{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T19:08:52Z","timestamp":1771960132446,"version":"3.50.1"},"reference-count":102,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011501","name":"Qinghai Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["2023-SF-129"],"award-info":[{"award-number":["2023-SF-129"]}],"id":[{"id":"10.13039\/501100011501","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In Xining City, Qinghai Province, which is located in a high-altitude hypoxic environment, this study employs high-throughput sequencing technology to conduct large-scale deafness-related gene screening among newborns. It aims to assess the carrier rate and variant types of deafness-related genes in local newborns; and based on different genotypic characteristics, provide targeted health education and clinical guidance to the parents of children with deafness, with the goal of achieving early diagnosis, early prevention, and early intervention of deafness. At the same time, this study also provides scientific basic data support for deafness prevention and treatment-related research in Qinghai Province.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From March 2023 to March 2025, the research team of the Affiliated Hospital of Qinghai University strictly abided by ethical norms. With the full informed consent of the participants, the team systematically and continuously collected heel blood samples from multi-ethnic newborns living in areas at different altitudes, and successfully obtained 3,615 complete blood samples required for the study. Subsequently, high-throughput sequencing technology was applied to detect these samples, and accurate data on deafness susceptibility-related genes were obtained. During the analysis phase, the research team took altitude (low altitude, medium altitude, high altitude), ethnicity (Tibetan, Hui, Han, Salar, Tu, etc.), and genotype (15 loci of 4 common deafness-causing genes: GJB2, SLC26A4, mitochondrial 12SrRNA, and GJB3) as the core dimensions. By comprehensively using statistical analysis and bioinformatics methods, a systematic multi-dimensional analysis was conducted to deeply explore the association characteristics between different factors and the carriage of deafness susceptibility genes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study collected a total of 3,615 cases of newborn blood spot specimens. After excluding 549 cases of substandard specimens, a valid screening cohort of 3,066 newborns was eventually formed. Within this valid cohort, 165 carriers of deafness-susceptible genes were identified, with an overall carriage rate of 5.38%.<\/jats:p>\n                    <jats:p>Stratified analysis by altitude showed that: in medium-altitude areas (with a sample size of 2,319 cases), 132 carriers were detected, corresponding to a carriage detection rate of 5.69%; in high-altitude areas (with a sample size of 742 cases), 33 carriers were detected, with a carriage detection rate of 4.45%. Statistical analysis indicated that the carriage detection rate of deafness-susceptible genes among newborns in high-altitude areas was significantly lower than that in medium-altitude areas.<\/jats:p>\n                    <jats:p>Genotyping data showed: GJB2 gene: A total of 73 mutations (2.38%) were detected, with the 235 del C mutation site being the most common, accounting for 67.12% of the total mutations in this gene. Among them, 58 cases were detected in medium-altitude areas and 15 cases in high-altitude areas, accounting for 20.55% (15\/73) of the total GJB2 gene mutations. SLC26A4 gene: A total of 67 mutations (2.19%) were detected, with the IVS7\u22122 mutation site having the highest frequency, accounting for 47.76% of the total mutations in this gene. Among them, 59 cases were detected in medium-altitude areas and 8 cases in high-altitude areas, accounting for 11.94% (8\/67) of the total SLC26A4 gene mutations. Mitochondrial 12S rRNA gene: A total of 33 mutations (1.08%) were detected, with the 1555 A\u2009&gt;\u2009G mutation site being the main one, accounting for 96.97% of the total mutations in this gene. Among them, 25 cases were detected in medium-altitude areas and 8 cases in high-altitude areas, accounting for 24.24% (8\/33) of the total mitochondrial 12S rRNA gene mutations. GJB3 gene: Only 1 rare mutation (0.03%) was detected at the 538 C\u2009&gt;\u2009T site, and no such mutation was found in high-altitude areas. Analysis of the ethnic distribution of the 3,066 neonates showed: Han ethnicity: A total of 1,983 cases, with 115 cases detected (5.80%), accounting for 69.70% of all