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.

This study aims to establish a quality grading standard that combines the conventional quality evaluation based on morphological characteristics of traditional Chinese medicine with the modern quality evaluation. Based on the existing standards and market circulation of Isatidis Radix, the diameter and color of Isatidis Radix decoction pieces were selected as the appearance traits for preliminary grading. The effects of internal quality indexes such as moisture, total ash, acid-insoluble ash, ethanol-soluble extractives, and 9 water-soluble components on different grades of decoction pieces were comprehensively compared, and the key grading indexes were determined by t-test. The relevance between appearance traits and the internal quality indexes was investigated by multi-dimensional statistical analyses such as correlation analysis, principal component analysis(PCA), orthogonal partial least squares-discriminant analysis(OPLS-DA), and hierarchical cluster analysis(HCA). Furthermore, the fluorescent substrate was employed to investigate the inhibitory effects of different grades of Isatidis Radix decoction pieces on the neuraminidase of influenza virus. The rationality of the selected grading index components was verified by network pharmacology. The results showed that the diameter of decoction pieces had significantly positive correlations with other index components except moisture. Considering the existing commodity specifications, grading standards, and actual market circulation of Isatidis Radix, the quality grading standard of Isatidis Radix decoction pieces was developed with diameter as the appearance trait and(R,S)-goitrin as the limit index component of being qualified. On this basis, the content of ethanol-soluble extractives, total sinigrin, and total nucleoside were selected for quality grading. The in vitro enzyme activity evaluation showed that the first grade of Isatidis Radix decoction pieces had stronger inhibitory effect on the neuraminidase of influenza virus, and the network pharmacology results showed that the selected index components for quality grading had significant correlations with influenza. This study established a quality grading standard combining appearance traits and internal quality indexes, which provides a scientific basis for improving the existing grading standards and the price and quality of Isatidis Radix decoction pieces.
Isatis/chemistry* ; Plant Roots/chemistry* ; Drugs, Chinese Herbal/standards* ; Network Pharmacology ; Neuraminidase/antagonists & inhibitors* ; Quality Improvement/standards* ; Viral Proteins

Objective: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. Methods: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. Results: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range (IQR) : 2-5]. The median duration of polymyxin B treatment was 7 days (IQR: 5-11). Polymyxin B therapy had a median antipyretic time of 37 h (IQR: 32-70). The incidence of acute renal dysfunction was 14.8% (four out of 27 cases), all classified as "injury" according to RIFLE criteria. The incidence of hyperpigmentation was 59.3%. Conclusion: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.
Humans ; Polymyxin B/adverse effects* ; Retrospective Studies ; Gram-Negative Bacterial Infections/complications* ; Fever/drug therapy* ; Sepsis/drug therapy* ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/complications*

Objective:To systematically evaluate the efficacy of different kinds of smoking cessation drugs by network Meta-analysis.Methods:Literature was retrieved from PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP, Wan fang database, from the establishment of the database to November 2022, and randomized controlled trials (RCT) about bupropion, varenicline, nicotine replacement therapy (NRT) versus placebo in the treatment of smoking patients were collected. After data extraction from included literature which met inclusion criteria, and quality evaluation with Cochrane 5.1 risk bias evaluation tool, network Meta-analysis was performed by Stata15.1 software.Results:A total of 19 RCTs, involving 6106 patients and three interventions measures (bupropion, varenicline, NRT) and one control measure (placebo) were included. The results of network Meta-analysis showed that in terms of short-term abstinence rate, varenicline [ OR=4.21, 95% CI (2.32, 7.63)], bupropion [ OR=2.81, 95% CI(1.05, 7.54)] were better than placebo ( P<0.05). The surface under the cumulative ranking area (SUCRA): varenicline (90.2%)>bupropion (64.8%)>NRT (41.7%)>placebo (3.2%). In terms of the long-term abstinence rate, varenicline [ OR=3.06, 95% CI (1.59, 5.90)], NRT [ OR=3.39, 95% CI (2.20, 5.21)] were better than placebo ( P<0.05). SUCRA: varenicline (83.8%)>NRT (73.9%)>bupropion (37.2%)>placebo (5.2%). Conclusion:The existing evidence shows that compared with bupropion, NRT, varenicline has the best effect on quitting smoking, but more high-quality randomized trial evidence is needed for verification.

Background: and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS. Methods: We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences. Results: From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence. Conclusions The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.

To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.
Child ; Diagnosis, Differential ; Female ; Gingival Neoplasms/surgery* ; Granular Cell Tumor/surgery* ; Humans ; Male ; Pregnancy

