OBJECTIVE: This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation. METHOD: We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered. RESULT: The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75. CONCLUSION Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.
Adolescent ; Adult ; Aged ; Auditory Perception ; Cochlear Implantation ; psychology ; Follow-Up Studies ; Humans ; Middle Aged ; Retrospective Studies ; Self Concept ; Social Identification ; Treatment Outcome ; Young Adult

ObjectiveTo evaluate the expression of endothelial differentiation gene/lysophosphatidic acid (LPA) receptors (Edg/LPA) and its clinical significance in human pancreatic cancer.MethodsFifty cases of pancreatic cancer and adjacent normal tissues were collected,and Real-time PCR,Western blot and immunohistochemistry was used to determine the expression of Edg-2/LPA1,Edg-4/LPA2 and Edg-7/LPA3 receptors mRNA and protein,and its relationship with clinicopathological parameters was analyzed.Results The expressions of Edg-2/LPA1,Edg-4/LPA2,Edg-7/LPA3 receptor mRNA were (0.142 ± 0.042 ) ％,(0.471 ±0.064)％,(0.231 ±0.043)％ in pancreatic cancer,and the corresponding values were (0.132 ±0.029)％,(0.027 ±0.015)％,(0.163 ±0.046)％ in adjacent normal tissues.The expressions of Edg-4/LPA2 receptor mRNA in pancreatic cancer were significantly lower than that in adjacent normal tissues ( P ＜0.05 ).The expressions of Edg-4/LPA2 receptor protein in pancreatic cancer were significantly lower than that in adjacent normal tissues ( P ＜ 0.05 ).The expressions of three types of Edg /LPA receptor mRNA in pancreatic cancer were parallel to serum CA19-9 levels.The expressions of Edg-4/LPA2 receptor mRNA were associated with tumor size,differentiation degree,and invasive ability and metastasis.While the expressions of Edg-2/LPA1,Edg-7/LPA3 receptor mRNA was associated with invasive ability and metastasis only.ConclusionsEdg-4/LPA2 receptor is highly expressed in pancreatic cancer,which suggesting the malignant biological behavior of pancreatic cancer.

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was <0 .05 .There was no statistical significance among group comparisons for other factors as the P was >0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

OBJECTIVE: To explore the characteristic of formant-a very important parameter in the spectrogram of three types of artistic voice (western mode; Chinese mode; Beijing opera). METHOD: We used MATLAB software to make the short-time Fourier transform and spectrogram analysis on the homeostasis vowel examples of the three types. RESULT: The western mode had different representation "singer formant" (Fs) based on the voice part; the Chinese mode's notable features were that F1, F2, F3, were continuous and the energy of them changed softly; the Beijing opera had the common representation which was a very wide formant and there was soft transition between formants and various harmonic, besides it showed a similar component like the "Fs" (two formants connected normally). CONCLUSION Different artistic voice showed their own characteristics of the formant parameter in the spectrogram, which had important value on the identification, objective evaluation and prediction.
Adult ; Female ; Humans ; Male ; Middle Aged ; Music ; Spectroscopy, Fourier Transform Infrared ; Voice Quality ; Young Adult

Objective:To construct the post competency evaluation index system for Da Vinci robot specialist nurses based on onion model, so as to provide references for the training and evaluation of Da Vinci robot specialist nurses in China.Methods:From August to September 2022, using the "onion model" as the theoretical framework, a preliminary draft of the index system was developed using domestic and foreign literature review, semi-structured interviews and group discussions. The Delphi method was applied to 22 nursing experts in the relevant fields to conduct two rounds of expert correspondence, screen and modify the items, and calculate the weight using the analytic hierarchy process. Finally, the post competency index system for Da Vinci robot specialist nurses based on the onion model was formed.Results:Two rounds of expert correspondence were conducted. The positive coefficient of experts was 90.91% (20/22) in the first round and 100.00% (20/20) in the second round, the coefficient of expert authority was 0.840 and 0.873, and the Kendall's coordination coefficient was 0.181 and 0.324 ( P<0.01), respectively. The final post competency evaluation index system for Da Vinci robot specialist nurses consisted of 4 first-level indicators, 14 second-level indicators and 58 third-level indicators. Conclusions:This study constructs a comprehensive post competency evaluation index system for Da Vinci robot specialist nurses based on onion model, with high expert enthusiasm and authority. It can provide references for the training and evaluation of Da Vinci robot specialist nurses in China.

Objective： ：To detect the gene mutation in cholangiocarcinoma patients using the next generation sequencing (NGS) technology, and to analyze its correlation to the prognosis of the patients. Methods: From June 2016 to June 2018, 40 patients diagnosed with cholangiocarcinoma received NGS examination to screen the possible mutations (single base mutation, structural variation, copy number variation and gene fusion, etc.). The disease control rates (DCR), progression-free survival (PFS) and overall survival (OS) of the patients, who received the first line therapy, were retrospectively reviewed to analyze the relationship between signaling pathway as well as its genetic variation and the prognosis of cholangiocarcinoma patients. Results: The median PFS of patients with and without TP53 mutation was 11.0 and 8.3 months, respectively (P=0.332), while OS was 14.3 and 32.9 months, respectively (P=0.041). The median PFS of patients with and without PI3K mutations was 8.3 and 11.0 months, respectively (P=0.285), while OS was 14.3 and 37.0 months, respectively (P=0.020). The median PFS of patients with and without mTOR pathway mutations was 6.3 and 10.3 months, respectively (P=0.020), while OS was 15.6 and 19.6 months, respectively (P=0.892). There was no significant effect of pathway-related gene mutations on patients’survival. Conclusion: The prognosis of cholangiocarcinoma patients with TP53 and PI3K pathway activation had obviously poor prognosis than those without. No significant difference was observed between the patients with and without mTOR pathway activation and IDH mutation.

