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*

BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.

Coronary heart disease is a physical and mental disease that is often combined with mental disorders such as depression,anxiety,sleep disorders,and stress,affecting the patient's prognosis.This review introduces the common mental disorders of patients with coronary heart disease,the types,characteristics and application status of digital and intelligent intervention technology,and analyzes the challenges of digital and intelligent intervention technology in the development of mental disorders in coronary heart disease,with a view to providing new information technology-driven nursing practice ideas and directions.

This case report described the sucussful treatment of a male infant born at 21 weeks and 4 days through assisted reproductive technology. After prenatal consultation and with the strong desire of the parents, active resuscitation and treatment were performed. The infant received 52 days of mechanical ventilation and was extubated to non-invasive ventilation at a corrected gestational age of 28 weeks and 6 days. During hospitalization, no vasoactive drugs were used, and necrotizing enterocolitis did not occur. The gastric tube was removed at a corrected gestational age of 37 weeks and 4 days. At a corrected gestational age of 40 weeks, cranial MRI showed no abnormalities. The infant was discharged at a corrected gestational age of 42 weeks after 143 days of treatment, without the need for any respiratory support. Follow-up until a corrected age of 6 months showed good growth and development.

Objective:To observe the impacts of using heated and humidified gas sources for delivery room resuscitation on the short-term outcomes of extremely preterm infants.Methods:A retrospective study was conducted on 231 extremely preterm infants admitted to the neonatal intensive care unit of Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, from January 2020 to December 2022. The infants were divided into two groups based on whether heated and humidified gas sources were used during delivery room resuscitation: the heated and humidified group (103 cases) and the non-heated and humidified group (128 cases). Independent sample t-tests, Chi-square tests, and Mann-Whitney U tests were used to compare general conditions and short-term outcomes between the groups. Multivariate logistic regression analysis was used to assess the impact of using heated and humidified gas sources during delivery room resuscitation on the short-term outcomes of extremely preterm infants. Results:Compared to the non-heated and humidified group, the heated and humidified group had a lower incidence of intubation resuscitation [28.2% (29/103) vs. 41.4% (53/128), χ 2=4.38], moderate to severe bronchopulmonary dysplasia (BPD)/death [22.3% (23/103) vs. 39.1% (50/128), χ 2=7.39] and low rectal temperature upon admission (<36.7 ℃) [57.3% (59/103) vs. 79.7% (102/128), χ 2=13.57], while the rectal temperature upon admission was higher [36.3 ℃ (36.0-36.7 ℃) vs. 35.9 ℃ (35.5-36.3 ℃), U=－5.05], with all differences being statistically significant (all P<0.05). After adjusting for gender, gestational age, mode of delivery, amniotic fluid condition, weight on admission, maternal premature rupture of membranes, assisted reproductive technology, and full course of prenatal steroid use, multivariate logistic regression analysis showed that the use of heated and humidified gas sources during delivery room resuscitation could increase the hospital admission rectal temperature ( β=0.46, 95% CI: 0.28-0.64), and decrease the risks of severe BPD/death ( aOR=0.39, 95% CI: 0.20-0.75), and low rectal temperature upon admission ( aOR=0.29, 95% CI: 0.16-0.55)(all P<0.05). Compared to the non-heated and humidified group, the heated and humidified group showed no statistically significant differences in the use of pulmonary surfactant [37.9% (39/103) vs. 43.8% (56/128), χ 2=1.45], incidence of stage Ⅲ or higher necrotizing enterocolitis [2.0% (2/103) vs. 5.5% (7/128), χ 2=2.06], grade Ⅲ or higher intracranial hemorrhage [2.9% (3/103) vs. 3.9% (5/128), χ 2=0.22], and retinopathy of prematurity requiring surgical treatment [3.9% (4/103) vs. 10.2% (13/128), χ 2=3.60] (all P>0.05). Conclusion:The use of heated and humidified gas sources during resuscitation of extremely preterm infants can reduce the risk of moderate to severe BPD/death, help maintain warmth during resuscitation, and do not adversely affect other short-term outcomes.

Objective:To summarize the survival rate, complications, and outcomes of 32 periviable extremely preterm infants (PEPIs) born at ≤23 gestational weeks.Methods:This was a retrospective observational study involving PEPIs born at the Shenzhen Maternity & Child Healthcare Hospital from January 1, 2015, to December 31, 2021. Clinical data of all subjects were collected and analyzed. The survival rates of PEPIs born from 2015 to 2019 and 2020 to 2021 were compared. Chi-square (or Fisher's exact) test was used for statistical analysis. Results:(1) During the study period, 32 PEPIs were admitted, accounting for 0.024% (32/132 534) of all newborns born in the same hospital during the study period. The median gestational age of the 32 PEPIs was 23 weeks (21 +4-23 +6 weeks), and the birth weight was 480 g (350-720 g). (2) The survival rate of PEPIs born between 2020 and 2021 was 10/19, which appears to be a trend higher than that between 2015 and 2019 (3/13, χ2=2.79, P=0.095), while the rate of withdrawal of treatment was 8/13 and 3/19, respectively, with a statistically significant difference ( χ2=7.16, P=0.007). (3) Thirteen of the 32 PEPIs survived on discharge, including four born at 22 weeks and nine at 23 weeks. The birth weights of these surviving infants were 300-<400 g in one case, 400-<500 g in five cases, 500-<600 g in four cases, 600-<700 g in one case, and ≥700 g in two cases. (4) The most common complication was moderate and severe bronchopulmonary dysplasia (10/13), followed by retinopathy of prematurity requiring surgical intervention (5/13), patent ductus arteriosus requiring ligation (4/13), late-onset sepsis (2/13), necrotizing enterocolitis (stage Ⅱa or above) (2/13) and grade Ⅲ-Ⅳ intraventricular hemorrhage or periventricular leukomalacia (2/13). The median duration of follow-up was ten months (6-69 months), and motor retardation occurred in three infants. Conclusions:The overall survival rate of PEPIs in our hospital is relatively high, with a lower incidence of complications during hospitalization and relatively better outcome. However, further studies are required for the long-term prognosis in this group of infants.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

