AIM: To study the pharmacokinetics of magnesium isoglycyrrhizinate (MgIG),which was diluted by 5%glucose injection in a total volume of 250 mL, after a single and multiple intravenous dose in 10 healthy volunteers.　METHODS: MgIG 100 mg once daily for 9 d in the multiple-dose regiment. Plasma MgIG concentrations are measured using high performance liquid chromatography (HPLC). Waters HPLC instrument was used with the Hypersil ODS2 C18 (5 μm, 300 mm×4.6 mm) column. The mobile phase was composed of 0.23 mol·L-1 phosphate buffer (pH=7.4):acetonitrile (79∶21).Flow rate was 1.0 mL·min-1 and column temperature was maintained at 40°C. The UV detector was set at 250 nm. The concentration time curves of MgIG were fitted to a two-compartment open model.　RESULTS: The pharmacokinetic parameters obtained from the single-dose study were as follows: cmax=(29±s 4) mg·L-1;t(1)/(2)α=(1.72±0.27) h;t(1)/(2)α=(23±3) h and AUC0-72=(448±75) mg·h·L-1. The steady-state pharmacokinetic parameters were: cssmin=(13±3) mg·L-1;cssmax=(42±6) mg·L-1;cav=(21±4) mg·L-1;t(1)/(2)α=(1.6±0.4) h;t(1)/(2)β=(24±4) h and AUCss0-24=(513±108) mg·h·L-1.CONCLUSION:The distribution and elimination rate of MgIG were not changed after multiple intravenous administration.

Objective:To investigate the clinical effect of endoscopic sinus surgery in the treatment of sinusitis and nasal polyps and its effect on nasal ventilation and olfactory function.Methods:80 patients with sinusitis and nasal polyps were selected in our hospital from January 2014 to June 2016,who were randomly divided into observation group and control group,each group of 40 cases.The control group was treated with traditional enucleation,while the observation group was treated with endoscopic sinus surgery.The clinical efficacy,the symptom scores,nasal airway resistance and olfactory function score before treatment and 3 months after treatment were compared between the two groups.Results:The total effective rate of the observation group was 95.00％,which was significantly higher than that of the control group 77.50％ (P＜0.05).There was no significant difference in nasal congestion,purulent nasal discharge,olfactory dysfunction,pain and total symptom score between the two groups before treatment (P＞0.05),nasal congestion,purulent nasal discharge,olfactory dysfunction,pain and total symptom score between the two groups at 3 months after treatment were lower than before treatment,and nasal pus,smell disorder,pain and total symptom scores of the patients in the observation group were lower than the control group (P＜0.05).There was no significant difference in nasal airway resistance and olfactory function score between the two groups before treatment and 3 months after treatment (P＞0.05),nasal airway resistance,olfactory function score of patients in two groups at 3 months after treatment were lower than before treatment,and the observation group was lower than that ofthe control group (P＜0.05).Conclusion:Endoscopic sinus surgery for sinusitis and nasal polyps is helpful to improve the clinical symptoms,promote the olfactory function and recovery of nasal ventilation,which is an effective method for treatment of sinusitis and nasal polyps.

Aim To investigate the pharmacokinetics of intravenous injection of magnesium isoglycyrrhizinate in single dose in Chinese healthy volunteers.Methods 9 healthy volunteers received magnesium isoglycyrrhizinate injections in single dose of 100,200,300 mg respectively.The concentrations of magnesium isoglycyrrhizinate in plasma at different time were assayed with HPLC-UV method.The pharmacokinetic parameters of magnesium isoglycyrrhizinate injections were calculated with program 3P87.Results It was found that the plasma concentration-time curves of the preparetion fitted two-compartment model.The main pharmacokinetic parameters were as follows: C_(max) were(28.79?3.54),(67.56?8.84) and(99.28?17.57) mg?L~(-1);T_(12?) were(1.72?0.27),(1.46?0.35) and(1.13?0.33) h;T_(12?)were(23.10?3.30),(23.95?4.72) and(24.25?4.12) h;V_d were(3.332?0.471),(2.921?0.382) and(2.921?0.622) L;CL were(0.209?0.041),(0.186?0.048) and(0.166?0.039) L?h~(-1);k_(10) were(0.063?0.012),(0.064?0.016) and(0.057?0.009) h~(-1);AUC_(0-72) were(448.68?75.06),(1015.29?225.14) and(1688.42?367.44) mg?h ?L~(-1).Conclusion The pharmacokinetics of the drug in the dosage range of 100～300 mg in human body approximately fit linear dynamic features.Compared with glycyrrhizic acid and other glycyrrhizinate salts,magnesium isoglycyrrhizinate is eliminated more slowly.This is beneficial to the treatment of chronic hepatitis.

Objective To evaluate the efficacy of auricular-plaster therapy indiabetes patients with insomnia, and provide suggestions for treatment.Methods The relevant randomized controlled trials and quasi-randomized controlled trials about using auricular-plaster therapy in diabetes patients with insomnia were searched in Cochrane Library, JBI, EMbase, Chinese Biological Medical Database ( CBM ) , Wanfang Data, VIP, China National Knowledge Internet(CNKI) and Pub Med. Information was selected. Retrieval time was limited from the foundation of those database to January 1st 2016. We use the Review manager 5. 3 analysis software to conduct Meta-analysis.Results 10 primary studies were included, which involved in 1 315 patients. Meta-analysis was processed based on different intervention methods and various outcome indicators. ①Different intervention methods:the effective rate of the auricular-plaster therapy group were higher than the control group, with significant differences [ OR= 7. 56, 95%CI ( 3. 92, 14. 58 ) , P<0. 000 01 ]; The effective rate of the comprehensive group ( including auricular-plaster therapy) were higher than the control group, with significant differences [OR=3.45, 95%CI(2.60,4.57), P=0.009];②Different results of outcome indicators, comprehensive interventionhas significant improvementonthe sleep quality of patients [MD=-1.96,95%CI(-2.33,-1.59),P<0.000 01];Moreover, comprehensive intervention could control postprandial blood glucose within twohours,with significant differences [MD=-1.86,95%CI(-1.94,-1.78),P<0.000 01].Conclusions Theauricular-plaster therapy can improve the sleep quality and sleep effect of diabetes patients with insomnia. However, because of the large literature difference, the results of the meta-analysis should be critical treated.

