Objective:To investigate the clinical characteristics,pathological features,treatment,and prognosis of clear cell adenocarcinoma of cervix(CCAC).Methods:Clinical data of 72 CCAC patients treated at Jiangxi Maternal and Child Health Hospital from January 1,1999,to June 20,2024,were retrospectively analyzed.Results:The median age at diagnosis was 50 years.Of the patients,19 were classified as early-stage(IB1,IB2,IIA1),51 as mid-advanced stage(IB3,IIA2-IVB),and 2 were unstaged.Among 38 patients,elevated cancer Antigen 125(CA125)levels were observed in19(50.0%).Abnormal thin-layer liquid-based cytology(TCT)results were de-tected in 14 of 20 patients(70.0%),and human papillomavirus(HPV)positivity was identified in 20 of 45 patients(44.5%).Immunohistochemical analysis revealed hepatocyte nuclear factor-1β(HNF-1β)positivity in 95.2%and paired box gene 8(PAX-8)positivity in 91.3%.Among 32 patients undergoing primary surgery,postoperative pa-thology confirmed pelvic lymph node metastasis in 5(15.6%),lymphovascular and stromal invasion in 9(28.1%),with no ovarian metastasis observed.With a median follow-up of 45 months,the5-year overall survival(OS)rate was 51.4%,with early-stage and mid-advanced stage OS rates of 57.9%and 47.1%,respectively.The 5-year OS rate for surgically managed patients was 52.8%,while preoperative neoadjuvant chemotherapy(9 cases)yielded a 5-year OS of 33.3%.Among38 patients treated primarily with radiotherapy and/or chemotherapy,the5-year OS was 47.1%,with 5 patients undergoing central lesion resection achieving an 80.0%5-year OS.Conclusions:CCAC predominantly affects middle-aged and elderly women,with advanced-stage presentations being common.HPV,TCT,and CA125 testing hold diagnostic value for CCAC.Patients with early-stage CCAC undergoing surgical treatment demonstrated a relatively favorable survival rate;however,individualized assessment remains essential.Neoadjuvant chemotherapy administered prior to surgery may have limited efficacy in improving patient prognosis.For selected patients completing radiotherapy and/or chemotherapy,central lesion resection may potentially im-prove prognosis,although further well-designed studies are required to validate this finding.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.

