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*

Background::Copper and zinc are involved in the development of multiple malignancies; yet, epidemiological evidence on hepatocellular carcinoma (HCC) is limited. This study aimed to investigate the association between dietary intake and serum levels of copper and zinc with the risk of HCC.Methods::A total of 434 case-control pairs matched for sex and age (±1 year) were included in this study. Cases with newly diagnosed HCC were from the Guangdong Liver Cancer Cohort (GLCC) study, and healthy controls were from the Guangzhou Nutrition and Health Study (GNHS). A semi-quantitative 79-item food frequency questionnaire (FFQ) was used to assess habitual dietary intakes of copper and zinc. Serum levels of copper and zinc were measured by using inductively coupled plasma mass spectrometry. The copper (Cu)/ zinc (Zn) ratio was computed by dividing copper levels by zinc levels. Conditional logistic regression models were performed to calculate the odds ratio (OR) and 95% confidence intervals (CI) for per 1 standard deviation increase (per-SD increase) in copper and zinc levels.Results::Higher dietary intake (OR per-SD increase = 0.65, 95% CI: 0.44, 0.96, Ptrend = 0.029) and serum levels of zinc (OR per-SD increase = 0.11, 95% CI: 0.04, 0.30, Ptrend <0.001) were both associated with a lower risk of HCC. Subgroup analyses showed that the inverse association was only pronounced in men but not in women ( Pinteraction = 0.041 for dietary zinc intake and 0.010 for serum zinc levels). Serum copper levels (OR per-SD increase = 2.05, 95% CI: 1.39, 3.03, Ptrend = 0.020) and serum Cu/Zn ratio (OR per-SD increase = 6.53, 95% CI: 2.52, 16.92, Ptrend <0.001) were positively associated with HCC risk, while dietary copper intake and dietary Cu/Zn ratio were not associated with HCC risk. Conclusion::Zinc may be a protective factor for HCC, especially among men, but the effects of copper on HCC risk are not clear.

Objective To investigate the effect of colquhounia root tablet(CRT)on hyperglucose-in-duced epithelial-mesenchymal transition(EMT)in renal tubular epithelial cells(HK-2),and to explore its possible action mechanism.Methods HK-2 was cultured in vitro,and HK-2 was divided into the following five groups:control group(CON group),hyperosmolar group(MA group),high glucose group(HG group),high sugar+CRT group(HG+CRT group),high sugar+phosphatidylinositol 3 kinase inhibitor group(HG+LY29400 group),high sugar+CRT+phosphatidylinositol 3 kinase inhibitor group(HG+CRT+LY29400).The real time immunofluorescence quantitative PCR(qPCR)was used to detect the mRNA ex-pression levels of E-cadherin,α-smooth muscle actin(α-SMA)and phosphatase and tensin homolog(PTEN)in each group.Western-blot was used to detect the protein expression levels of PTEN,phosphatidylinositol 3 kinase(PI3K),protein kinase B(Akt),phosphorylated protein kinase B(p-Akt),E-cadherin and α-SMA in each group.Results Compared with the CON group,the protein and mRNA expression levels of α-SMA,p-Akt protein expression level and p-Akt/Akt ratio in the HG group were increased,the protein and mRNA ex-pression levels of E-cadherin and PTEN were decreased,and the differences were statistically significant(P＜0.05).Compared with the HG group,the α-SMA protein and mRNA expression levels in the HG+CRT group were decreased,while the E-cadherin protein and mRNA expression levels were increased,and the differences were statistically significant(P＜0.05).Compared with the HG+CRT group,there was no significant differ-ence in the E cadherin,α SMA,PTEN,P13K and Akt protein expression levels and p-Akt/Akt ratio in the HG+CRT+LY29400 group had no significant differences(P＞0.05).while the expression level of p-Akt protein was increased,and the difference was statistically significant(P＜0.05).Conclusion In vitro,CRT could re-verse hyperglucose-induced renal tubular epithelial cell EMT via the PTEN/PI3K/Akt signaling pathway.

