck circumference, and waist circumference of NREM-OSA patients were significantly higher than those of REM-OSA patients（all P<0.01）. Clinical symptoms: In severe OSA, the Epworth Sleepiness Scale（ESS） scores of NREM-OSA patients were higher（P=0.01）. There were no significant differences in the incidence of memory decline, anxiety, and common comorbidities between the two groups. PSG parameters: The proportion of stage N1 in REM-OSA patients was lower than that in NREM-OSA patients in all degrees of OSA, while the proportions of stage N2 and REM were higher（taking severe cases as an example, all P<0.01）. In severe OSA, the number of respiratory events and total apnea index of NREM-OSA were higher（all P<0.01）, but the longest hypopnea duration of REM-OSA was longer（P=0.02）. In all degrees of OSA, the lowest oxygen saturation of REM-OSA was lower, and the time ratio of blood oxygen<90% was higher（taking severe cases as an example, all P<0.01）, while the sleep respiratory event-related arousal index of NREM-OSA was higher（taking severe cases as an example, P<0.01）. Conclusion:REM-OSA has unique clinical and PSG characteristics in mild and moderate OSA. Clinically, attention should be paid to REM phase monitoring to avoid missed diagnosis. In the treatment of severe OSA, airway management during the entire sleep period needs to be emphasized. Precise diagnosis and treatment strategies for OSA in different sleep phases are of great significance for improving the prognosis of patients.

Objective:To investigate the associations between seven composite anthropometric indices-body mass index（BMI）, waist-to-height ratio（WHtR）, neck-to-height ratio（NHR）, body roundness index（BRI）, a body shape index（ABSI）, weight-adjusted-waist index（WWI）, and relative fat mass index（RFM） -and the severity of obstructive sleep apnea（OSA）, and to evaluate their predictive value and diagnostic efficacy for OSA severity. Methods:This retrospective study enrolled 4 364 patients with suspected OSA from the Department of Otolaryngology-Head and Neck Surgery at the Second Affiliated Hospital of Xi'an Jiaotong University between September 2021 and April 2025. All participants underwent overnight polysomnography（PSG） and were categorized into four groups based on the apnea-hypopnea index（AHI）: non-OSA, mild, moderate, and severe. Correlation analysis was used to examine the relationships between the indices and AHI. Logistic regression was employed to assess their associations with OSA severity. Principal component analysis（PCA） was applied for dimensionality reduction to extract comprehensive components. The predictive performance of individual indices and principal components was evaluated using receiver operating characteristic（ROC） curve analysis, with the area under the curve（AUC） calculated. The optimal cutoff point, sensitivity, and specificity of each index for detecting OSA and severe OSA were determined. Results:All composite anthropometric indices showed significant positive correlations with AHI（P<0.01）, with BMI demonstrating the strongest correlation（r=0.484）. PCA extracted three principal components（cumulative variance explained: 95.34%）: PC1（loading highly on BRI, WWI, NHR） was positively associated with OSA severity（OR=1.54, 95%CI 1.480-1.610）, whereas PC2（loading highly on ABSI, BMI, WWI） was negatively associated（OR=0.75, 95%CI 0.700-0.800）. ROC analysis revealed that BMI, BRI, WHtR, and NHR had the best overall predictive performance（AUC range: 0.706-0.708）. Diagnostic efficacy analysis indicated that NHR demonstrated superior balanced performance for OSA screening, whereas BRI and WHtR offered the highest sensitivity（>80.00%）. For identifying severe OSA, BRI and WHtR showed the best diagnostic efficacy. PC1 maintained robust performance across both screening and severe OSA identification tasks. Conclusion:In addition to BMI, composite anthropometric indices such as NHR, BRI, and WHtR are also effective tools for screening and assessing OSA severity, offering specific insights into regional fat distribution（NHR） and central obesity（BRI/WHtR）, respectively. Furthermore, the composite feature dominated by cervical and central obesity（PC1） was identified as an important risk factor for OSA.

