Objective An HPLC-MS/MS method was established for the simultaneous determination of 7 components in Qingkailing Oral Liquid.Methods The assay was performed on a Waters ACQUITY UPLC BEH C18 column(2.1 mm×10 mm,1.7 μm)and the sample was eluted with a gradient mobile phase containing 10 mmol·L-1 of ammonium acetate and 0.1%of formic acid in water(A)-methanol(B).The mass spectrometry was carried out by electrospray ionization(ESI)with positive/negative ions in multiple reaction monitoring(MRM)mode for quantitative analysis.Results The linear ranges of adenine,chlorogenic acid,caffeic acid,geniposide,baicalin,hyodeoxycholic acid and cholic acid were 0.100 4-3.213,0.784 5-8.982,0.998-3.194,0.622 5-19.92,25.05-300.6,2.513-30.15 and 7.775-93.30 μg·mL-1(r≥0.999 0).The average recoveries(n=6)were 100.9%,98.74%,101.2%,100.2%,100.8%,99.97%and 98.94%with RSD of 1.58%,0.59%,1.78%,1.25%,0.65%,1.69%and 1.07%.The contents of the above mentioned 7 components in 15 tested samples were in the ranges of 0.12-0.18,0.19-0.24,0.06-0.09,0.34-0.37,4.54-4.85,0.49-0.67 and 1.82-2.19 mg·mL-1.The contents of 7 components in tested sample from different manufacturers were closed.Conclusion The method has shown good sensitivity,accuracy,and repeatability.The study can provide reference and data support for the quality control and subsequent research of Qingkailing Oral Liquid.

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.

Objectives:To investigate the risk factors of early postoperative complications in patients with a-cute subaxial cervical spinal cord injury after anterior bone grafting and fusion surgery.Methods:The clinical data of 168 cases of traumatic cervical spinal cord injury who underwent anterior surgery in our hospital from January 2017 to November 2021 were retrospectively analyzed.There were 133 males and 35 females.The age ranged from 23 to 82 years,with an average age of 53.8±11.2 years.There were 33 patients with preop-erative comorbidities(19.6％).ASIA classification of preoperative neurological impairment was as follows:34 patients of grade A,10 patients of grade B,62 patients of grade C,and 62 patients of grade D.50 patients were treated with high-dose methylprednisolone(29.8％).135 cases(80.4％)were treated with anterior cervical discectomy and fusion(ACDF),and 33 cases(19.6％)were treated with anterior cervical corpectomy and fusion(ACCF).Early postoperative complications and death of patients during hospitalization period were collected.Univariate logistic regression analysis was used to evaluate possible relationships between early postoperative complications and the factors including sex,age,preoperative comorbidities,cause of injury,neurological level of injury,preoperative ASIA grade,whether there was brain,thoracic and abdominal injury,whether high-dose methylprednisolone treatment was used,time from injury to surgery,preoperative hemoglobin(HGB),preopera-tive albumin(ALB),extent of surgery,surgical method,operative time,and intraoperative blood loss.A multi-variate logistic analysis was performed on the variables with P＜0.2 in the univariate analysis to identify signif-icant independent risk factors.Results:The incidence of early postoperative complications was 29.1％(49/168).Univariate logistic regression analysis showed that the cause of injury(P=0.032),preoperative ASIA grade(P＜0.001),whether combined with brain,thoracic and abdominal injury(P=0.043),whether high-dose methylpred-nisolone treatment was used(P=0.017),preoperative HGB(P=0.002),preoperative ALB(P=0.001)and surgical method(P=0.002)were correlated with early postoperative complications.Multivariate logistic regression analysis showed that preoperative ASIA grades A and B(P＜0.001,OR=5.389,95％CI 2.243-12.950)and high-dose methylprednisolone treatment(P=0.044,OR=2.541,95％CI 1.024-6.303)were independent risk factors for early postoperative complications.Conclusions:Preoperative ASIA grades A and B and high-dose methylpred-nisolone treatment are the independent risk factors for early postoperative complications in patients with acute subaxial cervical spinal cord injury.

IgA vasculitis (IgAV) is more common in children with vasculitis, while antineutrophilcytoplasmicantibodies (ANCA) associated vasculitis (AAV) in children is relatively rare. We report a case of IgA vasculitis nephritis with ANCA positive in a child. The clinical manifestations of the child were consistent with rapidly progressive nephritis syndrome, and the serum MPO-ANCA was strongly positive. Pathologically, crescentic glomerulonephritis was mainly presented, accompanied by a large amount of IgA deposition in the mesangial area. After treatment with glucocorticoids, rituximab and symptomatic treatment, the child's condition was relieved. This report aims to improve the understanding of the diagnosis and treatment of renal damage caused by vasculitis in children.

