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 analyze the clinical situation of critically ill children with Montgomery T-tube，aiming to summarize the characteristics of T-tube application in pediatric and the experience of postoperative airway management in PICU.Methods:The etiology，clinical characteristics，complications and ICU admissions of patients with Montgomery T-tube admitted to the Pediatric Hospital of Fudan University from April 2019 to December 2021 were analyzed，and the application of T-tube in patients with critical conditions requiring long-term mechanical ventilation was described in the light of clinical experience.Results:During the study period,seven children were admitted to the PICU after T-tube insertion,including three males and four females,aged 9~75 months.Five children received mechanical ventilation.Among them,there were five cases with congenital laryngeal malformations,one case with tracheoesophageal fistula,and one case with laryngeal papilloma.The main complications were sputum blockage,infection,and granulation proliferation.One child died of secretion blockage,while the other children were successfully evacuated from the T-tube.The longest retention time of the T-tube was 367 days.Five patients experienced hoarseness after removing the T-tube,and upon re-examination with fiberoptic bronchoscopy,no recurrence of subglottic stenosis was observed.There was no respiratory distress or wheezing,and there were no abnormalities observed during regular outpatient follow-up after discharge.After discharge,the quality of life of the six surviving children improved compared to preoperative,and they all resumed oral feeding.There were no complaints of swallowing difficulties or aspiration during outpatient follow-up.But they were all combined with malnutrition.Conclusion:The Montgomery T-tube is a secure and dependable airway stent utilized for airway remodeling and the maintenance of airway patency following interventional surgery.For critically ill children,early management of airway clearance and infection prevention are imperative.

Objective:To investigate the prevalence of sarcopenia among community-dwelling Chinese elderly and to explore the related factors.Methods:Data were obtained from the China Health and Retirement Longitudinal Survey(CHARLS)in 2015, an open national database.According to the criteria of the Asian Working Group(AWGS)on Sarcopenia in 2014, a cross-sectional survey was conducted on 7 584 Chinese residents aged 60 years and over who had undergone the standard sarcopenia test.General socio-demographic characteristics and living habits were compared between different gender groups.The prevalence of sarcopenia was analyzed with stratification.Multivariate Logistic regression analysis was used to analyze risk factors for sarcopenia.Results:The overall prevalence of sarcopenia was 6.4%(95% CI: 5.9-7.0)among the Chinese population aged 60 years or older.In the stratified analysis, the prevalence of sarcopenia was higher in males(9.9%, 95% CI: 9.0-10.9)than in females(3.0%, 95% CI: 2.4-3.5), in rural areas(7.2%, 95% CI: 6.5-7.9)than in urban areas(4.3%, 95% CI: 3.4-5.2), and in smokers(8.8%, 95% CI: 7.6-10.0)than in non-smokers(4.2%, 95% CI: 3.6-4.8). Multivariate Logistic regression showed that male gender( OR=5.368, 95% CI: 4.126-6.985)and old age( OR=1.191, 95% CI: 1.172-1.210)were risk factors for sarcopenia.In addition, the occurrence of sarcopenia was significantly associated with physical pain( OR=2.181, 95% CI: 1.695-2.673), alcohol consumption( OR=1.426, 95% CI: 1.057-1.923), low education level( OR=2.875, 95% CI: 1.577-5.241), increased waist circumference( OR=0.982, 95% CI: 0.973-0.990), decreased peak expiratory flow( OR=0.995, 95% CI: 0.994-0.997)and increased cystatin C levels( OR=2.088, 95% CI: 1.247-3.495)( P<0.05). Conclusions:The prevalence of sarcopenia is high among community-dwelling elderly in China, and the occurrence of sarcopenia is closely related to age, gender, education level, Waist circumference and alcohol consumption.

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction (CIPO) is a serious, life-threatening motility disorder that is often related to bacterial overgrowth. Fecal microbiota transplantation (FMT) results in restoration of the normal intestinal microbial community structure. We investigated the efficacy of FMT in the treatment of CIPO patients. METHODS: Nine patients (age 18–53 years) with CIPO were enrolled in this prospective, open-label study. Patients received FMT for 6 consecutive days through nasojejunal (NJ) tubes and were followed up for 8 weeks after treatment. We evaluated the rate of clinical improvement and remission, feeding tolerance of enteral nutrition, and CT imaging scores of intestinal obstructions. Lactulose hydrogen breath tests were performed before FMT and 8 weeks after FMT to evaluate for the presence small intestinal bacterial overgrowth (SIBO). RESULTS: FMT significantly alleviated bloating symptoms, and symptoms of pain were relieved 2 weeks after FMT. Enteral nutrition administered through a NJ tube after FMT was well-tolerated by 66.7% (6/9) of patients. CT scores of intestinal obstructions were significantly reduced after FMT (P = 0.014). SIBO was eliminated in 71.0% (5/7) of patients. CONCLUSIONS: This pilot study demonstrated the safety of using FMT. FMT may relieve symptoms in selected patients with CIPO. FMT may also improve patient tolerance of enteral nutrition delivered via a NJ tube.
Breath Tests ; Enteral Nutrition ; Fecal Microbiota Transplantation* ; Humans ; Hydrogen ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Lactulose ; Pilot Projects ; Prospective Studies

