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 explore the diagnostic accuracy of muscle ultrasound and plasma monocyte chemoattractant protein-1 (MCP-1) for ICU-acquired weakness (ICU-AW) in patients with sepsis.Methods:A prospective observational study was conducted. Patients with sepsis admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from April 2021 to October 2021 were enrolled. The demographic data were collected. The enrolled patients were evaluated with Medical Research Council (MRC) score every day until discharged from ICU. During this period, patients with total MRC score < 48 (for two consecutive times and a time interval of 24 hours) were divided into ICU-AW group, those with total MRC score ≥ 48 were served as non-ICU-AW group. On the 1st, 4th and 7th day following admission into ICU, ultrasound was used to measure the muscle linear thickness of the rectus femoris (RF-MLT), the cross sectional area of the rectus femoris (RF-CSA) and the muscle linear thickness of the vastus intermedius muscle (VI-MLT). And meanwhile, the plasmas samples of patients were collected to measure MCP-1 concentration by enzyme-linked immunosorbent assay (ELISA). The difference of each index was compared between the ICU-AW group and the non-ICU-AW group. The risk factors of ICU-AW in patients with sepsis were analyzed by binary Logistic regression. Besides, receiver operator characteristic curve (ROC curve) was plotted, the diagnostic value of ultrasound parameters and plasma MCP-1 level for ICU-AW in patients with sepsis was analyzed.Results:A total of 99 septic patients were enrolled, with 68 patients in the ICU-AW group and 31 patients in the non-ICU-AW group. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group tended to be older, and had higher sequential organ failure assessment (SOFA) score, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, higher rates of septic shock, higher blood lactic acid and lower Glasgow coma score (GCS). Binary Logistic regression analysis showed that APACHEⅡ score and septic shock were the risk factors of ICU-AW for septic patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.310 (1.138-1.509) and 0.232 (0.072-0.746), respectively, both P < 0.05]. The RF-MLT, RF-CSA and VI-MLT on the 1st, 4th and 7th ICU day was falling over time. Compared with the patients in the ICU-AW group, the patients in the non-ICU-AW group had smaller RF-MLT on the 7th day [cm: 0.32 (0.22, 0.47) vs. 0.45 (0.34, 0.63), P < 0.05] and higher 7-day RF-CSA atrophy rate [25.85% (10.37%, 34.28%) vs. 11.65% (2.28%, 22.41%), P < 0.05]. According to ROC curve analysis, 7-day RF-MLT had diagnostic value for ICU-AW of septic patients. Area under ROC curve (AUC) was 0.688 (95% CI was 0.526-0.849); when the cut-off value was 0.41 cm, the sensitivity and the specificity were 66.7% and 68.4%. The levels of plasma MCP-1 in the ICU-AW group were significantly higher than those in the non-ICU-AW group on the 1st, 4th and 7th day. ROC curve analysis showed that the plasma MCP-1 levels on the 1st, 4th and 7th day played a significant role to diagnose ICU-AW for septic patients, the AUC and 95% CI were 0.732 (0.629-0.836), 0.865 (0.777-0.953), 0.891 (0.795-0.986), respectively. When the cut-off values were 206.3, 410.9, 239.5 ng/L, the sensitivity was 87.1%, 64.0%, 82.4%, and the specificity was 54.4%, 96.1%, 86.2%, respectively. Conclusion:The muscle mass parameters on the 7th day of bedside ultrasound and plasma MCP-1 levels had certain diagnostic values for ICU-AW in patients with sepsis.

