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*

Dysregulation of p53 and phosphoinositide (PIPn) signaling are both key drivers of oncogenesis and metastasis. Our recent findings reveal a previously unrecognized interaction between these pathways, converging in the nucleus to form a PIPn-p53 signalosome that modulates nuclear AKT activation and downstream signaling, thereby influencing cancer cell survival and motility. This review examines recent insights into nuclear PIPn signaling in the context of established roles for p53 in cell dynamics and migration while also deliberating current research on how nuclear PIPns interact with p53 to form signalosomes that affect cell motility. We emphasize the critical role of PIPns in stabilizing p53 and activating de novo nuclear AKT signaling, which subsequently modulates key motility-related pathways. Understanding the unique operation and function of the PIPn-p53 signalosome in nuclear phosphatidylinositol 3-kinase (PI3K)-AKT activation offers novel therapeutic strategies for controlling cancer metastasis by targeting pertinent interactions and events.
Humans ; Tumor Suppressor Protein p53/metabolism* ; Signal Transduction ; Cell Movement ; Cell Nucleus/metabolism* ; Phosphatidylinositols/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Animals ; Neoplasms/pathology* ; Phosphatidylinositol 3-Kinases/metabolism*

Urine metabolomics serves as a crucial approach for discovering non-invasive biomarkers.It enables the detection of metabolite variations during disease progression and therapeutic interventions,offering novel insights for early disease diagnosis,prevention,and personalized treatment.Compared to other bodily fluids,urine exhibits dis-tinctive advantages,including ease of collection,metabolite abundance,and the capacity to promptly reflect bio-chemical metabolic pathway alterations in vivo.Strict adherence to standardized protocols for sample collection and preservation is imperative in urine metabolomics research.Nuclear magnetic resonance(NMR)and mass spectrom-etry(MS)are primary analytical techniques in urine metabolomics studies.Given the complex composition of urina-ry metabolites,appropriate analytical technologies should be selected based on specific research objectives,the combination of multiple techniques often employed to enhance the comprehensiveness and accuracy of metabolite analysis in samples.This review focuses on major technological advancements in urine metabolomics and their appli-cations in biomarker discovery from cancer screening.