This study aimed to observe the protective effect of momordicine I, a triterpenoid compound extracted from momordica charantia L., on isoproterenol (ISO)-induced hypertrophy in rat H9c2 cardiomyocytes and investigate its potential mechanism. Treatment with 10 μM ISO induced cardiomyocyte hypertrophy as evidenced by increased cell surface area and protein content as well as pronounced upregulation of fetal genes including atrial natriuretic peptide, β-myosin heavy chain, and α-skeletal actin; however, those responses were markedly attenuated by treatment with 12.5 μg/ml momordicine I. Transcriptome experiment results showed that there were 381 and 447 differentially expressed genes expressed in comparisons of model/control and momordicine I intervention/model, respectively. GO enrichment analysis suggested that the anti-cardiomyocyte hypertrophic effect of momordicine I may be mainly associated with the regulation of metabolic processes. Based on our transcriptome experiment results as well as literature reports, we selected glycerophospholipid metabolizing enzymes group VI phospholipase A 2 (PLA2G6) and diacylglycerol kinase ζ (DGK-ζ) as targets to further explore the potential mechanism through which momordicine I inhibited ISO-induced cardiomyocyte hypertrophy.Our results demonstrated that momordicine I inhibited ISO-induced upregulations of mRNA levels and protein expressions of PLA2G6 and DGK-ζ. Collectively, momordicine I alleviated ISO-induced cardiomyocyte hypertrophy, which may be related to its inhibition of the expression of glycerophospholipid metabolizing enzymes PLA2G6 and DGK-ζ.

Objective:To study the trends and ranges of blood pressure in extremely premature infants (EPIs) during the first 7 days after birth.Methods:From January 2016 to December 2020, EPIs born in our hospital were retrospectively analyzed. Their blood pressure were monitored using umbilical arterial catheters and no patients needed anti-hypotension treatment. The clinical data of the infants and their mothers, blood pressure data during the first 7 days after birth, clinical outcomes and complications were collected. The trends of blood pressure in untreated EPIs were analyzed and the blood pressure ranges of EPIs of different gestational ages (GA) were established.Results:A total of 145 cases of EPIs were included and their systolic pressure, diastolic pressure and mean blood pressure showed upward trends during 2~168 h after birth ( P<0.001). The diastolic pressure increased significantly within 24 h after birth ( P<0.05), systolic pressure and mean blood pressure increased significantly within 72 h after birth ( P<0.05). Blood pressure increased with age and GA. Conclusions:The blood pressure of EPIs will increase spontaneously during 7 days after birth. The ranges of blood pressure are measured for infants with different GA to provide clinical evidence for blood pressure management of EPIs during early postnatal period.

Objective:To study the effect of oropharyngeal colostrum administration on salivary secretory IgA (sIgA) levels in extremely/very low birth weight preterm infants fed by gastric tube.Methods:Preterm infants with birth weight <1 500 g ( n=90) hospitalized in neonatal intensive care unit of the Affiliated Shenzhen Maternity & Child Healthcare Hospital of Southern Medical University from August 2020 to January 2021 were enrolled as research subjects. They were assigned into observation group and control group. The observation group accepted oropharyngeal administration of colostrum before being fed by gastric tube once every 3 hours for 7 days. The control group was given normal saline before each feeding. Other nursing interventions were consistent with the observation group. Saliva samples were collected at the 2 hour and 7 day after birth and the levels of slgA were tested. SPSS 26.0 statistical software was applied to analyse the data. Results:A total of 81 preterm infants completed this study. The content of salivary sIgA in observation group (42 cases) on 7 day after birth were significantly higher than those on the 2 hour after birth [15.4 (0.6, 106.7) μg/ml vs. 0.6 (0.0, 5.3) μg/ml] ( P<0.05). There was no statistically significant difference between the sIgA levels in the saliva of the control group (39 cases) at the 7 postnatal day and 2 hour after birth [0.0 (0.0, 1.4) μg/ml vs. 0.0 (0.0, 5.2) μg/ml] ( P>0.05). The content of salivary sIgA in observation group were significantly higher than those in control group on the 7 day after birth, the difference was statistically significant ( P<0.05). The salivary sIgA levels in the observation group were negatively correlated with the starting time of oropharyngeal administration of colostrum ( r=-0.330, P<0.05), and positively correlated with the total number of oropharyngeal administration of colostrum ( r=0.388, P<0.05). Conclusions:Oropharyngeal colostrum administration can improve the levels of salivary sIgA of extremely/very low birth weight preterm infants fed by gastric tube.