Xiang Yang No.1 People's Hospital

Background:Hearing loss (HL) is a prevalent global health issue with a complex etiology in whichinflammation plays a significant role. The systemic immune inflammatory index (SII), a novel biomarker reflecting systemic inflammation, is hypothesized to correlate with HL. Methods: Utilizing National Health and Nutritional Health Survey (NHANES) data from 1999–2020, this study analyzed the relationship between the SII and HL, categorized ashigh-frequency hearing loss (HFHL) orspeech-frequency hearing loss (SFHL). Blood samples were collected to calculate the SII. Weighted multivariate linear and logistic regression analyses were used to examine the linear relationship between the SII and hearing loss. After the SII was categorized into quartiles, a trend test was applied to assess the linear association between the SII and HL. Subgroup analysis was conducted to explore the correlation between the SII and HL across different sexes. Results: Univariate logistic regression analysis revealed no significant correlation between the SII and the occurrence of hearing loss or SFHL (p>0.05), but there was a correlation between the SII and HFHL. Multivariate logistic regression revealed a significant positive correlation between the third quartile of the SII and hearing loss. In the second quartile, there was a significant positive correlation between the SII and SFHL. For HFHL, a significant positive correlation between the SII and HFHL was present only in the crude model and in the second and third quartiles. Stratified analysis of clinical variables revealed a positive correlation between SII and the onset of hearing loss in those with never alcohol intake and moderate alcohol intake, a positive correlation between the SII and HFHL in those with moderate alcohol intake,and a negative correlation between the SII and SFHL in those with a normal BMI, aged older than 60 years, and who were former smokers. In the RCSplot, a reverse U-shaped association was observed between the SII and the prevalence of hearing loss and SFHL (nonlinear p<0.05). There was a positive correlation between the SII and the incidence of HFHL. After stratification by sex, the SII showed a reverse U-shaped association with hearing loss in males and a positive correlation in females. Conclusion: The SII is positively correlated with HFHL and shows a potential U-shaped relationship with HL and SFHL. In males, there was a reverse U-shaped association between the SII and hearing loss, while in females, there was a positive correlation.

Objective For middle-aged and elderly patients with lung cancer undergoing radiotherapy, the care and support received from family members or close social supporters during treatment significantly influence the physical and mental state and treatment outcomes of the patient. Hope, a positive emotional state, reflects patients’ attitudes and expectations toward their condition, treatment process, and prognosis. The level of hope may vary among middle-aged and elderly patients with lung cancer undergoing radiotherapy. Therefore, exploring individual differences and developmental changes during radiotherapy is important. This study aims to evaluate whether heterogeneity exists in the levels of hope among middle-aged and elderly patients with lung cancer during thoracic radiotherapy, identify related predictive factors, and understand the level of family care received by patients at this stage, to provide targeted interventions for patients with lung cancer with different levels of hope. Methods A total of 124 patients with lung cancer were included. Their levels of hope and extent of family care were evaluated at four time points. Growth mixture models, univariate analysis, and multivariate logistic regression were used to study the trajectory in the level of hope, its association with outcomes, and its predictive factors. Results Two hope trajectory classes were identified: the slow decline (27.4%) and the rapid decline (72.6%). Age, marital status, level of education, and extent of family care were factors influencing the hope trajectory categories during radiotherapy for middle-aged and elderly patients with lung cancer (P < 0.05). Conclusion The trajectories of hope among middle-aged and elderly patients with lung cancer during radiotherapy were heterogeneous. Healthcare providers can tailor interventions based on the factors that influence these hope trajectory categories.