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.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To analyse the clinical features of encephalitis patients with antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR).Methods:Three anti-AMPAR encephalitis patients diagnosed in Tangdu Hospital, the Air Force Military Medical University between January 2020 and May 2021 were retrospectively reviewed. The clinical symptoms, supplementary examination, treatment options and outcomes with knowledge from literature were summarized in this study.Results:Three patients aging from 12 to 70 years presented with symptoms ranging from cognitive impairment, personality change to headache and paralysis. The lung occupying lesion was pathologically proved to be small cell lung cancer in case 1. Antibody to AMPAR (AMPAR-ab) was positive in both blood and cerebrospinal fluid of case 1, with coexisting antibodies against sex-determining region of Y chromosome-related high mobility group box 1 in blood, and the symptoms persisted but did not recur following therapy with corticosteroids. AMPAR-ab was detected only in serum in case 2, with the lesion located in both frontal and temporal lobes, centrum semiovale and lateral ventricle, combined with classic imaging features of intracranial hypotension, and the syndrome was partially improved following treatment with corticosteroids. The lesions were located in the pons and middle cerebellar peduncle, accompanied by cerebellar atrophy in case 3. Spinal cord magnetic resonance imaging showed long hyperintense lesions involving the cervical and thoracic cord, extending from C 2 to Th 10 level on T 2-weighted images. AMPAR-ab was positive in both serum and cerebrospinal fluid. And the symptoms improved significantly following treatment with corticosteroids and intravenous immunoglobulin. Conclusions:The clinical manifestations of anti-AMPAR encephalitis are highly heterogeneous, and brainstem and spinal cord can also be involved in addition to the limbic system, accompanied by brain atrophy. Combining with concurrent antibodies, especially the intracellular antibodies, malignancy needs to be closely monitored; the immunotherapy is effective and the presence of tumor superimposed with multiple antibodies may be associated with poor prognosis.

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

Objective:To analyze the current research status and hotspots of cardiac rehabilitation (CR) compliance at home and abroad, summarize the research experience of CR compliance and provide a basis for formulating future research priorities.Methods:In May 2021, Web of Science core database was used as the literature source to search the literatures related to cardiac rehabilitation compliance of cardiovascular disease population. CiteSpace visualization software was used to analyze the basic distribution characteristics of literature, co-occurrence analysis of authors and keywords, cluster analysis and emergence word analysis.Results:A total of 944 papers were included, and the annual publication volume showed an overall trend of fluctuating growth. The study area was widely distributed but unbalanced. The authors and institutions in the United States, Canada and the United Kingdom published more papers, especially the United States dominated. This research field formed a core group of authors, but there was little cooperation among authors. The research focused on the influence of patients' exercise endurance and exercise safety on compliance with cardiac rehabilitation, behavioral intervention to promote utilization of cardiac rehabilitation of patients, status of compliance with cardiac rehabilitation and investigation of related factors. The frontier of the research might be the study of the compliance of cardiac rehabilitation in the PCI perioperative population. At the same time, socioeconomic and patient symptom reports might be the key to improving the compliance of patients with cardiac rehabilitation.Conclusions:Behavioral interventions to promote the compliance of cardiac rehabilitation in people with cardiovascular diseases and the identification of influencing factors of compliance with cardiac rehabilitation are the key research issues. China needs to increase the support for whole-course cardiac rehabilitation of patients from aspects of medical insurance and administrative strategies. At the same time, China can focus on the development and verification of cardiac rehabilitation compliance assessment tools in the future, assist in the formulation of personalized cardiac rehabilitation programs and further develop emerging technologies, such as remote monitoring and reminder systems, which are conducive to improving cardiac rehabilitation compliance and improving disease prognosis of patients.

Objective:To explore the effects of out-of-hospital cardiac rehabilitation in coronary disease patients after percutaneous coronary intervention (PCI) .Methods:From January 2017 to March 2018, this study selected 70 coronary disease patients with PCI in Department of Geriatric Medicine at Jiangsu Province Hospital as subjects by convenience sampling. Those 70 patients were randomly divided into control group and experimental group, 35 cases in each group. Two groups all carried out routine treatment and nursing in hospital. Control group implemented outpatient follow-up after discharge; experimental group adopted out-of-hospital cardiac rehabilitation. The follow-up for patients of two groups lasted one year. This study compared the scores of Seattle Angina Questionnaire (SAQ) , Self-rating Anxiety Scale (SAS) and risk factors of patients between two groups.Results:The scores of SAS of experimental group were lower than those of control group 3, 6, 12 months after discharge with statistical differences ( P<0.05) . The dimension scores of SAQ of patients between two groups 3, 6, 12 months after discharge were higher than those of admission; the scores of SAQ of experimental group were higher than those of control group in the same period with statistical differences ( P<0.05) . A total of 12 months after discharge, the body mass index (BMI) of patients in experimental group was higher than that in control group; the blood glucose and fat were lower than those in control group; the patients with smoking was less than that in control group with statistical differences ( P<0.05) . Conclusions:Out-of-hospital cardiac rehabilitation nursing can relieve the anxiety of coronary disease patients with PCI and control or reduce the risk factors so as to improve the disease condition which is a method suitable for long-term management of PCI patients.