carriers. Hui ethnicity: A total of 476 cases, with 24 cases detected (5.04%), accounting for 14.55% of all carriers. Tibetan ethnicity: A total of 535 cases, with 24 cases detected (4.49%), accounting for 14.55% of all carriers. Mongolian ethnicity: A total of 24 cases, with 2 cases detected (8.33%), accounting for 1.21% of all carriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>1. Overall level: The overall carriage rate of deafness susceptibility genes in neonates from Xining, Qinghai is significantly lower than the national average for newborns (6.67%). Within the medium and high altitude regions of Qinghai Province, compared with the medium-altitude areas (altitude\u2009&gt;\u20091,500 meters and \u2264 2,500 meters), the carriage rate of deafness susceptibility genes in neonates from high-altitude areas (altitude\u2009&gt;\u20092,500 meters and \u2264 4,500 meters) shows a downward trend, which suggests that within the medium and high altitude range of the province, the detection rate of deafness susceptibility genes decreases with the increase of altitude. 2. Gene level: Among GJB2 gene mutations, the 235 delC gene mutation remains the most dominant type, and the detection rates of both GJB2 and GJB3 genes are lower than the national level. Notably, the detection rates of mitochondrial 12S rRNA gene mutations and SLC26A4 gene mutations in neonates from this region are both higher than the national average, with the detection rate of mitochondrial 12S rRNA gene mutations being more significantly higher. Since deafness caused by these two types of gene mutations can be effectively reduced in terms of onset risk through health education, conducting genetic testing targeting these specific genes has important clinical significance and public health value. 3. Ethnic background level: The detection rate of deafness susceptibility genes in Tibetan neonates is low, especially for the IVS7\u22122 A\u2009&gt;\u2009G mutation site, and this phenomenon is more prominent in high-altitude areas. On the contrary, the detection rate of deafness susceptibility genes in Mongolian and Hui neonates in high-altitude areas shows an increasing trend.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342920","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T18:29:44Z","timestamp":1771957784000},"page":"e0342920","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidimensional analysis of screening results of deafness susceptibility genes in 3066 newborns of different altitudes and nationalities in Xining, Qinghai(ISRCTN89197487)"],"prefix":"10.1371","volume":"21","author":[{"given":"Benhong","family":"Ren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazhen","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyuan","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dandan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjun","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongxia","family":"Tie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiannan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilan","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5320-1063","authenticated-orcid":true,"given":"Yi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"issue":"1","key":"pone.0342920.ref001","first-page":"3","article-title":"Clinical Practice Guidelines for Genetic Diagnosis and Genetic Counseling of Deafness in China (2023)","volume":"58","author":"Chinese Multi-Center Clinical Research Collaborative Group on Deafness Gene Screening and Diagnosis, Editorial Committee of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Chinese Society of Otorhinolaryngology Head and Neck Surgery","year":"2023","journal-title":"Chinese Journal of Otorhinolaryngology Head and Neck Surgery"},{"key":"pone.0342920.ref002","author":"China Hearing Medical Development Foundation","year":"2021"},{"issue":"7","key":"pone.0342920.ref003","first-page":"815","article-title":"Analysis of neonatal hearing and deafness gene combined screening results in Yuncheng area of Shanxi","volume":"40","author":"HQ He","year":"2023","journal-title":"Chinese Journal of Medical Genetics"},{"key":"pone.0342920.ref004","doi-asserted-by":"crossref","first-page":"110120","DOI":"10.1016\/j.ijporl.2020.110120","article-title":"Combined hearing screening and genetic screening of deafness among Hakka newborns in China","volume":"136","author":"X Zeng","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"18","key":"pone.0342920.ref005","first-page":"17","article-title":"Detection and analysis of deafness-related genes GJB2, SLC26A4, GJB3 and mitochondrial 12SrRNA in 5562 newborns