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*

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective To explore the ArcCHECK system-based methods for dose verification of ultra-long target for cervical cancer VMAT so as to assure the precision of cervical cancer radiotherapy.Methods A total of 33 patients with ultra-long target(target length≥26 cm)admitted to some hospital for cervical cancer VMAT from 2021 to 2023 were selected retrospectively,and radiotherapy plans were designed for the patients with VMAT technology and verified dosimetrically with different methods.Firstly,the dose distribution data were collected respectively at 5 and 8 cm away from the center of the ArcCHECK system along the bed exit direction,and enrolled into Group Test 1 and Test 2 respectively.Then the ArcCHECK system was flipped 180°,and the dose distribution data were acquired at 8 cm away from the center along the bed exit direction and included into Group Test 3.Dose merging between Group Test 2 and Test 3 with the Merge function was carried out to obtain the dose distribution data which were divided into Group Test 4.The monitor units of Group Test 1,2 and 4 were summarized,and difference analyses were performed on the length of the target area,detection point and irradiation time.Group Test 1,2 and 4 were compared in terms of γ pass rate,normalized dose deviation,confidence limit(CL)of pass rate and acceptance rate(γ pass rate≥95%and γ pass rate≥90%).Spearman's correlation coefficient was used to correlate the parameters such as maximum transverse diameter,length,volume and monitor unit of the target area and expected execution time of the plan.SPSS 19.0 software was used for statistical analysis.Results Group Test 1,2 and 4 had the monitor unit being(758.76±107.63)MU,and had statistically significant differences in length of the target area,detection point and irradiation time(P<0.01).In Group Test 4 γ pass rate under 2%/2 mm criterion did not reach 90%,and in Group Test 1 and 2 γ pass rates under 3%/3 mm and 3%/2 mm criteria both amounted to 95%.Group Test 1,2 and 4 had statistically significant differences in γ pass rate and normalized dose deviation(all P<0.05).In Group Test 1 there were more than 90%of the verification results where γ pass rate≥95%and more than 95%where γ pass rate≥90%under 3%/3 mm criterion.The monitor unit was positively correlated with the maximum transverse diameter,length and volume of the target area,respectively(0.337≤r≤0.568,P<0.05),and the expected execution time of the plan was positively correlated with the volume and monitor unit of the target area,respectively(0.457≤r≤0.517,P<0.01).Conclusion The dose verification method with the target at 5 cm away from the center along the bed exit direction can be applied clinically with high feasibility to the dose verification during the radiotherapy of the cervical cancer VMAT patients with ultra-long target,with the safety of the verification devices ensured effectively.

Objective:To explore the mechanism of Yiqi Jiedu Huayu Recipe(YQJDHY)on ulcerative colitis model rats based on the negative regulation of JAK2/STAT3 pathway by SOCS.Methods:The rats with ulcerative colitis were cloned by TNBS/ethanol method,and randomly divided into normal group,model group,SASP group,YQJDHY high-dose,medium-dose and low-dose groups.Serum IL-21 and IL-22 were detected by ELISA.Real-time quantitative polymerase chain assay(RT-PCR)was used to detect IL-23,IL-6,IL-17A,cytokine signaling inhibitor 1(SOCS1),SOCS3,tyrosine protein kinase 2(JAK2),transcription activa-tor 3(STAT3),retinoic acid-associated orphan receptorγ antibody(RORγt)mRNA expressions.Results:Pathological examination of rats in model group showed obvious inflammation and ulceration,indicating successful modeling.Compared with normal group,IL-21 and IL-22 contents in model group were significantly increased(P<0.05);the down-regulation of IL-21 and IL-22 in YQJDHY groups and SASP group were statistically different(P<0.05,P<0.01).Compared with model group,IL-23,IL-6,JAK2,STAT3 and IL-17A mRNA levels in intestinal mucosa and serum of YQJDHY groups and SASP group were significantly down-regulated(P<0.01),the ex-pressions of SOCS1 and SOCS3 mRNA in intestinal mucosa were increased in YQJDHY groups(P<0.01).The levels of RORγt mRNA in serum and intestinal mucosa of YQJDHY high-dose group and SASP group were increased(P<0.01).Compared with SASP group,the mRNA levels of JAK2 and STAT3 in YQJDHY high-dose group were increased(P<0.05).Conclusion:YQJDHY can increase the levels of SOCS1 and SOCS3 in ulcerative colitis model rats,and then inhibit JAK2/STAT3 signaling pathway,down-regulate the pro-duction of inflammatory factors,and reduce immune inflammatory response.

