Volume 101 ·  Issue 26 ·  2021

Surgical treatment involving vestibular system includes intractable vertigo surgery, inner ear surgery and vestibular tumor surgery. These operations often lead to the weakening or even loss of vestibular function, or further aggravation of the original dysfunction. If there is no standardized treatment after operation, patients are prone to recurrent vertigo, or long-term blurred vision and/or imbalance, as well as other symptoms. Through the use of medicines to promote vestibular compensation and standardized non-invasive vestibular rehabilitation training, symptoms can be eliminated as soon as possible, the duration of vestibular compensation can be shortened, stable vestibular compensation could be rapidly established, and thus the postoperative quality of life for those patients could be improved. Therefore, we should pay attention to standardize the vestibular rehabilitation after surgical treatment involving vestibular system.

Currently, the systematized nomenclature of medicine (SNOMED) of liver cancer is confusing, and it is mixed with the SNOMED of cholangiocarcinoma. We hereby presented our own points, hoping to provide a reference for standardizing the nomenclatures and classifications of liver cancer in future clinical studies. The preface of Chinese Guidelines of Primary Liver Cancer Diagnosis and Treatment (2019 Edition) indicated that primary liver cancer mainly includes three different pathological types, hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and mixed-type carcinoma of both HCC and ICC. These three types of carcinoma show great differences in terms of pathogenesis, biological behavior, histological morphology, treatment methods, and prognosis, among which, HCC accounts for 85% to 90%. Therefore, this study is a detailed analysis of the above-mentioned related SNOMED and proposes suggestions for corrections.

The disease burden and economic burden of seasonal influenza is substantial in China, and the Coronavirus disease 2019 (COVID-19) pandemic has brought new challenges to the prevention and control of influenza. As a priority group of influenza vaccination, the elderly are at higher risk of influenza-associated severe symptoms and deaths, and they are more price-sensitive vaccine users with better cost-effectiveness of vaccination program. Therefore, a reasonable financing mechanism of influenza vaccination should be designed for the elderly to increase their vaccination rate. This study proposes three financing strategies of influenza vaccination for the elderly in China, trying to explore the distribution of vaccination costs among individuals, central government and local governments under different financing strategies, including the individual-central-local mechanism (strategy 1), the central-local mechanism (strategy 2), and the local payment mechanism (strategy 3). Strategy 1 is feasible and sustainable for most regions in the short term. Strategy 2 is conducive to further increasing the vaccine coverage rate of the elderly. Strategy 3 encourages local fiscal payments to help relieve the financial pressure of the central government. The results revealed a relatively heavy financial burden of influenza vaccination for the elderly, and it is recommended to promote the development of a multiparty co-payment mechanism gradually based on local conditions.

After vestibular system dysfunction, the triggered symptoms can last for weeks, months or even longer, which can seriously affect the patient's quality of life. Systematic vestibular rehabilitation treatment, especially personalized vestibular rehabilitation training supervised by a special person, can promote patients to quickly establish stable vestibular compensation, thus eliminating symptoms and avoiding recurrent attacks. A large amount of evidence-based medical evidence confirms the effectiveness of vestibular rehabilitation treatment, but there is a lack of guiding norms at home and abroad on how to formulate personalized vestibular rehabilitation program and how to evaluate the efficacy of vestibular rehabilitation, so the application of this technology has been in a relatively messy state. This paper focuses on the indications, main mechanisms, technical methods, baseline evaluation, program formulation strategies, efficacy evaluation indicators, rehabilitation effect grading and negative influencing factors of vestibular rehabilitation to reach a consensus. The aim is to build a systematic framework of vestibular rehabilitation theory for professionals engaged in this field, quickly grasp the key program formulation strategies and core efficacy grading standards, improve the practical operability of vestibular rehabilitation training in the treatment of vertigo diseases, and standardize the popularization of this economical and effective treatment technology.

To explore the prognosis of individualized vestibular rehabilitation (VR) in patients with intractable vertigo and work out an effective and normative rehabilitation program.

