Autoimmune liver diseases （AILD） are a group of chronic liver diseases caused by abnormal activation of the immune system， mainly including autoimmune hepatitis， primary biliary cholangitis， primary sclerosing cholangitis， IgG4-related sclerosing cholangitis， and overlap syndrome. Clinical studies have shown that patients with AILD are often comorbid with thyroid diseases， especially autoimmune thyroid diseases （AITD）， such as Graves’ disease and Hashimoto’s thyroiditis. This article systematically reviews the epidemiological association， potential shared pathogenesis， and overlapping features between AILD and thyroid diseases. A deeper understanding of the immunological links between AILD and AITD may provide a theoretical basis for precision medicine and future research.

OBJECTIVE: To determine the prevalence of GJB2 gene c.109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. METHODS: One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c.109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c.109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children's Hospital of Ningbo University (Ethics No.: EC2023-009). RESULTS: For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c.109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c.109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined (n = 53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined (n = 24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls (P = 0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1 ± 12.0 dB nHL, P = 0.005). CONCLUSION Infants harboring the GJB2 c.109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c.109G>A variant can confer a more severe hearing loss.
Humans ; Connexin 26/genetics* ; Female ; Male ; Infant, Newborn ; Infant ; Hearing Loss/genetics* ; Retrospective Studies ; Child, Preschool ; Child ; Genotype ; Connexins/genetics* ; Mutation

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.

Objective:To explore the kinesiophobia-associated with dyspnea belief in patients with rib fractures and analyze its influencing factors.Methods:Convenience sampling was used to select 385 patients with rib fractures treated at Beijing Friendship Hospital, Capital Medical University, from January 2023 to December 2024 as study subjects. All patients were enrolled on day 5 after treatment, and the Breathlessness Beliefs Questionnaire (BBQ) was used to assess the dyspnea belief-associated kinesiophobia. Patients were divided into a negative group (BBQ score≤23) and a positive group (BBQ score≥24) for kinesiophobia. Logistic regression analysis was employed to investigate the factors influencing dyspnea belief-associated kinesiophobia.Results:The BBQ score for 385 patients was (29.47±7.33). A total of 218 patients experienced dyspnea belief-associated kinesiophobia, with an incidence of 56.62%. Patients in negative group and positive group for kinesiophobia showed statistically significant differences in gender, educational attainment, fracture time, fracture location, number of fractured ribs, presence of concomitant hemothorax/pneumothorax, pain, perceived burden, and post-traumatic stress disorder ( P<0.05). Logistic regression analysis showed that fracture time ( OR=0.640), fracture location ( OR=3.195), presence of concomitant hemothorax/pneumothorax ( OR=2.025), pain ( OR=2.498), self-perceived burden ( OR=1.202), and post-traumatic stress disorder ( OR=1.091) were the influencing factors of dyspnea belief-associated kinesiophobia ( P<0.05) . Conclusions:Patients with rib fractures exhibit high levels and incidence of dyspnea belief-associated kinesiophobia. Targeted management should be carried out for rib fracture patients with early-stage fractures, bilateral fractures, combined pneumothorax and pain, high levels of self-perceived burden and post-traumatic stress disorder.

Objective:To explore the kinesiophobia-associated with dyspnea belief in patients with rib fractures and analyze its influencing factors.Methods:Convenience sampling was used to select 385 patients with rib fractures treated at Beijing Friendship Hospital, Capital Medical University, from January 2023 to December 2024 as study subjects. All patients were enrolled on day 5 after treatment, and the Breathlessness Beliefs Questionnaire (BBQ) was used to assess the dyspnea belief-associated kinesiophobia. Patients were divided into a negative group (BBQ score≤23) and a positive group (BBQ score≥24) for kinesiophobia. Logistic regression analysis was employed to investigate the factors influencing dyspnea belief-associated kinesiophobia.Results:The BBQ score for 385 patients was (29.47±7.33). A total of 218 patients experienced dyspnea belief-associated kinesiophobia, with an incidence of 56.62%. Patients in negative group and positive group for kinesiophobia showed statistically significant differences in gender, educational attainment, fracture time, fracture location, number of fractured ribs, presence of concomitant hemothorax/pneumothorax, pain, perceived burden, and post-traumatic stress disorder ( P<0.05). Logistic regression analysis showed that fracture time ( OR=0.640), fracture location ( OR=3.195), presence of concomitant hemothorax/pneumothorax ( OR=2.025), pain ( OR=2.498), self-perceived burden ( OR=1.202), and post-traumatic stress disorder ( OR=1.091) were the influencing factors of dyspnea belief-associated kinesiophobia ( P<0.05) . Conclusions:Patients with rib fractures exhibit high levels and incidence of dyspnea belief-associated kinesiophobia. Targeted management should be carried out for rib fracture patients with early-stage fractures, bilateral fractures, combined pneumothorax and pain, high levels of self-perceived burden and post-traumatic stress disorder.

Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

This study established a school-supervisor-postgraduate "three-dimensional interaction" mode of academic norms and ethics education for medical postgraduates based on their training characteristics. The mode was evaluated and improved in practice. The results showed that after the implementation of the mode, graduate students significantly improved their awareness of how to standardize the implementation of experiments [(79.86% vs. 89.47%); P=0.021] and how to write formal experimental records [(84.72% vs. 92.76%); P=0.028]. In addition, there were significant increases in the pass rate of pre defense (85.42% vs. 94.08%; P=0.014) and blind review (84.03% vs. 93.42%; P=0.010). The "three-dimensional interaction" mode truly helps to achieve a win-win-win situation between postgraduate supervisors and the school, and is worth further practice and promotion.

Objective:To assess the validity and applicability of the questionnaires through the survey of patient-perceived service quality at the sample Internet hospital, gain the information of service quality of the Internet hospital and put forward suggestions for its improvement.Methods:Random cluster sampling method was used to conduct an online questionnaire survey on the perceived service quality of an Internet hospital in Beijing from September 15 to October 30, 2022. Altogether 450 valid questionnaires were collected. The questionnaire included 23 questions in 3 categories: environment quality, interaction quality and outcome quality; and it also investigated the patient′s demographic characteristics and chronic disease status. Cronbach′s alpha, Kendall′s W, and Bollen-Stine models were employed to analyze the reliability and validity of the questionnaire, Spearman correlation coefficient and Wilcoxon test were used to analyze the correlation and comparison of quality results, and expectation-performance gap and importance performance analysis methods were applied to analyze quality management issues and improvement priorities. Results:The Cronbach′s alpha of the questionnaire was 0.97, Kendall′s W was 0.36. The Bollen-Stine analysis showed that all the evaluation indicators met the consistency requirements. Taken 7 as the highest score, the overall perception score of the service quality of the Internet hospital was 5.22, the expected score was 5.41, and the difference was -0.19. Among the 23 indicators, 6 indicators had perceived scores exceeding the expected score, and 17 indicators had perceived scores below the expected score. The patient′s satisfaction score of the Internet hospital was 5.29, which was significantly correlated with the perceived score of service quality. The results of expectation-performance gap analysis and importance performance analysis suggested that emergency handling, risk notification, privacy protection, online and offline close combination, etc. should be the focus in the improvement of the Internet hospital′s service quality. Conclusions:The questionnaire of Internet hospital service quality is scientific and applicable, which can serve as references for future related research. The construction and operation of Internet hospitals need to focus on the aging needs, and improve the service quality and satisfaction level by strengthening medical security and information security management, coordinating online and offline medical resources, and improving the number and medical level of physicians.