Muscle-invasive bladder cancer (MIBC) is the predominant type of muscle-invasive urothelial carcinoma (MIUC). MIBC features an unfavorable prognosis with limited treatment approaches. The backbone of treatment strategy was neoadjuvant chemotherapy followed by radical cystectomy before 2021. Immunotherapy represented by nivolumab has gained breakthrough results in adjuvant setting, demonstrating significant improvement in disease free survival in high-risk MIUC population, and become a standard of care for MIUC adjuvant therapy since 2021. Immunotherapy has both efficacy and safety advantages compared to adjuvant chemotherapy. Predictors for adjuvant therapy response in MIUC have yet not been identified. The most evaluated predictive biomarkers to date for immune checkpoint inhibitor treatment response are programmed death ligand 1 (PD-L1) expression and circulating tumour DNA (ctDNA), etc. Further research is crucial to assess the value of the biomarkers. Studies of perioperative immunotherapy combined with chemotherapy or antibody-drug conjugate are ongoing. Combined immunotherapy as part of bladder-sparing treatment regimen for MIUC is limited to small scale studies and has shown promising early outcomes. Further phase 3 clinical trials are underway to add mature data to bladder-sparing strategies incorporating immune checkpoint inhibitors in adjuvant setting.

Muscle-invasive bladder cancer (MIBC) is the predominant type of muscle-invasive urothelial carcinoma (MIUC). MIBC features an unfavorable prognosis with limited treatment approaches. The backbone of treatment strategy was neoadjuvant chemotherapy followed by radical cystectomy before 2021. Immunotherapy represented by nivolumab has gained breakthrough results in adjuvant setting, demonstrating significant improvement in disease free survival in high-risk MIUC population, and become a standard of care for MIUC adjuvant therapy since 2021. Immunotherapy has both efficacy and safety advantages compared to adjuvant chemotherapy. Predictors for adjuvant therapy response in MIUC have yet not been identified. The most evaluated predictive biomarkers to date for immune checkpoint inhibitor treatment response are programmed death ligand 1 (PD-L1) expression and circulating tumour DNA (ctDNA), etc. Further research is crucial to assess the value of the biomarkers. Studies of perioperative immunotherapy combined with chemotherapy or antibody-drug conjugate are ongoing. Combined immunotherapy as part of bladder-sparing treatment regimen for MIUC is limited to small scale studies and has shown promising early outcomes. Further phase 3 clinical trials are underway to add mature data to bladder-sparing strategies incorporating immune checkpoint inhibitors in adjuvant setting.

IgA vasculitis (IgAV) is more common in children with vasculitis, while antineutrophilcytoplasmicantibodies (ANCA) associated vasculitis (AAV) in children is relatively rare. We report a case of IgA vasculitis nephritis with ANCA positive in a child. The clinical manifestations of the child were consistent with rapidly progressive nephritis syndrome, and the serum MPO-ANCA was strongly positive. Pathologically, crescentic glomerulonephritis was mainly presented, accompanied by a large amount of IgA deposition in the mesangial area. After treatment with glucocorticoids, rituximab and symptomatic treatment, the child's condition was relieved. This report aims to improve the understanding of the diagnosis and treatment of renal damage caused by vasculitis in children.

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 observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.

Objective: To observe the clinical efficacy of pushing Qiaogong point with varying intensities for treating stage Ⅰ essential hypertension. Methods: A total of 72 patients diagnosed with stageⅠ essential hypertension were enrolled in this study. They were divided into three groups using the random number table method, including a control group, a gentle pushing group, and a heavy pushing group, with 24 patients in each group. All three groups received the same therapeutic lifestyle interventions. The control group received no additional interventions, the gentle pushing group received additional pushing Qiaogong point with gentle strength, and the heavy pushing group received additional pushing Qiaogong point with heavy strength. The treatment duration was 4 weeks, followed by a 4-week follow-up period, during which blood pressure changes were observed and analyzed in all three groups. Results: After treatment, the blood pressure levels in all three groups showed a significant decrease (P<0.05). The effective rate in the control group was 43.5％, in the gentle pushing group was 78.3％, and in the heavy pushing group was 33.3％. The reduction in blood pressure levels in the gentle pushing group was significantly superior to that in both the control group and the heavy pushing group, indicating inter-group statistical significance (P<0.01). The efficacy of the heavy pushing group was comparable to that of the control group, indicating no statistical significance (P>0.05). During the follow-up period, compared with the end of the treatment within the same group, the blood pressure levels remained stable in both the control group and the gentle pushing group, indicating no intra-group statistical significance (P>0.05). The heavy pushing group showed a significant decrease in diastolic blood pressure (DBP) and mean blood pressure (MBP) compared with the end of the treatment, indicating intra-group statistical significance (P<0.05). During the follow-up, the gentle pushing group had lower systolic blood pressure (SBP) and MBP compared with both the heavy pushing group and the control group, indicating inter-group statistical significance (P<0.01), while there was no inter-group statistical significance in comparing the DBP (P>0.05). There was no statistical significance in comparing the SBP, DBP, and MBP between the heavy pushing group and the control group (P>0.05). Conclusion: Pushing Qiaogong point with gentle strength combined with lifestyle interventions showed a higher effective rate and long-term blood pressure stability in the treatment of stage Ⅰ essential hypertension. Pushing Qiaogong point with varying intensities showed varying effects on patients with stage Ⅰ essential hypertension.