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 investigate the unmet needs for assistive technology for people with physical disabilities in Chengdu,and analyze the related factors. Methods From November,2023 to March,2024,the persons with physical disabilities in Chengdu were selected from Sichuan Individuation service platform,and investigated using World Health Organization rapid Assistive Tech-nology Assessment. Results A total of 558 questionnaires were set up,and 527 effective questionnaires retured.26.8%of them reported un-met needs for aids,with the highest need for mobility aids(66.0%).Lack of support(54.9%),high price(26.3%)and lack of knowledge about aids(20.3%)were the main reasons for not obtaining the aids they needed.Loss of spouse(OR=3.615),serious mobility impairment(OR＞2.926)and serious self-care impairment(OR＞2.781)were the risks of unmet needs for aids. Conclusion It is important to popularize policies and products of aids,pay attention to personal adaptation for people with different barriers,and strengthen the service system,to meet the needs of people with disabilities.

AIM: To explore the improvement effect and mechanism of crocin on cognitive impairmrnt of Alzheimer's disease (AD) rats. METHODS: The hippocampus of SD rats were injected with Aβ 25-35 to establish AD model, then rats were randomly divided into AD group, AD + low, medium, high dose of crocin groups (10, 20, 40 mg/kg) and AD + donepezil group (1 mg/kg), intraperitoneal injection treatment for 4 weeks, set sham group. Dark avoidance test and water maze test were used to evaluate the learning and memory abilities of rats, ELISA was used to detect serum Aβ content, HE staining and Tunel staining were used to determine pathological changes and neuronal apoptosis of hippocampus of rats, immunohistochemistry was used to detect the expression of Brdu, Dcx and NeuN in hippocampus of rats, and Western blot was used to detect the protein expression of Aβ, DKK3, β-catenin, p-GSK-3β/GSK-3β, Caspase-3, Bax, Bcl-2 in hippocampus of rats. RESULTS: Compared to sham group, the learning and memory abilities of AD group rats were decreased, serum Aβ content increased, the pathological change in hippocampus was serious, neuronal apoptosis was increased, the expression of Brdu, Dcx, NeuN were decreased, the protein expression of Aβ, DKK3, p-GSK-3β/GSK-3β, Caspase-3, Bax were increased, protein expression of β-catenin, Bcl-2 were decreased (P<0.01). Compared to AD group, after the treatment of doses of crocin and donepezil, the learning and memory abilities of AD rats were improved, serum Aβ content were increased, and the pathological change in hippocampus were alleviated, neuronal apoptosis were reduced, the expression of Brdu, Dcx, NeuN were decreased, the protein expression of Aβ, DKK3, p-GSK-3β/ GSK-3β, Caspase-3, Bax were decreased, the protein expression of β-catenin, Bcl-2 were increased, notely, dose-dependent effect of crocin was significant. CONCLUSION: Crocin reduced neuronal apoptosis and mediated DKK3 to regulate GSK-3β/ β-catenin pathway to improve the cognitive impairment of AD rats.

ObjectiveIn view of the problems of large errors and poor accuracy in pulmonary function testing in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a predictive classification model of pulmonary function in patients with AECOPD was proposed by comparing the prediction performance of different machine learning models to find the optimal model. MethodsFrom January, 2018 to February, 2020, 90 patients with different degrees of COPD from the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University were collected. Six machine learning model algorithms (K-nearest neighbor, logistic regression, support vector machine, naive Bayes, decision tree and random forest) were used to establish AECOPD predictive classification models. Their area under the curve of receiver operating characteristic (AUC-ROC) and accuracy were compared. Ten-fold cross-validation method was used to validate the data set. ResultsThe model based on random forest worked best in predicting and classifying AECOPD patients, with an accuracy rate of 0.844 and an AUC-ROC of 0.916. ConclusionRandom forest-based predictive model is a powerful tool for identifying patients with AECOPD, providing decision support when it is difficult to give a definitive diagnosis.

