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*

The theory of"five viscera correlation"summarizes the long-term clinical practice of traditional Chinese medicine,ex-plains the physiological and pathological phenomena of the human body from a multi-dimensional perspective of system correlation,and guides the diagnosis and prevention of diseases.Syndrome differentiation and treatment of allergic rhinitis in children should be based on the theory of"five viscera correlation"combined with the physiological characteristics of deficiency and excess of the five viscera of children;make it clear that the location of the disease is inseparable from the nasal orifice and the pathogenesis is inseparable from the five viscera;in terms of syndrome differentiation and treatment,the viscera should be regulated and the orifice should be regulated via the viscera;on the basis of identifying the cause and examining the pathogenesis,attention should be paid to regulating the lungs and spleen,tonifying the kidneys,clearing the heart,and soothing the liver,so as to restore the harmony of the viscera and the unobstruct-ed nasal orifice.

Japanese encephalitis is an acute central nervous system infectious disease caused by Japanese encephalitis virus (JEV) with brain parenchyma inflammation, characterized by high fever, headache, positive meningeal irritation, impaired consciousness, convulsion, and respiratory failure, with mortality rate as high as 20%-30%, and with neurological sequelae in 30%-50% of survivors. The mechanism of brain damage caused by JEV infection is still unclear, and some studies imply its close relation with immune-inflammatory response. This article reviews the research progress on immune-inflammatory response mechanism of Japanese encephalitis to help to understand its pathogenesis.

The common complication of ischemic brain injury was ischemic brain edema,which was closely related to the function of the blood-brain barrier (BBB).In vitro studies,which have shown that vascular endothelial growth factor (VEGF) could bind to the receptor to activate a variety of cell signaling pathways,by inhibiting cell apoptosis,reduce oxidative stress and play a protective role in the brain.Fulong Antithrombotic Pill,Shenfu Injection,Naotaitong Granule and others traditional Chinese medicine can regulate the treatment of BBB injury by VEGF regulation.This article reviewde the study progress of VEGF and its related pathways in ischemic brain injury,and the treatment of BBB injury by Chinese medicine by interventional VEGF and its related pathways,which provide a theoretical basis for the clinical treatment of cerebral ischemic abnormalities and the development of new drugs.

BACKGROUND: Previous studies have confirmed that embryonic stem cells call be induced to differentiate into insulin-producing cells, but the induction process takes a long time. Most of the processes take about one month.OBJECTIVE: Activin A, all-trans retinoic acid (ATRA), basic fibroblast growth factor (bFGF) and nicotinamide were applied in vitro in combination to observe whether mouse embryonic stem cells could be induct to differentiate into insulin-producing cell in a relatively short time.DESIGN: Cell observation experiment.SETTING: Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.MATERIALS: This study was performed at Shanghai Institute of Endocrine and Metabolic Diseases from October 2004 to February 2006. Two mice of clean grade and of 12.5-14.5 days of gestational age were provided by Shanghai SLAC Laboratory Animal Co., Ltd (Permission No. 2004A034). The protocol was performed in accordance with ethical guidelines for the use and care of animals. Mouse embryonic stem cell lines were supplied by Dr Changxian Zhang (CNRS UMR5641, France). Activin A was the product of the R & D Corporation. ATRA and nicotinamide were supplied by the Sigma Corporation, USA. BFGF was supplied by Gibco Corporaion. METHODS: Head and viscera were removed from embryos of the pregnant mouse. The remaining tissues were cut into pieces and digested with trypsin. Cell suspension was centrifuged and inoculated at 3×108L-1. The cells could be used as mouse feeder layer after 2-3 times of passage. The mouse embryonic stem cells (ESCs) were inoculated onto the feeder layer in knockout Dulbecco's modified Eagle medium (DMEM) supplemented with leukemia inhibitory factors (LIF). ESCs were passaged at 1:3-1:6 after 2-3 days of culture. Culture medium with serum was added into the culture dishes to terminate the digestion. Cell fluid was centrifuged and supernatant was discarded. The sediments were prepared into suspension and inoculated at 2.5×104 with LIF-free culture medium. After 24-48 hours, embryonic bodies (EBs) were collected and replated in 1% Matrigel-coated dishes. When began to adhere to the dishes, EBs were cultured in 10% FBS/DMEM supplemented with 100μg/L activin A for 24 hours. Then EBs were switched to 10% FBS/DMEM for 6-8 hours as an interval. After this interval. EBs differentiated were cultured in 10% FBS/DMEM with 10<-6mol/L RA for another 24 hours followed by culture in 10% FBS/DMEM supplemented with 10μg/L bFGFs for 3-5 days. Finally, EBs differentiated were cultured in DMEM/F12 supplemented with N2 supplement, B27 supplement, 1μg/L laminin, 10μg/L bFGFs, and 10mmol/L nicotinamide for 3-5 days. Dithizone (DTZ) staining, inununofluorescent staining and reverse transcription-polymerase chain reaction (RT-PCR) were applied to detect insulin expression in the differentiated cells.MAIN OUTCOME MEASURES: Induction of ESCs, DTZ staining and immunofluorescent staining as wel as RT-PCR detection.RESULTS: Mouse ESCs growing on a feeder layer formed many colonies with clear boundary and dense structure. However, there was no obvious outer limit between these ESCs. EBs began to adhere to the dishes, which were coated with matrigel, on the 2nd day. After activin A and ATRA interval induction, EBs spread, and most of the living cells were epithelial cell-like when cultured in 10% FBS/DMEM supplemented with 10μg/L bFGFs. After culturing in DMEM/F12 supplemented with N2, B27, nicotinamide, bFGFs and laminin, the cells formed small clusters. The insulin-producing cells were stained dark red with DTZ, and the cells stained with primary antibody to insulin were insulin-positive. After 2 weeks of induction of activin A, ATRA, bFGFs and nicotinamide, the insulin-producing cells expressed insulin 2, Pdxl, Nkx6.1, Nkx2.2, PP, IAPP, Glut2, Somastatin, Hnf3β and Neuro D mRNA but did not express insulin 1 mRNA.CONCLUSION: Mouse ESCs call be induced to differentiate into insulin-producing cells by activin A, ATRA, bFGFs and nicotinamide in vitro. Induction time call be shortened to 2 weeks.