Objective:To investigate the efficacy of blood-nourishing and wind-dispersing decoction combined with warm acupuncture in the treatment of chronic urticaria and its effects on immune function and Th1/Th2 cytokines.Methods:A prospective study involving 144 patients with chronic urticaria was conducted at Shaanxi Traditional Chinese Medicine Hospital from August 2021 to August 2023. The patients were randomly divided into two groups using a random number table method: 72 in the study group and 72 in the control group. The control group received conventional western medicine treatment with oral loratadine tablets, while the study group received blood-nourishing and wind-dispersing decoction combined with warm acupuncture, in addition to the treatment provided to the control group. The efficacy, symptom scores, immune function, Th1/Th2 cytokine levels, safety, and recurrence rates were compared between the two groups.Results:The total response rate in the study group was significantly higher than that in the control group [93.06% (67/72) vs. 80.56% (58/72), χ2 = 4.91, P < 0.05]. Repeated measures analysis of variance results indicated that the differences in the time-point effect, between-group effect, and interaction effect of the symptom scores of the two groups were statistically significant ( Ftime-point = 2361.90, Fbetween-group = 24.29, Finteraction =18.39, all P < 0.05). Compared with before treatment, symptom scores in both groups decreased after 4 and 8 weeks of treatment (both P < 0.05), with the study group showing lower scores than the control group ( t = 5.30, 14.93, both P < 0.05). After 8 weeks of treatment, both groups showed an increase in CD4 + and CD4 +/CD8 + ratios, and a decrease in CD8 + and IgE levels compared with before treatment (all P < 0.05). Furthermore, the study group had better outcomes in CD4 +, CD4 +/CD8 +, CD8 +, IgE compared with the control group ( t = 9.44, 6.97, 13.80, 9.88, 27.45, 18.31, 7.55, 2.35, all P < 0.05). After 8 weeks of treatment, both groups showed increased levels of interleukin (IL)-2 and interferon-γ, and decreased levels of IL-4 and IL-10 compared with their baseline measurements (all P < 0.05). Additionally, the study group had superior results in IL-2, interferon-γ, IL-4, IL-10 compared with the control group [(55.56 ± 5.94) ng/L vs. (40.47 ± 5.88) ng/L, (27.75 ± 5.47) ng/L vs. (12.39 ± 5.52) ng/L, (3.07 ± 0.59) ng/L vs. (4.43 ± 0.60) ng/L, (4.57 ± 0.76) ng/L vs. (3.31 ± 0.91) ng/L, (4.51 ± 0.61) ng/L vs. (6.89 ± 0.68) ng/L, (7.91 ± 1.48) ng/L vs. (4.54 ± 1.53) ng/L, (28.97 ± 4.59) ng/L vs. (22.19 ± 4.37) ng/L, (15.45 ± 3.86) ng/L vs. (8.79 ± 3.76) ng/L, t = 15.32, 16.77, 13.71, 9.03, 22.10, 9.44, 9.08, 10.48, all P < 0.05]. There was no statistically significant difference in safety between the two groups ( χ2 = 0.53, P > 0.05); however, the study group had a lower recurrence rate compared with the control group ( χ2 = 7.34, P < 0.05). Conclusions:The combination of blood-nourishing and wind-dispersing decoction with warm acupuncture demonstrates a good therapeutic effect in the treatment of chronic urticaria. This approach effectively increases symptom scores, regulates Th1/Th2 cytokine levels, enhances immune function, and reduces recurrence rates, while also exhibiting good safety.

Objective:To investigate the clinical characteristics,pathological features,treatment,and prognosis of clear cell adenocarcinoma of cervix(CCAC).Methods:Clinical data of 72 CCAC patients treated at Jiangxi Maternal and Child Health Hospital from January 1,1999,to June 20,2024,were retrospectively analyzed.Results:The median age at diagnosis was 50 years.Of the patients,19 were classified as early-stage(IB1,IB2,IIA1),51 as mid-advanced stage(IB3,IIA2-IVB),and 2 were unstaged.Among 38 patients,elevated cancer Antigen 125(CA125)levels were observed in19(50.0%).Abnormal thin-layer liquid-based cytology(TCT)results were de-tected in 14 of 20 patients(70.0%),and human papillomavirus(HPV)positivity was identified in 20 of 45 patients(44.5%).Immunohistochemical analysis revealed hepatocyte nuclear factor-1β(HNF-1β)positivity in 95.2%and paired box gene 8(PAX-8)positivity in 91.3%.Among 32 patients undergoing primary surgery,postoperative pa-thology confirmed pelvic lymph node metastasis in 5(15.6%),lymphovascular and stromal invasion in 9(28.1%),with no ovarian metastasis observed.With a median follow-up of 45 months,the5-year overall survival(OS)rate was 51.4%,with early-stage and mid-advanced stage OS rates of 57.9%and 47.1%,respectively.The 5-year OS rate for surgically managed patients was 52.8%,while preoperative neoadjuvant chemotherapy(9 cases)yielded a 5-year OS of 33.3%.Among38 patients treated primarily with radiotherapy and/or chemotherapy,the5-year OS was 47.1%,with 5 patients undergoing central lesion resection achieving an 80.0%5-year OS.Conclusions:CCAC predominantly affects middle-aged and elderly women,with advanced-stage presentations being common.HPV,TCT,and CA125 testing hold diagnostic value for CCAC.Patients with early-stage CCAC undergoing surgical treatment demonstrated a relatively favorable survival rate;however,individualized assessment remains essential.Neoadjuvant chemotherapy administered prior to surgery may have limited efficacy in improving patient prognosis.For selected patients completing radiotherapy and/or chemotherapy,central lesion resection may potentially im-prove prognosis,although further well-designed studies are required to validate this finding.