born in Wuxi urban area","volume":"62","author":"AM Chen","year":"2022","journal-title":"Shandong Medicine"},{"key":"pone.0342920.ref006","volume-title":"Plateau Medicine","author":"RL Ge","year":"2021","edition":"2"},{"issue":"01","key":"pone.0342920.ref007","first-page":"3","article-title":"Qinghai diagnostic criteria for chronic mountain sickness issued at the 6th International Congress on Mountain Medicine and Hypoxic Physiology","author":"Expert Group on Chronic Mountain Sickness, International Society for Mountain Medicine","year":"2005","journal-title":"Journal of Qinghai Medical College"},{"issue":"2","key":"pone.0342920.ref008","first-page":"97","article-title":"Specifications for Genetic Deafness Gene Screening","volume":"101","author":"China Multi-Center Clinical Research Collaboration Group on Deafness Gene Screening and Diagnosis, National Technical Guidance Group on Prevention and Treatment of Deafness","year":"2021","journal-title":"Chinese Journal of Medicine"},{"issue":"5","key":"pone.0342920.ref009","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/ajmg.1320460504","article-title":"Genetic epidemiological studies of early-onset deafness in the U.S. school-age population","volume":"46","author":"ML Marazita","year":"1993","journal-title":"Am J Med Genet"},{"issue":"3","key":"pone.0342920.ref010","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/1098-1004(200009)16:3<190::AID-HUMU2>3.0.CO;2-I","article-title":"Molecular genetics of hearing impairment due to mutations in gap junction genes encoding beta connexins","volume":"16","author":"R Rabionet","year":"2000","journal-title":"Hum Mutat"},{"issue":"9","key":"pone.0342920.ref011","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1093\/hmg\/6.9.1605","article-title":"Connexin26 mutations associated with the most common form of non-syndromic neurosensory autosomal recessive deafness (DFNB1) in Mediterraneans","volume":"6","author":"L Zelante","year":"1997","journal-title":"Hum Mol Genet"},{"issue":"12","key":"pone.0342920.ref012","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1093\/hmg\/6.12.2173","article-title":"Prelingual deafness: high prevalence of a 30delG mutation in the connexin 26 gene","volume":"6","author":"F Denoyelle","year":"1997","journal-title":"Hum Mol Genet"},{"issue":"5","key":"pone.0342920.ref013","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1002\/(SICI)1098-1004(1998)11:5<387::AID-HUMU6>3.0.CO;2-8","article-title":"Identification of mutations in the connexin 26 gene that cause autosomal recessive nonsyndromic hearing loss","volume":"11","author":"DA Scott","year":"1998","journal-title":"Hum Mutat"},{"issue":"4","key":"pone.0342920.ref014","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1086\/301807","article-title":"Novel mutations in the connexin 26 gene (GJB2) that cause autosomal recessive (DFNB1) hearing loss","volume":"62","author":"PM Kelley","year":"1998","journal-title":"Am J Hum Genet"},{"key":"pone.0342920.ref015","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1086\/318803","article-title":"Connexin mutations in skin disease and hearing loss","volume":"68","author":"DPWL Kelsell","year":"2001","journal-title":"Am J Hum Genet"},{"issue":"4","key":"pone.0342920.ref016","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/00125817-200207000-00004","article-title":"GJB2 (connexin 26) variants and nonsyndromic sensorineural hearing loss: a HuGE review","volume":"4","author":"A Kenneson","year":"2002","journal-title":"Genet Med"},{"issue":"9100","key":"pone.0342920.ref017","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S0140-6736(97)11124-2","article-title":"Connexin-26 mutations in sporadic and inherited sensorineural deafness","volume":"351","author":"X Estivill","year":"1998","journal-title":"Lancet"},{"issue":"23","key":"pone.0342920.ref018","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1001\/jama.281.23.2211","article-title":"Carrier rates in the midwestern United States for GJB2 mutations causing inherited deafness","volume":"281","author":"GE Green","year":"1999","journal-title":"JAMA"},{"issue":"1","key":"pone.0342920.ref019","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/sj.ejhg.5200406","article-title":"High carrier frequency of the 35delG deafness mutation in European populations. Genetic Analysis Consortium of GJB2 35delG","volume":"8","author":"P Gasparini","year":"2000","journal-title":"Eur J Hum Genet"},{"issue":"8","key":"pone.0342920.ref020","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1056\/NEJM199802193380813","article-title":"Connexin 26 R143W mutation associated with