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*

Triple-negative breast cancer (TNBC) remains a refractory subtype of breast cancer due to its resistance to various therapeutic strategies. In this study, we introduce a "brake-release and accelerator-pressing" approach to engineer a microneedle patch embedded with copper-doped Prussian blue nanoparticles (Cu-PB) and the ferroptosis inducer sorafenib (SRF) for raised chemodynamic (CDT)/photothermal (PTT) combination therapy against TNBC. Upon transdermal insertion, the dissolving microneedles swiftly disintegrate and facilitate the release of SRF. Under gentle external light exposure, copper ions (Cu²⁺) and iron ions (Fe³⁺) were liberated from Cu-PB. The direct chelation of Cu²⁺ and the indirect suppression by SRF, collectively attenuate glutathione peroxidase 4 (GPX4) enzymatic function, destabilizing the cellular redox equilibrium (referred to as the "brake-release" strategy). The release of Cu²⁺ and Fe³⁺ ions instigates a Fenton/Fenton-like reaction within tumor cells, further yielding hydroxyl radicals and elevating reactive oxygen species (ROS) concentrations (referred to as the "accelerator-pressing" strategy). This overwhelming ROS accumulation, coupled with the impaired clearance of resultant lipid peroxides (LPO), ultimately triggers a robust ferroptosis cell death response. In summary, this study presents an innovative combinatorial therapeutic strategy based on dual-ferroptosis induction for TNBC, implying a promising therapeutic platform for developing ferroptosis-centered treatments for this aggressive breast cancer subtype.

Objective To compare the recovery rate of frozen platelets prepared by pooled buffy coats(PBCs)under different standing time points,so as to improve the preparation method of platelets.Methods The whole blood(400 ml)were collected from 50 blood donators,and was equally divided into 1-hour group(standing time of buffy coat pooled platelet for 1 h,n=50)and 24-hour group(standing time of buffy coat pooled platelet for 24 h,n=50).The concentrated platelets were stored at-80℃.The recovery rate and morphology of the platelet were compared between the two groups one month later.Results The platelet count and recovery rate of the frozen platelet in the 24-hour group were higher than those in the 1-hour group([2.45±0.13]×109 vs.[2.32±0.10]×109,83.55%±5.42%vs.79.32%±5.75%,both P<0.05).There was no significant difference in the average platelet volume,platelet distribution width,pH,P-selectin,or residual red blood cells between the two groups.Conclusion Residual red blood cells and platelet count from PBCs under different standing time points meet the national quality standards.The buffy coat pooled platelet count and recovery rate of 24-hour standing are higher than those of 1-hour standing.

Objective To compare the filtration effects of different models of leukocyte filters on erythrocyte suspensions,so as to provide a reference for the selection of leukocyte filters in clinic.Methods The erythrocyte suspensions prepared by Department of Blood Transfusion of The First Affiliated Hospital of Naval Medical University were used for filtration.The test was categorized into three groups based on the model of leukocyte filters,namely,AKTT-type(group Ⅰ),STTB-type(group Ⅱ),and STTA-type(groupⅢ).Each group was randomly assigned 8 bags of erythrocyte suspensions(specification 2U)with hematocrit≤55%and 10 bags of erythrocyte suspensions(specification 2U)with hematocrit>55%,and leukapheresis was applied.The quality indexes of the blood were detected before and after filtration,and the experimental data were comprehensively analyzed to evaluate the leukocyte filtration effect of various filters.Results When the hematocrit of the filtered erythrocyte suspensions was≤55%,there were significant differences in the platelet count after filtration(F=49.94,P<0.001)and filtration time(F=73.45,P<0.001)between groups,and the two indexes in group Ⅰ were superior to those in groups Ⅱ and Ⅲ.When the hematocrit of the filtered erythrocyte suspensions was>55%,there were significant differences in the platelet count after filtration(F=160.69,P<0.000 1),filtration time(F=366.09,P<0.000 1),residual leukocytes(F=4.28,P<0.05),and hemolytic rate(F=8.16,P<0.01)between groups.The platelet count after filtration and filtration time in group I were superior to those in group II and III.The indexes of residual leukocyte and hemolytic rate in groups I and II were superior to those in group III.Conclusion In order to ensure the safety and effectiveness of erythrocyte suspension transfusion,AKTT-type filter can be chosen to perform leukocyte filtration,which can further lower the blood transfusion complications.

This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

Objective To analyze the clinical characteristics and pathogen infection of severe patients with COVID-19 retrospectively.Methods The clinical data and laboratory test results of 85 severe COVID-19 patients combined with pathogenic bacterial infection ad-mitted to the Hospital of Xinjiang Production and Construction Corps from December 1,2022 to February 20,2023 were collected.The patients were divided into the cure group and death group based on the outcome.Meanwhile,the distribution and drug resistance of the infected pathogens were analyzed.Results The median age and length of hospitalization of 85 patients with severe COVID-19 were 82(75,84)years old and 14(9,23)days,respectively.Their most common underlying diseases were hypertension,heart disease,and diabetes.There were 63 patients in the cure group and 22 in the death group,with a mortality rate as high as 25.9%.The levels of white blood cell count,neutrophil to lymphocyte ratio,and C-reactive protein in the patients of the death group were significanly higher than those in the cure group(P<0.05).However,the percentage of lymphocytes was the opposite(P<0.05).A total of 128 strains of pathogenic bacteria were isolated from 85 patients.Among them,21 strains(16.4%)were Gram-positive bacteria,predominantly Staphylococcus aureus.66 strains(51.6%)were Gram-negative bacteria,mainly Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa.41 strains(32.0%)were fungi,primarily Candida albicans.The proportion of methicillin-resistant Staphylo-coccus aureus(MRSA)was as high as 56%,while those of carbapenem-resistant Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa were 14%,50%,and 18%,respectively.Conclusion The severe COVID-19 patients who are elderly or have underlying diseases may be infected with carbapenem-resistant Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and MRSA.In clinical practice,rational selection of antibiotics should be made and effective measures should be taken to prevent the spread of multidrug-resistant bacteria and reduce the risk of mortality.