OBJECTIVE: To determine the prevalence of GJB2 gene c.109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. METHODS: One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c.109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c.109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children's Hospital of Ningbo University (Ethics No.: EC2023-009). RESULTS: For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c.109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c.109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined (n = 53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined (n = 24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls (P = 0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1 ± 12.0 dB nHL, P = 0.005). CONCLUSION Infants harboring the GJB2 c.109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c.109G>A variant can confer a more severe hearing loss.
Humans ; Connexin 26/genetics* ; Female ; Male ; Infant, Newborn ; Infant ; Hearing Loss/genetics* ; Retrospective Studies ; Child, Preschool ; Child ; Genotype ; Connexins/genetics* ; Mutation

Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.

Objective To observe the clinical efficacy of acupuncture in treating chronic insomnia disorder based on Huang Yuanyu's theory of"central qi ascending and descending,harmony of the four dimensions"regarding visceral qi movement.Methods Sixty patients diagnosed with chronic insomnia disorder at the Preventive Treatment Department of Yangjiang Hospital of Traditional Chinese Medicine from March 2022 to February 2023.The patients were randomly divided into an observation group and a control group according to a random number table,with 30 cases in each group.The observation group received acupuncture therapy,while the control group received oral administration of Alprazolam Tablets.The treatment duration spanned 4 weeks with 1 course per week.Clinical efficacy was evaluated after 1 month,and the changes in the Pittsburgh Sleep Quality Index(PSQI)scores and Hamilton Anxiety Rating Scale(HAMA)scores were observed.The Hamilton Depression Rating Scale(HAMD)scores were compared between groups before and after treatment.Results(1)After treatment,the PSQI scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the HAMA scores and HAMD scores in the two groups of patients were significantly improved(P＜0.05),an the observation group in improvement of HAMA and HAMD was significantly superior to the control group,with statistically statistical significance(P＜0.05).(3)The total effective rate was 83.33%(25/30)in the observation group and 70.00%(21/30)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture based on the ascending and descending of visceral qi movement theory significantly alleviates anxiety and depressive states while improving sleep quality in patients with chronic insomnia disorder,demonstrating notable clinical efficacy.

ObjectiveTo investigate the association between variant degree of sarcopenia and all-cause mortality in Chinese elderly residents, and to provide insights into the prevention and control of sarcopenia in the elderly population. MethodsData from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 and 2020 were analyzed, and a total of 2 792 subjects aged 65 years or older were selected according to the inclusion and exclusion criteria. Univariate and multivariate Cox proportional hazards regression analysis were performed to explore the potential factors influencing all-cause mortality among the elderly in China, and Kaplan-Meier curves were used to visualize the survival of elderly people with variant degree of sarcopenia. Finally, a multiple-adjusted Cox proportional hazards regression model was used to control the confounding factors and explore the association between sarcopenia and all-cause mortality. ResultsBefore adjusting potential covariates, univariate and multivariate Cox proportional hazards regression models showed that 10-year all-cause mortality was significantly associated with variant degree of sarcopenia, namely possible sarcopenia (HR=1.40, 95%CI: 1.1‒1.68, P<0.001), mild-to-moderate sarcopenia (HR=1.49, 95%CI:1.20‒1.86, P<0.001), and severe sarcopenia (HR=1.68, 95%CI: 1.29‒2.19, P<0.001); after adjusting all confounders, 10-year all-cause mortality remained to be significantly associated with variant degree of sarcopenia, including probable sarcopenia (HR=1.38, 95%CI: 1.15‒1.66, P<0.001), mild-to-moderate sarcopenia (HR=1.48, 95%CI: 1.19‒1.84, P<0.001) and severe sarcopenia (HR=1.71, 95%CI: 1.31‒2.23, P<0.001). ConclusionIn Chinese elderly residents, sarcopenia is positively associated with an increased risk of 10-year all-cause mortality, and the progression of sarcopenia is positively associated with an increased risk of death.

