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 evaluate the clinical efficacy of different acupuncture-related therapies in treating postoperative pain in patients with osteoporotic vertebral compression fractures (OVCFs) after percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) using a network meta-analysis.MethodsA systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database (SinoMed) from their inception to January 15, 2025. Outcome measures included the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score, and overall efficacy rate. Literature screening, data extraction, and risk-of-bias assessment were independently performed by two researchers. Data analysis was conducted using Stata 17.0 software.ResultsA total of 35 randomized controlled trials involving 2860 patients were included. The data analysis revealed that, in terms of improving VAS and ODI scores, the top three effective therapies were Fu's subcutaneous needling, wrist-ankle acupuncture, and acupotomy. For the overall efficacy rates in pain treatment, the top three therapies were wrist-ankle acupuncture, warm acupuncture and moxibustion, and Fu's subcutaneous needling. Based on the combined results across the three outcome measures, Fu's subcutaneous needling was found to be the most effective in relieving pain and improving lumbar function.ConclusionFu's subcutaneous needling, wrist-ankle acupuncture, warm acupuncture and moxibustion, and acupotomy were all effective in treating postoperative pain post-PKP/PVP and improving lumbar function. However, further high-quality, large-sample studies are required to confirm these findings.

Based on the resutls of literature review and interviews of experts, two rounds of Delphi surveys were conducted. The mean, importance ratio, coefficient of variation and coordination coefficient were used for assessment of survey from multiple perspectives, and finally form a framework model of factors affecting the efficacy of Tuina therapy. A total of 37 experts were selected for questionnaire surveys, the positive coefficients of experts' participatation in the first round and second round were 92.5% and 80.0%, respectively. The overall coordination coefficient in the second round is 0.68. The items were included into the consensus meeting if the importance ratio of items were equal to and more than 80%. After the expert consensus meeting, 22 items were included to form a framework model of factors affecting the efficacy of Tuina therapy, and summarized as 5 major influencing factors, including diagnostic factors, treatment factors, prognostic factors, patient factors, and doctor-patient communication. This framework can guide and help young Tuina practitioners to improve clinical efficacy. It is also clearly pointed out that the effect of Tuina for pain is not only related to disease diagnosis or manipulation, but also related to home exercise, health care, and doctor-patient communication.

Tuina (Chinese massage) is an important part of Traditional Chinese Medicine. It is a simple and inexpensive technique, and has shown effectiveness for muscle and bone diseases, visceral diseases, gynecological diseases, and common diseases in children. This paper aims to analyze the factors influencing the effects of Tuina. The factors included the aspects of diagnosis, treatment, prognosis, patient factors and doctor-patient communication. During the treatment of Tuina, doctors should carry out good doctor-patient communication, properly evaluate and exam patients, and clarify diagnosis, take appropriate Tuina techniques according to the patients' constitution, health condition, and comorbidity. Only in such way, could Tuina achieve effectiveness and safety.

Objective:To investigate the effectiveness of stroke standardized patient (SP) combined with the subjective-objective-assessment-plan (SOAP) problem-based medical recording method in the practice teaching of Physiotherapy. Methods:A randomized controlled study was conducted, and 116 students from the undergraduate class of rehabilitation therapy were selected as research subjects. The students in the control group received traditional teaching, and those in the experimental group received the teaching model of stroke SP combined with the SOAP assessment recording method. The effectiveness of teaching was compared between the two groups at the end of the course. SPSS 24.0 was used for statistical analysis; the chi-square test was used for categorical data, and the paired samples t-test was used for comparison between groups. Results:Compared with the control group, the experimental group had significantly higher scores of practical skills (85.97±3.19 vs. 78.14±3.86, P<0.05), basic theoretical knowledge (86.00±3.74 vs. 84.07±5.24, P<0.05), and writing of rehabilitation treatment records (85.74±4.76 vs. 66.86±4.16, P<0.05). Compared with the control group, the experimental group had significantly higher scores of the dimensions of knowledge confidence (12.55±1.30 vs. 8.79±1.59, P<0.01), skill confidence (10.86±1.51 vs. 7.45±1.27, P<0.01), and communication confidence (11.69±1.71 vs. 7.83±1.44, P<0.01). Conclusion:In the practice teaching of Physiotherapy, stroke SP combined with the SOAP assessment recording method can effectively improve the professional quality and clinical thinking ability of students, enhance their professional confidence, make up for the shortcomings of traditional teaching methods, and promote the teaching reform of rehabilitation medicine.