A total of 35 patients diagnosed with intractable vertigo who visited Eye & ENT Hospital of Fudan University from September 2017 to December 2019 were enrolled. All the participants consisted of 15 males and 20 females, aged from 24 to 71 years old, and underwent an individualized VR. Follow-ups were conducted at 2 and 4 weeks post-rehabilitation. Assessments consisted of self-rating anxiety scale (SAS), dizziness handicap inventory scale (DHI), activities-specific balance confidence sacle (ABC), computerized dynamic posturography (CDP), and video-electronystagmograph (VNG) were performed.

SAS, DHI, ABC scores gradually improved after VR. The scores of SAS scale of pre-VR, 2 and 4 weeks post-VR were 41±8, 37±8 and 36±8, respectively. The scores of DHI were 56(40, 78), 46(22, 74), 16(6, 76), respectively. Meanwhile, the scores of ABC were 80±17, 87±11 and 91±9, respectively. There were significant statistical differences of aforementioned three scale scores at different time points (P=0.020, P<0.01,P=0.002), which was not influenced by age and gender (all P>0.05). No interactive effects were revealed among age, gender and time (allP>0.05). The improvement of vestibular function to control balance was statistically significant after 2-and 4-week rehabilitation (bothP<0.001). The value of directional preponderance was significantly improved after 4-week VR (P=0.007), while no obvious improvement was found after 2 weeks treatment (P=0.593). There was a statistically significant difference in the value of unilateral weakness (UW) between pre-VR and post-VR since 2 weeks (P=0.001).

Individualized VR in patients with intractable vertigo can not only eliminate anxiety, control dizziness, increase activities of daily life, but also improve the function of vestibulo-spinal and vestibulo-ocular reflex pathways.

To analyze the clinical efficacy of multisensory training and rehabilitation treatment in patients with balance disorders.

From January to December 2020, 95 patients with balance disorders in the Vertigo Center of Department of Otorhinolaryngology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were enrolled. All patients were treated according to the treatment guidelines of Chinese Medical Association or expert consensus. Those with poor recovery or unsatisfactory treatment results underwent multisensory training and rehabilitation for 1 month after a comprehensive evaluation. The scores of Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC), Somatization Symptom Self-Rating Scale (SSS), 9-item Patient Health Questionnaire (PHQ9) and the 7-item Generalized Anxiety Disorder (GAD7) were evaluated and compared before and after the treatment.

Totally, 95 patients were enrolled. There were 34 males and 61 females, aged (44±14) years. VAS (2.1±1.1 vs 5.9±2.5, P<0.01), DHI (15.6±7.7 vs 33.1±13.2,P<0.01), SSS (1.5±0.6 vs 2.4±0.8, P<0.01), PHQ9 (6.0±2.7 vs 8.6±4.3,P=0.01) and GAD7 (5.2±2.6 vs 9.5±2.8, P<0.01) decreased after treatment, while BBS (53.4±10.0 vs 34.8±10.7,P<0.01) and ABC (89.6±8.0 vs 55.7±21.8, P<0.01) increased.

Multisensory training and rehabilitation therapy can effectively enhance the vertigo control rate and balance ability in patients with balance disorders, reduce the risk of falling, promote their mental and psychological state, and thus improve the quality of life.

To confirm the direct projection pathway between the medial vestibular nucleus (MVN) and vestibular efferent (VE) neurons and explore its electrophysiological characteristics.

Newborn [(9±1) day-old] male and female Wistar rats were used in the study. The postsynaptic currents of VE were recorded after stimulating neurons in MVN by the whole-cell patch clamp recording technique. The action potentials (APs) of the afferent neurons in MVN were recorded retrogradely after stimulating the area of VE neurons distribution medial to genu of facial nerve (g7), and the position and shape of the recorded neurons were determined by biocytin staining.

