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*

Invasive fungal infections (IFIs) have become prominent global health threats, escalating the burden on public health systems. The increasing occurrence of invasive fungal infections is due primarily to the extensive application of chemotherapy, immunosuppressive therapies, and broad-spectrum antifungal agents. At present, therapeutic practices utilize multiple categories of antifungal agents, such as azoles, polyenes, echinocandins, and pyrimidine analogs. Nevertheless, the clinical effectiveness of these treatments is progressively weakened by the emergence of drug resistance, thereby substantially restricting their therapeutic utility. Consequently, there is an imperative need to expedite the discovery of novel antifungal agents. This review seeks to present an exhaustive synthesis of novel antifungal drugs and candidate agents that are either under current clinical investigation or anticipated to progress into clinical evaluation. These emerging compounds exhibit unique benefits concerning their modes of action, antimicrobial spectra, and pharmacokinetic characteristics, potentially leading to improved therapeutic outcomes relative to conventional antifungal regimens. It is anticipated that these novel therapeutic agents will furnish innovative treatment modalities and enhance clinical outcomes in managing invasive fungal infections.

Objective:This study aimed to provide basic data for the prevention, diagnosis and treatment of pediatric viral myocarditis (VMC) in China through analyzing the epidemic characteristics and disease burden of pediatric inpatients with VMC from 2016 to 2021.Methods:We performed a descriptive statistical analysis to the age, genders, seasons, regions and hospitalization cost and days of pediatric VMC inpatients and the death. All of the information was obtained from 27 Children′s hospitals or Maternal and Child Health hospitals of 23 provinces of China from 2016 to 2021.Results:A total of 7 647 599 cases including 1 646 VMC inpatients were admitted into our study. The annual numbers of hospitalizations were 173, 227, 313, 301, 295 and 337, with the hospitalized constituent ratios being 14.9/100 000, 17.9/100 000, 23.0/100 000, 20.5/100 000, 26.5/100 000 and 26.4/100 000 from 2016 to 2021. In recent 6 years, the proportion of VMC hospitalizations had increased yearly ( P<0.001), and had associated with the onset age ( P<0.001). Aged 12-≤18 years owned the highest hospitalized constituent ratio. The Northeast of China owned the largest number of VMC inpatients, and the East second to it. Among the 1 646 VMC children, there were 68 deaths, with the hospitalized case fatality rate of 4.13%. There were no significant differences between genders, age, seasons, years and fatality rate of VMC inpatients. For the diseases burden, the median of hospitalization days of all VMC inpatients was 10 days (IQR 6, 21), and the median of hospitalization cost was 1 1 842.3 RMB (IQR 6 969.22, 19 714.78). The median of hospitalization days of deceased VMC children was only 1 day (IQR 1, 3), the median cost could be 8 874.03 RMB (IQR 5 277.94, 5 6 151.59). Conclusions:In this study, we found that proportion of hospitalization of VMC children increased year by year, adolescence might be a risk factor of VMC. The fatality of VMC inpatients could be up to 4.13%, and the death led to a huge economic burden of society, family and individuals.

Objective The scope of related research on ethical conflicts in the interprofessional collaboration in nursing was reviewed,so as to summarize the obstacles and coping strategies that lead to ethical conflicts in interprofessional collaboration and provide references for promoting nurse engagement in interprofessional collaboration.Methods Based on the methodological framework of the scope review,we systematically searched domestic and foreign databases including the Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,VIP,Wanfang and SinoMed.The time limit for database retrieval was from the establishment of each database to March 2023.The selected studies were summarized and analyzed.Results Totally 13 articles published between 1991 and 2022 were included.The obstacle factors that lead to ethical conflicts in nurse engagement of interprofessional collaboration can be divided into 3 categories,including personal factors(insufficient professional knowledge,differences in professional values),interprofessional factors(imbalanced power between professions,lack of respect and collaboration between cooperators)and environmental factors(insufficient resources and staffing,high-intensity workload,and high-pressure work environment).At the same time,in view of these 3 aspects,it puts forward some countermeasures,such as enhancing professional knowledge,strengthening interprofessional education,improving understanding and cooperation among medical workers in different wards,providing medical practitioners with a team-based,ethical work environment that facilitates interprofessional collaborations and open dialogues.Conclusion It is of great significance for nurses to get involved in interprofessional collaborations,in order to ensure high-quality nursing services.Further studies are needed for the development of education and the core competency framework construction for interprofessional collaborations in nursing.More attention should be paid to develop the organizational atmosphere at the same time,so as to continuously improve nurse'capabilities in interprofessional collaborations.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

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.