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Objective Serum glycated albumin (GA) is associated with the levels of blood glucose and short term glycemic fluctuation. The aim of this study was to investigate the associations between GA and arterial stiffness in a health screening population. Method A total of 11 014 participants (men, 56.2%;mean age, 46.8±7.8 years) who attended physical examination were invited and had completed standardized questionnaires. Serum GA and homocysteine (HCY), brachial-ankle pulse wave velocity (baPWV), and central systolic blood pressure (cSBP) were measured. A series of single and multiple factor analyses and stratified analysis were performed. Result The mean level of serum GA was lower in men (13.69 ± 2.69) than in women (13.82 ± 1.92) (t=2.78, P=0.005). The values of baPWV (men: F=53.9, P for trend<0.001;women:F=37.7, P for trend<0.001) and cSBP (men:F=10.3, P for trend<0.001;women:F=13.5, P for trend<0.001) increased with quartiles of GA levels in both men and women. After adjustment for age, history of hypertension, diabetes, family history of diabetes, smoking status, body mass index, waist circumference, blood pressure, blood lipids, kidney function, fasting glucose, postprandial glucose, and hemoglobin A1c, GA was positively associated with baPWV (βestimate, 0.019;95%CI:0.002-0.036;P=0.032) and cSBP (βestimate, 0.251; 95% CI: 0.107-0.394; P=0.001) in men. Stratified analysis also showed that the positive associations of GA with baPWV and cSBP remained significant in men both with and without diabetes or hypertension (P<0.05). However, the association between GA and HCY was not significant in multifactor analysis and stratified analysis. The above results were similar in women. Conclusion Serum GA levels were positively associated with baPWV and cSBP not only in patients with diabetes or hypertension but also in participants without diabetes or hypertension after adjusting for conventional factors and glucose markers. The findings suggest that GA may help detect the development of arterial stiffness in the health screening population.

Objective To analyze related behaviors of individual preparedness and influencing factors on violent terrorist attacks among undergraduates.Methods A total of 1 800 undergraduates from 5 colleges or universities in Guangzhou were selected,using the stratified cluster method.A questionnaire involving the response to violent terrorist attack behavior was used to assess the individual preparedness behaviors among undergraduates.A self-made questionnaire was applied to collect information on demographic factors,cognitive and preparedness behaviors.Results The mean score of individual preparedness behavior among undergraduates was 13.49 ± 5.02 while information on seeking behavior was 4.27 ± 1.64,avoidance behavior was 5.97± 2.16 and violent terrorist attack response behaviors was 23.73 ± 7.21,with 30.0 percent of undergraduates behaved properly.Significant differences were found in the scores of behaviors on the response to violent terrorist attack with different gender,major they pursue or religious belief (P＜0.05),among undergraduates involved in this study.Results from the logistic regression analysis revealed that persons being girls (OR=1.46,95％ CI:1.06-2.01),with bigger perceived probability (OR=1.60,95％ CI:1.12-2.30),with higher alertness (OR=3.77,95％ CI:2.15-6.61),with stronger coping confidence (OR=0.34,95％ CI:0.24-0.48) and bigger affective response (OR1=3.42,95％ CI:2.40-4.86; OR2 =0.23,95 ％ CI:0.1 3-0.41),would present more prominent behavior responses when facing the violent terrorist attack.Conclusion Individual response behaviors to violent terrorist attacks among undergraduates were relatively ideal.Perceived probability,alertness,coping confidence and affective response appeared to be independent influencing factors related to response behaviors against violent terrorist attack.In colleges and universities,awareness on violent terrorist attacks should be strengthened among undergraduates.Focus should target on psychological education dealing with disaster,knowledge and skills needed for emergency response,so as to respond to the emergency on campus.

OBJECTIVETo study the incidence and influencing factors of psychological violence among college students in Guangzhou in 2010.

METHODSConvenience sampling method was used and 2 200 college students from 61 classes of three universities in Guangzhou were interviewed with self-designed questionnaire about the incidence and influencing factors of the psychological violence in 2010. The valid sample was 2 060. Chi-square test and multinomial logistic regression were used to assess the incidence and influencing factors of the psychological violence between different genders.

RESULTSA total of 66.3% (1 365/2 060) college students reported having experienced at least one kind of psychological violence during the past 12 months, either as a perpetrator or as a victim. The proportion of psychological violence among males (72.3%, 775/1 072) was significantly higher than that in females (59.7%, 590/988)(χ(2) = 36.39, P < 0.05). The incidence of perpetration only, victimization only, and both perpetration and victimization of psychological violence were 16.1% (331/2 060), 8.9% (184/2 060) and 41.3% (850/2 060), respectively. The incidence of victimization only in females was 10.4% (103/988), which was significantly higher than that in males (7.6%, 81/1 072) (χ(2) = 5.20, P < 0.05). The incidence of both perpetration and victimization in males was 47.3% (507/1 072), which was significantly higher than that in females (34.7%, 343/988) (χ(2) = 33.56, P < 0.05). In males, the multinomial logistic regression showed the risk factors for perpetration only was having harmful behavior habits (OR = 1.90). For victimization only, the risk factors were with siblings (OR = 2.42) and prior mistreatment by teachers from primary to senior high school (OR = 1.78). For both perpetration and victimization, the risk factors were with siblings (OR = 1.88), having harmful behavior habits (OR = 1.98), bad family economic conditions (difficult OR = 1.99, general OR = 1.67) and prior mistreatment by teachers from primary to senior high school(OR = 2.07). In females, the risk factors for perpetration only were self-claimed shortage of monthly living expenses(OR = 2.14) or just enough (OR = 2.26), having harmful behavior habits (OR = 1.69) (all P values<0.05) . For victimization only, the risk factors were bad family economic conditions (difficult OR = 6.67, 15 persons; general OR = 3.81), bullied by others before university(OR = 2.05). For both perpetration and victimization, the risk factors were self-claimed shortage of monthly living expenses (OR = 1.81), bad family economic conditions (OR = 2.43), disharmonious relations between parents (OR = 1.76), physical punishment by parents (OR = 1.66), bullied by others before university (OR = 2.14) and prior mistreatment by teachers from primary to senior high school(OR = 1.73). Having a religious faith was the protective factor (OR = 0.38) (all P values<0.05).