Objective:To deeply explore the comprehensive function impairment of chronic heart failure (CHF) patients and analyze its influencing factors.Methods:From November 2018 to January 2019, this study selected medical workers (doctors and nurses) , CHF patients or their family members in Department of Cardiovascular at a Class Ⅲ Grade A hospital in Jiangsu Province as subjects by purposive sampling. Semi-structured interview was carried out for the subjects with the phenomenological method. Colaizzi analysis was used to extract concepts. Two researchers matched the concept with the international classification of functioning, disability and health (ICF) based on Cieza link rules. This study took ICF category no more than 5% of the former after two interviews as the sample size saturated standard.Results:Finally, a total of 28 interviewees were included. A total of 80 ICF categories were linked, 31 (38.8%) of them in body function, 5 (6.2%) in body structure, 28 (35.0%) in activity participation and 16 (20.0%) in environmental factors. Other 482 concepts could not be linked with ICF categories with health status (30.7%) for the most followed by personal factors (27.4%) .Conclusions:ICF could be used to describe the comprehensive function impairment of CHF patients and its influencing factors. Being linked with multitudinous ICF categories indicates the complex function impairment and the numerous influencing factors. This study will be beneficial to carry out the individualized, detailed and dynamic treatment and nursing based on comprehensive evaluation for CHF patients.

Objective:To construct the different functional graded care programs for elderly patients with chronic heart failure (CHF) .Methods:In March 2019, convenience sampling was used to select 24 nursing experts from 14 ClassⅢ Grade A hospitals in Northeast, North China, East China, South China, Central China and Northwest China as the subjects of correspondence. Based on the "International Classification of Functioning, Disability and Health" (ICF) , we took the function as the starting point to construct the different functional graded care programs for elderly CHF patients through systematic reviews, expert meeting and expert consultations.Results:In three rounds of questionnaires, the recovery rates were 100.00%, 100.00% and 95.83%; the authority coefficients of experts were 0.912, 0.914 and 0.913; the coordination coefficients were 0.348, 0.451 and 0.752, respectively; the differences were all statistical ( P<0.001) . The finally constructed different functional graded care programs for elderly CHF patients included heart function, respiratory function, water and electrolyte function, energy and drive function, emotional function, skin protection function, sleep function, and activity and participation function, totaling 8 ICF functions, 14 nursing measures and 161 nursing activity. Conclusions:The different functional graded care programs for CHF patients is comprehensive and systematic, which can not only improve nurses' nursing decision-making, standardize nursing behaviors, but also can be dynamically adjusted. It is scientific and feasible, and can satisfy the individualized and differentiated care demands of CHF patients with impaired function in different disease stages. At the same time, it also provides a theoretical framework for the future development of nursing information systems.

Objective : To investigate the behavior problems and influencing factors of school-age students from the third to the sixth grade in Zhongshan,and to provide evidence for early intervention of behavior problems in children. Methods : According to the proportion of population in urban area and township in Zhongshan,students of Grade Three to Six from eight primary schools（three in urban area and five in township）were recruited by stratified sampling method. The behavior problems in children were assessed by the Conners Parent Symptom Questionnaire（PSQ）. Sociodemographic information,family discipline and so on was investigated by a general questionnaire. The influencing factors for behavior problems were analyzed by a logistic regression model. Results : A total of 2 292 questionnaires were issued,and 2 236 valid questionnaires were recycled,with an effective rate of 97.56%. The positive rate of behavioral problems was 11.72%. The results of multivariate logistic regression analysis showed that the risk factors for behavior problems were females（OR=1.594,95%CI：1.170-2.171）,birth asphyxia（OR=2.372,95%CI：1.320-4.261）,main family discipline（laissez-faire：OR=3.326,95%CI：1.450-7.630;doting：OR=3.244,95%CI：1.867-5.638;autocratic：OR=2.609,95%CI：1.584-4.296,mixed：OR=2.313,95%CI：1.669- 3.207）,less than four hours per week for father-child communication（OR=1.551,95%CI：1.052-2.286）,negative life events（OR=2.188,95%CI：1.448-3.308）,living in township（OR=2.031,95%CI：1.330-3.102）,academic performance （average：OR=2.786,95%CI：1.868-4.156;poor：OR=6.665,95%CI：3.236-13.727;very poor：OR=25.068,95%CI：5.786-108.617）;the protective factors were occupation of mother as civil servants or professional personnel（OR=0.449,95%CI：0.238-0.844）and higher grades（Grade Five：OR=0.496,95%CI：0.339-0.727;Grade Six：OR=0.468,95%CI：0.309-0.710）. Conclusion Females,birth asphyxia,main family discipline,less communication between father and child,occupation of mother,negative life events,place of residence,academic performance and grade were the influencing factors for behavior problems.

Objective To analyze the imaging features of several rare primary renal tumors.Methods The CT and MR images of 1 3 cases with pathologically proved rare primary renal tumors were analyzed retrospectively.The imaging features including location, number,size,shape,margin,density or intensity,internal structures and pattern of enhancement were observed.Results Of the 13 cases,4 were primary renal lymphoma (PRL),which performed as renal hilar mass involving the renal parenchyma in 3 cases and multiple nodules at bilateral kidney in 1 case.3 were hemanyiopericytoma (HA),which located in the renal parenchyma in 1 case and protruded from renal surface in 2 cases.All the HA showed obvious enhancement,with small vessels within the tumor in 2 cases.Two cases of inflammatory myofibroblastic tumor (IMT)were mainly located in renal sinus,among which the renal parenchyma was involved in 1 case. One case with adult Wilms tumor showed mixed heterogeneous signal intensity in both T1-and T2-weighted images,indicating intratumoral hemorrhage.One case of neuroendocrine tumor was located in the renal parenchyma with ipsilateral adrenal and regional lymph node metastasis. One case of metanephric adenoma (MA)demonstrated as renal parenchymal mass with slightly enhancement.One case of meoblastic nephroma (MN)showed as a heterogeneous mass with continuous enhancement.Conclusion The imaging features of rare primary renal tumors are characteristical.It is important to analyze the imaging characteristics carefully in order to improve the diagnostic accuracy.