recessive nonsyndromic sensorineural deafness in Africa","volume":"338","author":"GW Brobby","year":"1998","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0342920.ref021","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1097\/00001756-199906230-00010","article-title":"Three novel connexin26 gene mutations in autosomal recessive non-syndromic deafness","volume":"10","author":"Y Fuse","year":"1999","journal-title":"Neuroreport"},{"issue":"1","key":"pone.0342920.ref022","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1038\/sj.ejhg.5201250","article-title":"Mitochondrial DNA mutations in patients with postlingual, nonsyndromic hearing impairment","volume":"13","author":"HT Jacobs","year":"2005","journal-title":"Eur J Hum Genet"},{"issue":"11","key":"pone.0342920.ref023","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1093\/hmg\/11.11.1311","article-title":"A mutation in GJB3 is associated with recessive erythrokeratodermia variabilis (EKV) and leads to defective trafficking of the connexin 31 protein","volume":"11","author":"I Gottfried","year":"2002","journal-title":"Hum Mol Genet"},{"issue":"4","key":"pone.0342920.ref024","first-page":"267","article-title":"23 newborn deafness gene screening mutation spectrum analysis","volume":"38","author":"Y Ruan","year":"2024","journal-title":"Journal of Clinical Otolaryngology Head and Neck Surgery"},{"issue":"5","key":"pone.0342920.ref025","first-page":"354","article-title":"Screening and analysis of genetic loci for hereditary deafness in 3785 newborns in Yantai area","volume":"20","author":"YH Zhang","year":"2022","journal-title":"Chinese Journal of Hearing and Language Rehabilitation Science"},{"issue":"9","key":"pone.0342920.ref026","first-page":"1126","article-title":"Analysis of common hereditary deafness gene mutations in 52120 newborns with abnormal hearing screening in Henan Province","volume":"48","author":"M Lu","year":"2022","journal-title":"South China Preventive Medicine"},{"issue":"5","key":"pone.0342920.ref027","first-page":"761","article-title":"Analysis of GJB2, SLC26A4 and 12S rRNA gene mutations in 481 patients with deafness in Hubei","volume":"20","author":"RY Chen","year":"2022","journal-title":"Chinese Journal of Otology"},{"issue":"1","key":"pone.0342920.ref028","first-page":"67","article-title":"Analysis of deafness gene screening in 523006 newborns in Jining area","volume":"20","author":"HY Wu","year":"2022","journal-title":"Chinese Journal of Otology"},{"issue":"4","key":"pone.0342920.ref029","doi-asserted-by":"crossref","first-page":"928","DOI":"10.3390\/genes14040928","article-title":"Insight into the natural history of pathogenic variant c.919-2A>G in the SLC26A4 gene involved in hearing loss: the evidence for its common origin in southern Siberia (Russia)","volume":"14","author":"VY Danilchenko","year":"2023","journal-title":"Genes (Basel)"},{"issue":"5","key":"pone.0342920.ref030","doi-asserted-by":"crossref","first-page":"470","DOI":"10.5582\/bst.2018.01156","article-title":"A novel compound heterozygous mutation in the GJB2 gene is associated with non-syndromic hearing loss in a Chinese family","volume":"12","author":"H Jiang","year":"2018","journal-title":"Biosci Trends"},{"issue":"7","key":"pone.0342920.ref031","doi-asserted-by":"crossref","DOI":"10.1101\/cshperspect.a033233","article-title":"Inner Ear Connexin Channels: Roles in Development and Maintenance of Cochlear Function","volume":"9","author":"F Mammano","year":"2019","journal-title":"Cold Spring Harb Perspect Med"},{"issue":"2","key":"pone.0342920.ref032","first-page":"198","article-title":"Analysis of newborn hearing screening and diagnosis results with mtDNA 12 SrRNA gene mutation","volume":"30","author":"CY Qu","year":"2022","journal-title":"Journal of Audiology and Speech Diseases"},{"issue":"1","key":"pone.0342920.ref033","first-page":"28","article-title":"Analysis of susceptible gene mutations for hereditary hearing loss in newborns in southwest Guizhou and its clinical significance","author":"GX Hong","year":"2023","journal-title":"Technology and Health"},{"issue":"2","key":"pone.0342920.ref034","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/s41431-019-0510-6","article-title":"Comprehensive genetic testing of Chinese SNHL patients and variants interpretation using ACMG guidelines and ethnically matched normal controls","volume":"28","author":"Y Yuan","year":"2020","journal-title":"Eur J Hum Genet"},{"issue":"11","key":"pone.0342920.ref035","first-page":"2128","article-title":"Gjb3 Gene Mutations in Non-Syndromic Hearing Loss of Bloch, Kurd, and Turkmen Ethnicities in Iran","volume":"49","author":"F