Objective·To investigate the pathological and physiological changes underlying noise-induced cochlear nucleus damage and the regulating function of astrocytes on the damage,using a combination of morphological analysis,and molecular biology techniques.Methods·Forty-eight male C57BL/6J mice were randomly divided into two groups and exposed to 110 dB SPL(sound pressure level)broadband noise for 2 hours.Auditory brainstem response(ABR)tests were performed on the mice on days 1,7,14,30,and 90 after the noise exposure.Immunofluorescence staining of cochlear nuclear tissue was conducted to observe cochlear nuclear neurons and auditory synapses,as well as astrocyte activation levels.In addition,the damage to the cochlear nuclear neurons and synapses caused by noise was verified through Western blotting.Results·A significant decrease in cochlear nuclear Bushy cells after noise exposure was observed.The Western blotting results showed that there was severe loss of nerve fibers in cochlear nuclear neurons,indicating that noise caused significant damage to cochlear nucleus neurons.Moreover,a significant loss of auditory synapses labeled with vesicular glutamate transporter 1(Vglutl)was observed,which was the severest on day 14 after noise exposure and slowly recovered on day 90.Interestingly,astrocytes in the cochlear nucleus displayed obvious clustering and activation after noise exposure.By staining with glial fibrillary acidic protein(GFAP),most astrocytes were distributed around the cochlear nucleus,granule cell area,and auditory nerve root before noise exposure,and they had a small size.However,on day 14 after noise exposure,a large number of activated astrocytes aggregated in the ventral cochlear nucleus,and they all showed a pattern of growth around the synapses.Conclusion·Noise exposure leads to significant damage in the cochlear nucleus,and it is possible that astrocytes are involved in its damage and repair processes.These findings will provide a crucial foundation for further understanding the mechanisms of sound signal analysis,integration,and neural plasticity in the cochlear nucleus.

Facial paralysis causes both physical pain and psychological distress to patients. It is difficult for a patient with facial paralysis to engage with a normal social life and at work. Progresses have been made in recent years in the treatment of facial paralysis. More attentions have been caught by masseteric to facial nerve transposition, which has advantages of adjacency in location, abundancy in nerve supply and reliability in the outcome and now has deemed an important option of facial reanimation. It has not been long since the application of the technique of masseteric to facial nerve transposition in China, therefore it still lacks a universal guidance on practice. In order to achieve the aim of better quality control and popularisation of the technique, hereby a consensus with suggestions on facial reanimation with masseteric to facial nerve transposition is proposed as the reference for surgeons specialised in facial reanimation. This consensus is proposed, discussed and drafted by experts from plastic and reconstructive surgery, oral and maxillofacial surgery, head and neck surgery and neurosurgery.

Regression discontinuity design (RDD) is a rigorous quasi-experimental method. Based on the randomness of the distribution of samples around the critical value, the data on both sides are used for regression respectively, so as to avoid the interference of potential confounding factors and provide strong evidence for the inference of causal correlation. This study introduces the RDD and its research progress, and expounds its application in detail combined with cases, in order to provide reference for the application of RDD in epidemiological research.

Regression discontinuity design (RDD) is a rigorous quasi-experimental method. Based on the randomness of the distribution of samples around the critical value, the data on both sides are used for regression respectively, so as to avoid the interference of potential confounding factors and provide strong evidence for the inference of causal correlation. This study introduces the RDD and its research progress, and expounds its application in detail combined with cases, in order to provide reference for the application of RDD in epidemiological research.

