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*

ObjectiveTo observe the effects of acupuncture at channel points in treating functional dyspepsia （FD） patients of spleen-stomach weakness syndrome and to explore its potential mechanism. MethodsSixty FD patients of spleen-stomach weakness syndrome were randomly divided into an acupuncture group and a domperidone group， with 30 patients in each group. Acupuncture group was given acupuncture at Zusanli （ST36）， Neiguan （PC6）， Gongsun （SP4）， and Yinlingquan （SP9） using even reinforcing-reducing method. Unilateral points were selected alternately on the left and right sides， once daily， for 30 minutes each session， 5 sessions per course， and a 2-day interval between courses. Domperidone group was given domperidone tablets orally， one tablet each time， three times daily， 15~30 minutes before meals. The total course of treatment was 4 weeks in both groups. Pairwise comparisons of the symptom scores including postprandial fullness and discomfort， early satiety， epigastric pain， and epigastric burning discomfort， and the levels of serum 5-hydroxytryptamine （5-HT）， vasoactive intestinal peptide （VIP）， and glucagon-like peptide-1 （GLP-1） were conducted at pre-treatment， 4， and 8 weeks post-treatment. The clinical efficacy was analyzed and evaluated after treatment. ResultsCompared with baseline， the symptom scores of postprandial fullness and discomfort， early satiety， epigastric pain and epigastric burning discomfort and the levels of serum 5-HT， VIP and GLP-1 of both groups were significantly decreased after 4 weeks and 8 weeks treatment （P＜0.05）. At 4 weeks post-treatment， all symptom scores and the levels of 5-HT and GLP-1 of the acupuncture group were significantly lower than those of the domperidone group （P＜0.05）. At 8 weeks post-treatment， the symptom scores of postprandial fullness and discomfort， early satiety and epigastric pain and the levels of 5-HT and VIP of the acupuncture group were significantly lower than those of the domperidone group （P＜0.05）. The total effective rate of the acupuncture group （96.67%， 29/30） was higher than that of the domperidone group （86.67%， 26/30， P＞0.05）. ConclusionAcupuncture at channel points shows good clinical efficacy in the treatment of spleen-stomach weakness syndrome FD， and its mechanism may be related to the decreased levels of 5-HT， VIP， and GLP-1 in serum.

ObjectiveTo investigate the changing trend of the disease burden of hepatitis B and its related liver cirrhosis in China， to identify related influencing factors， and to provide a basis for optimizing prevention and treatment strategies. MethodsBased on the data from Global Burden of Disease Study in 2021， the Joinpoint regression model was used to calculate the average annual percentage change of the age-standardized incidence rate， prevalence rate， mortality rate， and disability-adjusted life year （DALY） rate of chronic hepatitis B and its related liver cirrhosis from 1992 to 2021. An age-period-cohort model was established to assess the risk of disease onset， and the ARIMA model was used to predict the trend of disease burden from 2022 to 2031. ResultsFrom 1992 to 2021， there was a tendency of reduction in the overall age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate of hepatitis B and its related liver cirrhosis in China， with an average annual decline of 4.52% （95% confidence interval ［CI］： -4.63% to -4.44%， P<0.05）， 2.73% （95%CI： -2.80% to -2.66%， P<0.05）， 3.41% （95%CI： -3.50% to -3.33%， P<0.05）， and 3.55% （95%CI： -3.65% to -3.48%， P<0.05）， respectively. Compared with female individuals， male individuals had significantly higher age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate. From 1992 to 2021， the risk of hepatitis B and its related liver cirrhosis in China first decreased， then increased， and decreased again with age， and it showed an tendency of reduction with time， while it first increased and then decreased with birth cohort. The predictive model showed that there would be a tendency of reduction in the age-standardized incidence rate， prevalence rate， mortality rate， and DALY rate of hepatitis B and its related liver cirrhosis in China from 2022 to 2031. ConclusionFrom 1992 to 2021， there was a tendency of reduction in the disease burden of hepatitis B and its related liver cirrhosis in China， and it would maintain a downward trend in the next decade. There are sex and age differences in the risk of hepatitis B and its related liver cirrhosis.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