Aliazami","year":"2020","journal-title":"Iran J Public Health"},{"issue":"10441","key":"pone.0342920.ref036","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1016\/S0140-6736(23)02874-X","article-title":"AAV1-hOTOF gene therapy for autosomal recessive deafness 9: a single-arm trial","volume":"403","author":"J Lv","year":"2024","journal-title":"Lancet"},{"issue":"2","key":"pone.0342920.ref037","first-page":"146","article-title":"Analysis of the Results of Combined Screening for Neonatal Hearing and Deafness Genes in Tianjin","volume":"41","author":"HY Liu","year":"2023","journal-title":"Journal of Clinical Pediatrics"},{"key":"pone.0342920.ref038","volume-title":"A Study on the Carrying Status of Pathogenic Genes for Nonsyndromic Deafness in Neonates in Inner Mongolia Region","author":"CY Liang","year":"2021"},{"issue":"02","key":"pone.0342920.ref039","first-page":"200","article-title":"Analysis of the results of neonatal deafness gene screening in Inner Mongolia region","volume":"21","author":"JJ Gao","year":"2023","journal-title":"Chinese Journal of Otology"},{"issue":"07","key":"pone.0342920.ref040","first-page":"1422","article-title":"Analysis of the Results of Screening for Common Hereditary Deafness Genes in 6,698 Neonates","volume":"27","author":"LT Wei","year":"2023","journal-title":"Anhui Medical and Pharmaceutical Journal"},{"issue":"06","key":"pone.0342920.ref041","first-page":"873","article-title":"Analysis of the Results of 1,007 Neonatal Hearing Screenings and Deafness Gene Sequencing","volume":"20","author":"WT Huang","year":"2022","journal-title":"Chinese Journal of Otology"},{"issue":"21","key":"pone.0342920.ref042","first-page":"4050","article-title":"Analysis of the Characteristics of Mutations in Genes Susceptible to Hereditary Deafness in 8,145 Neonates in Yinchuan City","volume":"37","author":"JP Zhao","year":"2022","journal-title":"Maternal and Child Health Care of China"},{"issue":"01","key":"pone.0342920.ref043","first-page":"33","article-title":"Screening and analysis of genes GJB2, SLC26A4, and mitochondrial DNA 12SrRNA for deafness in 941 neonates in Xinjiang region","volume":"12","author":"M Yu","year":"2014","journal-title":"Chinese Scientific Journal of Hearing and Speech Rehabilitation"},{"issue":"09","key":"pone.0342920.ref044","first-page":"1122","article-title":"Analysis of the Results of Neonatal Deafness Gene Screening in Cangzhou Region","volume":"28","author":"WZ Di","year":"2020","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"02","key":"pone.0342920.ref045","first-page":"181","article-title":"Molecular epidemiological investigation and analysis of genes susceptible to deafness in 25,205 neonates in Chengde City","volume":"20","author":"XL Xue","year":"2022","journal-title":"Chinese Journal of Otology"},{"issue":"06","key":"pone.0342920.ref046","first-page":"903","article-title":"Analysis of the Results of Screening for Common Deafness Genes in 43,133 Pregnant Women in Liaoning Region","volume":"19","author":"M Zhang","year":"2021","journal-title":"Chinese Journal of Otology"},{"issue":"05","key":"pone.0342920.ref047","first-page":"77","article-title":"Investigation on the mutations of genes for hereditary deafness in neonates in Shenyang region","volume":"26","author":"BY Zhu","year":"2028","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"04","key":"pone.0342920.ref048","first-page":"205","article-title":"Summary of combined screening for neonatal hearing and genes in Heilongjiang province","volume":"30","author":"ZY Yun","year":"2015","journal-title":"Chinese Medical Digest (Otorhinolaryngology)"},{"issue":"1","key":"pone.0342920.ref049","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/gim.2016.66","article-title":"Newborn genetic screening for hearing impairment: a population-based longitudinal study","volume":"19","author":"C-C Wu","year":"2017","journal-title":"Genet Med"},{"issue":"06","key":"pone.0342920.ref050","first-page":"873","article-title":"Analysis of the results of hearing screening and deafness gene sequencing in 1,007 newborns","volume":"20","author":"WT Huang","year":"2022","journal-title":"Chinese Journal of Otology"},{"issue":"08","key":"pone.0342920.ref051","first-page":"33","article-title":"Analysis of the results of combined screening for hearing and deafness genes in 223,617 newborns in Changzhi City","volume":"26","author":"Y Liu","year":"2022","journal-title":"The Medical Forum"},{"issue":"04","key":"pone.0342920.ref052","first-page":"308","article-title":"Analysis of the results of combined screening for neonatal hearing and deafness genes in 27,660 