Objective This study aims to assess nerve regeneration characteristics and their impact on vocal fold (VF) movement after unilateral recurrent laryngeal nerve (URLN) injuries to inform clinical treatment strategies. Methods Four types of URLN injury models in rabbits were created: clamp, electrocautery, transection, and ligation. Nerve damage and regeneration were evaluated using electron microscopy at 2, 4, 8, and 12 weeks postinjury. VF movement range and speed were assessed using tracking software. Results The N-ratio (the ratio of myelinated axon area to total nerve trunk area) and myelinated axon density (MAD, the number of axons per unit area): clamp group were the highest at all times compared to the other groups. Postinjury, the electrocautery group was higher than the transection and ligation groups, except at 2 weeks. In the clamp and electrocautery groups, N-ratio and MAD increased between 4 and 8 weeks postinjury. At 4 weeks, 100% of the clamp group and 66.7% of the electrocautery group showed partial recovery of injured VF movement. Compared to the normal VF, the affected VF’s mean motion range (MMR) was 22% less (P < 0.05), and mean motion speed (MMS) was 58% slower (P < 0.05). At 8 weeks, MMR was 7% less (P < 0.05), and MMS was 41% slower (P < 0.05). At 12 weeks, MAD started to decrease. However, the N-ratio continued to increase. MMR was 2% lower (P > 0.05), and MMS was 24% slower (P < 0.05). Conclusion The severity of RLN injuries was as follows: ligation > transection > electrocautery > clamp injury. Recovery of VF motion range preceded recovery of motion speed. Asynchronous motion of bilateral VFs was a characteristic feature of RLN injury repair.

BackgroundThe optimal initial corticosteroid strategy for idiopathic sudden sensorineural hearing loss (SSNHL) remains uncertain, and randomized trials may not capture real-world variability. Observational comparisons are vulnerable to confounding, particularly when post-treatment variables are inappropriately adjusted. We evaluated the real-world comparative effectiveness of initial systemic versus intratympanic corticosteroids using a prespecified causal inference framework.MethodsWe conducted a retrospective cohort study (2012–2019) of adults with idiopathic SSNHL and complete baseline and discharge audiometry. Patients receiving combined systemic–intratympanic therapy or missing exposure data were excluded. The exposure was the initial corticosteroid route (systemic oral/IV vs. intratympanic). Propensity scores were estimated from baseline covariates including age, sex, symptom profile, comorbidities, baseline PTA, and time from symptom onset to treatment initiation. Primary estimation used augmented inverse probability of treatment weighting (AIPW) to retain all eligible patients; 1:1 propensity-score matching (caliper 0.2 SD of logit PS) with regression adjustment addressed residual imbalance as a sensitivity analysis. Outcomes were PTA gain (primary), complete recovery (≥30 dB gain), and effective improvement (≥15 dB gain).ResultsAmong 284 adults (systemic = 240; intratympanic = 44), crude mean PTA gain was 13.8 vs. 3.8 dB (difference 10.0 dB). In AIPW analysis, systemic therapy was associated with greater PTA gain (adjusted mean difference 10.1 dB; 95% bootstrap CI 1.8–19.5) and a higher probability of complete recovery (adjusted risk difference 16.9%; 95% CI 9.4–23.4). The risk difference for effective improvement was 11.4% (95% CI − 15.3 to 30.9). Findings were directionally consistent in IPTW, overlap-weighted, and matched analyses.ConclusionIn this single-center real-world cohort, initial systemic corticosteroids were associated with greater short-term hearing improvement and a higher likelihood of complete recovery compared with intratympanic therapy. Weighting-based doubly robust estimators improved precision and generalizability, while matched analyses yielded consistent direction but wider uncertainty.

The aim of this study was to analyze negative middle ear pressure in children with obstructive sleep apnea (OSA) and establish and evaluate predictive models according to these findings. This retrospective study involved 931 children: 715 with OSA and 216 controls. Demographic, clinical, lateral head radiograph, and tympanometry data were collected. These characteristics of children with OSA were analyzed, with a particular focus on exploring the value of middle ear-related parameters for the diagnosis of pediatric OSA. Additionally, a logistic regression model incorporating optimal indicators was developed to predict pediatric OSA. The model was visualized via a nomogram and evaluated for discrimination, calibration, clinical effectiveness and external validation. Children with OSA were younger and exhibited longer soft palates, larger tonsils and adenoids than non-OSA children. Additionally, children with OSA presented higher acoustic admittance (AC) and resonance frequency (RF), lower middle ear pressure (MEP), and narrower pressure gradient (PG) than non-OSA children. The external auditory canal volume (ECV), MEP, and PG were identified as independent predictors of childhood OSA. We constructed a foundational prediction model for childhood OSA (Model 0, AUC = 0.845, 95