Objective:To investigate the clinical characteristics, response, and prognosis of splenic diffuse red pulp small B-cell lymphoma (SDRPL) .Methods:Eight cases of SDRPL were diagnosed and treated at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, between May 2017 and April 2022. Data on the clinical features, laboratory results, bone marrow and spleen biopsy results, response, and prognosis were collected and analyzed.Results:The median age at diagnosis was 54 (42-69) years. Splenomegaly and lymphocytosis were present in all cases, and PET/CT revealed normal to slightly elevated splenic FDG uptake. All cases were in stage Ⅳ, with spleen, peripheral blood, and bone marrow but no proximal lymph nodes involved. The cytoplasm of neoplastic villous cells was abundant, and splenic pathology showed that small homogenous lymphocytes permeated the splenic sinus and splenic cord, and the white pulp atrophied. Immunohistochemistry was not typical, and B-cell markers including CD19, CD20 and CD79α were positive. After a median follow up of 35.5 (4-60) months, 7 cases were alive after splenectomy with or without chemoimmunotherapy. The patient with CCND3 P284A and MYC S146L mutation developed to B-cell prolymphocytic leukemia (B-PLL) 1 month after splenectomy and died at 16 months of follow-up.Conclusion:A rare indolent B-cell lymphoma that primarily affects the elderly, SDRPL. Most patients achieved long-term survival, but the prognosis of patients who progress to B-PLL was poor.

Objective:To prepare 99Tc m-hydrazinonicotinamide(HYNIC)-αCD8/Fab ( 99Tc m-αCD8/Fab), and explore the predictive value of 99Tc m-αCD8/Fab SPECT/CT imaging for the efficacy of anti-programmed death-1 (PD-1) immunotherapy. Methods:The αCD8/Fab was modified with HYNIC- N-hydroxysuccinimide (NHS) and IRDye800-NHS to form HYNIC-αCD8/Fab and IRDye800-αCD8/Fab (Dye-αCD8/Fab), respectively. 99Tc m-αCD8/Fab was prepared in sodium bicarbonate buffer (pH=8.5), with SnCl 2 being used as the reducing agent. The labeling yield and radiochemical purity of 99Tc m-αCD8/Fab and its stability in PBS and fetal bovine serum (FBS) were tested in vitro. The mouse spleen and human peripheral blood lymphocytes were isolated for cell-specific binding and blocking experiments of 99Tc m-αCD8/Fab in vitro. SPECT/CT imaging was used to analyze the specific binding ability of the 99Tc m-αCD8/Fab probe in CT26 colon cancer mouse models (BALB/c). The near infrared fluorescence imaging and SPECT/CT imaging were performed to detect the intra-tumoral CD8 + T cell infiltration after anti-PD-1 therapy in tumor bearing mice, and the results were further verified by HE and immunofluorescence staining. CD8 + T cell depletion study was performed to determine the role of CD8 + T cells in the tumor responses to anti-PD-1 therapy. Two-way analysis of variance was used to compare the data difference. Results:The labeling yield of 99Tc m-αCD8/Fab was 90% with a high radiochemical purity (95%) and good stability in vitro (radiochemical purity still more than 80% after 720 min in PBS and FBS). 99Tc m-αCD8/Fab could specifically bind to mouse CD8 + T cells ((10.30±0.81) percent added radioactive dose (%AD)/10 6 cells), compared with the binding ability in human peripheral blood lymphocytes group and CD8 antibody blocking group ((1.78±0.61) and (1.59±0.25) %AD/10 6 cells; F=10.07, P<0.001). SPECT/CT imaging showed that 99Tc m-αCD8/Fab had markedly higher tumor uptake in the CT26 colon cancer mouse models. Near-infrared fluorescence imaging showed that the tumor uptake of 99Tc m-αCD8/Fab in the responsive group was significantly higher than in the nonresponsive group after anti-PD-1 treatment ((8.9±1.1)% vs (7.1±0.8)%; F=4.69, P=0.024), and SPECT/CT imaging found the similar result. HE and immunofluorescence staining of tumor and lymph nodes showed that the proportion of lymphocyte infiltration was higher in the responsive group. Furthermore, CD8 + T cell depletion significantly reversed the therapeutic effect of anti-PD-1 immunotherapy in tumor-bearing mice. Conclusions:In this study, 99Tc m-αCD8/Fab was successfully obtained. CD8-specific SPECT imaging could sensitively visualize the tumor-infiltrating CD8 + T cells, suggesting the potential application value to predict and evaluate the efficacy of immunotherapy in the clinical settings.