neonates in Xianyang region","volume":"24","author":"P Pang","year":"2024","journal-title":"Chinese Journal of Ophthalmology and Otorhinolaryngology"},{"issue":"05","key":"pone.0342920.ref053","first-page":"465","article-title":"Analysis of the results of neonatal deafness gene screening in Wuwei City","volume":"45","author":"P Fan","year":"2019","journal-title":"South China Journal of Preventive Medicine"},{"issue":"20","key":"pone.0342920.ref054","first-page":"76","article-title":"Analysis of the results of screening for genes for hereditary deafness in 6,060 neonates","volume":"60","author":"XC Wang","year":"2020","journal-title":"Shandong Medical Journal"},{"issue":"05","key":"pone.0342920.ref055","first-page":"510","article-title":"Analysis of the results of combined screening for neonatal deafness genes and hearing in 9,147 neonates in Shandong Province","volume":"28","author":"Y Sun","year":"2020","journal-title":"Journal of Audiology and Speech Pathology"},{"issue":"05","key":"pone.0342920.ref056","first-page":"49","article-title":"Analysis of the Results of Neonatal Deafness Gene Testing in Weihai Region","volume":"43","author":"SY Sun","year":"2020","journal-title":"Heilongjiang Medicine and Science"},{"issue":"02","key":"pone.0342920.ref057","first-page":"5","article-title":"Analysis of the results of screening for common deafness genes in 4,129 pregnant women in Zaozhuang City and their clinical significance","volume":"9","author":"WJ Zhu","year":"2024","journal-title":"Clinical Research and Practice"},{"issue":"06","key":"pone.0342920.ref058","first-page":"671","article-title":"Screening and analysis of mutation sites of genes for hereditary deafness in 47,332 neonates in Zibo City","volume":"28","author":"K Mu","year":"2020","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"13","key":"pone.0342920.ref059","first-page":"62","article-title":"Research on the results of detection of genes for congenital deafness in 1,500 infants","volume":"6","author":"H Wu","year":"2020","journal-title":"Smart Health"},{"issue":"06","key":"pone.0342920.ref060","first-page":"22","article-title":"Detection and extended follow-up results of genes for hereditary deafness in 20,496 neonates","volume":"26","author":"YJ Ruan","year":"2020","journal-title":"Strait Journal of Preventive Medicine"},{"issue":"02","key":"pone.0342920.ref061","first-page":"310","article-title":"Analysis of the results of screening for genes for hereditary deafness in 35,517 infants in Lishui region","volume":"30","author":"XD Zhang","year":"2022","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"05","key":"pone.0342920.ref062","first-page":"377","article-title":"Analysis of the Results of Neonatal Deafness Gene Screening in Some Areas of Ningbo","volume":"23","author":"SQ Pan","year":"2023","journal-title":"Chinese Journal of Ophthalmology and Otorhinolaryngology"},{"issue":"09","key":"pone.0342920.ref063","first-page":"1126","article-title":"Analysis of the current situation of mutations in common hereditary deafness genes in 52,120 neonates with abnormal hearing screenings in Henan Province","volume":"48","author":"M Lu","year":"2022","journal-title":"South China Journal of Preventive Medicine"},{"issue":"05","key":"pone.0342920.ref064","first-page":"34","article-title":"Investigation and research on screening for genes for hereditary deafness and mutation rates of deafness genes in neonates","volume":"42","author":"J Guo","year":"2022","journal-title":"Harbin Medical Journal"},{"issue":"05","key":"pone.0342920.ref065","first-page":"905","article-title":"Analysis of the results of combined screening for neonatal hearing and deafness genes in 780 neonates in Liyuan community, Wuhan city","volume":"37","author":"H Guo","year":"2022","journal-title":"Maternal and Child Health Care of China"},{"key":"pone.0342920.ref066","author":"WL Lin","year":"2019"},{"issue":"17","key":"pone.0342920.ref067","first-page":"2538","article-title":"Analysis of the Results of Combined Screening for Neonatal Deafness Genes and Hearing in 4,370 Neonates in Zhongshan City","volume":"15","author":"YF Zhang","year":"2018","journal-title":"Laboratory Medicine and Clinical"},{"issue":"02","key":"pone.0342920.ref068","first-page":"169","article-title":"Analysis of the results of neonatal deafness gene screening in 16,869 neonates in Loudi City","volume":"31","author":"L Qiu","year":"2023","journal-title":"Journal of Audiology and Speech Pathology"},{"issue":"03","key":"pone.0342920.ref069","first-page":"307","article-title":"Clinical study on combined screening for neonatal hearing and deafness genes in Changsha