Objective:To advance the precision diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome（OSAHS）, this study aimed to identify phenotypes with distinct pathophysiological and clinical features based on multidimensional clinical data using unsupervised clustering methods. Methods:Polysomnography indicators （apnea-hypopnea index[AHI], lowest oxygen saturation, oxygen desaturation index, arousal index） and clinical symptom scale data（Epworth Sleepiness Scale[ESS], Insomnia Severity Index[ISI], Self-Rating Anxiety Scale[SAS], Self-Rating Depression Scale[SDS10]） were collected from 6 633 OSAHS patients who attended the Departments of Otorhinolaryngology-Head and Neck Surgery at the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Central Hospital, and the Stomatological Hospital of Xi'an Jiaotong University. After Z-score normalization, K-means clustering was applied. The optimal number of clusters was determined using the elbow method and silhouette coefficient, and the results were visualized using box plots and radar charts. Results:Following data cleaning, 1 331 OSAHS patients were included in the final analysis and classified into four clinical phenotypes: ①Classic sleepy type（n=227）: characterized by concurrent objective sleep disturbance and subjective sleepiness; ②Asymptomatic hypoxic type（n=383）: characterized by severe physiological abnormalities but mild subjective symptoms; ③High symptom-mild physiological type（n=413）: characterized by high subjective symptom burden but relatively mild objective abnormalities; ④Symptom perception-dominant type（n=308）: characterized by prominent emotional and insomnia symptoms with the mildest physiological abnormalities. Significant differences were observed among phenotypes in sex distribution（P<0.05）, whereas no statistically significant differences were found in age, body mass index, or AHI. Significant differences were observed among phenotypes in BMI（P=0.023） and SDS（P=0.016）, whereas no statistically significant differences were found in age or AHI. Conclusion:OSAHS patients exhibit multidimensional clinical phenotypes. Classification based on the integration of objective AHI with multidimensional subjective and objective information should be adopted to formulate the individualized treatment strategies.

Contactless sensing enables the simultaneous monitoring of multiple sleep indicators without disturbing the individual’s sleep. However, complex relationships among multiple tasks pose challenges for joint monitoring. In the paper, we develop a contactless sleep health monitoring system named SHMIU, which analyzes IR-UWB signals reflected off the human body and predicts sleep stages, sleep apnea state, and blood oxygen saturation during sleep. For enhancing the performance of three tasks, we design a mixture of experts based multi-task learning model and dynamically reweight tasks via Nash bargaining to optimize multi-task learning. We conduct experiments on a 100-subject dataset, and the experimental results show that SHMIU achieves balanced performance across three tasks, with its performance comparable to or superior to that of existing two-task methods.

Abstract Purpose This study aimed to analyze the effectiveness of sleep apnea‐specific hypoxic burden (SASHB) and sleep disordered breathing index (SBII) in assessing cognitive dysfunction in adults with obstructive sleep apnea (OSA) and to compare them with the apnea‐hypopnea index (AHI). Methods The clinical data of 100 adult OSA patients aged 18–59 years admitted to the Department of Otorhinolaryngology–Head and Neck Surgery, the Second Affiliated Hospital of Xi 'an Jiaotong University, from December 2023 to December 2024 were retrospectively collected and divided into mild, moderate, and severe OSA groups according to AHI. Results In terms of cognitive assessment, there were significant differences in MoCA scores between the two groups ( p < 0.001). Correlation analysis showed that AHI, SASHB and SBII were negatively correlated with MoCA score, and the correlation between SASHB and SBII was stronger after excluding confounding factors. SBII (AUC = 0.846) and SASHB (AUC = 0.835) were better than AHI (AUC = 0.662) in evaluating cognitive function. Conclusion SASHB and SBII are more important in assessing cognitive dysfunction in adults with OSA, and may be important indicators for assessing cognitive impairment in OSA patients. In the future, larger prospective studies are needed to clarify further the relationship between SASHB, SBII and cognitive function.

