Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective　To investigate the relationship between the composite dietary antioxidant index (CDAI) and excess heart age (EHA), offering theoretical insights into the nutritional prevention of cardiovascular disease (CVD). Methods Data for this cross-sectional analysis was derived from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020, which included 16 442 participants aged 30 to 74 years without a history of CVD. The heart age was estimated using the Framingham risk score function, and EHA was subsequently calculated. The CDAI was formulated based on intake levels of vitamins A, C, E, zinc, selenium, and carotenoids to represent the overall level of antioxidants. The association between CDAI and EHA was evaluated using multivariate linear regression, multivariate logistic regression, and restricted cubic splines (RCS). Results Multiple regression analysis indicated that CDAI was negatively correlated with both EHA (β=-0.07, 95%CI: -0.14 to -0.01) and high CVD risk (defined as EHA≥10 years) (OR=0.98, 95%CI: 0.96 to 1.00), with RCS analysis suggesting that this relationship is a nonlinear and inverse L-shaped. In the female subgroup, significant negative, nonlinear associations were observed between CDAI and both EHA (β=-0.10, 95%CI: -0.12 to 0.00) and high CVD risk (OR=0.97, 95%CI: 0.94 to 0.99). Conversely, in males, these correlations did not reach statistical significance. Conclusions Our findings suggest that individuals with higher CDAI compliance had a lower risk of CVD, and this negative correlation was gender specific. This discovery offers new theoretical guidance for the nutritional prevention of CVD, underlining the necessity for more comprehensive clinical and foundational research to further explore this association.

AIM: To observe the effect of orthokeratology combined with vision therapy and Clouclip(OCVTC)on myopic children with dysfunctional accommodation.METHODS: A prospective, non-randomized control study was conducted on 99 myopic children(99 eyes)with dysfunctional accommodation at the optometry center were of Langfang Aier Eye Hospital from April 2022 to January 2023. and they selected and divided into three groups: 39 children in OCVTC group, 30 in orthokeratology(Ortho-k)group, and 30 in single vision spectacle lens(SVL)group. The OCVTC group received office-based accommodative therapy for 3 mo and home reinforcement for 3 mo, and Clouclip was used in the first 3 wk to monitor and remind children of eye habits; the accommodative amplitudes and facility were measured at baseline, 3, 6, and 12 mo after treatment.RESULTS: The OCVTC group showed significantly better improvement in accommodative amplitude compared with both the Ortho-k group and the SVL group(all P<0.05), and the Ortho-k group was better than the SVL group at 3, 6, and 12 mo after the intervention(both P<0.05). Similarly, accommodative facility was significantly enhanced in the OCVTC group compared with the other groups at 6 and 12 mo after intervention, and the Ortho-k group was better than the SVL group(all P<0.05). Both accommodative amplitude and facility in the OCVTC group were significantly improved at 3, 6, and 12 mo after the intervention compared with the baseline(all P<0.05). Additionally, 13%(5/39)of cases in the OCVTC group showed a decrease in accommodative amplitude at 12 mo after treatment, with no cases showing a decrease in accommodative facility.CONCLUSION: For myopic patients with dysfunctional accommodation, orthokeratology combining with visual training and Clouclip will enhance accommodative amplitude and facility, and maintain a stable effect over a long time.

Objective To explore the psychosocial factors affecting the recurrence of the patients with myasthenia gravis (MG).Methods The retrospective analysis was adopted.One hundred and sixty-one pa-tients with MG treated in the neurosurgery department of this hospital from January 2019 to January 2021 were selected as the research subjects.The psychosocial data of the patients were collected.The correlation be-tween the gender,age of onset,history of underlying diseases,body mass index (BMI),education level,occu-pational nature,per capita monthly family income,living environment,payment method of medical expenses and mental state with the disease recurrence was analyzed.Results Among 161 patients,111 cases developed the recurrence (included in the recurrence group) and 50 cases (included into the stable group).There were statistically significant differences in the age,gender and mental status between the two groups (P<0.05),but there were no statistically significant differences in the history of underlying diseases,BMI,education lev-el,occupational nature,per capita monthly household income,living environment and payment method of med-ical expenses between the two groups (P>0.05).The multivariate logistic regression analysis results showed that the age of onset (OR=0.304,95％CI:0.146-0.634) and anxiety combined with depression (OR=2.706,95％CI:1.090-6.719) were the influencing factors of the recurrence in the patients with MG (P<0.05).Conclusion It is necessary to pay special attention to MG patients with young onset age,anxiety and depression status,which are prone to relapse.