The resting membrane potentials of VE neurons located medial to g7 ranged between -70 mV and -55 mV in current clamp recordings. Excitatory postsynaptic currents (EPSCs) were recorded in the VE neurons medial to the g7 evoked by single-pulse (0.08 mA, 0.1 Hz, 100 μs) electrical stimulation of MVN. The mean values of amplitude and duration were (195.6±23.7) pA and (23.9±5.9) ms, respectively. APs were recorded in MVN after stimulating the distribution area of VE neurons. The mean amplitude of the action potentials was (62.0±4.3) mV, and the mean duration was (94.9±4.7) ms. Biocytin staining indicated that the recorded neurons located in MVN and the axons′ terminals went into the area medial to g7 in which VE neurons located.

There is a direct excitatory pathway projecting from MVN to VE neurons medial to g7. Its physiological function may be related to the feedback regulation of vestibular center to peripheral vestibular afferent signals.

To investigate the Helicobacter pylori (H. pylori) eradication rate and improvement of dyspepsia in patients who were newly diagnosed with H. pylori infection and dyspepsia and treated by bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang(JHWK).

Patients who were newly diagnosed with dyspepsia and H. pylori infection and treated in 16 medical centers in China between December 1, 2017 and September 30, 2019 were randomly divided into two groups. The experimental group received bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days), followed by JHWK (30 days), and the course of treatment was 44 days in total. In the control group, the administration regimen was bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days). The main outcome measure was H. pylori eradication rate, while the secondary outcome measures were dyspepsia symptom changes and adverse events during the treatment and the 1st month after treatment.

A total of 1 054 patients were included in the study. There were 522 cases enrolled in the experimental group, including 224(42.91%) men and 298(57.09%) women, and the age was 53(26, 73) years old; 532 cases enrolled in the control group, including 221(41.54%) men and 311(58.46%) women, and the age was 46(22, 71) years old. Based on PP analysis, it was found that theH. pylori eradication rate in the experimental group was significantly higher than those in the control group (93.85% vs 87.88%, P=0.001). In the group of all enrolled patients, the symptom dyspepsia after H. pylori eradication was significantly improved compared with that before treatment [4(4, 7) vs 15(10, 22), P<0.001], so was the superior and middle abdominal pain [1(1, 4) vs 4(1, 8),P<0.001], the postprandial fullness [1(1, 4) vs 4(4, 9),P<0.001], the early satiety [1(1, 1) vs 4(1, 4),P<0.001], and the heartburn [1(1, 1) vs 1(1, 4),P<0.001]. The symptom dyspepsia after treatment was significantly improved compared with that before treatment in the experimental, the control groups, the successful and the unsuccessfulH. pylori eradication groups. The superior and middle abdominal pain after treatment was signifcantly improved than that before treatment [1(1, 2) vs 1(1, 4), P<0.001], so were the postprandial fullness [1(1, 3) vs 1(1, 4),P=0.002] and the dyspepsia[4(4, 7) VS 7(4, 10), P<0.001]. There was no statistically significant difference in the incidence of adverse events between the experimental group and the control group (1.34% vs 0.38%,P=0.09).

Compared with bismuth-containing quadruple therapy, bismuth-containing quadruple therapy followed by JHWK significantly improves the H. pylori eradication rate without increasing the incidence of adverse events. H. pylori eradication therapy can improve symptoms of patients with H. pylori infection and dyspepsia.

To explore the effect of video distraction on preoperative separation anxiety and induction compliance of preschool children receiving strabismus surgery under general anesthesia.

In this prospective trial, 80 children aged 3 to 6 years scheduled for strabismus surgery under inhalation anesthesia were randomly allocated to one of two groups, a control group and a video distraction group, with 40 cases in each group. Children in the video distraction group continuously watched videos from waiting in the holding area, separating with parents, entering the operating room and induction of anesthesia, while children in the control group didn′t watch videos during the same process. The modified Yale Preoperative Anxiety Scale (mYPAS) of children were recorded upon arriving at the holding area(T₁)and separating with parents(T₂). Induction Compliance Checklist (ICC) score was recorded when the anesthesia induction was performed. The emergence time, the occurrence rate of adverse events in post-anesthesia care unit (PACU) including nausea and vomiting, laryngospasm, severe cough, hypoxemia and sinus bradycardia, incidence of postoperative adverse reactions such as pain, dizziness, nausea and vomiting and lethargy, the parents′ satisfaction of anesthesia were also assessed.

