Objective To analyze the death rate and life loss of injuries in Jinshan District of Shanghai from 1990 to 2023, and to provide a scientific basis for the formulation of injury prevention and control measures. Methods Excel 2010 was used to establish a database for injury death reports in Jinshan District from 1990 to 2023, and the crude mortality rate, standardized mortality rate, age-specific mortality rate, potential years of life lost (PYLL), rate of potential years of life lost (PYLLR) and standardized rate of potential years of life lost (SPYLLR) were calculated. Results From 1990 to 2023, the crude mortality rate due to injuries in Jinshan District was 52.25/100 000, while the standardized mortality rate was 36.95/100 000. Based on the standardized mortality rate, the top four causes of injury-related deaths were traffic accidents, falls, drowning, and suicide. Traffic accidents ranked first as the leading cause of death for both males (19.30/100 000) and females (8.41/100 000). The top cause of death for the 0-14 years old group was drowning, the 15-64 years old group was traffic accidents, and the 65 years old and above was falls. Over the 34-year period, according to SPYLLR, the top four causes of death for both genders were consistently traffic accidents, drowning, suicide, and falls. Conclusion From 1990 to 2023, traffic accidents, falls, drowning, and suicide have been the primary causes of injury-related deaths in Jinshan District, Shanghai. It is essential to develop targeted prevention and control strategies based on the specific characteristics of these injury-related fatalities.

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*

The incomplete degradation of tumour cells by macrophages (Mϕ) is a contributing factor to tumour progression and metastasis, and the degradation function of Mϕ is mediated through phagosomes and lysosomes. In our preliminary experiments, we found that overactivation of NADPH oxidase 2 (NOX2) reduced the ability of Mϕ to degrade engulfed tumour cells. Above this, we screened out liquiritin from Glycyrrhiza uralensis Fisch, which can significantly inhibit NOX2 activity and inhibit tumours, to elucidate that suppressing NOX2 can enhance the ability of Mϕ to degrade tumour cells. We found that the tumour environment could activate the NOX2 activity in Mϕ phagosomes, causing Mϕ to produce excessive reactive oxygen species (ROS), thus prohibiting the formation of phagolysosomes before degradation. Conversely, inhibiting NOX2 in Mϕ by liquiritin can reduce ROS and promote phagosome-lysosome fusion, therefore improving the enzymatic degradation of tumour cells after phagocytosis, and subsequently promote T cell activity by presenting antigens. We further confirmed that liquiritin down-regulated the expression of the NOX2 specific membrane component protein gp91 phox, blocking its binding to the NOX2 cytoplasmic component proteins p67 phox and p47 phox, thereby inhibiting the activity of NOX2. This study elucidates the specific mechanism by which Mϕ cannot degrade tumour cells after phagocytosis, and indicates that liquiritin can promote the ability of Mϕ to degrade tumour cells by suppressing NOX2.

Objective: To investigate the achievement of the target for blood glucose control among community patients with type 2 diabetes mellitus (T2DM) and its influencing factors, so as to provide insights into developing blood glucose management strategies and intervention measures. Methods: Basic information, lifestyle, medication use, disease history, and HbA1c test results of T2DM patients aged 18 years and older and living in Jinshan District, Shanghai Municipality for more than 6 months were collected through Jinshan District Chronic Disease Follow up Management System and district-level information platform. The proportion of blood glucose achieving the control target (HbA1c<7%) was analyzed. Factors affecting the achievement of the target for blood glucose control were identified using a multivariable logistic regression model. Results: A total of 16 758 T2DM patients were included, with 7 844 males (46.81%) and 8 914 females (53.19%), and a median age of 69.00 (interquartile range, 12.00) years. There were 8 095 patients achieving the blood glucose control target, accounting for 48.31%. Multivariable logistic regression analysis showed that age (60-69 years, OR=0.749, 95%CI: 0.675-0.832; 70-79 years, OR=0.892, 95%CI: 0.801-0.993; ≥80 years, OR=1.238, 95%CI: 1.086-1.411), body mass index (overweight, OR=0.926, 95%CI: 0.863-0.993; obesity, OR=0.800, 95%CI: 0.718-0.891), disease course (6-10 years, OR=0.728, 95%CI: 0.673-0.787; ≥11 years, OR=0.534, 95%CI: 489-0.583), smoking (daily, OR=0.792, 95%CI: 0.730-0.860), drinking (daily, OR=0.788, 95%CI: 0.642-0.967), medication adherence (intermittent, OR=0.293, 95%CI: 0.271-0.317; self discontinuation, OR=0.074, 95%CI: 0.064-0.087), hypertension (OR=0.643, 95%CI: 0.588-0.703) and cardiovascular and cerebrovascular diseases (OR=0.671, 95%CI: 0.563-0.800) were the influencing factors for the achievement of the target for blood glucose control among T2DM patients. Conclusion The blood glucose control among T2DM patients is mainly affected by age, body mass index, disease course, smoking, drinking, medication adherence and comorbidities.