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015,so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015,and the cases increased by 14.08％compared with those in 2014. All the malaria cases were imported,and 5 cases(1.23％)were from Southeast Asia and 400(98.77％)were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province,where Taizhou,Lianyungang,Nantong,Huaian and Yangzhou cities accounted for 68.64％of all the cases in the province. Jiangsu Institute of Parasitic Diseases(JIPD)reference lab checked all the cases and classified 299 falciparum malaria cases,13 vivax malaria cases,18 quartan malaria cases,71 ovale malaria cas-es,and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province,there are no local malaria cases for 4 consecu-tive years,but the imported cases are on the rise. Compared to 2014,the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases,improve malaria diagnosis and treatment abili-ties for all levels of medical institutions,and promote the abilities of Plasmodium check,and focus survey and disposal of all Center for Disease Control(CDC)staffs across Jiangsu Province.

Clinical education for undergraduates in China can be divided into three phases:preclinical phase,clinical clerkship phase,clinical practice phase,and each phase has its own features and different teaching tasks.Currently there are four teaching methods mostly applied in clinical education:lecture-based Learning (LBL),team-based learning (TBL),case-based learning (CBL) and problem-based learning (PBL).LBL is a teacher-centered.teaching method,which focuses on making knowledge accurate,systematic and comprehensive;TBL,CBL and PBL are student-centered teaching methods,which can improve students' enthusiasm and subject initiative.Each teaching method has advantages and dis-advantages.According to the different characteristics of three stages of medical education,this paper analyzes the reasonable application of different medical teaching methods in three stages of undergraduate medical education:in preclinical stage,combining LBL with TBL teaching methods;in clinical clerkship phase,combining the teaching methods of LBL,TBL and CBL;in clinical practice stage,combining CBL with PBL teaching methods.

Objective To evaluate the efficacy of brief cognitive behavioral therapy (BCBT) combined with routine treatment (RT) for patients with schizophrenia in communities of Beijing.Methods 64 patients who met the criteria for schizophrenia according to the International Statistical Classification of Diseases and Related Health Problem,Tenth Revision (ICD-10) were randomly allocated to two groups,one group received 8 sessions of BCBT combined RT and the other group received only RT.All the subjects were evaluated using the Positive and Negative Syndrome Scale (PANSS),Schedule for Assessing Insight (SAI) and Personal and Social Performance Scale (PSP) at baseline,weeks 12,38 and 64.The effective and recurrence rates were also calculated and compared between the two groups.Results (1) Compared with the baseline,the scores of PANSS total (all P=0.000),PANSS-positive (all P=0.000),PANSS-negative (P=0.049,0.045,0.024) and PANSS-general (all P=0.000) in BCBT group decreased significantly at weeks 12,38 and 64.The scores of PANSS total (P=0.001,0.004)and PANSS-general (P=0.003,0.001)in RT group decreased significantly at 38 and 64 week and the score of PANSS-positive (P-0.002) in RT group decreased significantly at 38 week compared with the baseline.The scores of PANSS total (53.9± 10.9,51.0±11.1,48.1 ± 11.9)and PANSS-negative (12.1±4.3,12.1 ±4.3,11.2±4.4) in BCBT group were significandy lower than that in RT group (59.4±13.2,57.3±11.9,57.6±12.9;14.3±5.2,14.4±5.1,14.3±5.1) at 12,38 and 64 week (F=3.875,4.747,9.943 ; P=0.042,0.033,0.002 ; F=7.989,8.814,14.355 ; P=0.006,0.004,0.000)and the scores of PANSS-positive and PANSS-general were significantly lower than that in RT group (10.8±3.8 vs.12.8±4.3; 25.6±5.3 vs.28.7±6.8) at 64 week (F=5.223,P=0.040; F=4.229,P=0.044).(2) After treatment,the score of SAI in BCBT group increased significantly (P=0.000,0.001,0.000)and there was no change of SAI in RT group (all P=1.000).The score of SAI in BCBT group (9.4± 3.0,10.4±3.6) were significantly higher than that of RT group (7.0±3.7,7.8±3.9) at 12 and 64 week (F=8.139,8.936;P=0.006,0.004).(3) The scores of PSP in BCBT group increased significantly after treatment (all P＜0.01) and the scores of PSP in RT group increased significantly at 38 and 64 week (P=0.000,0.030).The scores of PSP in BCBT group (69.1±13.0,75.6± 12.6) were significantly higher than that of RT group (63.4±11.6,61.9± 10.8)at 38 and 64 week (F=7.548,21.419,P=0.042,0.000).(4) By the end of follow-up,the effective rates of CBT and RT group were 59.4％ (19/32) and 28.1％ (9/32) respectively and the difference between the two groups was significant (X2=6.349,P＜0.05).The recurrence rates of both groups were 9.4％ (3/32).Conclusions Both RT and BCBT combined with RT showed benefits on the overall symptoms,positive symptoms,general psychopathology symptoms and social functioning of community patients with schizophrenia,and the latter had better effect than the former in the long term.Adjunct BCBT could also improve patients' negative symptoms and insight better than only RT.

