Objective:To investigate the treatment methods and their efficacy for bilateral frontal lobe contusion.Methods:The clinical data of 37 patients with bilateral frontal lobe contusion who received treatment in Fujian Provincial Hospital between May 2017 and May 2018 were analyzed. The 37 patients were divided into surgical group ( n = 19) and non-surgical group ( n = 18) according to different treatment methods. Clinical efficacy was compared between the two groups. All patients underwent intracranial pressure monitoring. Intracerebral pressure was divided into three stages: < 20 mmHg, 20-40 mmHg, > 40 mmHg. Clinical efficacy was compared among patients with different levels of intracranial pressure. Results:In the surgical group, one patient died, one patient was in a vegetative state, two patients had severe disability, eight patients had mild disability, and seven patients well recovered. In the non-surgical group, four patients died, three patients were in a vegetative state, six patients had severe disability, three patients had mild disability, and two patients well recovered. There was significant difference in good recovery rate between the two groups ( χ2 = 9.83, P < 0.05). The good recovery rate was statistically significant among patients with different levels of intracranial pressure ( χ2 = 7.97, P < 0.05). The vegetative state rate in patients with > 40 mmHg intracranial pressure was significantly higher than that in patients with < 20 mmHg intracranial pressure (50.0% vs. 0.0%, χ2 = 7.65, P < 0.05). The good recovery rate in patients with > 40 mmHg intracranial pressure was significantly lower than that in patients with < 20 mmHg intracranial pressure (0.0% vs. 61.5%, χ2 = 7.57, P < 0.05). Conclusion:The choice of treatment for bilateral frontal lobe contusion mainly depends on clinical symptoms, dynamic brain CT findings, and the changes in dynamic intracranial pressure monitoring. Active surgery can reduce the incidence of death and severe disability. Intracranial pressure monitoring has a positive role in guiding clinical treatment.

Objective To survey a prevalence of osteoporosis and prevalence of osteoporosis combined with hyponatremia in elderly hospitalized patients,and their risk factors.Methods We enrolled 2496 elderly hospitalized patients with detected plasma levels of sodium,calcium,25 (OH) D3,PTH,plasma PINP,and β-CTX.At the same time,sex,age,height,weight,smoking history,drinking history and BMI(kg/m2) in form of a questionnaire were recorded and calculated.The risk factors for osteoporosis were analyzed using multivariate Logistic regression method.Results The osteoporosis prevalence was 12.2％ (305/2496 inpatients)with 31.5 ％ (96/305)in male,68.5％ (209/305)in female(x2 =4.651,P=0.031).The prevalence of osteoporosis with hyponatremia was 27.5 ％ (84/305),with 24.8 ％ (21/84) in male and 75.2 ％ (63/84) in female(x2 =9.251,P=0.025).As compared with three groups of non-osteoporosis,normal serum Na+ with and without osteoporosis,the osteoporosis patients with hyponatremia were more aged,in a higher proportion of women and smokers,in lower BMI,and in low levels of serum sodium,BMD 25(OH)D3 (F=13.783,0.861,7.146,24.520,0.548,x2 =15.113、4.472;P =0.001,0.000,0.021,0.015,0.003,0.021,0.005).Multivariate Logistic regression analysis showed that aging,female,low BMI,smoking history,drinking history,low plasma 25(OH)D3 level,low plasma PINP level,and high plasma β-CTX level were the risk factors for osteoporosis(OR 4.215,2.271,3.176,2.013,1.237,3.987,1.843,1.972;all P＜0.05).Conclusions The osteoporosis prevalence is high in elderly patients,especially in old women.The risk factors for osteoporosis are diverse,and clinical conditions of osteoporosis patients with hyponatremia are much more severe than the others.More efforts should be given to them and need to be focused on the complications of osteoporosis.

Objective: To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia. Methods: From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chisquare test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia. Results: About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for nonstudy purposes. After adjusting for confounding factors, parents unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P<0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P<0.05). The results of grade stratification analysis showed that parents unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P<0.05). Among the higher grade of primary school students, continuous use of electronic screens for nonstudy purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P<0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P<0.05). Conclusions Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.