Objective:To observe the feelings of listening to music and the importance of music in the daily life of post-lingual deaf adults with cochlear implants, and to explore the relevant influencing factors.Methods:This was a cross-sectional survey study. From January 2021 to August 2021,the Music-Related Quality of Life Scale was used to evaluate the music needs and music experiences of 63 post-lingual deaf adults who met the inclusion criteria, including 27 males and 36 females, aged (40.7±12.3) years, at the time of surgery (36.8±13.1) years, and with a preoperative hearing aid ineffective time of (3.9±5.8) years. Indicators analyzed included age, duration of ineffective preoperative hearing aid wear, preoperative music preference, duration of postoperative cochlear implant use, current hearing aid modality, and auditory rehabilitation outcomes. Whether the six factors mentioned above constituted an influence on the subjects′ music listening was investigated using SPSS 25.0 statistical software.Results:All of the observations in the scale were correlated with a single factor. The two sub-dimensions of music experience section were related to the effect of auditory rehabilitation. In the importance section, the effect of auditory rehabilitation was the influential factor of the dimension of "participation importance", and the preoperative enjoyment of music was the relevant influential factor of the dimension of "perceived importance". There was a significant difference between the groups when they were grouped by the above factors ( P value<0.05), while there was no statistically significance between the groups when they were grouped by other factors ( P value>0.05). Conclusions:Post-lingual deaf adults show the need and attempt to listen to music after cochlear implantation. The effectiveness of auditory rehabilitation and the degree of music preference preoperatively are two important factors that influence music listening in implant recipients. Once the level of auditory communication has been restored to a certain degree, it is important to pay more attention to the needs of music for implant recipients and train them in time, especially for those with music preferences preoperatively.

Objective:To investigate the application value of intraoperative motor nerve monitoring in cervical neurogenic tumor surgery.Methods:The efficacy of intraoperative neuromonitoring (IONM) was analyzed retrospectively in 18 patients, including 6 males and 12 females, aged from 15 to 74 years, treated in Affiliated Drum Tower Hospital, Medical School of Nanjing University from June 2019 to September 2022 who underwent total cystectomy of cervical neurogenic tumors under intraoperative nerve monitoring.Results:All 18 patients had complete tumor removal, including 8 patients with tumors from the vagus nerve and 10 patients with tumors from the brachial plexus nerve. Postoperative nerve functions were normal in patients with tumors from brachial plexus nerve, and incomplete vocal cord paralysis occurred in 2 patients with tumors from vagus vagus nerve. The total incidence of motor nerve injury was 11.1% (2/18). All patients were followed up for 6 to 45 months, with no tumor recurrence.Conclusion:Intraoperative neuromonitoring has significant values in surgery of cervical neurogenic tumors, which is helpful to remove completely the tumors on the basis of protecting the nerve functions to the maximum extent.

Abstract: Objective　To analyze epidemiological characteristics of influenza in Nanning from 2013 to 2022, to provide a reference for the prevention and control of influenza. Methods The data of influenza incidence and etiology surveillance results of the influenza virus in Nanning from 2013 to 2022 were collected to build a database. Data statistical analysis was performed through SPSS 21.0 and Joinpoint software to explore the epidemic trend and epidemic characteristics of the influenza virus in Nanning, and the seasonal index method was used to analyze the epidemic seasons. Results The reported incidence of influenza in Nanning showed an overall upward trend from 2013 to 2022, with an annual percent change (APC) of 47.63% (P<0.05), and an average annual incidence rate of 84.47/105 (ranging from 6.65/105 to 302.55/105). The peak months for influenza in Nanning were January, June, and December, with the seasonal indices of influenza all exceeding 100%, and the proportions of reported cases was 12.69%, 29.41%, and 25.97%, respectively. Both male and female incidence rates showed an upward trend without significant difference (P=0.66). The male-to-female case ratio was 1.24∶1, with the highest case distribution in the 5-<10 years age group, accounting for 31.17%, mainly among students, scattered children, and preschoolers. Xixiangtang District reported the largest influenza cases (21.12%), and Xingning District had the highest annual incidence (214.72/105). Influenza outbreaks mainly occurred in schools and kindergartens, accounting for 97.84%; primary schools accounted for 63.07% of the total. From 2013 to 2022, the dominant strains of influenza viruses alternated in Nanning, with a higher proportion of influenza A (H1N1) and (H3N2) viruses from Jan. 2013 to Mar. 2019. The dominant strains from April 2019 to Dec. 2022 were influenza A (H3N2) and B (Victoria) lineage. Conclusions The intensity of the influenza epidemic in Nanning City showed an increasing trend from 2013 to 2022, with obvious seasonality. The dominant subtypes of influenza viruses varied each year. The main affected groups were students and children, and the outbreaks mainly occurred in schools. Therefore, it is necessary to strengthen the prevention and control of influenza in schools, and the timely detection and handling of outbreaks.