Objective To evaluate the efficacy of brief cognitive behavioral therapy (BCBT) combined with routine treatment (RT) for patients with schizophrenia in communities of Beijing.Methods 64 patients who met the criteria for schizophrenia according to the International Statistical Classification of Diseases and Related Health Problem,Tenth Revision (ICD-10) were randomly allocated to two groups,one group received 8 sessions of BCBT combined RT and the other group received only RT.All the subjects were evaluated using the Positive and Negative Syndrome Scale (PANSS),Schedule for Assessing Insight (SAI) and Personal and Social Performance Scale (PSP) at baseline,weeks 12,38 and 64.The effective and recurrence rates were also calculated and compared between the two groups.Results (1) Compared with the baseline,the scores of PANSS total (all P=0.000),PANSS-positive (all P=0.000),PANSS-negative (P=0.049,0.045,0.024) and PANSS-general (all P=0.000) in BCBT group decreased significantly at weeks 12,38 and 64.The scores of PANSS total (P=0.001,0.004)and PANSS-general (P=0.003,0.001)in RT group decreased significantly at 38 and 64 week and the score of PANSS-positive (P-0.002) in RT group decreased significantly at 38 week compared with the baseline.The scores of PANSS total (53.9± 10.9,51.0±11.1,48.1 ± 11.9)and PANSS-negative (12.1±4.3,12.1 ±4.3,11.2±4.4) in BCBT group were significandy lower than that in RT group (59.4±13.2,57.3±11.9,57.6±12.9;14.3±5.2,14.4±5.1,14.3±5.1) at 12,38 and 64 week (F=3.875,4.747,9.943 ; P=0.042,0.033,0.002 ; F=7.989,8.814,14.355 ; P=0.006,0.004,0.000)and the scores of PANSS-positive and PANSS-general were significantly lower than that in RT group (10.8±3.8 vs.12.8±4.3; 25.6±5.3 vs.28.7±6.8) at 64 week (F=5.223,P=0.040; F=4.229,P=0.044).(2) After treatment,the score of SAI in BCBT group increased significantly (P=0.000,0.001,0.000)and there was no change of SAI in RT group (all P=1.000).The score of SAI in BCBT group (9.4± 3.0,10.4±3.6) were significantly higher than that of RT group (7.0±3.7,7.8±3.9) at 12 and 64 week (F=8.139,8.936;P=0.006,0.004).(3) The scores of PSP in BCBT group increased significantly after treatment (all P＜0.01) and the scores of PSP in RT group increased significantly at 38 and 64 week (P=0.000,0.030).The scores of PSP in BCBT group (69.1±13.0,75.6± 12.6) were significantly higher than that of RT group (63.4±11.6,61.9± 10.8)at 38 and 64 week (F=7.548,21.419,P=0.042,0.000).(4) By the end of follow-up,the effective rates of CBT and RT group were 59.4％ (19/32) and 28.1％ (9/32) respectively and the difference between the two groups was significant (X2=6.349,P＜0.05).The recurrence rates of both groups were 9.4％ (3/32).Conclusions Both RT and BCBT combined with RT showed benefits on the overall symptoms,positive symptoms,general psychopathology symptoms and social functioning of community patients with schizophrenia,and the latter had better effect than the former in the long term.Adjunct BCBT could also improve patients' negative symptoms and insight better than only RT.

Objective To investigate the effect of small interfering RNA (siRNA) targeting cytoplasmic domain of tissue factor on apoptosis of vascular endothelial cells. Methods Specific siRNA targeting cytoplasmic domain of tissue factor were designed, and synthetic oligos were inserted into plasmid DNA. The siRNA constructs were transfected into human umbilical vascular endothelial cells (HUVEC) with liposome. The HUVEC were transfected with the constructs encoding siRNA Ⅰ, siRNA Ⅱ and pcDNA~(TM)6.2 GW/-miR plasmid separately. The transfected HUVEC were mixed with CD8~+ T lymphocytes. The apoptotic rate of tranfected HUVEC mixed with lymphocytes was analyzed by flow cytometry. Magnetic beads were used to measure PT of the supematant in the mixed lymphocytes culture. Results The siRNA constructs were confirmed by DNA sequence analysis. The apoptotic rate of HUVEC transfected with siRNA Ⅰ and Ⅱ plasmids was decreased significantly as compared with the empty control group (P<0.01). The apoptosis rate of HUVEC transfected with siRNA Ⅰ plasmid was lower than that of HUVEC transfected with siRNA Ⅱ plasmid (P<0.05). APTT of the culture supernatants in the three transfection groups was lower in the control groups (P <0.05), but there was significant difference among the three transfection groups. Conclusion The siRNA targeting cytoplasmic domain of tissue factor were successfully constructed, siRNA can protect HUVEC, and reduce the apoptotic rate of endothelial cells in mixed lymphocyte reaction without influencing the coagulation function.