There were no significant difference in mYPAS score and the proportion of mYPAS score>30 between 2 groups at T₁ (all P>0.05). At T₂, the mYPAS score and the proportion of mYPAS score>30 in video distraction group were (34.41±13.23) and 52.50%, which were lower than those in control group (50.64±20.96, 87.50%) with statistically significant difference (allP<0.05). The ICC score of video distraction group was lower than that of the control group, which was (1.83±2.26) vs (4.03±2.99), and the difference was statistically significant (P<0.05). The proportion of children with ICC score=0 in video distraction group was 37.50%, which was higher than that in the control group (12.50%), while the proportion of children with ICC score=4-10 was lower than that of the control group, which was 17.50% vs 45.00%, and the difference was statistically significant (P<0.05). No significant intergroup differences were observed in emergence time, incidence of adverse events in PACU, and incidence of postoperative adverse reactions (P>0.05). The parents′ satisfaction of anesthesia in the video distraction group was (9.23±0.89), which was higher than that in the control group (8.63±1.23), with statistically significant (P<0.05).

Preoperative video distraction alleviates separation anxiety, improves induction compliance of preschool children receiving strabismus surgery under general anesthesia, and increases the parents′ satisfaction of anesthesia.

To explore the short and long term outcomes of coronary artery disease(CAD) patients with heart failure with reduced ejection fraction (HFrEF) after two different revascularization strategies.

The CAD patients with HFrEF who had undegone successful revascularization from January 1, 2005 to December 31, 2014 in Anzhen Hospital were analyzed based on registries. The baseline characteristics, changes of left heart function and the MACCE after a mean follow-up of 3.1 years were compared.

A total of 1 813 CAD patients with HFrEF who had undergone successful PCI (n=687) or CABG (n=1 126) satisfied the inclusion criteria were included. The age of all patients included was (59.6±10.0) years and male patients accounted for 83.1%. For the coronary angiographic features, the CABG group showed higher SYNTAX score (27.3±10.2 vs 31.1±10.4, P<0.01) and greater left ventricular end diastolic diameter (LVEDD) [(59.8±7.2) vs (57.9±7.7)mm,P<0.001]. The LVEF before revascularization was similar in PCI and CABG group [(35.8±5.1)% vs (35.9±4.6)%,P>0.05]. At three-month, one-year or three-year follow-up after revascularization, the improvement of LVEF was similar in the two groups (P>0.05). After multivariable adjustment, three-year outcomes revealed that the risks of all-cause mortality and cardiac death were not statistically significant between CABG and PCI group (16.3% vs 14.3%,HR=1.5, 95%CI: 1.2-2.1, P=0.07; 8.5% vs 8.2%, HR=1.3, 95%CI: 1.1-1.4, P=0.20). With regards to other endpoints, CABG group had a higher rate of stroke (6.2% vs 2.9%, HR=2.9, 95%CI:2.3-3.6, P<0.01) but a lower rate of repeat revascularization (6.5% vs 15.1%,HR=0.5, 95%CI:0.3-0.7, P<0.01) compared to PCI group. And for patients with SYNTAX score≥33, PCI group showed a comparable risk of all-cause mortality or cardiac death (HR=0.8, 95%CI: 0.4-1.3, P=0.06; HR=0.7, 95%CI:0.4-1.0, P=0.90).

In CAD patients with HFrEF who had undergone successful revascularization, PCI is not inferior to CABG for long-term survival. PCI should be taken into consideration to become an alternative strategy in patients with left ventricular dysfunction.

To explore the relationship between microsurgery and prognosis of acoustic neuroma.