Objective:To investigate the effect of ultrasound monitoring of inferior vena cava collapse index (IVC-CI) guiding fluid replacement on circulation in elderly patients during induction of general anesthesia.Methods:A total of 71 elderly patients who underwent elective surgery under general anesthesia and tracheal intubation at Hunan Provincial People′s Hospital from April 2021 to September 2022 were randomly divided into control group (35 cases) and observation group (36 cases) using a random number table method. Before anesthesia, both groups of patients underwent IVC ultrasound examination and calculated the IVC-CI value. For patients with IVC-CI≥40%, the observation group was given 8 ml/kg of crystal solution before anesthesia induction, while the control group was not treated. The incidence of hypotension, the use of vasoactive drugs, and the total infusion volume from anesthesia induction to skin incision were recorded in two groups. Mean arterial blood pressure (MBP), heart rate (HR), oxygen saturation (SpO 2), cardiac index (CI), and cardiac volume variability (SVV) before anesthesia (T 0), 5 min after induction (T 1), 1 min after tracheal intubation (T 2), 5 min after tracheal intubation (T 3), 10 min after tracheal intubation (T 4), and 1 min before skin incision (T 5) were recorded and compared between the two groups. Results:The incidence of hypotension (27.8% vs 60.0%) and utilization rate of vasoactive drugs (25.0% vs 48.6%) in the observation group were lower than those in the control group, and the total infusion volume during anesthesia induction was higher than that in the control group, with statistical significance (all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 were significantly different from those at T 0 in the control group ( F=3.85, 14.66, 3.96, all P<0.05). SVV, CI and MBP at T 1, T 3, T 4 and T 5 in the observation group were significantly different from those at T 0 ( F=3.51, 13.20, 4.35, all P<0.05). There was no significant difference in SVV, CI, MBP, HR and SpO 2 between 2 groups (all P>0.05). Conclusions:For the elderly patients with preoperative IVC-CI≥40%, pre-filling with 8ml/kg crystal solution before anesthesia induction can significantly reduce the incidence of hypotension and the utilization rate of vasoactive drugs in the elderly patients during anesthesia induction.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective To analyze the trend of death level and the probability of premature death caused by chronic obstructive pulmonary disease (COPD) in Jinshan District of Shanghai from 1980 to 2020, and to provide reference for the formulation of prevention and control measures of COPD. Methods The death cases of COPD in Jinshan District from 1980 to 2020 were collected through the death cause registration information system. The crude mortality, standardized mortality, age group mortality, early death probability and annual change percentage in different periods were calculated. Results From 1980 to 2020, the crude mortality of COPD in Jinshan District was 154.38/100 000, and the standardized mortality was 82.66/100,000. In the past 41 years, the standardized mortality of COPD showed a downward trend in males and females (APC=-1.79%, -2.52%, P<0.001). In the same period, the mortality of COPD in subjects aged 30-69 years old and subjects aged 70 years old and above also decreased (APC=-8.79%, -4.79%, P<0.001), and the probability of premature death caused by COPD showed a downward trend in males and females (APC=-9.61%, -10.71%, P<0.001). Conclusion The mortality rate and the probability of premature death of COPD in Jinshan District have decreased in the past 41 years. However, COPD is still one of the major chronic diseases that pose a serious threat to the health of residents in Jinshan District. Comprehensive prevention and treatment measures should be taken to reduce the mortality and the probability of premature death of COPD.