Complex brain diseases seriously endanger human health, and early diagnostic biomarkers and effective treatments are currently lacking. Due to ethical constraints on human research, establishing monkey models is crucial to address these issues. With the rapid development of technology, transgenic monkey models of a range of brain diseases, especially autism spectrum disorder (ASD), have been successfully established. However, to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies, there is still a lack of a standard tool, i.e., a system for collecting and analyzing the daily behaviors of brain disease model monkeys. Therefore, with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes, we established a standard daily behavior collection and analysis system, including behavioral data collection protocols and a monkey daily behavior ethogram (MDBE) for rhesus and cynomolgus monkeys, which are the most commonly used non-human primates in model construction. Then, we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms. We then established a sub-ethogram (ASD monkey core behavior ethogram (MCBE-ASD)) specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE. Subsequently, we demonstrated the high reproducibility of the system.
Animals ; Autism Spectrum Disorder ; Macaca mulatta ; Disease Models, Animal ; Behavior, Animal ; Macaca fascicularis ; Male ; Humans

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objective To summarize the radiological features of follicular dendritic cell tumor of spleen (FDCS).Methods The clinical, radiological and pathological data of 8 patients from November 2011 to November 2017 in 5 hospitals with FDCS confirmed by pathology were retrospectively analyzed. All patients underwent CT examinations including plan and enhanced CT. Three patients underwent additional MRI and two patients underwent PET‐CT examinations simultaneously. The imaging features such as location, number, shape, boundary, size, internal structure, density (or signal, 18F‐fluorodeoxyglucose uptake), enhancement model and the relationship with surrounding structures were observed and compared with pathological results. Results Of the 8 patients with FDCS, 7 were located in the spleen and 1 was located in the spleen of the ectopic spleen of the pancreas. Seven patients with splenic FDCS underwent splenectomy and 1 patient with pancreatic ectopic spleen FDCS underwent resection of the pancreas. Multiple lesions were detected in 1 case, while single in the others. Tumor was round or oval. The tumors were well‐circumscribed and presented as expansive growth. On unenhanced CT, the tumors showed a slightly lower density, and hemorrhage and necrosis could be detected in 6 lesions. Calcification was seen in 1 case, significant necrosis, and cystic change was presented in the pancreatic ectopic spleen FDCS. The solid part presented isointensity or slightly hypointensity on T1WI, and hyperointensity on T2WI. Cystic necrosis areas were hypointensitive on T1WI, and hyperointensitive on T2WI. Spoke‐like areas with hypointensity on T1WI and hyperointensity on T2WI were detected in the center of the solid part with the distribution among the substantial degenerative and necrotic regions. PET‐CT showed that the 18F‐fluorodeoxyglucose was uptaked obviously. The enhancement CT showed that at the arterial phase, the tumors were markedly enhanced and continuously enhanced at portal vein phase and balance phase. Multiple liver metastases were detected in 1 case with huge FDCS. One patient was followed up for 6 years, and gastric lymphoma was detected. The others were followed up for 6 to 53 months, there remained no transfer or recurrence.Conclusions The features of FDCS of spleen mainly manifest as solid or cystic mass with clear solitary sphenoma accompanied by scarring, calcification and hemorrhage. The enhancement mode is persistent enhancement. MRI and PET‐CT help to further reflect the tumor pathological basis and biological characteristics.

Objective To analyze the relationship among perceived stress, resilience and sleep quality in patients with coronary heart disease, and to examine the mediating effect of resilience between perceived stress and sleep quality. Methods Totally 231 patients with coronaryheartdisease were selected. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess the sleep quality, perceived stress and resilience respectively. Results The average scores of PSQI were (7.2 ± 2.8) points, and 71.4％ (165/231) of the participants had sleep problems (PSQI>5). CD-RISC-10 scores were negatively correlated with PSQI scores and PSS scores (r=-0.62,-0.43, P<0.01), and PSS scores were positively correlated with PSQI scores (r=0.33, P<0.01). Furthermore, Bootstrap-generated 95％CI was (0.130-0.319, P<0.01) and did not include 0, which indicated that resilience significantly mediated the relationship between perceived stress and sleep quality. The mediating effect size of resilience was 56.1％. Conclusion It suggests that patients with coronary heart disease have poor sleep quality. Perceived stress and resilience could affect sleep quality, and resilience could mediate the relationship between perceived stress and sleep quality.

Objective To explore the feasibility of establishing an acute pericardial effusion animal model guided by ultrasound. Methods Six experimental pigs were anesthetized. A PTC needle was injected and guided to the right ventricular anterior wall under real-time high frequency ultrasound,40 ml and 80 ml normal saline were respectively infused into the pericardial cavity within 5 minutes. Ultrasonography and pathologic examination were applied to confirm this porcine model. The amount of the fluid was estimated by ultrasound at 1 hour and 8 hours after infusion. Results With ultrasound guidance,the PTC needle smoothly entered the pericardial cavity and the saline was successfully injected. The fluid dispersed from local to the entire pericardial cavity. Pericardial effusion last within 8 hours and no significant change of the fluid amount was found (all P ＞0.05). This acute pericardial effusion model was successfully established with a rate of 100%. Conclusions It is feasible to establish an animal model of acute pericardial effusion under the guidance of ultrasound. This method is safe,rapid and effective. It can provide a suitable animal model for the study of acute pericardial effusion.