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:To investigate the clinicopathological features of pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma).Methods:A retrospective case series study was conducted. A total of 41 cases of pulmonary MALToma who were admitted to multiple centers from April 2002 to August 2023 were collected, including 33 cases from Fujian Provincial Hospital, 5 cases from Binzhou People's Hospital, 1 case from the Second Hospital of Zhangzhou, 1 case from the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, and 1 case from Jinjiang Hospital. The results of pathological morphological examination, immunohistochemical examination and genetic testing of patients were summarized, their clinicopathological characteristics were analyzed, and the relevant literature was reviewed.Results:Among the 41 patients, there were 24 males and 17 females, aged (58±13) years (range: 36-81 years). The longest diameter of the tumor under the gross macroscopic examination was (2.8±2.0) cm, with a range of 0.8-9.7 cm. Under the microscope, diffuse, flakelike and nodular patterns of lymphoid tissue were seen in the lung tissue with small- to medium-sized lymphoid cells including small lymphocytes, centrocyte-like cells, mononuclear cells and plasma cells. A small number of activated cells were noted, and the lymphoid cells grew along the alveoli. In some areas, the lymphoid cells invaded the bronchi, and lymphatic follicular implantation was rare; 1 case was accompanied by large cell transformation. Tumor cells expressed CD20, Pax-5, bcl-2, and CD43, with Ki-67 proliferation index of 2%-20%, and 50% in some areas of 1 case. The positive rate of clonal B-cell receptor gene rearrangement was 100.00% (29/29); the positive rate of MALT1 gene was 18.75% (3/16), and the positive rate of API2-MALT1 fusion was 66.67% (2/3). The treatment methods included surgery, anti-inflammatory therapy, radiotherapy, and chemotherapy. Follow-up for 4-143 months showed that 43.90% (18/41) had disease-free survival, 21.95% (9/41) had tumor bearing survival, 9.76% (4/41) died, and 24.39%, (10/41) were lost to follow-up. The progression-free survival of patients aged ≥ 60 years was worse than that of patients aged < 60 years ( χ2 = 5.39, P = 0.020). Conclusions:Pulmonary MALToma belongs to indolent B-cell lymphoma, and its diagnosis requires a combination of clinical imaging, pathology and immunophenotyping. If necessary, genetic testing can be used to assist in the diagnosis. The differential diagnosis should be made from pneumonia, low-grade B-cell lymphoma, and extrapulmonary MALToma with lung involvement. The treatment methods include anti-inflammatory therapy, surgical resection and chemotherapy, and the prognosis is good.

Objective Chronic intermittent hypoxia (CIH)animal model was used to mimic the status of obstructive sleep apnea (OSA) in order to investigate the pathological mechanism of CIH-induced cardiac remodeling and observe the protective effect of antioxidants.Methods FVB mice (8-10 weeksold) were randomly divided into control (saline,i.p.) group and CIH group,reduced form of nicotinamide adenine dinucleotide phosphate oxidase inhibitor,apocynin (APO,3 mg · kg-1 · d-1,i.p.) alone or CIH+APO,SOD mimic MnTMPyP (SODM,5 mg · kg-1 d-1,i.p.) alone or CIH + SODM (n =5 each).After 4 weeks,cardiac function and structure were determined by echocardiography,cardiac inflammation,apoptosis,cardiac fibrosis and cardiac MDA contents were examined by Western blot and chemical-biological methods,respectively.Results (1) Heart weight,LVIDd and LVIDs were increased while LYEF and FS were reduced in CIH group compared to control group (all P ＜ 0.05).(2) Myocardial protein expression of ANP and VCAM-1 was significantly upregulated,myocardial MDA content and apoptosis as well as myocardial fibrosis marker CTGF and PAI-1 were increased in CIH group compared to control group (all P ＜ 0.05).(3) Above parameters were similar between APO and CIH + APO as well as SODM and CIH + SODM (all P ＞ 0.05).Conclusion CIH could induce cardiac remodeling and CIH-induced cardiac inflammation,cardiac oxidative injury,cardiac apoptosis and cardiac fibrosis serve as the pathological mechanisms of CIH-induced cardiac remodeling.The protective effects of the two antioxidants suggest that the main mechanism of CIH-induced cardiac injury is oxidative stress.

OBJECTIVE To evaluate the commonly encountered pathogens and drng resistance of bacteria causing secondary infection in patients with malignant tumors and provide reference for clinical antimicrobial usage.METHODS Statistical analysis was made retrospectively in the classification and antimicrobial susceptibility testing in 1 204 strains of pathogens isolated from clinical samples of hospitalized patients with malignant tumors from Jan 2003 to Oct 2005.RESULTS Among 1 204 strains,Gram-positive strains accounted for 31.1%;Gram-negative ones accounted for 52.8%;and fungi accounted for 16.1%.The principal strains were Candida albicans,Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,and Pseudomonas aeruginosa.The most frequent infection sites were in respiratory tract,urinary tract and skin-soft tissue.Multiple drug resistant rate of Gram-positive and Gram-negative strains had a tendency of elevation.CONCLUSIONS To reduce the coming of drug resistant strains,etiologic examination should be done in treatment of infectious diseases and antimicrobial therapy should be decided according to the results of susceptibility.

OBJECTIVE To investigate the bacteriologic feature and the spectrum of drug resistance in lung cancer patients who got nosocomial nonfermenters bacteria infection,and to conclude the experience and how to prevent and control the nosocomial infection.METHODS A rectrospective analysis of the composition of the pathogens,the feature of drug resistance and the prognosis of 109 lung cancer inpatients with nosocomial infection was made.RESULTS Nosocomial nonfermenters bacteria infections were most happened in hospital lung cancer patients.Main strains included Pseudomonas aeruginosa 55(49.5%),Acinetobacter baumannii 23(20.7%),and Stenotrophomonas maltophilia 8(7.2%).The sensitive rate of P.aeruginosa to imipenem was 100%,but to Cotrimoxazole,the resistant rate was 100%.The sensitive rate was relatively high to ticarcillin,piperacillin and their compounds.The antimicrobial resistance rate of A.baumannii was higher than P.aeruginosa.Stenotrophomonas were resistant to most antibiotics,and the resistance rate to imipenem was 100.0%.CONCLUSIONS The resistance rate of nosocomial nonfermenters bacteria infection is high.The treatment is difficult and the prognosis is bad.The mortality of multiple infection is high.