ObjectiveTo develop a patient-reported traditional Chinese medicine kidney deficiency pattern (TCM-KDP) scale for colorectal cancer (CRC) patients and evaluate its reliability and validity.MethodsWe administered the TCM-KDP questionnaire to postoperative patients with stage II and III CRC as part of a multicenter randomized controlled trial (RCT) conducted in China from December 2018 to September 2021. The TCM-KDP scale consists of eight items on patient-reported symptoms and is scored on a five-point Likert scale. The scale’s reliability was assessed using Cronbach’s α and test-retest reliability, while content validity was evaluated with the content validity index. We compared the differences in serum cytokine levels and other clinical factors between patients with higher and lower KDP scores.ResultsOf the 378 patients analyzed in the original RCT, 352 (93.2%) completed the TCM-KDP questionnaire. The Cronbach’s α of the eight-item TCM-KDP scale was 0.734, and the test-retest reliability was 0.745. Our exploratory factor analysis yielded eight factors that explained the variance of 50.34%. The mean TCM-KDP score was 2.80 ± 0.92. Compared with patients with stage II CRC, those with stage III CRC had significantly higher TCM-KDP scores (2.25 vs. 2.50, P = .026). We categorized all patients into high- or low-KDP score groups (the cut-off score was 2.8). Patients with lower TCM-KDP scores had significantly higher serum interleukin-1β expression levels (P = .04).ConclusionThe patient-reported TCM-KDP scale demonstrated relatively good feasibility, internal consistency, and test-retest reliability among patients with CRC. Future studies could apply this scale to other cancer types and diseases.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Objective To explore the effects and mechanism of Baitouweng Decoction in intestinal mucosal healing in mice with ulcerative colitis(UC)based on RIPK1/RIPK3/MLKL signaling pathway.Methods Totally 30 C57BL/6 male mice were randomly divided into control group,model group,Baitouweng Decoction group,infliximab group and combination group(Baitouweng Decoction+infliximab),with 6 mice in each group.A mouse model of UC was established by free administration of 3.5%sodium gluconate sulfate solution for 7 days.After modeling,Baitouweng Decoction group was given 8 g/kg Baitouweng Decoction solution by gavage daily,while the infliximab group was given 5 mg/kg infliximab intraperitoneal injection,the combination group was given synchronous gastric and intraperitoneal injection,while the control group and model group were given equal volume of normal saline by gavage for 7 consecutive days.The body mass of mice was recorded daily,fecal characteristics were observed,and disease activity index(DAI)score was performed,colon length was measured after intervention,ELISA was used to detect the contents of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),RT-qPCR was used to detect mRNA expressions of RIPK1,RIPK3 and MLKL in colon tissue,Western blot and immunofluorescence staining were used to detect the expressions of RIPK1,RIPK3 and MLKL protein in colon tissue.Results Compared with the control group,the model group mice showed a decrease in body mass(P<0.01),an increase in DAI score(P<0.01),a shortened colon length(P<0.01),and an increase in serum IL-6 and TNF-α content(P<0.01);colonic mucosal was destructed,with disappearance of crypts and glandular structures,extensive infiltration of inflammatory cells,and increased pathological score of colon tissue(P<0.01);the mRNA and protein expressions of RIPK1,RIPK3 and MLKL in colon tissue increased(P<0.01,P<0.05).Compared with the model group,the body mass of mice in each treatment group increased(P<0.01),and the DAI score decreased(P<0.01),colon length increased(P<0.01),and the contents of serum IL-6 and TNF-α decreased(P<0.05,P<0.01);the destruction of the colonic mucosal barrier was reduced,the pathological score of colon tissue was reduced(P<0.05);the expressions of RIPK1,RIPK3 and MLKL mRNA and protein in colon tissue decreased(P<0.05,P<0.01).Conclusion Baitouweng Decoction can alleviate intestinal mucosal damage and inflammation in UC mice,and its mechanism may be related to the inhibition of the RIPK1/RIPK3/MLKL signaling pathway.

Objective To explore the occurrence and influencing factors of delayed cerebral ischemia(DCI)after clipping surgery in patients with anterior circulation aneurysms.Methods A retrospective analysis was conducted on 248 patients with anterior circulation aneurysms who underwent clipping surgery in our hospital from May 2018 to May 2023.The patients were divided into the DCI group and the non-DCI group based on the occurrence of DCI after surgery.A1∶1 propensity score matching method was used to match 54 patients in the DCI group with 54 patients in the non-DCI group.The random forest algorithm was employed to rank the importance of factors influencing DCI.Multivariable Logistic regression analysis was performed to identify independent risk factors for DCI,and the E-value method was used to assess the sensitivity of model parameters.A DCI risk prediction model was constructed,and the discriminative ability and accuracy of the model were evaluated using ROC curve and Hosmer-Lemeshow test.Results After matching,no statistically significant differences were observed between the two groups in terms of gender,age,body mass index(BMI),smoking history,alcohol consumption,history of cerebral infarction,history of subarachnoid hemorrhage,aneurysm location,and maximum aneurysm diameter(all P＞0.05).Compared to the non-DCI group,the DCI group had a higher proportion of modified Fisher grade 3-4 and Hunt-Hess grade IV patients,higher levels of D-dimer(D-D),total bilirubin(TBIL),TNF-α,high-sensitivity C-reactive protein(hs-CRP),IL-6,and glutamate,and lower levels of immunoglobulin(Ig)G,IgM,and IgA(all P＜0.05).The random forest analysis showed that including Hunt-Hess grade,modified Fisher grade,D-D,glutamate,TB1L,IgA,and IL-6 in the multivariable regression analysis achieved the lowest out-of-bag error rate.Multivariable analysis revealed that Hunt-Hess grade Ⅳ,modified Fisher grade 3-4,D-D,glutamate,TBIL were independent risk factors for DCI,while IgA was a protective factor(all P＜0.05).The risk prediction equation was as follows:P=1/[1+e(3.142+1.307 Hunt-Hess grade+1.086 modified Fisher grade+0.976 D-D+0.748 glutamate+0.552 TBIL-0.524 IgA+0.487 IL-6)].A patient with a risk probability P＞0.65 was considered to have a postoperative occurrence of DCI.The ROC curve results showed that after internal validation,the AUC of the model was 0.869(95％CI:0.836-0.897),with sensitivity and specificity of 81.08％and 97.34％,respectively,indicating good discrimination of the model.The Hosmer-Lemeshow test results showed that after internal validation,the goodness of fit of the model wasx2=4.219,P=0.561,indicating good fit of the model.Conclusions Hunt-Hess grade Ⅳ,modified Fisher grade 3-4,D-D,glutamate,TBIL,and IL-6 are identified as independent risk factors for DCI,while IgA is a protective factor.The predictive model constructed using these factors demonstrates high accuracy and discriminative ability.A risk probability P＞0.65 indicates a postoperative occurrence of DCI in patients.