Background:Seasonal allergic rhinitis (SAR) is a pollen-triggered condition causing nasal inflammation and quality of life impairment. Pumecitinib, a topical Janus kinase (JAK) inhibitor may modulate allergic inflammation. We evaluated the efficacy, safety, and pharmacokinetics of pumecitinib nasal spray administered over a 14-day period during the pollen season in patients with moderate-to-severe seasonal allergic rhinitis (SAR). Methods:This phase 2, randomised, double-blind, placebo-controlled, parallel-group study was carried out at 20 centres in China. Adults aged 18-65 years with moderate-to-severe SAR were randomised 1:1:1:1 to receive placebo or pumecitinib nasal spray at doses of 0·2 mg, 1·2 mg, or 2·0 mg administered twice daily for 14 days. The primary efficacy endpoint was the mean change from baseline in daily reflective total nasal symptom score (rTNSS) over 14 days. The secondary endpoints included reflective total ocular symptoms (rTOSS), individual nasal and ocular symptoms, and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores This study is registered with chitr.org.cn, ChiCTR2400081767, and is completed. Findings:Between March 20 and June 5, 2024, 169 patients were randomly assigned and 168 received treatment (92 male, 76 female) and were included in the full analysis set. Both the 1·2 mg and 2·0 mg doses of pumecitinib demonstrated significant improvements compared with placebo in the mean change from baseline in the daily rTNSS over 14 days (least-squares [LS] mean difference -1·2 [95% CI -2·2 to -0·2], p = 0·021, and -1·2 [-2·2 to -0·2], p = 0·018, respectively). These two dosage groups significantly improved rTOSS, individual nasal and ocular symptoms, and RQLQ scores compared to the placebo group. Treatment-emergent adverse events (TEAEs) occurred in 15% (0·2 mg), 33% (1·2 mg), 21% (2·0 mg), and 24% (placebo) of patients; most were mild, with no clear dose-response relationship. Interpretation:Pumecitinib 1·2 mg and 2·0 mg twice daily significantly alleviated nasal and ocular symptoms and improved quality of life in moderate-to-severe SAR, with a favourable safety profile during 14-day treatment. This provides proof of concept for topical JAK inhibition in SAR, warranting larger trials. Funding:PrimeGenX Therapeutics Co., Ltd.

Objective:To summarize the clinical outcomes of endoscopic mucosal flap technique combined with absorbable corticosteroid drug-eluting stent in children with congenital bony nasal stenosis. Methods:A retrospective review was performed on 9 children（age 7 days to 5 years） treated from January 2019 to July 2025. Among them, there were 6 cases of congenital choanal atresia and 3 cases of congenital nasal pyriform aperture stenosis （CNPAS）. Except for 1 case of stenosis of the nasal meatus treated conservatively, the rest were treated by endoscopic choanal atresia repair. During surgery, mucosa over the atretic plate was preserved and fashioned into mucosal flaps to cover raw surfaces; partial vomer removal was performed when necessary to enlarge the neochoana, followed by placement of an absorbable corticosteroid drug-eluting stent for support, flap stabilization, and local anti-inflammation. Follow-ups were scheduled at 2 weeks, 1, 2, 3 and 6 months, and thereafter, assessing nasal patency, feeding/sleeping, endoscopic findings, and restenosis/reatrestia. Results:Among 6 choanal atresia cases, 5 remained patent without reatrestia during follow-up, while 1 complete bony case developed reatrestia and was deemed a failure. Among 3 pyriform aperture stenosis cases, the conservatively managed child had prolonged symptoms（20 days） after upper respiratory infections requiring intranasal medications, whereas the two surgically treated children achieved resolution of nasal obstruction and normal feeding. Conclusion:Endoscopic mucosal flap technique combined with absorbable corticosteroid drug-eluting stent may provide favorable patency maintenance and mucosal healing in most children with congenital bony nasal stenosis, while complete bony choanal atresia remains at high risk of reatrestia.