region","volume":"21","author":"SH Zhou","year":"2023","journal-title":"Chinese Journal of Otology"},{"issue":"14","key":"pone.0342920.ref070","first-page":"1952","article-title":"Analysis of the Results of Combined Screening for Neonatal Hearing and Deafness Gene Detection in 6,957 Neonates","volume":"36","author":"Y Yang","year":"2020","journal-title":"The Journal of Practical Medicine"},{"issue":"17","key":"pone.0342920.ref071","first-page":"4206","article-title":"Screening and analysis of mutations in neonatal deafness genes in 1649 neonates in Jiangxi Province","volume":"32","author":"QP Xia","year":"2017","journal-title":"Maternal and Child Health Care of China"},{"issue":"06","key":"pone.0342920.ref072","first-page":"475","article-title":"Analysis of the results of combined screening for neonatal hearing and genes susceptible to deafness in 10,313 neonates","volume":"40","author":"Q Li","year":"2022","journal-title":"Journal of Clinical Laboratory Science"},{"issue":"18","key":"pone.0342920.ref073","first-page":"17","article-title":"Detection and analysis of genes GJB2, SLC26A4, GJB3, and mitochondrial 12S rRNA related to deafness in 5,562 neonates born in Wuxi City","volume":"62","author":"AL Chen","year":"2022","journal-title":"Shandong Medical Journal"},{"issue":"09","key":"pone.0342920.ref074","first-page":"14","article-title":"Analysis of the results of neonatal deafness gene screening in Huai\u2019an city","volume":"30","author":"CX Sun","year":"2022","journal-title":"Chinese Medical Engineering"},{"issue":"03","key":"pone.0342920.ref075","first-page":"548","article-title":"Analysis of the Results of Combined Screening for Neonatal Deafness Genes and Hearing in Nanjing Region","volume":"31","author":"H Xu","year":"2023","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"02","key":"pone.0342920.ref076","first-page":"220","article-title":"Application and research of the combined screening model for neonatal hearing and deafness genes in Zhangjiagang City","volume":"34","author":"JM Zha","year":"2023","journal-title":"Jiangsu Preventive Medicine"},{"issue":"10","key":"pone.0342920.ref077","first-page":"70","article-title":"Investigation on the Mutation Modes of Deafness Genes in 2534 Neonates in Ma\u2019anshan Region","volume":"25","author":"XQ Zhang","year":"2017","journal-title":"Chinese Journal of Healthy Birth & Genetics"},{"issue":"12","key":"pone.0342920.ref078","first-page":"1616","article-title":"Screening and analysis of genes susceptible to deafness in neonates in Jiangmen region, Guangdong province","volume":"22","author":"J Tang","year":"2022","journal-title":"Journal of Tropical Medicine"},{"issue":"02","key":"pone.0342920.ref079","first-page":"92","article-title":"Analysis of the Results of Neonatal Deafness Gene Screening in Guangming District, Shenzhen City","volume":"30","author":"J Zeng","year":"2023","journal-title":"Journal of Rare and Uncommon Diseases"},{"issue":"21","key":"pone.0342920.ref080","first-page":"108","article-title":"The value of combined hearing screening and hereditary deafness gene detection in diagnosing neonatal hearing disorders","volume":"28","author":"JH Fan","year":"2022","journal-title":"Contemporary Medicine"},{"issue":"06","key":"pone.0342920.ref081","first-page":"1530","article-title":"Analysis of the value of screening for genes GJB2, GJB3, PDS, 12SrRNA and combined hearing screening in the diagnosis of neonatal hearing disorders","volume":"44","author":"JF Li","year":"2023","journal-title":"Jilin Medical Journal"},{"issue":"03","key":"pone.0342920.ref082","first-page":"230","article-title":"Analysis of mutations in neonatal deafness genes in northern Guangdong region","volume":"18","author":"ZZ Ma","year":"2023","journal-title":"Chinese Pharmaceutical Biotechnology"},{"issue":"02","key":"pone.0342920.ref083","first-page":"162","article-title":"Analysis of mutations in deafness genes in 585 Hmong neonates in Hainan province","volume":"31","author":"HZ Xu","year":"2023","journal-title":"Journal of Audiology and Speech Pathology"},{"issue":"03","key":"pone.0342920.ref084","first-page":"420","article-title":"A cross-sectional study of neonatal deafness genes in Baisha Li Autonomous County, Hainan Province","volume":"22","author":"ZD Zhao","year":"2024","journal-title":"Chinese Journal of Otology"},{"issue":"01","key":"pone.0342920.ref085","first-page":"109","article-title":"Analysis of Neonatal Deafness Gene Screening in Li Neonates in Hainan Province","volume":"22","author":"ZD Zhao","year":"2024","journal-title":"Chinese Journal of Otology"},{"issue":"12","key":"pone.0342920.ref086","first-page":"1147","article-title":"Analysis