Objective: To analyze the current status and related factors of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing, so as to provide a basis for comprehensive public health interventions for common diseases. Methods: Through stratified cluster random sampling in October 2022, a total of 11 262 junior high school, senior high school, and vocational high school students in 16 districts of Beijing were surveyed with self administered questionnaires, physical examinations and visual acuity examinations. The χ 2 test and binary Logistic regression model were used to analyze group differences in the comorbidity of myopia, obesity and depression symptoms and factors influencing the comorbidity. Stratified analysis was applied to analyze the associations between health risk behaviors and the comorbidity. Results: The detection rate of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing was 3.35%, the comorbidity rate among vocational high school students (4.61%) was higher than that in junior high school students (2.80%) and senior high school students (3.41%). The comorbidity rate was higher among students in suburban areas (3.66%) than that in urban areas (2.92%), and the differences was statistically significant ( χ 2=15.02, 4.63, P <0.05). Binary Logistic regression analyses indicated that middle school students with poor dietary behaviors ( OR =1.59) and excessive screen time ( OR =1.70) were associated with elevated risk of comorbidity of myopia, obesity, and depression symptoms. Both boys and girls with poor dietary behaviors ( OR =1.63, 1.69) and excessive screen time ( OR =1.45, 2.23) had elevated likelihood of comorbidity of myopia, obesity and depression symptoms. Students in junior high school and senior high school with poor dietary behaviors ( OR =2.16, 1.47) and excessive screen time ( OR =2.20, 1.63 ) had elevated likelihood of comorbidity of myopia, obesity, and depression symptoms ( P <0.05). Conclusions The current status of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing is concerning. Schools and parents should work together to guide students to develop healthy behaviors such as balanced diet and moderate video, in order to achieve the goal of controlling myopia, obesity and depression symptoms.

Objective: To investigate the comorbidity of screening myopia and scoliosis among primary and secondary school students in Beijing from 2019 to 2022 and its influencing factors, in order to provide new ideas for comprehensive prevention and control of myopia and scoliosis in children and adolescents. Methods: From 2019 to 2022, 34 923, 34 321, 36 008 and 35 598 primary and secondary school students in Beijing were selected by stratified cluster random sampling method, and visual acuity examination, scoliosis examination and questionnaire survey were conducted on them. Chisquare test was used to analyze the intergroup differences between screening myopia and scoliosis among primary and secondary school students, and the correlation factors between screening myopia and scoliosis were analyzed by multivariate Logistic regression. Results: From 2019 to 2022, the prevalence of screening myopia increased by year,while scoliosis decreased by year, and the comorbidity rate in 2022 (0.69%) decreased by 1.62% compared with 2019 (2.31%). In 2022, screening myopia with scoliosis rates (0.98%) than urban suburbs (0.50%), high school students (1.65%) >professional high school students (1.21%) >junior middle school students (0.76%) >primary school students (0.22%) (χ2=28.97, 153.55, P<0.01). The results of multivariate Logistic analysis found that insufficient sleep time and parents did not limit the use of electronic screen time were the risk factors for screening myopia and scoliosis [OR(95%CI)=1.59(1.20-2.12), 1.34(1.02-1.76), P<0.05]. Teachers often or always remind that reading and writing posture and one hour or more of moderateintensity physical activity every day were protective factors for screening myopia and scoliosis [OR(95%CI)=0.70(0.52-0.96), 0.56(0.34-0.92), P<0.05]. Conclusions The comorbidity of acadmic screening myopia and scdiosis is not optimistic in Beijing. Attention should be paid to the reading and writing posture and related behavioral habits of children and adolescents, and ensure that children in each school section have sufficient sleep time, so as to prevent the occurrence and development of screening myopia and scoliosis.