OBJECTIVE:To investigate the temporal patterns of regeneration and functional recovery following a unilateral recurrent laryngeal nerve (URLN) electrocautery injury. METHODS:Unilateral recurrent laryngeal nerve（RLN） injury rabbit models (n = 12) were established. At 2, 4, 8, and 12 weeks post-injury, RLN and neuromuscular junction regeneration were evaluated via transmission electron microscopy and immunofluorescence. Thyroarytenoid muscle histopathology was assessed by hematoxylin and eosin staining, and vocal fold (VF) movement was quantified via laryngoscopy. Correlation between neuroelectrophysiological changes and VF motion was analyzed in eight patients with RLN electrocautery injuries. RESULTS:At 2 weeks, myelin sheaths and synaptic membranes showed extensive disintegration. The single muscle fiber diameter (SMFD) decreased to 56.16%, the muscle fiber area ratio (MFAR) decreased to 40.35%, and the motion range ratio (MRR) decreased to 12.2%. At 4 weeks, the myelin lamellae continued to disintegrate with a small amount of regeneration. Regeneration of the presynaptic membrane (more than the postsynaptic membrane) began. MFAR was 46.86%, and MRR was 77.9%. At 8 weeks, the density of myelinated axon (DMA) peaked, but the axons and myelin sheath remained thin and immature. Postsynaptic membrane regeneration was significant, with partial overlap by the presynaptic membrane. MFAR rose to 58.59%, and MRR recovered to 96.9%. At 12 weeks, myelin sheaths thickened and matured despite a drop in DMA. Synaptic membrane number and morphology were normalized. SMFD and MFAR neared normal levels at 94.52% and 91.57%, respectively, and MRR recovered fully. 77.8% of patients exhibited partial or complete VF movement recovery. CONCLUSION:Despite causing initial injury, electrocautery may still permit sufficient axonal regeneration and subsequent muscle reinnervation to enable partial or complete recovery of VF movement.

Allergic rhinitis (AR) is a common, persistent nasal disorder that poses significant public health challenges worldwide. Current treatment options frequently fail to achieve adequate symptom control in a substantial subset of patients. Over the past two decades, biologic therapies that target type 2 inflammatory pathways have been used to treat patients experiencing poorly controlled symptoms, despite standard-of-care (SoC) treatment. Although biological treatment options for AR remain limited worldwide, the recent approval of novel agents, such as stapokibart for seasonal allergic rhinitis (SAR), has accelerated clinical research and development in this field. Evidence for biologic therapy in the management of perennial allergic rhinitis (PAR) is currently sparse. To standardise the use of biologics in AR management and promote their evidence-based application, a multidisciplinary expert panel was convened. This position paper evaluates current evidence regarding the efficacy and safety of biologic agents for AR, incorporating data from both international and regional clinical studies. Here, we provide recommendations on appropriate indications for biologic therapy and emphasise its role in patients with uncontrolled SAR, supporting clinical decision-making and facilitating the integration of biologics into routine practice.

Age-related hearing loss and balance decline are prevalent features of organismal aging, yet how the cochlea and vestibular organs converge on shared cellular liabilities remains insufficiently resolved. In particular, whether mitochondrial ultrastructural injury and mitochondrial quality-control programs co-vary with synaptic vulnerability and sensory functional decline across these systems within an age-resolved framework has not been clearly delineated. Here, we compared cochlear and vestibular aging in SAMP8 mice of different ages using integrated functional assays, region-resolved quantification of hair cells and CtBP2/GluA2 synapses, cochlear NF200+ fiber area fraction, transmission electron microscopy, and targeted qPCR of mitophagy/autophagy-lysosome genes. The results show that ABR thresholds rose progressively across 5.6-32 kHz. VsEP exhibited age-dependent threshold shifts and prolonged P-wave latency. Relative to the magnitude of synaptic and functional changes, cochlear hair-cell numbers were broadly preserved, although regional OHC loss was observed in middle-to-basal turns, whereas vestibular macular hair-cell density declined with age. Ultrastructurally, the proportion of pathological mitochondria increased with age, featuring electron-lucent matrix, disrupted cristae organization, and rounded/swollen profiles. What's more, guided by an adult-versus-aged transcriptomic screen nominating the Ca2+ extrusion gene Atp2b4, we derived z-scored molecular indices, including a flux-burden signature (z(p62)-z(Lc3b)) and a TFEB-lysosome module. Descriptive coupling across age-group means indicated that mitochondrial pathology burden aligned closely with high-frequency ABR loss and basal synaptic uncoupling, and tracked the flux-burden signature more consistently than the TFEB-lysosome module. Together, these findings support age-aligned associations among mitochondrial ultrastructural injury, molecular remodeling, synaptic vulnerability, and progressive sensory decline across cochlear and vestibular systems.