Objective:To investigate the efficacy of blood-nourishing and wind-dispersing decoction combined with warm acupuncture in the treatment of chronic urticaria and its effects on immune function and Th1/Th2 cytokines.Methods:A prospective study involving 144 patients with chronic urticaria was conducted at Shaanxi Traditional Chinese Medicine Hospital from August 2021 to August 2023. The patients were randomly divided into two groups using a random number table method: 72 in the study group and 72 in the control group. The control group received conventional western medicine treatment with oral loratadine tablets, while the study group received blood-nourishing and wind-dispersing decoction combined with warm acupuncture, in addition to the treatment provided to the control group. The efficacy, symptom scores, immune function, Th1/Th2 cytokine levels, safety, and recurrence rates were compared between the two groups.Results:The total response rate in the study group was significantly higher than that in the control group [93.06% (67/72) vs. 80.56% (58/72), χ2 = 4.91, P < 0.05]. Repeated measures analysis of variance results indicated that the differences in the time-point effect, between-group effect, and interaction effect of the symptom scores of the two groups were statistically significant ( Ftime-point = 2361.90, Fbetween-group = 24.29, Finteraction =18.39, all P < 0.05). Compared with before treatment, symptom scores in both groups decreased after 4 and 8 weeks of treatment (both P < 0.05), with the study group showing lower scores than the control group ( t = 5.30, 14.93, both P < 0.05). After 8 weeks of treatment, both groups showed an increase in CD4 + and CD4 +/CD8 + ratios, and a decrease in CD8 + and IgE levels compared with before treatment (all P < 0.05). Furthermore, the study group had better outcomes in CD4 +, CD4 +/CD8 +, CD8 +, IgE compared with the control group ( t = 9.44, 6.97, 13.80, 9.88, 27.45, 18.31, 7.55, 2.35, all P < 0.05). After 8 weeks of treatment, both groups showed increased levels of interleukin (IL)-2 and interferon-γ, and decreased levels of IL-4 and IL-10 compared with their baseline measurements (all P < 0.05). Additionally, the study group had superior results in IL-2, interferon-γ, IL-4, IL-10 compared with the control group [(55.56 ± 5.94) ng/L vs. (40.47 ± 5.88) ng/L, (27.75 ± 5.47) ng/L vs. (12.39 ± 5.52) ng/L, (3.07 ± 0.59) ng/L vs. (4.43 ± 0.60) ng/L, (4.57 ± 0.76) ng/L vs. (3.31 ± 0.91) ng/L, (4.51 ± 0.61) ng/L vs. (6.89 ± 0.68) ng/L, (7.91 ± 1.48) ng/L vs. (4.54 ± 1.53) ng/L, (28.97 ± 4.59) ng/L vs. (22.19 ± 4.37) ng/L, (15.45 ± 3.86) ng/L vs. (8.79 ± 3.76) ng/L, t = 15.32, 16.77, 13.71, 9.03, 22.10, 9.44, 9.08, 10.48, all P < 0.05]. There was no statistically significant difference in safety between the two groups ( χ2 = 0.53, P > 0.05); however, the study group had a lower recurrence rate compared with the control group ( χ2 = 7.34, P < 0.05). Conclusions:The combination of blood-nourishing and wind-dispersing decoction with warm acupuncture demonstrates a good therapeutic effect in the treatment of chronic urticaria. This approach effectively increases symptom scores, regulates Th1/Th2 cytokine levels, enhances immune function, and reduces recurrence rates, while also exhibiting good safety.