Traditional manual testing of ventilator performance is labor-intensive, time-consuming, and prone to errors in data recording, making it difficult to meet the current demands for testing efficiency in the development and manufacturing of ventilators. Therefore, in this study we designed an automated testing system for essential performance parameters of ventilators. The system mainly comprises a ventilator airflow analyzer, an automated switch module for simulated lungs, and a test control platform. Under the control of testing software, this system can perform automated tests of critical performance parameters of ventilators and generate a final test report. To validate the effectiveness of the designed system, tests were conducted on two different brands of ventilators under four different operating conditions, comparing tidal volume, oxygen concentration, and positive end expiratory pressure accuracy using both the automated testing system and traditional manual methods. Bland-Altman statistical analysis indicated good consistency between the accuracy of automated tests and manual tests for all respiratory parameters. In terms of testing efficiency, the automated testing system required approximately one-third of the time needed for manual testing. These results demonstrate that the designed automated testing system provides a novel approach and means for quality inspection and measurement calibration of ventilators, showing broad application prospects.
Ventilators, Mechanical/standards* ; Equipment Design ; Humans ; Automation

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*

Objective To analyze the risk factors of multi-drug resistant bacterial infection of urinary system in type 2 diabetes mellitus(T2DM)patients and establish a decision tree model.Methods A total of 371 patients with T2DM were selected and divided into infected(IF,n=47)group and non-infected(NIF,n=324)group.The influencing factors of multi-drug resistant urinary system infection were analyzed in patients with T2DM.IBM SPSS Modeler was used to establish a decision tree model for predicting multi-drug resistant urinary system infection.Results The infection rate of multidrug resistant bacteria in urinary system was 12.67%.Age,female proportion,DM duration,use of antibiotics before admission,length of hospital stay,and hemoglobin A1c(HbA1c)in IF group were higher than that in NIF group(P<0.05).Logistic regression analysis showed that age≥60 years old(OR 2.629,95%CI 1.349～5.125,P=0.005),woman(OR 3.044,95%CI 1.506～6.151,P=0.002),DM duration≥10 years(OR 3.320,95%CI 1.671～6.593,P=0.001),length of hospital stay>15 days(OR 2.406,95%CI 1.237～4.682,P=0.010)and HbA1c>8.02%(OR 2.363,95%CI 1.210～4.617,P=0.012)were influencing factors for multidrug-resistant bacteria infection of urinary system.Decision tree model showed that sex was the most important factor in urinary multidrug-resistant infections.Receiver operating characteristic curve results showed that the area under the curve value of Logistic regression model was slightly higher than that of decision tree(Z=1.465,P=0.143).Conclusions Age,sex,DM duration,length of hospital stay,and HbA1c are the influencing factors of T2DM patients complicated with urinary multi-drug resistant bacteria infection,the decision tree model established in this study has good risk prediction efficiency,which is helpful for early clinical identification of high-risk patients with multi-drug resistant bacteria infection of urinary system.

Objective To analyze the risk factors of multi-drug resistant bacterial infection of urinary system in type 2 diabetes mellitus(T2DM)patients and establish a decision tree model.Methods A total of 371 patients with T2DM were selected and divided into infected(IF,n=47)group and non-infected(NIF,n=324)group.The influencing factors of multi-drug resistant urinary system infection were analyzed in patients with T2DM.IBM SPSS Modeler was used to establish a decision tree model for predicting multi-drug resistant urinary system infection.Results The infection rate of multidrug resistant bacteria in urinary system was 12.67%.Age,female proportion,DM duration,use of antibiotics before admission,length of hospital stay,and hemoglobin A1c(HbA1c)in IF group were higher than that in NIF group(P<0.05).Logistic regression analysis showed that age≥60 years old(OR 2.629,95%CI 1.349～5.125,P=0.005),woman(OR 3.044,95%CI 1.506～6.151,P=0.002),DM duration≥10 years(OR 3.320,95%CI 1.671～6.593,P=0.001),length of hospital stay>15 days(OR 2.406,95%CI 1.237～4.682,P=0.010)and HbA1c>8.02%(OR 2.363,95%CI 1.210～4.617,P=0.012)were influencing factors for multidrug-resistant bacteria infection of urinary system.Decision tree model showed that sex was the most important factor in urinary multidrug-resistant infections.Receiver operating characteristic curve results showed that the area under the curve value of Logistic regression model was slightly higher than that of decision tree(Z=1.465,P=0.143).Conclusions Age,sex,DM duration,length of hospital stay,and HbA1c are the influencing factors of T2DM patients complicated with urinary multi-drug resistant bacteria infection,the decision tree model established in this study has good risk prediction efficiency,which is helpful for early clinical identification of high-risk patients with multi-drug resistant bacteria infection of urinary system.