Objectives: . Branchio-oto syndrome (BOS) primarily manifests as hearing loss, preauricular pits, and branchial defects. EYA1 is the most common pathogenic gene, and splicing mutations account for a substantial proportion of cases. However, few studies have addressed the structural changes in the protein caused by splicing mutations and potential pathogenic factors, and several studies have shown that middle-ear surgery has limited effectiveness in improving hearing in these patients. BOS has also been relatively infrequently reported in the Chinese population. This study explored the genetic etiology in the family of a proband with BOS and provided clinical treatment to improve the patient’s hearing. Methods: . We collected detailed clinical features and peripheral blood samples from the patients and unaffected individuals within the family. Pathogenic mutations were identified by whole-exome sequencing and cosegregation analysis and classified according to the American College of Medical Genetics and Genomics guidelines. Alternative splicing was verified through a minigene assay. The predicted three-dimensional protein structure and biochemical experiments were used to investigate the pathogenicity of the mutation. The proband underwent middle-ear surgery and was followed up at 1 month and 6 months postoperatively to monitor auditory improvement. Results: . A novel heterozygous EYA1 splicing variant (c.1050+4 A>C) was identified and classified as pathogenic (PVS1(RNA), PM2, PP1). Skipping of exon 11 of the EYA1 pre-mRNA was confirmed using a minigene assay. This mutation may impair EYA1-SIX1 interactions, as shown by an immunoprecipitation assay. The EYA1-Mut protein exhibited cellular mislocalization and decreased protein expression in cytological experiments. Middle-ear surgery significantly improved hearing loss caused by bone-conduction abnormalities in the proband. Conclusion . We reported a novel splicing variant of EYA1 in a Chinese family with BOS and revealed the potential molecular pathogenic mechanism. The significant hearing improvement observed in the proband after middle-ear surgery provides a reference for auditory rehabilitation in similar patients.

To summarize the nursing experience of a child with pulmonary rejection after hematopoietic stem cell transplantation who underwent double lung transplantation and was complicated with bronchiolitis obliterans after lung transplantation and underwent second lung transplantation.The key points of nursing included:the implementation of step-wise lateral position and prone position alternate non-invasive mechanical ventilation to improve lung function;sequential airway clearance was used to control pulmonary infection;precise volume management to prevent pulmonary edema;to strengthen the observation and medication management,prevent hospital infection and rejection;to provide goal-oriented personalized nutritional support to improve nutritional status;psychological nursing measures were implemented to improve the treatment confidence and compliance of children;health education and follow-up management should be strengthened to improve the long-term quality of life.After active treatment and careful nursing,the child recovered and was discharged 26 days after surgery.

Objective:To analyze the current situation and existing problems of the technical support system for occupational disease prevention and control in china, and to put forward development measures and suggestions.Methods:In January 2021, a cluster method was used to conduct a questionnaire survey on the relevant institutions of national occupational disease prevention and control technology support. Mainly investigate the development of occupational disease prevention and control centers (institutes) , municipal and county-level disease control centers, occupational health examination, occupational disease diagnosis and occupational health intermediary services. Data are described by number and composition ratio (%) , and descriptive analysis is made on the data.Results:As of December 2020, there were 140 occupational disease prevention and control centers (institutes) nationwide, an increase of 65 compared with 2019. There were 323 municipal and 2704 county-level centers for disease control and prevention, accounting for 97.00% (323/333) and 95.01% (2704/2846) of the total number of centers for disease control and prevention. There were 4520 occupational health examination institutions, 587 occupational disease diagnosis institutions, 1093 occupational health technical service institutions and 623 radiological health technical service institutions.Conclusion:The supporting force and ability of occupational disease prevention and control technology need to be improved, and the strength of occupational disease prevention and control hospitals (institutes) is still weak; The municipal and county-level centers for disease control and prevention need to further improve their conditions and capabilities; The number of occupational health examination, occupational disease diagnosis, treatment and rehabilitation institutions was relatively insufficient.

Objective:To retrieve and summarize the evidence on early enteral nutrition in critically ill patients with prone position ventilation.Methods:The relevant evidence on early enteral nutrition in critically ill patients with prone position ventilation was systematically searched through computer in domestic and foreign guideline websites, institutional websites and databases. The quality was assessed using the literature evaluation criteria and systematic review evaluation tools of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. The retrieval time limit was from January 1, 2015 to November 11, 2020.Results:A total of 10 articles were included, involving one clinical decision, four guidelines, three systematic reviews, and two original literature. A total of 18 pieces of evidence from 7 aspects were summarized on early enteral nutrition assessment, restart timing, body position, feeding program (intake, transgastric/postpyloric feeding, nasogastric feeding rate, nutritional preparations) , monitoring (gastric residual volume, gastric antral motility index) , drug prevention, staffing and training.Conclusions:This study summarizes the evidence of early enteral nutrition in critically ill patients with prone position ventilation, and provides evidence-based evidence for nursing managers to formulate enteral nutrition plans scientifically.