Pulmonary fluid refers to a thin and continuous liquid layer mainly consisting of airway mucus and lining liquid on the inner surface of alveoli, which is essential for maintaining a healthy lung. The clinical significance of rheological properties of pulmonary fluid in airway stability, pulmonary barrier and clearance functions, ventilator induced lung injury and surfactant replacement therapy in infant respiratory distress syndrome was introduced in this paper. Furthermore, a variety of classical methods for measuring surface tension and liquid viscosity, such as Langmuir-Wilhelmy balance, captive bubble method, glass capillary viscometer and rotational viscometer, and emerging techniques (e.g. particle tracking microrheometer and axisymmetric drop shape analysis) were reviewed, and their advantages and drawbacks were also compared, in order to provide an important reference for the assisted diagnosis and treatment of lung diseases in clinical practice.

Objective:To explore the status quo of postpartum hemorrhage assessment in obstetric doctors and nurses and provide a reference for developing a scientific, effective and practical early warning assessment tool for postpartum hemorrhage.Methods:The obstetric doctors and nurses were selected from 92 hospitals across China by convenient sampling from April 6th to 13th, 2019. The self-designed questionnaire was used to investigate their demographic information and status of postpartum hemorrhage assessment. Totally 4 490 questionnaires were distributed. The questionnaires were reviewed to ensure the integrity of information after collected. Totally 4 490 valid questionnaires were collected, with a recovery rate of 100%.Results:The hospitals where 4 406 out of the 4 490 obstetric doctors and nurses worked assessed high risk factors for postpartum hemorrhage, accounting for 98.1%. There was statistically significant difference in assessing high risk factors for postpartum hemorrhage or not between hospitals of different kinds ( P<0.05) . Among the hospitals which assessed high risk factors for postpartum hemorrhage, high risk factors for postpartum hemorrhage were assessed jointly by doctors and nurses or midwives in the hospitals where 77.6% of the obstetric doctors and nurses worked, and the postpartum hemorrhage high risk factor scale was used for postpartum hemorrhage assessment in hospitals where 62.1% of the obstetric doctors and nurses worked. The top 2 time of assessing high risk factors for postpartum hemorrhage was postpartum assessment and intrapartum assessment. The most frequently used method to measure amount of bleeding was weighing. According to the obstetric doctors and nurses, the biggest challenge when assessing high risk factors for postpartum hemorrhage was "no appropriate tool for assessing high risk factors for postpartum hemorrhage". Conclusions:Obstetric doctors and nurses pay attention to the assessment of high risk factors for postpartum hemorrhage, but there is no continuous and dynamic assessment for these high risk factors yet, and the measurement of amount of bleeding needs to be consistent. Hospital managers and obstetric doctors and nurses are in badly need of a postpartum hemorrhage assessment tool which is suitable for clinical use.

?? [Abstract]? Objective? To understand the knowledge level of part-time nurses on dynamic posts of obstetric nursing and their needs for dynamic post training of obstetric nursing,so as to provide basis for the formulation of staff management training programs for dynamic posts of obstetric nursing. Methods? By purposive sampling, 47 part-time nurses hired by the Department of Nursing in China-Japan Friendship Hospital from November to December of 2018 were selected for the study. Self-designed Obstetric Nursing Dynamic Post Perception and Training Implementation Questionnaire was used to investigate the participants' perception and training needs towards the dynamic posts of obstetric nursing. In the study, totally 47 questionnaires were distributed and 47 valid ones were collected, yielding an effective recovery rate of 100%. Results? In the 47 part-time nurses, 68.09%(32/47) of them understood the dynamic post of obstetric nursing, 87.23%(41/47) of them held the opinion that admission criteria was needed for the dynamic post, 100% of them expressed the needs for pre-service training. The contents of the top three training needs were: "emergency management of sudden changes of obstetric patients" "effects of commonly used drugs in Obstetric Department" "theoretical knowledge of Obstetrics specialty", and different training time was set according to the difficulty of posts. Conclusions? Part-time nurses have insufficient knowledge of dynamic posts in obstetric nursing, and need to acquire obstetric specialty knowledge urgently. At the same time, training programs and assessment criteria for dynamic posts of obstetric nursing should be formulated to ensure the safe and effective operation of nursing work.