OBJECTIVE:To test whether the configuration of the initial pure tone audiogram (ascending, descending, flat or total-deaf) predicts complete recovery and to explore its value as a building block for prognostic models. STUDY DESIGN:Retrospective cohort study. SETTING:Single tertiary care centre. METHODS:Adults with unilateral ISSNHL treated from January 2012 to December 2019 were categorised by audiogram configuration. Baseline characteristics and treatments were recorded. Multivariable logistic regression identified independent predictors of complete recovery; model performance was summarised by AUC and Nagelkerke R2. RESULTS:Among 487 patients (43.8% flat, 29.4% descending, 21.9% total-deaf, 4.9% ascending), 80 (16.4%) achieved complete recovery. Complete recovery occurred in 50.0% of ascending, 25.2% flat, 9.8% descending and 0% total-deaf. Descending (OR 0.25; 95% CI 0.15-0.42) and total-deaf (OR 0.05; 95% CI 0.01-0.22) configurations independently predicted worse outcomes. Age and higher initial PTA were also negative predictors. AUC = 0.78; Nagelkerke R2 = 0.32. CONCLUSION:The initial audiogram configuration is an independent prognostic marker in ISSNHL. Ascending and flat patterns confer better prognosis than descending and total-deaf patterns; such classifications should be integrated into clinical risk stratification and future predictive models.

PURPOSE:The aim of this study was to analyze the correlation between pituitary function and obstructive sleep apnea (OSA) in pituitary adenomas (PA) patients, and to investigate the effect of related hormone levels on the severity of OSA. METHODS:The clinical data of 82 patients with PA aged 18-70 years admitted to the Department of Neurosurgery, Xi'an Jiaotong University Affiliated Hospital from March 2023 to February 2025 were retrospectively collected and divided into functional and non-functional PA group. RESULTS:Functional PA patients were younger and had a higher platelet-lymphocyte ratio (all p < 0.05). Among the PSG related parameters, Patients with functional PA showed higher apnea-hypopnea index (AHI), total sleep time spent with arterial oxygen saturation<90 % and longest apnea duration and oxygen desaturation index with >3 % desaturation (all p < 0.01). In terms of pituitary function parameters, free triiodothyronine (FT3) and insulin-like growth factor-1 (IGF-1) were significantly increased in OSA group, while the levels of cortisol, estradiol and progesterone were all lower (all p < 0.05). Correlation analysis showed that AHI was positively correlated with FT3 and IGF-1. After adjusting for confounding factors, mediation analysis based on regression revealed that FT3 and IGF-1 mediated the association between PA and OSA severity. CONCLUSION:OSA was more severe in functional PA patients compared with non-functional PA patients. FT3 and IGF-1 are reliable predictors of AHI in PA patients, and may become important indicators for early clinical diagnosis of OSA in PA patients. Larger prospective studies are needed to further clarify the relationship between PA and OSA in the future.

This study aimed to investigate the distribution of epicardial adipose tissue (EAT) and adipose metabolism in patients with obstructive sleep apnea (OSA) without comorbidities, such as cardiovascular disease and diabetes—an approach to eliminate confounding factors and explore the role of EAT in OSA-related visceral adipose disorders. The clinical data of 180 patients were retrospectively collected from July 2017 to December 2023 at the Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University. Patients were categorized into mild–moderate (apnea–hypopnea index, AHI < 30 events/hour) and severe OSA groups (AHI ≥ 30 events/hour) based on their polysomnography (PSG) results. Epicardial adipose tissue volume (EATV) and attenuation (EATA) were quantified using coronary computed tomography angiography and 3D-Slicer software, with adipose tissue defined by a Hounsfield unit threshold of -190 to -30 HU. The Chinese visceral adiposity index (CVAI) is a composite metric specific to the Chinese population that integrates age, body mass index, waist circumference, triglyceride, and high-density lipoprotein levels. Significant differences were observed in EATV, EATA, and CVAI between the mild–moderate and severe OSA groups (all p < 0.05). Elastic net regression, restricted cubic spline curves, and subgroup analysis using forest plots demonstrated that CVAI had the strongest correlation with the apnea–hypopnea index (AHI) and OSA severity among the visceral adipose parameters (all p < 0.05). After controlling for the effects of baseline data and visceral adipose tissue, multiple linear regression analysis revealed that OSA severity still affected the EATV and EATA (all p < 0.05). OSA progression without cardiovascular disease and diabetes may promote an increase in EATV, especially in the atrial region. In addition, the change in epicardial adipose tissue appears to be independent of visceral adipose tissue. This underscores EAT as a distinct fat depot and highlights its potential role in early cardiovascular risk assessment for OSA patients, offering perspectives for future research into mechanistic pathways and clinical interventions.