Objective To explore the relationship between ambient temperature variation and blood pressure fluctuations in acute ischemic stroke patients.Methods Clinical data of 5 730 ischemic stroke patients hospitalized at the Departments of Neurology and Geriatrics of The Second Hospital of Tianjin Medical University and air temperature data during the corresponding period were retrospectively analyzed.The relationship between air temperature and blood pressure in patients with acute ischemic stroke was analyzed.Results Of 5 730 patients,4 428 (77.28％)had hypertension and most of them were male(56.26％ 3 362 cases).The systolic and diastolic blood pressure levels were higher in hypertensive males than in hypertensive females[(153.9 ± 21.7) mmHg vs.(150.7 ± 23.6)mmHg,(85.9±13.3)mmHg vs.(83.0±12.5)mmHg,1 mm Hg=0.133 kPa,both P＜0.05].The systolic pressure tended to increase and diastolic pressure tended to decrease with increasing age (both P ＜ 0.05).The systolic and diastolic blood pressure levels of patients were slightly higher in autumn and winter than in spring and summer (P ＜ 0.05).The mean monthly maximum and minimum temperature had negative correlations with the systolic blood pressure of patients.There was a linear positive correlation between the average monthly diurnal temperature range and the systolic and diastolic blood pressure.The systolic or diastolic blood pressure increased by 0.088 mmHg or 0.076 mmHg respectively with each 1 ℃ drop in the mean monthly maximum and minimum temperature.The systolic or diastolic blood pressure increased by 1.043 mmHg or 0.654 mmHg respectively with each 1 ℃ increase in the average monthly diurnal temperature range.Conclusions Hypertension is a risk factor for ischemic stroke,and ambient temperature variation is related to baseline blood pressure fluctuations in hypertensive patients with acute ischemic stroke.The temperature reduction and the increase of average diurnal temperature rang can lead to the elevation of blood pressure,which is more obvious in autumn and winter,especially in elderly patients.

Objective:To explore the characteristics of cognitive function in patients with early onset and adult onset schizophrenia.Methods:In this cross-sectional study, 546 patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected.Among them, 62 cases were defined as early onset schizophrenia (EOS, age of onset＜18 years) and 175 patients were defined as adult onset schizophrenia (AOS, age of onset≥25 years).Patients underwent clinical assessments with the Positive and Negative Symptom Scale (PANSS) and the Personal and Social Performance Scale (PSP), and comprehensive neuropsychological assessments.Results:The EOS patients got lower scores in motor function-PEGDOM T score [ (26±12) vs. (30±11), P＜0.01], working memory-average T score of PASAT and WMSSP[ (34±12) vs. (38±10), P＜0.05]and executive function (inhibition) -Stroop T score [ (35±12) vs. (39±10), P＜0.05]than AOS patients.No differences were fund in processing speed, verbal memory and learning, visual memory and learning (Ps＞0.05) between the two groups.Conclusion:It suggests that the EOS patients have worse motor function, working memory and inhibition.

Objective To investigate the effect of different serum sodium levels on heart function and prognosis in very elderly patients with heart failure. Methods Totally 152 elderly patients(aged ≥ 85 years)with hyponatremia were enrolled.Based on the serum sodium level ,they were divided into mild(125 mmol/L ≤ Na+ < 135 mmol/L) ,moderate(125 mmol/L ≤ Na+ < 135 mmol/L) ,and severe hyponatremia(Na+ < 115 mmol/L)groups ,and 76 patients with normal blood sodium level(Na+ ≥ 135 mmol/L)were selected as control group. The general data ,levels of serum creatinine and N-terminal pro-brain natriuretic peptide (NTproBNP)and prognosis were compared among the above groups. Results Compared with the control group ,patients with severe hyponatremia were much older ,with more diuretics administration ,higher level of serum creatinine , lowerlevelofeGFRandleftventricularejectionfractions[(38.1±3.9)％ vs.(45.2±9.7)％ ].There were higher incidences of coronary atherosclerotic heart disease [72.4％ (n=21)vs. 56.6％ (n=43)] ,diabetes[41.4％ (n=12)vs. 23.7％ (n=18)] ,chronic renal insufficiency [22.6％ (n=8)vs. 11.8％ (n=9)] ,stroke[20.6％ (n=6)vs. 9.2％ (n=7)]in patients with severe hyponatremia compared with other groups. The severe hyponatremia group showed significantly higher levels of NTproBNP [(4823. 9 ± 588. 1 )ng/L v s. (1124. 4 ± 349. 1 )ng/L ,(1836. 2 ± 369. 3 )ng/L ,(2894. 1 ± 687. 3 )ng/L ]and higher rates of mortality [27.6％ (n=8) vs.5.3％ (n=4) ,7.6％ (n=6) ,13.6％ (n=6)]as compared to the control group ,mild and moderate hyponatremia groups. Furthermore ,length of stay in hospital were markedly longer in patients with severe hyponatremia than those with mild and moderate hyponatremia[(11.1 ± 7.1)d vs. (19.6 ± 5.7)d ,(16.1 ± 4.2)d] . Conclusions Hyponatremia is a common type of electrolyte disorder in very elderly patients with heart failure ,and severe hyponatremia may predictand increased risk of death.