Objective To evaluate the impact of flash glucose monitoring(FGM)system on glycemic control and adverse pregnancy outcome in pregnant women with type 2 diabetes mellitus(T2DM).Methods This prospective,open-label,randomized,controlled clinical trial involved 109 women with T2DM at 16～18 weeks of gestation who visited Liaocheng People's hospital and Liaocheng Women and Children Hospital from June 2018 to June 2022.They were randomly assigned to FGM group(54 cases)and control group(55 cases).The FGM group wore FGM at 20,24,28 and 32 weeks of pregnancy respectively.The Con group underwent self-monitoring of blood glucose(SMBG).Both groups adjusted insulin doses based on blood glucose monitoring results.HbA1c was measured at 18 weeks and 36 weeks of pregnancy.Information related to adverse pregnancy outcomes was compared between the two groups.Results Fasting and postprandial glucose and HbA1c were significantly lower in FGM group compared with con group(P<0.05).Neonatal hypoglycemia was significantly lower in FGM group(P<0.05).There was no difference between the two groups in terms of BMI,insulin dose,gestational week of delivery,Apgar score,neonatal weight and the incidence of preeclampsia,premature delivery,polyhydramnios,cesarean section,SGA,macrosomia and postpartum hemorrhage(P>0.05).Time in range(TIR),time below range(TBR),time above range(TAR),and mean amplitude of glucose excursion(MAGE)were significantly improved at 32 weeks compared to 20 weeks in FGM group(P<0.05).Conclusions Repeated intermittent use of FGM in pregnant women with T2DM could reduce the blood glucose level and the incidence of neonatal hypoglycemia.

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.

Our hospital first used the housing and training information management platform in 2018 in order to improve the management efficiency and teaching quality of standardized resident training in the Department of Otolaryngology-Head and Neck Surgery. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, through continuous optimization and upgrading of system functions and the mobile APP terminal, the integrated development of teaching and management and the maximization of resource sharing have been realized, thus making up for the defects and deficiencies of the traditional resident training management mode. Our practice shows that the new resident training management mode based on informatization mobile platform can not only save time and effort for departments to grasp all aspects of resident training management, but also enable residents to complete the resident training plan step by step and reasonably with improvement in their knowledge, skills, and competence. Therefore, the new resident training management mode has broad application prospects.

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.

Objective::To build a reference fetal growth chart for the Chinese population based on fetal ultrasound measurements.Methods::This was a multicenter, population-based retrospective cohort study. Longitudinal ultrasound measurement data were collected from 24 hospitals in 18 provinces of China from 1 st September through 31 st October of 2019. The estimated fetal weight (EFW) was calculated based on head circumference, abdominal circumference, and femur length using Hadlock formula 3. Fetal growth curves were estimated using a two-level linear regression model with cubic splines. All participants were divided into two groups: the northern group ( n = 5829) and the southern group ( n = 3246) based on the geographical division of China and male fetus group ( n = 4775) and female fetus group ( n = 4300) based on fetal gender. The EFW was compared by fetal gender and geographical group. All statistical models were adjusted for maternal sociodemographic characteristics. Results::A total of 9075 participants with 31,700 ultrasound measurement records were included in this study. Male fetuses demonstrated significantly larger EFW compared to female ones starting at 16 weeks of gestation and extending to delivery (global test P < 0.01). The overall geographic difference in EFW was significant (global test P = 0.03), and week-specific comparisons showed that the northern group had a greater EFW starting at 15 weeks of gestation and extending to 29 weeks of gestation, although this difference did not extend to the time of delivery. The Z-score of EFW confirmed that our Chinese fetal growth charts differed from previously published standards. Conclusion::This study provides EFW and ultrasound biometric reference measurements for Chinese fetuses and reveals differences from other fetal growth charts. The chart is worth promoting in more regions of China but should be tested prudently before use.