Objective:To determine whether basal prolactin levels impact pregnancy outcomes of the patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) procedures rely on endogenous gonadotropin. Methods:This retrospective cohort study finally included 3009 patients from July 1st, 2014 to March 31st, 2018 receiving IVF/ICSI cycles owing to tubal or male factors in Center for Gynecological Endocrinology & Reproductive Medicine, Peking Union Medical College Hospital. We compared assisted reproductive outcomes among patients according to their median prolactin levels (16.05 μg/L). Subgroup analyses divided by different prolactin levels were done through multifactor analyses. A repeated analysis of variance was used to illustrate the relationship between the scale of prolactin grows while stimulating and cumulative pregnancy outcomes.Results:There were more number of oocytes retrieved [9 (5,12)] and embryos [6 (3,10)] in those with basal prolactin above the median level (>16.05 μg/L) compared with patients with basal prolactin ≤16.05 μg/L [8(5, 11), P=0.013; 5(3, 9), P=0.015]. Prolactin beyond 30 μg/L was beneficial to cumulative clinical pregnancy ( OR=1.281, 95% CI=1.030-1.764, P=0.046) and prolactin above 40 μg/L was a good indication for cumulative live birth rate ( OR=1.916, 95% CI=1.115-3.290, P=0.008). Conclusion:For patients receiving IVF/ICSI treatment in an agonist long protocol, a higher prolactin level during controlled ovarian stimulation is positively associated with cumulative pregnancy/live birth rates.

Objective:To determine whether basal prolactin levels impact pregnancy outcomes of the patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) procedures rely on endogenous gonadotropin. Methods:This retrospective cohort study finally included 3009 patients from July 1st, 2014 to March 31st, 2018 receiving IVF/ICSI cycles owing to tubal or male factors in Center for Gynecological Endocrinology & Reproductive Medicine, Peking Union Medical College Hospital. We compared assisted reproductive outcomes among patients according to their median prolactin levels (16.05 μg/L). Subgroup analyses divided by different prolactin levels were done through multifactor analyses. A repeated analysis of variance was used to illustrate the relationship between the scale of prolactin grows while stimulating and cumulative pregnancy outcomes.Results:There were more number of oocytes retrieved [9 (5,12)] and embryos [6 (3,10)] in those with basal prolactin above the median level (>16.05 μg/L) compared with patients with basal prolactin ≤16.05 μg/L [8(5, 11), P=0.013; 5(3, 9), P=0.015]. Prolactin beyond 30 μg/L was beneficial to cumulative clinical pregnancy ( OR=1.281, 95% CI=1.030-1.764, P=0.046) and prolactin above 40 μg/L was a good indication for cumulative live birth rate ( OR=1.916, 95% CI=1.115-3.290, P=0.008). Conclusion:For patients receiving IVF/ICSI treatment in an agonist long protocol, a higher prolactin level during controlled ovarian stimulation is positively associated with cumulative pregnancy/live birth rates.