The oral specialist diagnosis and treatment has the characteristics of diagnosis and treatment behavior immediacy, phased diagnosis and treatment process, diagnosis and treatment population diversity, diagnosis and treatment effect subjectivity, and patient dominance of outpatient medical record storage. In the process of fulfilling the notification obligation, there may be risks such as the protection of the autonomous rights and interests of minor patients, the limited communication time, the insufficient clarity of the first diagnosis plan, the new requirements for the performance form, and the expansion of the application of the presumption of fault. The oral specialist diagnosis should pay attention to the true expression of the informed object; the diversification of the informative channels to obtain the clear attitude of the patient; the optimization of the informative process to make up for the information imbalance; the strict implementation of the core medical safety system to promote the actual fulfillment of the notification obligation.

【Objective】 To investigate the clinical characteristics, long-term follow-up rate, level and control rate of low-density lipoprotein cholesterol (LDL-C) in patients with atherosclerotic cardiovascular disease (ASCVD) aged ≥75 years who underwent percutaneous coronary intervention (PCI) during hospitalization. 【Methods】 We selected ASCVD patients aged ≥75 years with PCI from January 2016 to December 2020 in The First Affiliated Hospital of Xi’an Jiaotong University, collected the baseline data of the patients and the follow-up of 1 month, 3 months, 6 months and 12 months after discharge by HIS system, and analyzed their LDL-C and control rate at each follow-up. 【Results】 A total of 1 129 patients were enrolled in this study, aged 78 (ranging from 75 to 89) years. Among them 72.1% were male; myocardial infarction was the main type of ASCVD (71.5% ); hypertension was the most common risk factor, accounting for 85.2% (717/842), followed by diabetes, 58.6% (493/842); 74.6% met the ultra-high risk criteria of the 2020 Chinese Expert Consensus on Lipid Management in Ultra-High Risk ASCVD Patients, and the LDL-C control rate was only 8.1% . The four routine follow-up rates of 1 129 elderly ASCVD patients were 49.5%, 24.1%, 17.1%, and 24.6%, respectively. The detection rates of LDL-C during follow-up were 26.3%, 5.3%, 10.4%, and 13.8%, respectively. LDL-C control rates in ultra-high risk ASCVD were 59.4%, 45.1%, 37.1%, and 17.6%, respectively, while LDL-C control rates in non-ultra-high risk ASCVD patients were 67.3%, 55.6%, 47.4%, and 44.0%, respectively. 【Conclusion】 The elderly patients with ASCVD-PCI were mainly ultra-high risk patients. The routine follow-up rate and the LDL-C compliance rate during follow-up were low and showed a downward trend.

Marsdenia tenacissima injection, a standard Marsdenia tenacissima extract (MTE), has been approved as an adjuvant therapeutic agent for various cancers. Our previous study showed that MTE inhibited the proliferation and metastasis of prostate cancer (PCa) cells. However, the underlying mechanisms and active ingredients of MTE against PCa were not completely understood. This study revealed that MTE induced significant decreases in cell viability and clonal growth in PCa cells. In addition, MTE induced the apoptosis of DU145 cells by reducing the mitochondrial membrane potential and increasing the expression of Cleaved Caspase 3/7, Cyt c, and Bax. In vivo, DU145 xenografted NOD-SCID mice treated with MTE showed significantly decreased tumor size. TUNEL staining and Western blot confirmed the pro-apoptotic effects of MTE. Network pharmacology analysis collected 196 ingredients of MTE linked to 655 potential targets, and 709 PCa-associated targets were retrieved, from which 149 overlapped targets were screened out. Pathway enrichment analysis showed that the HIF-1, PI3K-AKT, and ErbB signaling pathways were closely related to tumor apoptosis. Western blot results confirmed that MTE increased the expression of p-AKT^Ser473 and p-GSK3β^Ser9, and decreased the expression of p-STAT3^Tyr705in vitro and in vivo. A total of 13 compounds in MTE were identified by HPLC-CAD-QTOF-MS/MS and UPLC-QTOF-MS/MS. Molecular docking analysis indicated that six compounds may interact with AKT, GSK3β, and STAT3. In conclusion, MTE induces the endogenous mitochondrial apoptosis of PCa by regulating the AKT/GSK3β/STAT3 signaling axis, resulting in inhibition of PCa growth in vitro and in vivo.
Mice ; Animals ; Male ; Humans ; Mice, Inbred NOD ; Mice, SCID ; Marsdenia ; Proto-Oncogene Proteins c-akt ; Glycogen Synthase Kinase 3 beta ; Molecular Docking Simulation ; Phosphatidylinositol 3-Kinases ; Tandem Mass Spectrometry ; Prostatic Neoplasms ; Apoptosis ; STAT3 Transcription Factor