AIM:To investigate the improvement effect of blood flow-limited resistance training on renal fibro-sis in type 2 diabetes mellitus(T2DM)rats and its potential mechanism to attenuate renal fibrosis by inhibiting the trans-forming growth factor β1(TGF-β1)/Smad3 signaling pathway.METHODS:The T2DM model was prepared by combining a high-fat diet and streptozotocin(STZ),and after successful modeling,the rats were randomly divided into a T2DM con-trol group,a low-load resistance training group,a high-load resistance training group,a blood flow restriction group and a blood flow restriction combined with resistance training group for 8 weeks of exercise.The renal index,fasting blood glu-cose(FBG),serum creatinine(SCr),and blood urea nitrogen(BNU)were recorded in each group.The morphological changes of the kidneys were observed by hematoxylin and eosin(HE)and Masson's trichrome staining,and the collagen volume fraction was calculated.The mRNA expression levels of renal Klotho,TGF-β1,and α-smooth muscle actin(α-SMA)were detected by RT-qPCR.The protein expression levels of renal Klotho,TGF-β1,Smad3,phosphorylated Smad3(p-Smad3),α-SMA and connective tissue growth factor(CTGF)were detected using Western blot.RESULTS:Compared with the other groups,FBG,SCr,BNU,and renal collagen volume fraction were significantly decreased in the blood flow restriction combined with resistance training group of rats(P<0.05),Klotho expression was significantly in-creased(P<0.05),and the expression of TGF-β1,p-Smad3,CTGF and α-SMA was significantly decreased(P<0.05),and there was no significant change in the expression level of Smad3(P>0.05).CONCLUSION:Blood flow restriction combined with resistance training attenuates renal fibrosis in T2DM rats,the mechanism of which may be related to the up-regulation of Klotho expression,disruption of the TGF-β1/Smad3 signaling pathway,and inhibition of the deposition of epi-thelial-mesenchymal transformation.

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.

This article focuses on a case study of sitosterolemia in a child who initially presented with hemolytic anemia and thrombocytopenia. Sitosterolemia is a rare autosomal recessive lipid metabolism disorder, difficult to diagnose due to its non-typical clinical manifestations. The 8-year-old patient was initially misdiagnosed with pyruvate kinase deficiency. Comprehensive biochemical and molecular biology analyses, including gene sequencing, eventually led to the correct diagnosis of sitosterolemia. This case highlights the complexity and diagnostic challenges of sitosterolemia, emphasizing the need for increased awareness and accurate diagnosis in patients presenting with similar symptoms.

Objective:To investigate the current situation of fall fear in elderly patients after operation of intertrochanteric fracture, analyze the influencing factors and build a prediction model.Methods:A prospective cohort study and convenient sampling method were used to select 303 elderly patients with intertrochanteric fracture after surgery in the Department of Orthopedics, Affiliated Hospital of Jining Medical University from January 2021 to December 2022 as the modeling group. According to the scores of fall fear when getting out of bed for the first time, they were divided into 211 cases in the fall fear group and 92 cases in the non-fall fear group. Multivariate Logistic regression was used to analyze the influencing factors of fall fear after operation of femoral intertrochanteric fracture in elderly patients, and a risk prediction score model was established. ROC curve was used to evaluate the differentiation of the model, calibration chart was used to evaluate the calibration degree of the model, and Bootstrap method was used for internal verification. Data of 81 elderly patients with intertrochanteric fracture treated from January to May 2023 were collected as a validation set for external verification of the model.Results:A total of 6 influencing factors were included in the prediction of fall fear risk model for elderly patients after operation of intertrochanteric fracture: gender ( OR = 3.229, 95% CI 1.672 - 6.401), number of co-existing diseases ( OR = 9.578, 95% CI 4.532 - 20.245), pain ( OR = 1.684, 95% CI 1.074 - 2.463), depression ( OR = 1.719, 95% CI 1.371 - 2.155), social support ( OR = 0.859, 95% CI 0.784 - 0.942), and ability to perform activities of daily living ( OR = 0.960, 95% CI 0.932 - 0.989) (all P<0.05). The area under ROC curve of the prediction model was 0.853, the sensitivity was 0.896, and the specificity was 0.663. The area under the externally verified ROC curve was 0.766, the sensitivity was 0.800, and the specificity was 0.645. The calibration curve was close to the reference curve in the model prediction, indicating that the model hasd a good prediction effect. Conclusions:The prediction effect of this model is good, and it can quickly predict the risk of fall fear in elderly patients after operation of intertrochanteric fracture, and provide a basis for medical personnel to provide timely intervention measures.