Objective:To investigate the incidence and treatment of gastric cancer in 16 medical centers in Tianjin from 2020 to 2021.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 122 gastric cancer patients who underwent surgery in 16 medical centers, including Tianjin Medical University Cancer Institute & Hospital, et al, in Tianjin from 2020 to 2021 were collected. There were 2 112 males and 1 010 females, aged (64±11)years. Observation indicators: (1) general data of patients; (2) treatment situations; (3) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted by the chi-square test. Results:(1) General data of patients. From 2020 to 2021, a total of 3 122 gastric cancer patients received surgeries in 16 medical centers in Tianjin, including 2 112 males and 1 010 females. There were 1 443 cases in 2020, including 976 males and 467 females, aged (63±11) years. There were 1 679 cases in 2021, including 1 136 males and 543 females, aged (65±11) years. Of the 3 122 pati-ents, cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 696, 667, 1 466, 293, accounting for 22.293%(696/3 122), 21.365%(667/3 122), 46.957%(1 466/3 122), 9.385%(293/3 122), respectively. Cases with early gastric cancer, locally advanced gastric cancer, advanced gastric cancer account for 17.265%(539/3 122), 73.350%(2 290/3 122), 9.385%(293/3 122). There were 2 829 patients without distant metastasis and 293 patients with distant metastasis. For the 2 829 patients without distant metas-tasis, cases in stage T1, T2, T3, T4a, T4b accounted for 19.053%(539/2 829), 12.089%(342/2 829), 20.148%(570/2 829), 41.499%(1 174/2 829), 7.211%(204/2 829)respectively, cases in stage N0, N1, N2, N3 account for 37.328%(1 056/2 829), 16.331%(462/2 829), 15.836%(448/2 829), 30.505%(863/2 829). For the 293 advanced gastric cancer patients with distant metastasis, 190 cases had peri-toneal metastasis, 47 cases had lymph node metastasis, 27 cases had ovarian metastasis, 37 cases had liver metastasis, 14 cases had other metastasis (some patients had ≥2 distant metastases). (2) Treatment situations. ① For the 539 with early gastric cancer, cases undergoing endoscopic submu-cosal dissection, laparoscopic surgery, open surgery were 22, 150, 86 in 2020, versus 19, 212, 50 in 2021, showing a significant difference between them ( χ2=19.42, P<0.05). For the 498 patients with early gastric cancer who underwent laparoscopic or open surgery, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 25, 81, 30, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrec-tomy were 18, 309, 35, respectively, showing a significant difference between them ( χ2=40.62, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery and laparoscopic surgery were 446 and 617 in 2020, versus 410 and 817 in 2021, showing a significant difference between them ( χ2=17.75, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proxi-mal gastrectomy were 336, 377, 143, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 377, 920, 137, respectively, showing a significant difference between them ( χ2=89.64, P<0.05). Of the 293 patients with advanced gastric cancer, 175 cases underwent surgeries due to hemorrhage, stenosis, perforation, 76 cases under-went surgery after chemotherapy, 42 cases underwent surgery directly. ② For 756 cases of 3 122 pati-ents undergoing total gastrectomy, 357 and 4 cases received open digestive tract reconstruction including Roux-en-Y and other anastomosis, versus 380 and 15 cases with laparoscopic digestive tract reconstruction including Roux-en-Y and other anastomosis, showing a significant difference between them ( χ2=5.57, P<0.05). For 1 687 cases undergoing distal gastrectomy, 84, 160, 158, 55 cases received open digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, versus 154, 489, 417, 170 cases with laparoscopic digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, showing a significant difference between them ( χ2=10.90, P<0.05) . Of the 539 patients with early gastric cancer, 65 cases had lymph node metastasis, in which 18 of 306 stage T1a cases had lymph node metastasis and 47 of 233 stage T1b cases had lymph node metastasis. The number of detected lymph nodes for the 2 290 patients with advanced gastric cancer was 31±15, including ≥16 for 2 059 cases and ≥30 for 1 276 cases. Of the 3 122 patients, cases with neoadjuvant therapy, complete response and incomplete response was 128, 13 and 115 in 2020, versus 250, 49 and 201 in 2021, showing a significant difference between them ( χ2=5.51, P<0.05). (3) Postoperative complications. Of the 3 122 patients, 746 cases had postoperative complications, with an incidence of 23.895%(746/3 122). There were 62 patients with grade 3 or more complications. Reoperation was conducted in 34 patients. There were 14 cases of postoperative death. The duration of postoperative hospital stay and hospital expense were (11±5)days and (98 114±46 598)yuan for the 3 122 patients, (26±14)days and (122 066±68 317)yuan for cases with complications, (40±21)days and (196 926±12 747)yuan for cases with grade 3 or more complications. Conclusion:Compared with 2020, cases undergoing laparoscopic surgery and distal gastrectomy for gastric cancer in Tianjin increases in 2021, and the digestive tract reconstruction also differs. The number of patients with neoadjuvant chemotherapy and complete response rate for advanced gastric cancer increases.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.