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 With the help of the cloud platform software of ancient and modern medical records,to analyze the prescription medication rule of Chinese medical master Chen Keji's application of Corydalis yanhusuo in the treatment of heart diseases,and to summarize and inherit the medication experience.Methods Medical record prescriptions with Corydalis yanhusuo used by Academician Chen Keji to treat heart diseases from 2002 to 2010 were collected and sorted out.Improved mutual information method,association rules,complex system clustering,unsupervised entropy hierarchical clustering and other methods were used to conduct statistical,correlation and cluster analysis on the normalization,frequency of application and combination of drug pairs in the prescriptions.Results A total of 146 clinical cases of by Academician Chen Keji were collected,and the main diseases were chest arthralgia,palpitation,and vertigo.In addition to Corydalis yanhusuo,Radix Salviae liguliobae,Radix chuanxiong and Radix Paeoniae Rubra had the highest frequency of single drug use.In the treatment of chest Bi disease,the use of xin,bitter,warm drugs,liver,heart,spleen meridian,high frequency drug for Radix chuanxiong-Corydalis yanhusuo,Radix Paeoniae Rubra-Corydalis yanhusuo;Commonly used angle herbs are Radix Paeoniae Rubra-Radix chuanxiong-Corydalis yanhusuo,Trichosanthes Kirilowii Maxim-Bulbus Allii Macrostemi-Corydalis yanhusuo.Cluster analysis suggested that the commonly used prescriptions for the treatment of chest Bi were Guanxin No.2,Gualsankyu Baibanxia Decoction and Bupleurum Shugan Powder.In the treatment of palpitation,sweet,bitter and warm drugs are mainly used,which are classified into liver,lung and spleen channels.The high-frequency counterpart herbs are Radix Sophorae flavescentis-Corydalis yanhusuo;Commonly used horn medicine is Ophiopogon japonicus-Corydalis yanhusuo-Schisandra chinensis.Cluster analysis suggested that Shengmai Decoction and Tianwang Buxin Dan were commonly used by Academician Chen,and Corydalis yanhusuo,Radix Sophorae flavescentis and Rhizoma Coptidis were his characteristic herbs for palpitation.In the treatment of vertigo,sweet,bitter,warm and plain Chinese medicines were mainly used.The correlation analysis of drug combinations suggested that Ramulus Uncariae cum Uncis-Corydalis yanhusuo and Gastrodia elata-Corydalis yanhusuo were commonly used as paired herbs,Gastrodia elata-Ramulus Uncariae cum Uncis-Corydalis yanhusuo were commonly used as angle herbs.Conclusion Academician Chen Keji,based on the combination of traditional Chinese and western medicine,used Corydalis yanhusuo to promote blood circulation and relieve pain in the treatment of chest Bi,to promote blood circulation and eliminate palpitation in the treatment of palpitation,and to calm down and eliminate daze in the treatment of vertigo.

Objective To investigate the safety and efficacy of endoscopic varices ligation(EVL) plus endoscopic varices sclerotherapy(EVS)for esophageal varices hemorrhage in patients with liver cirrhosis. Methods Fifty?two liver cirrhosis patients with esophageal varices bleeding were randomly divided into EVL group(n=24)and EVLS group(n=28)according to random numbers generated by computer after first EVL. The EVL group continued undergoing EVL, and the EVLS group was treated by EVS. The interval of treatment was 2 weeks till varices disappeared. All patients were followed up for 18 months with endoscopy and endoscopic ultrasonography(EUS). The efficacy,changes of esophageal varices and perforating veins, varices recurrence and rebleeding were observed. Results There was no significant difference of complete cure rate between EVLS group and EVL group[67.9%(19/28)VS 62.5%(15/24),P>0.05]. The mean session of treatment(2.68±1.0 VS 1.83±0.7,P<0.05), and perforating veins obliteration rate after treatment in EVLS group was higher than that in EVL group[70.8%(17/24)VS 23.8%(5/21),P<0.05]. During 18 months of follow?up,there was no significant difference of rebleeding rate between the two groups[3.6%(1/28)VS 12.5%(3/24),P>0.05],and the varices recurrence rate was higher in EVL group than that in EVLS group[77.3%(17/22)VS 44.0%(11/25), P<0.05]. Child?Pugh class B patients in EVL group had a higher varices recurrence rate compared to that in EVLS group[75.0%(9/12)VS 31.5%(5/16), P<0.05]. Endoscopic recurrences occurred in patients with non?occlusive perforating veins. Conclusion EVL plus EVS sequential procedure is safe and effective for treatment of esophageal varices hemorrhage,especially for Child?Pugh class B patients.Perforating veins may play a key role in the development of esophageal varices and recurrence after endoscopic therapy. EUS findings can direct the endoscopic therapy and predict the variceal recurrence.