A total of 553 acoustic neuroma surgical cases admitted to the First Affiliated Hospital of Soochow University from January 1, 1986 to September 30, 2016, were collected retrospectively. They were divided into 1986-1995 group, 1996-2005 group, and 2006-2016 group. The general information, tumor size, preoperative hospital stay, total hospital stay, operation time, intraoperative blood transfusion, use of neuroelectrophysiological monitoring, internal auditory canal wall grinding, tumor resection degree, postoperative facial nerve function rating (House-Brackmann grading), discharge status, and quality of life assessment KPS of patients were statistically analyzed.

Compared with the 1986-1995 group and the 1996-2005 group, the average age of patients in the 2006-2016 group ((52.9±13.3) years) was larger but the overall tumor volume ((3.7±0.8) cm) was smaller, and preoperative hospital stay ((4.9±1.9) days), the total hospital stay ((19.4±6.4) days) was significantly reduced, the operation time ((4.6±1.0) hours) was shortened, the intraoperative blood transfusion rate (18.5%) was significantly reduced, the intraoperative neuroelectrophysiological monitoring utilization rate (8.9%), and the internal auditory canal rate (12.7%) was higher. While increasing the tumor total resection and near total resection rate (89.2%), it further improved the postoperative facial nerve function retention rate (71.5%), and significantly increased the discharge cure rate (88.5%) (P<0.05). At the same time, the postoperative quality of life assessment good rate (KPS≥60 points) and excellent rate (KPS≥80 points) of the patients in the 2006-2016 group increased significantly, reaching 94.2% and 45.8% (P<0.05).

The maturity of microsurgery techniques and the use of intraoperative neuroelectrophysiological monitoring can shorten the treatment cycle of patients with acoustic neuroma, increase the tumor resection rate and postoperative facial nerve function retention rate, and effectively improve the quality of life of patients after surgery.

Twenty-five patients diagnosed with otogenic vertigo at the outpatient clinic of the Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People′s Hospital from January to June 2020 were selected. Among them, 8 cases were male and 17 cases were female, aged (48±13) years. All the patients underwent internet combined with offline follow-up vestibular rehabilitation for 12 weeks, which included vestibulo-ocular reflex exercises, proprioceptive exercises and static/dynamic balance exercises. Computerized dynamic posturography (CDP) and dizziness handicap inventory (DHI) scores were compared before and after rehabilitation. The DHI score improved significantly after 12 weeks of vestibular rehabilitation (48.3±15.9 vs 26.7±17.9, t=5.319, P<0.001). Meanwhile, the sensory organization test (SOT) score was also improved (73.3±8.1 vs 76.1±6.6,t=2.066, P=0.050), while the difference of motor control test (MCT) latent stage score before and after rehabilitation was not statistically significant (140±13 vs 141±16, t=0.791, P=0.436). The current study demonstrates that vestibular rehabilitation based on mobile internet is convenient, economical and effective, and patients can benefit from it.

The clinical values of video head impulse test (vHIT), caloric test (CT) and sensory organization test (SOT) at different stages before and after rehabilitation of 30 patients with vestibular neuritis (VN) in Vertigo Center Ward of Air Force Special Medical Center from January 2019 to January 2020 were analyzed and compared. There were 19 males (63.3%) and 11 females (36.7%), respectively, aged 18-68 (44±14) years. After 1 week and 3 months of rehabilitation in VN patients, the results of the three examinations were detached, and the recovery rates among the three observed indicators of each examination were statistically different (P<0.001). After 1 week of rehabilitation, the total recovery rate of vHIT was 0, which was lower than that of CT (40.0%) and SOT (43.3%) (bothP<0.001). After 3 months of rehabilitation, the total recovery rate of vHIT was 13.3%, which was also lower than CT (86.7%) and SOT (80.0%) (bothP<0.001). The current study indicates that the results of observed indicators from vHIT, CT and SOT were detached at different stages of VN rehabilitation. Therefore, the clinical significance of different vestibular function examinations is different but complementary.