of the Carrying Status of Neonatal Deafness Genes in Hainan Province","volume":"22","author":"XL Fan","year":"2022","journal-title":"Chinese Tropical Medicine"},{"issue":"13","key":"pone.0342920.ref087","first-page":"2362","article-title":"Analysis of the Results of Detection of Genes for Hereditary Deafness in Neonates in Qiannan Prefecture, Guizhou Province","volume":"48","author":"X He","year":"2021","journal-title":"Modern Preventive Medicine"},{"issue":"02","key":"pone.0342920.ref088","first-page":"140","article-title":"Screening and screening of mutations in neonatal deafness genes in 751 neonates in northwest region","volume":"8","author":"X Yang","year":"2020","journal-title":"Journal of Developmental Medicine Electronic Journal"},{"issue":"11","key":"pone.0342920.ref089","first-page":"242","article-title":"Prerequisites and guidelines for acclimatization to great and extreme altitude in prevention of altitude sickness","volume":"141","author":"F Berghold","year":"1991","journal-title":"Wien Med Wochenschr"},{"issue":"5","key":"pone.0342920.ref090","first-page":"296","article-title":"Acute mountain sickness and Meni\u00e8re disease","volume":"110","author":"HP Verschuur","year":"1993","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"issue":"3","key":"pone.0342920.ref091","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1136\/bjsm.26.3.161","article-title":"Altitude-dependent changes of directional hearing in mountaineers","volume":"26","author":"ME Rosenberg","year":"1992","journal-title":"Br J Sports Med"},{"issue":"1","key":"pone.0342920.ref092","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s40794-024-00238-9","article-title":"Ear, nose and throat disorders and international travel","volume":"11","author":"N McHugh","year":"2025","journal-title":"Trop Dis Travel Med Vaccines"},{"issue":"03","key":"pone.0342920.ref093","first-page":"187","article-title":"Study on the impact of acute entry into high-altitude environment on hearing","volume":"32","author":"WJ Zou","year":"2023","journal-title":"Journal of Regional Anatomy and Operative Surgery"},{"issue":"1","key":"pone.0342920.ref094","first-page":"12","article-title":"Hypoxia regulates the expression of voltage-gated potassium channels in cochlear auditory neurons","volume":"39","author":"S Feng","year":"2023","journal-title":"Journal of Modern Medicine and Health"},{"issue":"4","key":"pone.0342920.ref095","first-page":"39","article-title":"Etiological analysis of sudden deafness in high-altitude areas","volume":"25","author":"M Cuo","year":"2015","journal-title":"Journal of Plateau Medicine"},{"key":"pone.0342920.ref096","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1186\/1479-5876-9-154","article-title":"Genetic mutations in non-syndromic deafness patients of Uyghur and Han Chinese ethnicities in Xinjiang, China: a comparative study","volume":"9","author":"Y Chen","year":"2011","journal-title":"J Transl Med"},{"key":"pone.0342920.ref097","author":"PC Gao","year":"2019"},{"issue":"12","key":"pone.0342920.ref098","first-page":"1349","article-title":"Research progress on the correlation between common deafness gene mutations and differences among regions and ethnic groups","volume":"12","author":"K Zhou","year":"2019","journal-title":"China Journal of New Clinical Medicine"},{"issue":"05","key":"pone.0342920.ref099","first-page":"506","article-title":"A study on the characteristics of common deafness gene mutations in Han and Hui newborns in Xingqing District, Yinchuan City","volume":"28","author":"J Gu","year":"2020","journal-title":"Journal of Audiology and Speech Pathology"},{"issue":"08","key":"pone.0342920.ref100","article-title":"Analysis on the Characteristics of Gene Mutations in Deafness Patients of Han and Mongolian Ethnic Groups in Hohhot Region, Inner Mongolia","volume":"16","author":"XY Guo","year":"2024","journal-title":"Journal of Molecular Diagnosis and Therapy"},{"key":"pone.0342920.ref101","author":"MT Liu","year":"2021"},{"issue":"1","key":"pone.0342920.ref102","first-page":"8","article-title":"Research progress in diagnosis and treatment of hereditary hearing loss","volume":"38","author":"Q Wang","year":"2024","journal-title":"Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T18:30:02Z","timestamp":1771957802000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342920"}},"subtitle":[],"editor":[{"given":"Nejat","family":"Mahdieh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":102,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0342920","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]}}}