OBJECTIVE：To systematically e valuate the efficacy and safety of expectorant/antioxidants in the treatment of chronic obstructive pulmonary disease （COPD），and to provide evidence-based reference for clinical use. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，Web of Science ，CBM，CNKI，VIP，Wanfang database ，etc.，randomized controlled trials（RCTs）about expectorant/antioxidants （trial group ）versus placebo （control group ）in the treatment of COPD were collected during the inception to May 2021. After literature screening and data extraction ，the quality of included literatures were evaluated with risk bias evaluation tool recommended by Cochrane systematic evaluator manual 5.1.0. The consistency check was performed by using Gemtc 14.3 software；network Meta-analysis ，clustering and hierarchical sorting were performed with Stata 15.1 software. The publication bias was analyzed by inverted funnel plot. RESULTS ：A total of 12 RCTs，involving 4 637 patients，were included. Five interventions measures were involved ，such as low-dose N-acetylcysteine （NAC），high-dose NAC ，carbo- cisteine， erdosteine and placebo. The results of network Meta-analysis showed that in terms of annual acute aggrava- tion rate ，the patients receiving high-do se NAC [MD ＝－0.45， 163.com 95％CI（－0.74，－0.17），P＜0.05]，carbocisteine [MD ＝－0.59，95％CI（－0.86，－0.32），P＜0.05] and erdosteine [MD ＝－0.26，95％CI（－0.51，－0.01），P＜0.05] in trial group were significantly lower than those in control group ；the annual acute aggravation rate of patients receiving high-dose NAC[MD ＝－0.55， 95％CI（－0.98，－0.11），P＜0.05] and carbocisteine [MD ＝－0.69，95％CI（－1.11，－0.26），P＜0.05] in trial group were significantly lower than those receiving low-dose of NAC ，there was no statistical significance among other groups （P＞0.05）； probability cumulative ranking results （calculated by the area under the curve ）of its network Meta-analysis was carbocisteine ＞ high-dose NAC ＞erdosteine＞placebo＞low-dose NAC. In terms of the incidence of ADR ，there was no statistical significance among groups （P＞0.05）；probability cumulative ranking results （calculated by the area under the curve ） of its network Meta-analysis was erdosteine ＞high-dose NAC ＞low-dose NAC ＞placebo＞carbocisteine. The results of clustering and hierarchical ranking showed that the efficacy and safety of the five interventions could be grouped into three categories ，including placebo and low-dose NAC with low efficacy and safety ，carbocisteine with good efficacy but low safety ，and high-dose NAC and erdosteine with good efficacy and safety. The results of publication bias showed that taking the annual acute exacerbation rate as the index ， there was a greater possibility of publication bias in this study ；taking the incidence of adverse event as index ，there was little possibility of publication bias in this study. CONCLUSIONS ：NAC，carbocisteine and erdosteine all can reduce the annual acute aggravation rate and have low incidence of ADR. Carbocisteine is the best in terms of annual acute aggravation rate ，erdosteine is the best in terms of safety. High-dose NAC and erdosteine are both better in term of efficacy and safety.

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
Acquired Immunodeficiency Syndrome/prevention & control* ; China/epidemiology* ; Disease Outbreaks ; HIV Infections/prevention & control* ; Humans ; Prevalence

The purpose of this experiment was to study the effects of different shading conditions on the growth,physiological characteristics and biomass allocation of Polygonatum cyrtonema,which offered a theoretical basis for its cultivation.Different light environments(100%,80%,60% and 35% light transmittance) were simulated with shading treatments.Growth and photosynthetic indexes of P.cyrtonema were measured and the variances were analyzed.The results show that shading decreased superoxide anion radical(O-·2)production rate and hydrogen peroxide(H_2O_2) accumulation,kept the activity of SOD,POD and CAT enzyme at a high level.Furthermore,The content of chlorophyll a and chlorophyll b,net photosynthetic rate(Pn),stomatal conductance(Gs),transpiration rate(Tr),maximal photochemical efficiency of photosystem Ⅱ(Fv/Fm),photochemical quenching index(q P) and effective quantum yield of photosystem II(ΦPSⅡ) of P.cyrtonema were increased while the intercellular CO2 concentration(Ci),Foand NPQ were decreased by shading.Shading is beneficial to P.cyrtonema growth,can increase the total biomass P.cyrtonema.The allocation proportion of biomass on the aerial portion of P.cyrtonema increased but underground parts decreased with increasing shading conditions.In this study,P.cyrtonema can grow well in shading conditions,shading is beneficial to the formation of the yield and quality of the rhizomes of P.cyrtonema,especially in 65% light transmittance.
Biomass ; Chlorophyll ; Chlorophyll A ; Photosynthesis ; Plant Leaves ; Plant Stomata ; Plant Transpiration ; Polygonatum ; growth & development ; physiology ; Sunlight

The study is aimed to explore the effect of combination use of nitrogen(N) and zinc(Zn) fertilizers on the growth, yield and the effective components of Agastache rugosa. A. rugosa was grown under two N application rate (120, 300 kg·hm⁻²) and five Zn levels (0, 20, 50, 100，150 kg·hm⁻²) under field condition. The effect of the treatments on the physiological indicators, distribution of nitrogen and zinc and volatile oil components of A. rugosa were studied. The results showed that the combination use of N and Zn could significantly affect the growth and development, yield and volatile oil components of A. rugosa. Under the test conditions, the highest yield of Agastaches Herba was obtained when 50 kg·hm⁻² of Zn fertilizer was applied with high N application rate of 300 kg·hm⁻². Under the same N application rate, the increase of Zn production was positively correlated with the amount of Zn application in a certain concentration range, but excessive Zn application led to the decrease of yield. With the increase of N application level, the content of Zn also significantly increased. The combination use of N and Zn increased the yield of Agastaches Herba. High level of N application was beneficial to the absorption and accumulation of N and Zn of A. rugosa. Zn fertilizer could also promote the absorption and accumulation of N of A. rugosa. The interaction between N and Zn had significant influence on the main chemical constituents of the volatile oil of A. rugosa. Among the volatile oil chemical constituents of A. rugosa the content of pulegone (34.56%-53.91%) and piperonyl methyl ether (18.86%-42.27%) were much higher. Under the same N application rate, different Zn application rates also had significant effects on the main chemical components of volatile oil.