Objective:To evaluate the methodological quality and evidence quality of outcome of the systematic reviews/meta analyses on traditional exercise for the improvement of cardiopulmonary function.Methods:By searching for PubMed, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and CBM databases in Chinese or English, the Systematic Reviews/meta analysis of traditional exercises for improving cardiopulmonary function was conducted. The retrieval time was March 8th, 2020. The AMSTAR 2 scale was used to evaluate the methodological quality of the systematic review/meta-analysis that met the inclusion criteria. Since the included studies cannot reflect the overall effect of traditional exercises on improving cardiopulmonary function, and the methodological quality of systematic reviews was generally low, a secondary analysis of the RCT studies included in the systematic reviews was conducted. The methodological quality evaluation of the original RCT study adopted the Cochrane Reviewers’ Handbook Version 5.0.0 bias risk assessment method (Risk of Bias, ROB), and applied the Revman 5.3 software to merge the original RCT data. The GRADE system was used for evidence evaluation.Results:A total of 32 systematic reviews/meta analysis were included, and the AMSTAR2 scale indicated that only one of the 32 systematic reviews/meta included was of high-quality, 1 was of low-quality, and the others were of extremely low quality. A total of 57 RCTs were included in the 32 systematic reviews for bias risk assessment and data consolidation. GRADE evidence quality evaluation showed that 14 evidences were of medium quality, 26 evidences were of low quality, and 5 evidences were of extremely low quality.Conclusions:Traditional exercises can improve cardiopulmonary function, but with low evidence quality. Thus, clinicians should make clinical decisions based on conditions.

Objective:To figure out the clinical factors contributing to the oocytes utility rate (OUR) of high responders in in vitro fertilization (IVF)-embryo transfer treatment.Methods:OUR was defined by the number of usable embryos for transfer and (or) cryopreservation divided by the number of oocytes retrieved in a freeze-all cycle. The cycles with ≥15 eggs were included from January 2013 to December 2019. Those with OUR at the top 10% (Group A) and the bottom 10% (Group B) were picked and compared for patients′ characteristics, parameters relating to ovary stimulation and pregnant outcomes. Multifactorial logistic regression was applied to reveal the risk factors affecting OUR in them.Results:A total of 43 patients were included in Group A (OUR: 77.4%, 601/776) and 47 for Group B (OUR: 11.9%, 104/874). Previous IVF/intracytoplasmic sperm injection (ICSI; OR=0.10, 95% CI: 0.01-0.81) and endometriosis ( OR=0.16, 95% CI: 0.03-0.84) were negative factors for OUR ( P<0.05); dual suppression protocol ( OR=3.74, 95% CI: 1.06-26.86) and longer days of stimulation ( OR=3.24, 95% CI: 1.25-8.42) were protective factors in terms of ovarian stimulation ( P<0.05), on contrary to that, any decline of estradiol during the stimulation led to poorer OUR ( OR=0.16, 95% CI: 0.04-0.64). Although two groups had similar quantities of eggs and metaphase of meiosis Ⅱ (MⅡ) oocytes, distinguished cumulative clinical pregnancy rate and cumulative live birth rate were seen in Group A and group B respectively [95.3% (41/43) vs 40.4% (19/47) and 90.7% (39/43) vs 31.9% (15/47), all P<0.01]. Conclusions:High responders with attempted IVF/ICSI and endometriosis should be considered as risk factors for OUR. Over ovarian stimulation, dual suppression and a slightly longer stimulating duration could be tried; besides, estradiol decline should be prevented for a better OUR.

Objective:To investigate the feasibility of a novel in vitro fertilization (IVF) strategy with levonorgestrel intrauterine system (Mirena) in situ in infertility patients after successful conservative treatment of early well-differentiated endometrial adenocarcinoma (EC) and atypical endometrial hyperplasia (AEH). Methods:The clinical characteristics of infertility patients after a complete regression of previous EC and AEH who underwent IVF with a Mirena in situ from March 2018 to December 2019 in Center for Gynecological Endocrinology & Reproductive Medicine, Peking Union Medical College Hospital were retrospectively analyzed. These patients underwent one or more cycles to harvest at least 4 blastocysts cryopreserved, before removing the Mirena and re-evaluating the endometrium. Then the outcomes of frozen-thawed embryo transfer (FET) were commenced. Results:A total of 20 patients were included with a median age of 33 years. The complete regression of endometrial lesion was achieved at 4.3 months. Thirty-four IVF cycles were conducted in total, leading to a median oocytes retrieved of 8. We had attempted 21 embryo trasfer but only 14 cycles were effective, and 5 patients got clinical pregnancy and 2 patients had ongoing pregnancy.Conclusion:It is a supposedly practical way that IVF with the Mirena until pooling enough blastocysts before removing the device and initiating embryo trasfer for assisting reproduction and endometrial protection in patients after fertility-sparing treatment of EC or AEH.