Objective:To explore the relationship between glycosylated hemoglobin A 1c/high-density lipoprotein cholesterol ratio (HbA 1c/HDL-C) and urinary albumin-creatinine ratio (UACR) in Chinese adults. Methods:In this cross-sectional study, the clinical data of 43 820 community residents (age>40 years) from the Risk Evaluation of Cancers in Chinese Diabetic Individuals (REACTION study; March-December 2012) across eight centers (Liaoning, Guangdong, Shanghai, Gansu, Guangxi, Henan, Hubei, and Sichuan) in China were collected and analyzed. Participants were divided into three groups based on UACR levels:<10 mg/g, 10-30 mg/g, and >30 mg/g. The HbA 1c/HDL-C ratio was divided into four groups according to quartile division of the subjects: 1st quartile (Q1<3.79), 2nd quartile (3.79≤Q2<4.59), 3rd quartile (4.59≤Q3≤5.66), and 4th quartile (Q4>5.66). Multivariate ordinal logistic regression model was used to analyze the relationship between HbA 1c/HDL-C and UACR. Receiver operating characteristic (ROC) analysis was used to explore the predictive value of HbA 1c/HDL-C to UACR. Results:The 43 820 subjects included 13 452 (30.70%) male and 30 378 (69.30%) female patients, with an average age of (58.00±0.05) years. According to results of one-way analysis of variance analysis, the HbA 1c/HDL-C ratio was significantly associated with the risk of increased UACR ( F=495.73, P<0.001). After adjusting for clinically relevant confounding variables in logistic regression model, compared with participants with the lowest HbA 1c/HDL-C ratio (Q1), women with the highest HbA 1c/HDL-C ratio (Q4) had a 1.483-fold (95% CI 1.376-1.598, P<0.001) and men had a 1.161-fold (95% CI 1.019-1.323, P<0.001) increased risk of UACR. The ROC curve analysis showed that the area under the curve of HbA 1c/HDL-C for predicting increased UACR was 0.623 (95% CI 0.597-0.606), with a sensitivity of 60.18% and a specificity of 54.91%. The HbA 1c/HDL-C ratio showed the highest predictive value of all glycemic and lipidemic parameters. In individuals with well-controlled blood glucose (HbA 1c<6.5%) or lipid levels (HDL-C≥1.0 mmol/L), the HbA 1c/HDL-C ratio was still independently associated with the risk of increased UACR after adjusting for confounding variables [ OR(95% CI) of quartile 4: 1.563 (1.210-2.019, P=0.001) in participants with HbA 1c<6.5% and 1.822 (1.687-1.968, P<0.001) in participants with HDL-C≥1.0 mmol/L]. Conclusion:As a novel compound indicator for evaluating glucose homeostasis and dyslipidemia, the HbA 1c/HDL-C ratio was independently associated with increased UACR in the general population aged>40 years in China, which was superior to both glycemic and lipid parameters alone.

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.