Objective To evaluate the impact of COVID-19 prevention and control measures on the disease burden of upper respiratory infections(URIs)in China.Methods Age-standardized incidence rate,mortality rate,and di-sability-adjusted life-year rate in Global Burden of Disease(GBD)2021 database were used to describe the disease burden and compared before and after the outbreak of COVID-19.The disease burden in 2022-2024 was predicted by the autoregressive integrated moving average model in R 4.4.0 software.Results The disease burden of URIs in China showed a fluctuating downward trend from 1990 to 2021.Age-standardized incidence rate,mortality rate,and disability-adjusted life-year rate showed a downward trend from 2018 to 2019.The age-standardized incidence rate decreased from 137 869.97/100 000(95％UI:121 058.04/100 000-158 137.76/100 000)in 2019 to 137 060.04/100 000(95％UI:120 167.04/100 000-156 888.93/100 000)in 2020.The age-standardized mortality rate were 0.15/100 000(95％UI:0.09/100 000-0.40/100 000)and 0.15/100 000(95％UI:0.09/100 000-0.38/100 000,respectively.The age-standardized disability-adjusted life-year rate decreased from 51.76/100 000(95％UI:32.16/100 000-77.43/100 000)to 51.44/100 000(95％UI:32.19/100 000-76.90/100 000.In 2021,the above-mentioned indicators were higher than those in 2020,but still lower than those in 2019.The au-toregressive integrated moving average model predicted that over the next three years,the age-standardized incidence rate and disability-adjusted life-year rate might show an upward trend,and the age-standardized mortality rate was likely to decline.Conclusion The disease burden of URIs in China shows a downward trend,and declines signifi-cantly after the outbreak of COVID-19.After COVID-19 being categorized as a class B infectious disease managed with class B measures,the age-standardized incidence rate increases,which reflects the effectiveness of the COVID-19 prevention and control measures on reducing the disease burden of URIs.

Objective To evaluate the impact of COVID-19 prevention and control measures on the disease burden of upper respiratory infections(URIs)in China.Methods Age-standardized incidence rate,mortality rate,and di-sability-adjusted life-year rate in Global Burden of Disease(GBD)2021 database were used to describe the disease burden and compared before and after the outbreak of COVID-19.The disease burden in 2022-2024 was predicted by the autoregressive integrated moving average model in R 4.4.0 software.Results The disease burden of URIs in China showed a fluctuating downward trend from 1990 to 2021.Age-standardized incidence rate,mortality rate,and disability-adjusted life-year rate showed a downward trend from 2018 to 2019.The age-standardized incidence rate decreased from 137 869.97/100 000(95％UI:121 058.04/100 000-158 137.76/100 000)in 2019 to 137 060.04/100 000(95％UI:120 167.04/100 000-156 888.93/100 000)in 2020.The age-standardized mortality rate were 0.15/100 000(95％UI:0.09/100 000-0.40/100 000)and 0.15/100 000(95％UI:0.09/100 000-0.38/100 000,respectively.The age-standardized disability-adjusted life-year rate decreased from 51.76/100 000(95％UI:32.16/100 000-77.43/100 000)to 51.44/100 000(95％UI:32.19/100 000-76.90/100 000.In 2021,the above-mentioned indicators were higher than those in 2020,but still lower than those in 2019.The au-toregressive integrated moving average model predicted that over the next three years,the age-standardized incidence rate and disability-adjusted life-year rate might show an upward trend,and the age-standardized mortality rate was likely to decline.Conclusion The disease burden of URIs in China shows a downward trend,and declines signifi-cantly after the outbreak of COVID-19.After COVID-19 being categorized as a class B infectious disease managed with class B measures,the age-standardized incidence rate increases,which reflects the effectiveness of the COVID-19 prevention and control measures on reducing the disease burden of URIs.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

A case of giant liquid tophus in both lower legs was reported. The patient was a 41-year-old man with a history of gout for more than 10 years. The patient had hyperlipidemia and prediabetes, and the long-term use of hormone cortisol drugs was suspected. After standardized treatment for lowering uric acid, reducing blood lipids, and correcting glucose intolerance, the patient lost 12 kg over six months. The patient was admitted to the hospital upon discovering symmetrical enlargement of both calves. Ultrasound showed subcutaneous masses with clear boundaries behind the gastrocnemius muscle, approximately 14.9 cm×6.7 cm on the left and 13.6 cm×4.6 cm on the right. Based on the clinical information and morphological features, a diagnosis of gouty tophus was made. Following ultrasound-guided puncture drainage, aspirate about 200 mL fluid from the subcutaneous masses of each lower legs. The patient continued to receive standardized uric acid-lowering treatment and the patient′s condition improved. For such atypical giant liquid tophus, clinical practitioners should remain vigilant, differentiating them from tumors, infections, autoimmune diseases, and promptly perform pathological examinations through puncture to be diagnosed. After a definitive diagnosis, surgical excision can be performed concurrently with standardized uric acid-lowering treatment to achieve a favorable prognosis.

Cancer stem cells(CSCs)are a small group of cells found in tumors that have same self-renewing properties as nor-mal stem cells.In recent years,with continuous development of science and technology in various aspects,people's research on tumor diseases has been deepened.CSCs has been defined as a key factor in promoting tumor development,especially participating in pro-moting tumor recurrence,metastasis,chemotherapy resistance,etc.Currently,CD133 has become one of popular CSCs markers,and can be highly expressed in a variety of CSCs.CD133 is closely related to diagnosis of cancer diseases,and plays an important role in dignosis and drug targeting for gastric cancer,lung cancer,brain tumor,liver cancer,ovarian cancer and colorectal cancer.This article reviews structure,function,immune mechanism escape of CD133,signal pathway of CD133 in tumorigenesis,and correlation of CD133 with various tumors as well.