An accurate forecasting of the COVID-19 pandemic’s trajectory is crucial for informing effective prevention and control strategies. The aim of this study was to develop and compare COVID-19 forecasting models (SEIR, ARIMAX, and LSTNet) incorporating multi-symptom Google Trends signals, and to evaluate whether PCA-derived components improve out-of-sample prediction of daily confirmed cases. We conducted a correlation analysis between the confirmed cases numbers from Johns Hopkins University’s COVID-19 database and the symptomatology data from Google Trends. SEIR, ARIMAX and LSTNet model were established respectively based on this data and compared their predictive performance. Symptom-related Google Trends series were strongly correlated (e.g. taste loss vs smell loss r = 0.96, 95

Objective:Airborne pollen is a major contributor to allergic diseases. This study investigates the correlation between airborne pollen dynamics and allergic rhinitis (AR) incidence in Xi'an (2020-2023) and compared with 1984 data for informing evidence-based prevention strategies. Methods:The species and concentration of daily pollen in Xi'an were monitored for 4 consecutive years (2020-2023). Daily pollen concentrations were analyzed alongside clinical AR records from the Second Affiliated Hospital of Xi'an Jiaotong University and public health awareness metrics (Baidu search indices for "allergic rhinitis", "pollen allergy", and "loratadine"). Results:The pollen season in Xi'an occurred from March to May and from August to October, with higher concentrations in spring. Compared to the 1984 data, pollen counts increased significantly (+121.9%, P>0.05). Correlation analysis revealed a positive relationship between pollen concentration and the number of AR patients during the autumn pollen season from 2020 to 2022 (r=0.307~0.636, P<0.05). "Pollen allergy" search index correlated positively lwith pollen concentration over the four-year autumn period (r=0.512~0.750, P<0.001), while trends for "allergic rhinitis" and "loratadine" search indices were less consistent, showing positive correlation only in the autumn pollen season. The public perception of sensitized pollen species in Xi'an did not match the actual AR-related pollen species. Conclusion:Pollen counts increased significantly in Xi'an, whereas pollen species diversity decreased in the last 40 years. Our results showed the 40-year characteristics comparison of pollen concentration in Xi'an can serve as a basis for developing effective preventive and management measures for patients with pollen-related allergies, including environmental control, timely pollen monitoring, desensitization therapy, and patient health education, to guide the scientific control and prevention of pollen-induced allergic diseases. This study underscores the need for integrated environmental and public health strategies to mitigate pollen-induced AR in rapidly urbanizing regions.

BackgroundAcute otitis media (AOM) is a prevalent pediatric infection worldwide, with mitochondrial dysfunction and immune responses implicated in its pathogenesis. However, the precise mechanisms remain elusive.MethodsMitochondrial-related genes were extracted from Spn-AOM and NTHi-AOM datasets in the Gene Expression Omnibus (GEO). Differentially expressed mitochondrial genes (MitoDEGs) were identified and analyzed through functional enrichment analysis. Key MitoDEGs strongly linked to AOM were determined using least absolute shrinkage and selection operator (LASSO) and random forest (RF) models. Immune cell infiltration patterns were evaluated via the Cibersort algorithm, and associations between hub MitoDEGs and immune cells were examined. A regulatory network was established to elucidate gene regulation, and qRT-PCR validation was performed in C57BL/6 mice.ResultsWe identified 18 MitoDEGs in Spn-AOM and 14 in NTHi-AOM. Functional enrichment analysis highlighted their involvement in mitochondrial processes, peroxisomal activity, cell cycle control, and amino acid metabolism. LASSO and RF analyses pinpointed FAM110B, LIG1, and PDK1 as key genes. Immune infiltration analysis demonstrated significant associations between these genes and immune cell composition. TF-miRNA-mRNA network predictions suggested potential regulatory mechanisms.ConclusionThis study reveals mitochondrial gene expression alterations in AOM, identifying FAM110B, LIG1, and PDK1 as critical genes associated with immune cell infiltration. These findings provide insights into the mitochondrial-immune interplay in AOM pathogenesis.