Henoch-Schonlein purpura (HSP) is the most common small blood vessel vasculitis in childhood. The main clinical manifestations are non-thrombocytopenic purpura, abdominal pain, joint swelling and pain, and renal involvement, and it is less common in adults. Adult HSP is more likely to develop nephrotic syndrome when it involves the kidney and develops into end-stage renal disease. This paper reports a case of adult HSP with bullous purpura-like rash as the first manifestation, in order to improve the understanding of the diagnosis and treatment of adult HSP.

In recent years, with the rapid development of vertigo/vestibular medicine, the clinical efficacy of vestibular rehabilitation as an effective non-drug treatment for peripheral and central vertigo/vestibular diseases has been confirmed in more and more studies. This article will focus on the clinical research of vestibular rehabilitation, and expound the development course of clinical research of vestibular rehabilitation, the current situation at home and abroad, and the latest progress in common peripheral vestibular diseases and central nervous system diseases, in order to provide useful ideas and references for the scientific/standardized research of vestibular rehabilitation in China.

Vestibular disease leads to vertigo/dizziness, nystagmus, postural imbalance, etc., which seriously affects people's life and health. Vestibular rehabilitation, as an effective therapy without adverse reactions in clinical intervention strategies of vestibular diseases, has been paid more and more attention. Its fundamental mechanism is to play a role by promoting vestibular compensation. The occurrence of static vestibular compensation depends on a series of plastic changes from molecules to neural circuits, while the neural mechanisms of dynamic vestibular compensation involve sensory substitution, behavioral substitution and vestibular adaptation. This paper briefly reviews the latest research progress of vestibular dynamic and static compensatory nerve mechanism, in order to provide reference for the application and further optimization of clinical vestibular rehabilitation strategies.

Cellular immunotherapy has always been a research hotspot in the field of kidney transplantation, which has attracted much attention. Adoptive infusion of immunomodulatory cells to induce transplant immune tolerance can reduce the side effects such as infection and malignant tumors caused by long-term immunosuppressant administration in transplant patients. Some preclinical animal studies and early clinical trials of immunomodulatory cells have achieved satisfactory results, but there are still many difficulties in further promoting the clinical application of cell preparations. Modification of regulatory cells through genetic engineering technology and nanotechnology to improve the efficacy of cell preparations is expected to induce immune tolerance against grafts and benefit the majority of transplant patients.

Although the International Prognostic Score for Lymphoma (IPI) is able to stratify patients well, due to the heterogeneity of the disease in patients with lymphoma, there can be huge differences in prognosis in patients with the same score. Recently, the concept of stratification of immune prognosis in cancer patients has emerged, which indicates that there are complex and dynamic interactions between immune system and tumor cells at various stages to regulate patient prognosis. This article will summarize the immune prognostic indexes of lymphoma and the application of the latest technology.

Cervical cancer screening with high-risk human papillomavirus (hrHPV) testing is effective in reducing cervical cancer morbidity and mortality, but only clinically validated human papillomavirus (HPV) tests can be used for cervical cancer screening. In 2020, there were at least 254 different HPV tests worldwide, of which more than 90% lacked regulatory evaluation or were not clinically validated. Based on this, the study evaluated the current HPV detection methods with the second-generation hybrid capture method (HC2) recommended by the international validation standard (Meijer-2009) and the PCR-enzyme immunoassay (PCR-EIA) with GP5+ /6+ as the primer as the standard control, and updated the list of hrHPV detection methods that met the international validation standard (Meijer-2009) on the basis of the 2015 systematic review.