OBJECTIVE: To assess the reliability and validity of Adversity Quotient Scale in evaluating the adversity quotient among nurses. METHODS: A total of 409 nurses were selected as study subjects from three first-class hospitals in Fujian Province by cluster sampling method. The adversity quotient was investigated by Adversity Quotient Scale and its reliability and validity were tested. RESULTS: The Cronbach′s alpha coefficient, Spearman-Brown coefficient, Guttman Split-Harf coefficient and retest reliability of Adversity Quotient Scale were 0.931, 0.826, 0.823 and 0.940, respectively. The content validity ratio of Adversity Quotient Scale was 0.980. The scores of control, attribution, extension and tolerance factors were positively correlated with the total score of Adversity Quotient Scale(correlation coefficients were 0.813, 0.844, 0.874 and 0.822, respectively, P<0.05). Before model modification, the initial model fitting index of confirmatory factor analysis was χ~2/df=3.72, root mean square residual approximate(RMSEA)=0.09, the overall fitting of the model was not high. After model modification, the combined reliability of control, attribution, extension and tolerance factors were 0.780, 0.796, 0.831 and 0.871, respectively. The fitting index of the modified model was χ~2/df=3.08, RMSEA=0.07, showing a good fitting of the model. CONCLUSION: Adversity Quotient Scale has a good reliability and validity in the assessment of nurses, which can be a reliable and effective adversity quotient assessment tool.

Disulfiram, a drug that has been used for alcohol dependence. As an approved drug in clinical medicine, disulfiram can be used as the anticancer drug in the treatment of breast cancer, prostate cancer, glioblastoma, lung cancer, etc. This paper summarized the mechanism of disulfiram for anticancer treatment and the function for liver cancer therapy, and we also analyzed the potential mechanism of disulfiram for the treatment of liver cancer and its’ value in the clinical application.

Purpose To investigate the clinicopathological characteristics and treatment of combined hepatocellular carcinoma-cholangio carcinoma (cHCC-CC).Methods 24 cases of cHCC-CC were collected.The clinical pathological characteristics,imaging,immunophenotyping and clinical features were retrospectively analyzed and reviewed the literature.Results There were 18 males and 6 females in 24 cases of cHCC-CC.The age ranged from 36 to 68 years (mean age was 54.38).Tumour location:right hepatic lobe in 15 cases,left hepatic lobe in 6 cases,both left lobe and right hepatic lobe in 1 case,hepatic caudate and left lateral lobe in 1 case,diffuse nodular liver tumors in 1 case.Grossly,the texture and color of tumor was related to the composition of tumor.Microscopically,classic cHCC-CC had two areas composed of hepatocellular carcinoma area and cholangiocar cinoma area of mixed distribution or migration distribution.3 cases were cHCC-CC with stem cell properties (cholangiolocellular carcinoma type,CLC type).Immunohistochemical staining revealed that HCC like area mainly expressed CD10,CK8,Hepatocyte and CD10,cHCC-CC area expressed CK7 and EMA.CLC type expressed the immunophenotypic features of intermediate type of HCC.Conclusion The clinical manifestations of cHCC-CC are not specific,the preoperative diagnosis is difficult,and it should be combined with pathological characteristics,imaging features and immunophenotype diagnosis.

Objective To investigate the status of sleep quality and the family-related factors among elder-ly pregnant women who already have one child.Methods A total of 299 elderly pregnant women who already have one child were investigated using pittsburgh sleep quality index(PSQI),family APGAR index and a self-designed questionnaire. Results The total prevalence of poor sleep quality was 30.8% among elderly pregnant women who already have one child.PSQI score was average(6.31 ± 2.95). PSQI score were higher than the adult female norm and pregnant woman for the first time(u=16.396,5.497,P<0.05).Univariate analysis showed that the determi-nants of sleep quality included pregnancy,family support(parents),family support(husband),family support (child),family dysfunction,family right(χ2= 12.312,21.049,18.617,11.682,13.494,6.779,P < 0.05). Logistic regression analysis showed that pregnancy,family support(parents),family support(husband),family support(child)and family dysfunction were associated with sleep quality. Conclusion The poor sleep quality among elderly pregnant women who already have one child is related to low family support(parents,husband, child),obstacle of family dysfunction and late pregnancy.