Objective To explore the ArcCHECK system-based methods for dose verification of ultra-long target for cervical cancer VMAT so as to assure the precision of cervical cancer radiotherapy.Methods A total of 33 patients with ultra-long target(target length≥26 cm)admitted to some hospital for cervical cancer VMAT from 2021 to 2023 were selected retrospectively,and radiotherapy plans were designed for the patients with VMAT technology and verified dosimetrically with different methods.Firstly,the dose distribution data were collected respectively at 5 and 8 cm away from the center of the ArcCHECK system along the bed exit direction,and enrolled into Group Test 1 and Test 2 respectively.Then the ArcCHECK system was flipped 180°,and the dose distribution data were acquired at 8 cm away from the center along the bed exit direction and included into Group Test 3.Dose merging between Group Test 2 and Test 3 with the Merge function was carried out to obtain the dose distribution data which were divided into Group Test 4.The monitor units of Group Test 1,2 and 4 were summarized,and difference analyses were performed on the length of the target area,detection point and irradiation time.Group Test 1,2 and 4 were compared in terms of γ pass rate,normalized dose deviation,confidence limit(CL)of pass rate and acceptance rate(γ pass rate≥95%and γ pass rate≥90%).Spearman's correlation coefficient was used to correlate the parameters such as maximum transverse diameter,length,volume and monitor unit of the target area and expected execution time of the plan.SPSS 19.0 software was used for statistical analysis.Results Group Test 1,2 and 4 had the monitor unit being(758.76±107.63)MU,and had statistically significant differences in length of the target area,detection point and irradiation time(P<0.01).In Group Test 4 γ pass rate under 2%/2 mm criterion did not reach 90%,and in Group Test 1 and 2 γ pass rates under 3%/3 mm and 3%/2 mm criteria both amounted to 95%.Group Test 1,2 and 4 had statistically significant differences in γ pass rate and normalized dose deviation(all P<0.05).In Group Test 1 there were more than 90%of the verification results where γ pass rate≥95%and more than 95%where γ pass rate≥90%under 3%/3 mm criterion.The monitor unit was positively correlated with the maximum transverse diameter,length and volume of the target area,respectively(0.337≤r≤0.568,P<0.05),and the expected execution time of the plan was positively correlated with the volume and monitor unit of the target area,respectively(0.457≤r≤0.517,P<0.01).Conclusion The dose verification method with the target at 5 cm away from the center along the bed exit direction can be applied clinically with high feasibility to the dose verification during the radiotherapy of the cervical cancer VMAT patients with ultra-long target,with the safety of the verification devices ensured effectively.