Objective To investigate the influence of two different dose of atorvastatin on the prognosis and endothelial function in post-PCI acute coronary syndrom patients.Methods 92 post-PCI ACS patients were randomly divided into two groups,atorvastatin 20mg and atorvastatin 10 mg group.In each group the patients were treated with atorvasta- tin 20mg or 10mg respectively.After one month we add or decrease the dose of atorvastatin according to the blood lipid level.After 12 month the blood lipid level、FMD、NO、ET、NOS、UAP、AMI were compared between two groups. Results The clinical setting have no significant association between two groups before treating,After treated 1 and 12 month the TC,LDL-C level were significantly decreased as compared with the base level before treating in each group. After treated 1 month,in atorvastatin 20 mg group the TC,LDL-C level were significantly decreased and NO、NO/ET level were significantly higher than those in atorvastatin 10 mg group.During 12 month follow up the incidence of angina pectoris onset and rehospitalization were significantly higher in atorvastatin 10 mg group(P

Objective To realize excellent remote medical treatment for patients.Methods The ECG monitoring module based on Bluetooth technology was designed.The ECG module and Bluetooth radio-frequency module,which possessed the function of data acquisition and simple processing,were connected through data wire to act as ECG terminal.By using C8051F020 and ROK 101 007 Bluetooth module,ECG Bluetooth transmission module read in HCI command through serial port,thus realizing mutual communication.VC++6.0 was used as developing tool to edit remote monitoring server programme running on the computers in monitoring center.Results ECG monitoring module could acquire ECG data in real time and transmit it to personal computers,and then send it to the monitoring center through Wide Band.In this way,real-time information exchange between doctors and users was realized.Conclusion This module makes full use of the advantages of Bluetooth technology and has strong practicability.

Objective To study the association of glucagon like peptide 1 receptor (GLP1R) gene polymorphism with type 2 diabetes in Han population in Shanghai. Methods In the study, 360 type 2 diabetic patients and 313 normal control subjects were enrolled. Diabetic patients were further subdivided into insulin treated non obese patients (BMI28, 192 subjects). A single nucleotide polymorphism (SNP) rs 2268657 was genotyped in all the subjects enrolled in the study using allele specific real time PCR and its association with type 2 diabetes was examined. Results The frequencies of AA,AG, GG genotype incontrol group were0.086,0.447, 0.466 respectively, 0.155, 0.375, 0.470 in non obese diabetic patient group respectively, and 0.109, 0.500, 0.391 in obese diabetic patient group respectively. There was significant difference of the frequency of genotype AA between control group and non obese diabetic patient group (OR=1.939, P

The conventional invasive tissue blood oxygen content measurement is poor in continuity.The weakness of the signal,strong interference and random transmission of the photon in tissues make the measurement difficult.Recently,near infrared spectrum technology has been applied to tissue blood oxygen content measurement.This paper presents a hardware design method for tissue blood oxygen content measurement by near infrared spectrum technology.

Objective To study the association of single nucleotide polymorphism (SNP) of the protein tyrosine phosphatase-1B (PTP-1B) gene with type 2 diabetes mellitus and obesity in Chinese. Methods SNPs in the PTP-1B gene were detected by direct sequencing to PCR products, and the detected SNPs were genotyped in case-spouse samples with the technique of fluorescence real-time PCR. Results Totally 6 SNPs were found in PTP-1B gene. Three SNPs (I5/37 C→A,I6/82 A→G, I7/301 C→T) were in the intron regions and the other 3 (E8/45 C→T, E9/35 G→A, E10/372 G→A)in the exon regions. Among them, E9/35 G→A was a newly found mutation site. The A allele frequency of I5/37 C→A, T allele frequency of I7/301 C→T and G allele frequency of I6/82 A→G in type 2 diabetes were significantly higher than those in the normal spouse group (P