Objective To compare the clinical effects of closed reduction and intramedullary nailing versus open reduction and plate fixation in the treatment of displaced midshaft clavicular fractures.Methods A prospective,randomized,controlled trial was performed between July 2012 and May 2014 in 194 patients with acute displaced midshaft clavicular fracture.They were 136 males and 58 females,from 16 to 65 years of age.They were randomly divided into 2 groups to received either closed reduction and intramedullary nailing (n =98) or open reduction and plate fixation (n =96).We recorded operation time,intraoperative blood loss,hospitalization expenses,fracture healing time and complication rate.Functional assessments were conducted at 3,6 and 12 months using the Disabilities of the Arm,Shoulder and Hand (DASH) and Constant-Murley scores.The preoperative general data showed no statistical significance between the 2 groups (P ＞ O.05).Results All the 194 patients were followed up for 12 to 27 months (average,15.6 ±3.1 months).The operation time (27.7 ± 16.3 min),intraoperative blood loss (18.6 ± 14.4 mL),hospitalization expenses (12,462.0 ±3,263.4 yuan),and fracture healing time (12.1 ± 3.0 weeks) in the intramedullary nailing group were significantly better than those(62.3 ± 19.4 min,40.3 ± 17.4 mL,24,760.0 ± 3,320.4 yuan,and 16.9 ± 2.8 weeks) in the plate fixation group (P ＜ 0.05).At 3 months after surgery,the DASH (13.4 ± 3.5) and Constant-Murley (88.5 ±5.9) scores in the plate fixation group were significantly better than those (24.8 ± 6.7 and 69.1 ± 6.2,respectively) in the intramedullary nailing group (P ＜ 0.05).At 6 and 12 months after surgery,there were no significant differences in the Constant-Murley scores or DASH scores between the 2 groups (P ＞ 0.05).The complication rate in the intramedullary nailing group (25.5％,25/98) was significantly higher than in the plate fixation group (9.4％,9/96) (P ＜ 0.05).Conclusions In the treatment of displaced midshaft clavicular fractures,compared with open reduction and plate fixation,closed reduction and intramedullary nailing has advantages of less invasion,lower cost and faster fracture healing,but a disadvantage of higher complication rate.The 2 treatments may lead to similar functional recovery of the shoulder.

Objective To investigate effect of Rho kinase combined with Sheng Mai injection on tumor necrosis factor alpha ( TNF-α) , interleukin-10 (IL-10), intercellular adhesion molecule-1 (ICAM-1) and adhesion molecule CD11/CD18 in patients withⅡ°superficial burn.Methods 48 cases patients withⅡ°superficial burn were collected and divided into experimental group and control group, according to different therapy, 24 cases in each group.The two groups were given symptomatic treatment such as anti-infectious, keep warm, anti-shock, pain-relieve and wound-healing treatment, the control group were given Rho kinase on the basis of symptomatic treatment, and experimental group were given Sheng Mai injection on the basis of control group, for a course of two weeks.The serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels were compared after treatment. ResuIts After treatment, the serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels after treatment were lower than those before treatment in two groups (P<0.05).Compared with control group, the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 were lower than those of experimental group (P<0.05).ConcIusion Rho kinase combined with Sheng Mai injection could significantly reduce the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 in patients with Ⅱ°superficial burn.

Objective To analyze the clinical characteristics and prognosis of acute pyelonephritis (APN) in children.Methods A retrospective analysis was performed in 230 pediatric patients with APN admitted from January 2009 to December 2010.The clinical characteristics,etiology,drug-resistant and prognosis were reviewed,and logistic regression analysis was performed to identify the risk factors of renal scarring after APN.Results Among 230 patients with APN,93 were boys and 137 were girls with a malefemale ratio of 1∶ 1.47.Ninety-nine patients were younger than 1 year with a male-female ratio of 1.30∶1 ;75 patients were 1 to 5 year with a male-female ratioof 1 ∶ 2.75 ; 56 patients were older than 5 year with a male-female ratio of 1∶2.29.A total of 106 strains were detected,in which 91 strains were Gram-negative bacteria,13 strains were Gram-positive bacteria and 2 strains were fungus.The most frequent bacteria were Escherichia coli (65 strains,61.32％),Klebsiella pneumonia (13 strains,12.6％) and Enterococcus faecium (9 strains,8.49％).Forty-four strains of Escherichia coli produced ESBLs,and all of them were resistant to ampicillin,part of them resistant to cephalosporin,compound sulfamethoxazole and aztreonam,but all were sensitive to amikacin,amoxicillin/clavulanic acid,nitrofurantoin,and imipenem.Renal emission computed tomography (ECT) was performed again in 52 children who were followed up for 6-12 months,in which 31 cases (59.62％) developed renal scar,and 21 cases (40.38％) were recovered.Abnormalities in urinary system or vesicoureteric reflux were identified as the risk factors for renal scarring after APN (OR =6.89,P ＜ 0.05).Conclusions The incidence of APN in children drops with age,which is frequently in the males younger than 1 year,and in the females older than 1 year.Escherichia coli is the most frequent pathogen of APN in children,and most strains are multidrug resistant.Children with abnormalities in urinary system or vesicoureteric reflux are prone to develop renal scarring.

Objective To study the chemical constituents of Rhodiola kirilowii.Methods The compounds were separated and purified by various chromatographic techniques and their structures were elucidated on the basis of physicochemical properties and spectroscopic methods.Results Five compounds were purified and their structures were identified as 4-(β-D-glucopyranosyloxy)-3-hydroxy-2-(hydroxymethyl)-butanenitrfle (1),epicatechin (2),arbutin (3),rutin (4),and β-D-glucose (5).Conclusion Compound 1 is a new cyano-compound and other compounds are isolated from the plant for the first time.