Objective:To explore the mechanism of Yiqi Jiedu Huayu Recipe(YQJDHY)on ulcerative colitis model rats based on the negative regulation of JAK2/STAT3 pathway by SOCS.Methods:The rats with ulcerative colitis were cloned by TNBS/ethanol method,and randomly divided into normal group,model group,SASP group,YQJDHY high-dose,medium-dose and low-dose groups.Serum IL-21 and IL-22 were detected by ELISA.Real-time quantitative polymerase chain assay(RT-PCR)was used to detect IL-23,IL-6,IL-17A,cytokine signaling inhibitor 1(SOCS1),SOCS3,tyrosine protein kinase 2(JAK2),transcription activa-tor 3(STAT3),retinoic acid-associated orphan receptorγ antibody(RORγt)mRNA expressions.Results:Pathological examination of rats in model group showed obvious inflammation and ulceration,indicating successful modeling.Compared with normal group,IL-21 and IL-22 contents in model group were significantly increased(P<0.05);the down-regulation of IL-21 and IL-22 in YQJDHY groups and SASP group were statistically different(P<0.05,P<0.01).Compared with model group,IL-23,IL-6,JAK2,STAT3 and IL-17A mRNA levels in intestinal mucosa and serum of YQJDHY groups and SASP group were significantly down-regulated(P<0.01),the ex-pressions of SOCS1 and SOCS3 mRNA in intestinal mucosa were increased in YQJDHY groups(P<0.01).The levels of RORγt mRNA in serum and intestinal mucosa of YQJDHY high-dose group and SASP group were increased(P<0.01).Compared with SASP group,the mRNA levels of JAK2 and STAT3 in YQJDHY high-dose group were increased(P<0.05).Conclusion:YQJDHY can increase the levels of SOCS1 and SOCS3 in ulcerative colitis model rats,and then inhibit JAK2/STAT3 signaling pathway,down-regulate the pro-duction of inflammatory factors,and reduce immune inflammatory response.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the distribution of Oncomelania hupensis snails in different water systems in Anqing City from 2016 to 2022, so as to provide insights into snail control in the city. Methods Snail survey data and distribution of water systems in snail-infested environments were collected from schistosomiasis-endemic areas of Anqing City from 2016 to 2022. The vector maps of towns and water systems in Anqing City were downloaded from National Geomatics Center of China. The GPS toolbox APP version 2.7.9 was downloaded from a smartphone to record the longitude and latitude of each snail-infested environment in Anqing City, which were loaded into the software LocaSpace Viewer version 4.4.6 to map the distribution of snail-infested environments. The area of snail habitats, area of emerging snail habitats, area of re-emerging snail habitats, type of snail habitats and density of living snails were descriptively analyzed. The spatial database of snail-infested environments in Anqing City was built with the software ArcGIS version 10.8, and the density of living snails was subjected to spatial autocorrelation analysis in snail-infested environments. The hotspot clusters of density of living snails were identified in snail-infested environments and the density of living snails was subjected to standard deviation ellipse analysis in snail-infested environments. Results A total of 515 snail-infested environments were identified in water systems in Anqing City in 2022. The area of snail habitats reduced from 6 909.32 hm² in 2016 to 6 087.48 hm² in 2022, with a reduction of 11.89%, and the areas of snail habitats reduced by 2.39%, 21.71% and 1.67% in the main stream of the Yangtze River, the Wanhe River system and the Caizihu River system in Anhui City, respectively, while the area of snail habitats increased by 3.94% in the Huayang River system. Emerging or re-emerging snail habitats were identified in Anqing City each year during the period from 2016 to 2018 and from 2020 to 2020. The density of living snails appeared a tendency towards a decline in the Wanhe River system (b = -0.030, t = -3.019, P < 0.05) and Huayang River system (b = -0.029, t = -4.296, P < 0.05) in Anqing City from 2016 to 2022, and fluctuated in the main stream of the Yangtze River (b = 0.028, t = 1.019, P > 0.05) and the Caizihu River system (b = 0.020, t = 1.877, P > 0.05). A positive global spatial autocorrelation was identified in the density of living snails in Anqing City each year from 2016 to 2022 (all Moran's I values > 0, all P values < 0.05), and the hotspot clusters of density of living snails in snail-infested environments were mainly distributed in the Wanhe River system (Shankou Township, Hongpu Township, Yueshan Township and Wanghe Townshpi), the main stream system of the Yangtze River (Dalongshan Township, Wanhe Farm, Haikou Township and Huayang Township), the Huayang River system (Dashi Township and Xuqiao Township) and the Caizihu River system (Xiushan Township and Fangang Township). The ratio of the long to short axes of the standard deviation ellipse was 1.72 to 2.06 for the density of living snails in snail-infested environments in Anqing City from 2016 to 2022, and snails were mainly distributed in the southwest to northeast, and appeared the east-west and north-south spread. Conclusions The areas of snail habitats and the density of living snails appeared a tendency towards a decline in different water systems in Anqing City from 2016 to 2022; however, there is still a risk of snail spread. Reinforced surveillance and precision control of snails are required in Anqing City.

Objective To investigate the application value of CT perfusion imaging in patient with traumatic brain injury(TBI).Methods Thirty-seven patients with TBI were included retrospectively and divided into mild,moderate,and severe groups according to Glasgow coma scale(GCS)score.Perfusion parameters of the cerebral hemispheres on the injured side and the contralateral side of the level of basal ganglia were compared.After three months,the correlations between perfusion parameters and GCS score at baseline and Glasgow outcome scale-extended(GOSE)score at follow-up were further analyzed,respectively.Results The injured side of TBI patients showed hypo-perfusion compared with that of the contralateral side.The abnormal perfusion volumes of time to maximum of the residual function(Tmax)>10 s was significantly negatively correlated with GOSE score(ρ=-0.55,P=0.01),and could distinguish the good prognosis group from the poor prognosis group with GOSE score[area under the curve(AUC)=0.82,P= 0.01].In the group of patients undergoing decompressive craniectomy,the abnormal perfusion volumes of Tmax>4 s and Tmax>6 s were significantly associated with GCS score(ρ=0.61,P=0.01;ρ=0.53,P=0.03).Conclusion CT perfusion imaging may be useful in assessing the hemodynamics and severity of TBI,and in predicting the clinical prognosis.