CONCLUSIONThe incidence of psychological violence among college students is very serious in Guangzhou in 2010. And the influencing factors of it between different genders are different. Females are affected by a wider ranges of factors than males, and are more influenced by family and parents.

Adolescent ; Aggression ; classification ; psychology ; Family ; psychology ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Risk Factors ; Sex Factors ; Stress, Psychological ; epidemiology ; Students ; Surveys and Questionnaires ; Universities

Objective To assess the effect of lifestyle intervention on risk factors of chronic disease.Methods A total of 400 adults with high-risk of chronic disease received 3 months' lifestyle intervention.The effect of lifestyle intervention was then estimated.Results A total of 387 adults took physical examination.After lifestyle intervention,body mass index,waist circumference,blood pressure,glucose,glyceride,total cholesterol,and high density liopportein were significant decreased (t values were 27.50,19.01,7.46,6.56,5.29,7.74,7.27 and-7.64,respectively; all P＜0.05); however,low density liopportein showed no significant difference (t=0.73,P=0.469).A total of 373 adults had lifestyle and cardiovascular risk estimated.The scores of lifestyle and physical exercise showed statistically significant difference before and after lifestyle intervention (x2 values were 48.405 and 50.778,respectively; both P＜0.05).However,diet,alcohol drinking and cigarette smoking showed no significant difference (x2 values were 0.087,0.112 and 1.410,respectively; all P＞0.05).Moreover,the estimated cardiovascular risk showed significant difference (x2=10.284,P＜0.05).Conclusion Lifestyle intervention could be an effective tool for those with higher risk of chronic disease.

Objective To provide scientific support for the prevention and control of expressway traffic injury by analyzing the epidemiological features of expressway traffic injury in China.Methods The secular trend and epidemiologic features of expressway traffic injury from 1994 to 2009 in China were analyzed.The indicators including mortality of mileage,accident rate of mileage,and accident mortality were used to evaluate the severity of expressway traffic injury in China.Cluster analysis was used to compare the differences of accident rate of mileage and accident mortality from 29 provinces,municipalities and autonomous regions.Results Except for the yearly increase of the accident mortality and the fluctuant decrease of the mortality and accident rate of mileage,other indicators reflecting the domestic expressway traffic injury from 1994 to 2009 were increased and then decreased,when the decreased indicators were still higher than those in 1994.In addition to the number of accidents of the four basic traffic injury indicators,the proportions of other three indicators(number of wounded and death,direct property damage)in the road traffic injury were increased year by year and the increase was the most obvious in regard of the direct property damage which had accounted for more than 30％ since 2006.The data from 2007 to 2009 showed that the peak time of traffic accidents was at around 4:00 am and around 4:00 pm.The traffic accidents caused by the drivers accounted for 93.02％ and the drivers with less than five years of driving accounted for 40.92％.Pedestrians and passengers were vulnerable to the expressway traffic injury and the accident mortality was the highest(72.75 per 100 accidents).Rear collision(44.17％)and bumping the fixed objects(16.35％)were the major accident types.There was a high accident proportion on the dry road(77.60％)and sunshine day(65.39％).Conclusions With worsening situation of the expressway traffic injury in China,we should,based on the epidemiological features of traffic injury on expressway,take appropriate measures such as strengthening traffic management of expressway and education of road users and improving the emergency medical service level.