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.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

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.

Objective:To evaluate the deformity changes in the treatment of congenital clubfoot in infants by ultrasound, and to explore its clinical application value.Methods:Seventeen infants with congenital clubfoot treated in the Department of Pediatric Orthopaedics of the Third Affiliated Hospital of Zhengzhou University from March 2020 to June 2021 and 27 normal infants in the same period were selected. The distance between medial malleolus and scaphoids (MM-N distance) of all feet was measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone (C-C distance), medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data before, after treatment and during follow-up were statistically analyzed.Results:A total of 88 feet of 44 infants were evaluated. The mean number of cast was 4.7±1.1, the follow-up time was (96.9±59.3)days. The MM-N distance, C-C distance and posterior tibial calcaneal angle in the clubfoot group were improved after treatment and at the last follow-up, and the differences were statistically significant (all P<0.01). During the treatment, 1 case had false correction, and 2 cases recurred in the last follow-up. Conclusions:Ultrasound can clearly display the medial, dorsal, lateral and posterior articular structures of normal and clubfoot, and can observe the deformity changes of clubfoot during the correction process, which can provide guidance for the clinical treatment of clubfoot.

BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.

Objective To explore the application effects of evidence-based nursing in percutaneous endoscopic gastrostomy ( PEG ) postoperative enteral nutrition and the effects of prevention and treatment of complications. Methods A retrospective and prospective cohort study method was adopted. The control group was composed of 58 cases of PEG enteral nutrition patients, on whom evidence-based nursing was not conducted before January 2013, while the intervention group was composed of 60 cases of PEG enteral nutrition patients, on whom evidence-based nursing was conducted after January 2013. Intervention effects of nursing were compared and analyzed between two groups. Results The incidence of complications in the intervention group (11. 67%) was significantly lower than that of the control group (43. 10%) (P<0. 01), and the incidence of infectious complications in the intervention group (5. 00%) was significantly lower than that of the control group (20.69%) (P<0. 01). There was no significant association between feeding time and complications (P >0. 05);there was significant association between ways of nutrition infusion and replacement rate of skin dressing (P<0. 01). Conclusions Application of evidence-based nursing in postoperative enteral nutrition of PEG patients can effectively prevent complications from happening, promote recovery of patients′ gastrointestinal function and overall nutritional status, and eventually shorten the time of hospitalization.

OBJECTIVETo examine the association between domestic violence and mental/general health status among married migrant women at reproductive age.

METHODSA total of 958 eligible married migrant women of reproductive age who were selected through community-based multiple-stage sampling method in one urban district in Shanghai and interviewed in April and May 2010. Chi-square test, Fisher's exact test and unconditional logistic regression model were used for data analysis.

RESULTSThe overall prevalence of domestic violence in husbands was 40.0%. Among 5 adverse outcomes related to general health and 6 adverse outcomes related to mental health, exposing to physical or sexual violence in the life time or in the previous year were associated with 2 adverse outcomes related to general health (including often in pain/discomfort and sleeping problems) and 4 adverse outcomes related to mental health (including often feeling nervous/tense/worry, easily getting frightened, crying more than usual, often feeling worthless on herself or being indifferent to the surroundings). Experience of control behavior was associated with 1 adverse outcome that related to general health (often in pain or discomfort) and 3 adverse outcomes related to mental health including easily get frightened, feeling worthless on herself or indifferent to the surroundings, Experience of emotional violence in the previous year was associated with pain or discomfort feelings. Compared with those who had never experienced any violence from husband after adjusting for potential influencing factors in logistic regression models, respondents who had ever experienced physical or sexual violence, control behavior or emotional violence, the numbers were respectively, presented 2.25-3.70 times, 1.94-4.75 times and 2.12 times, more likely to report the above-mentioned adverse health outcomes.

CONCLUSIONDomestic violence was associated with general and mental health among married migrant women at reproductive age, especially physical or sexual violence and control behaviors.

Adult ; China ; Cross-Sectional Studies ; Domestic Violence ; Female ; Humans ; Logistic Models ; Marriage ; Middle Aged ; Surveys and Questionnaires ; Transients and Migrants ; Women's Health ; Young Adult

Stroke is characterized by high incidence,high morbidity,and high mortality.It seriously threats to human life and the quality of life.Studies have confirmed that neuroendocrine dysfunction occurs after the onset stroke and dkectly inpact on the outcomes of patients.It has great value for identifying the clinical conditions and outcomes,and has a guiding significance for clinical treatment.This article reviews neuroendocrine biomarkers of the neurological outcomes after stroke.

Objective To examine the association between domestic violence and mental/general health status among married migrant women at reproductive age. Methods A total of 958 eligible married migrant women of reproductive age who were selected through community-based multiple-stage sampling method in one urban district in Shanghai and interviewed in April and May 2010. Chi-square test,Fisher’s exact test and unconditional logistic regression model were used for data analysis. Results The overall prevalence of domestic violence in husbands was 40.0%. Among 5 adverse outcomes related to general health and 6 adverse outcomes related to mental health, exposing to physical or sexual violence in the life time or in the previous year were associated with 2 adverse outcomes related to general health(including often in pain/discomfort and sleeping problems) and 4 adverse outcomes related to mental health(including often feeling nervous/tense/worry,easily getting frightened,crying more than usual,often feeling worthless on herself or being indifferent to the surroundings). Experience of control behavior was associated with 1 adverse outcome that related to general health (often in pain or discomfort) and 3 adverse outcomes related to mental health including easily get frightened,feeling worthless on herself or indifferent to the surroundings, Experience of emotional violence in the previous year was associated with pain or discomfort feelings. Compared with those who had never experienced any violence from husband after adjusting for potential influencing factors in logistic regression models,respondents who had ever experienced physical or sexual violence,control behavior or emotional violence,the numbers were respectively, presented 2.25-3.70 times,1.94-4.75 times and 2.12 times,more likely to report the above-mentioned adverse health outcomes. Conclusion Domestic violence was associated with general and mental health among married migrant women at reproductive age,especially physical or sexual violence and control behaviors.

OBJECTIVETo evaluate the effect of infiltration resin on masking white spot lesions by assessing the change in the white spot area.

METHODSSeventy-four maxillary anterior teeth with post-orthodontic decalcification teeth were investigated in this study. All teeth were treated with infiltration resin according to manufacturer recommendation. Standardized digital images were taken before, immediately after, and one week after treatment. The results were classified into three groups: com-pletely masked, partially masked and unchanged. The images of partially masked teeth were analyzed using an image analysis software. The size of the white spot lesion (W) and the whole-tooth facial surface (T) were measured, and the W:Tratio (%) was calculated. Statistical evaluation of the lesions was performed using Kruskal-Wallis and Mann-Whitney tests.

RESULTSAmong the 74 teeth, 20 (27%) teeth were classified as completely masked and 54 (73%) teeth were classified as partially masked; no tooth was unchanged. The W:T ratio significantly decreased from 39.28% before treatment to 9.46% after treatment (P < 0.05).

CONCLUSIONResin infiltration is an effective treatment for masking white spot lesion. However, the masking effect depends on the lesion depth and activity.

Acid Etching, Dental ; Color ; Dental Caries ; Dental Enamel ; Humans ; Lip ; Tooth Demineralization