With advances in technology, more and more genes associated with non-syndromic deafness (hearing loss as the only obvious clinical manifestation) have been discovered. Among them, autosomal dominant genes account for about 20%. In this study, a whole exome sequencing (WES) approach was used to genetically analyze 863 unrelated Chinese to identify three possible novel variants in the MAP1B gene encoding highly conserved microtubule-associated proteins in three unrelated Chinese lineages (c.4198A>G, p.1400S>G; c.2768T>C, p.923I>T; c.5512T>C, p.1838F>L). Since the p.1400S>G, p.923I>T and p.1838F>L mutations are located at highly conserved MAP1B residues, they affect the extension of axons and other functions by acting on the microtubule system, especially Ser1400 in the MTA domain of MAP1B is located at a highly conserved phosphorylation site necessary for the function of embryonic cortical neurons. According to this, the authors hypothesize that the replacement of Ser1400 with glycine can lead to insufficient phosphorylation of MAP1B, which can lead to neuronal dysfunction. To elucidate the pathophysiological mechanism of the MAP1B mutation, the authors obtained induced pluripotent stem cells (iPSCs) from 1 member of a Chinese Han family bearing the MAP1B p.1400S>G mutation and a control group, and subsequently differentiated auricular sensory neuron-like (OSN-like) cells from these iPSCs. The effects of MAP1B p.1400S>G mutation on phosphorylation activity, morphology and electrophysiological characteristics of these cochlear neuron-like cells were evaluated. The results showed that the iPSCs of both mutant individuals and control group could be induced to differentiate into auditory nerve precursor cells, but the expression of MAP1B in the neurons of mutant individuals was significantly lower than that of control group. The axon length of OSN-like cells obtained by induced differentiation of mutant individual cells was 30% shorter than that of control cells. Further electrophysiological experiments demonstrated that MAP1B mutation affected the functional maturation of OSN-like cells. And CRISPR/Cas9 technology can repair the abnormal cells of mutant individuals to function normally. Finally, the authors used CRISPR/Cas9 technology to reproduce the abnormal morphology and dysfunction of Osn-like cells of patients and the hearing impairment phenotype of patients using MAP1B knockout mice. The experimental results showed that MAP1B knockout did not significantly affect the survival of hair cells in the inner ear of mice, but significantly affected the maturation of neurons and axon extension in the spiral ganglion of inner ear, which impaired the hearing of mice. In summary, this study skillfully and rigorously discovered a new deafness-related gene locus using a variety of techniques.

In order to actively respond to the major public health challenge of cervical cancer, the World Health Organization (WHO) released the Global Strategy for Accelerating the Elimination of Cervical Cancer in 2020 and proposed phased goals to be achieved by 2030. Human papillomavirus (HPV) vaccination coverage is an important key indicator. In order to understand the current status of HPV vaccine immunization program inclusion and vaccination coverage in various countries around the world, and to provide data support for the realization of the strategy of eliminating cervical cancer, WHO and the United Nations Children's Fund (UNICEF) used the immune system performance data reported by countries through the WHO/UNICEF joint report form from 2010 to 2019 to analyze the implementation effect of HPV vaccination programs and the vaccination coverage of the target population. As of June 2020, 55% (107/194) of WHO member countries included HPV vaccines in national or regional immunization programs, with the Americas (85%) and Europe (77%) being the regions with the highest proportion of countries with HPV vaccines included in immunization programs. In 2019, the number of countries that included HPV vaccines in their immunization programs reached a historical peak, with low-and middle-income countries (LMICs) accounting for 14/16. It is estimated that approximately 15% of girls completed the full course of HPV vaccination in 2019, with a first dose rate of 20%. In countries where the HPV vaccine has been included in the immunization programme, only 53% of girls aged 9 to 15 have completed the full course of vaccination. The current global HPV vaccination program has a first-dose coverage of 67% and a full-course coverage of 53%. Among them, the average first-dose vaccination rate of LMICs is higher than that of high-income countries (HICs), but its full-course vaccination rate is lower than that of HICs due to the high shedding rate. Of the 87 countries where HPV vaccine full-course vaccination data are available, only 5 countries have achieved the target of 90% full-course vaccination rate, and 22 countries have achieved full-course vaccination rates above 75%. The global HPV vaccination coverage of school-age girls is still far behind the phased target of eliminating cervical cancer by 2030. Therefore, we should continue to pay attention to the speed of HPV vaccine incorporation into national immunization programs, especially in countries with large populations, and further improve the implementation effect of current HPV vaccination programs.