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 retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective:To evaluate and compare efficacy of intravenous immunoglobulin (IVIG) versus recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR:Fc) in the treatment of toxic epidermal necrolysis (TEN) .Methods:Clinical data were collected from patients with TEN treated with IVIG or rhTNFR:Fc in Wuhan No.1 Hospital from 2013 to 2019. There were 11 patients in the IVIG group, including 3 males and 8 females, aged 25-72 years, and the median TEN-specific severity-of-illness score (SCORTEN) was 3 points; there were 10 patients in the rhTNFR:Fc group, including 5 males and 5 females, aged 32-84 years, and the median SCORTEN was 2 points. These patients all showed no response to the 5-day treatment with prednisolone acetate at a dose of 0.6-1.0 mg·kg -1·d -1, and then received IVIG at a dose of 400 mg·kg -1·d -1 for 5 consecutive days, or subcutaneous injection of rhTNFR:Fc at a dose of 25 mg every other day for 4-6 sessions. Changes in skin lesions and adverse events were recorded in the 2 groups. Statistical analysis was carried out by using Mann-Whitney U test. Results:Compared with the rhTNFR:Fc group, the IVIG group showed a significant decrease in the time to onset of reduction of skin lesion exudate (1.73 ± 1.19 days vs. 3.00 ± 1.56 days, P < 0.05) , time to onset of pain relief in the lesion area (1.64 ± 1.28 days vs. 3.70 ± 1.63 days, P < 0.05) , time to lightening of color of the lesion base (2.45 ± 1.12 days vs. 3.90 ± 1.59 days, P < 0.05) , time to onset of new epidermis growth (3.09 ± 1.13 days vs. 5.20 ± 1.22 days, P < 0.05) , and in the time to onset of lesion drying at the intertriginous sites (4.82 ± 2.22 days vs. 7.90 ± 3.14 days, P < 0.05) . However, there was no significant difference in the length of hospital stay between the IVIG group (17.70 ± 8.33 days) and rhTNFR:Fc group (16.70 ± 4.71 days, P > 0.05) . No adverse reactions were observed during the treatment, and no recurrence or complications were found in the 21 patients during the follow-up of 6 months. Conclusion:IVIG and rhTNFR:Fc are both effective in the treatment of TEN, but IVIG is superior to rhTNFR:Fc in terms of the time to onset of pain relief, skin lesion exudate reduction and epidermal growth.

Objective:To evaluate the effectiveness of HIV/syphilis joint self-testing in promoting syphilis testing among men who have sex with men (MSM).Methods:In July 2019, the research participants were recruited through the Danlan website (https://www.danlan.org). Participants who met the selection criteria, and were randomly assigned into one of the three study groups (1∶1∶1) including HIV/syphilis joint self-testing group and lottery incentive self-testing group and control group. Self-test reagents were mailed to HIV/syphilis joint self-testing group and lottery incentive self-testing group, and the subjects in control group were encouraged to go to offline locations for testing. One month later, follow-up was conducted to evaluate the differences in the testing rates of syphilis among the three groups.Results:A total of 145 subjects were included in this study, including 48 in control group, 49 in HIV/syphilis joint self-testing group and 48 in lottery incentive self-testing group. During the follow-up period, the self-testing rate of syphilis was 74.4% (32/43) in HIV/syphilis joint self-testing group, 70.0% (28/40) in lottery incentive self-testing group and 36.4% (16/44) in control group. Multivariate logistic analysis revealed that the proportions of syphilis testing in HIV/syphilis joint self-testing group and lottery incentive self-testing group were 5.38 (95% CI: 2.06-14.04) times and 4.54 (95% CI: 1.75-11.74) times higher than that in control group during the follow-up period. Conclusions:HIV/syphilis joint self-testing and lottery-incentives-prompted self-testing significantly increased the testing rate of syphilis in MSM, respectively. HIV/syphilis joint self-testing is feasible for promotion.

The etiology of inflammatory bowel disease (IBD) is unclear, and its treatment is difficult. The correct diagnosis of IBD is crucial for treatment, but there is a lack of the diagnostic gold standard. A comprehensive diagnosis and analysis combined with clinical manifestations, endoscopy, imaging and histopathology is required. Therefore, the problem to be solved urgently is to develop a personalized treatment plan through a standardized multidisciplinary treatment (MDT) and the optimized combination of existing diagnosis and treatment methods, so as to improve the efficacy. Based on the current situation of IBD diagnosis and treatment, with reference to the successful experience of MDT diagnosis and treatment at home and abroad, and combined with China′s national conditions, this consensus is finally formulated by organizing multiple experts in relevant fields to conduct online voting. The significance, the institutional composition, the operating mode, the clinical practice and the MDT integrated management are discussed in detail. Through the formulation and publication of this consensus, we hope that it can promote the development of standardized IBD-MDT, improve the therapeutic efficacy of IBD in China, and strengthen the training of professionals.

The etiology of inflammatory bowel disease (IBD) is unclear, and its treatment is difficult. The correct diagnosis of IBD is crucial for treatment, but there is a lack of the diagnostic gold standard. A comprehensive diagnosis and analysis combined with clinical manifestations, endoscopy, imaging and histopathology is required. Therefore, the problem to be solved urgently is to develop a personalized treatment plan through a standardized multidisciplinary treatment (MDT) and the optimized combination of existing diagnosis and treatment methods, so as to improve the efficacy. Based on the current situation of IBD diagnosis and treatment, with reference to the successful experience of MDT diagnosis and treatment at home and abroad, and combined with China′s national conditions, this consensus is finally formulated by organizing multiple experts in relevant fields to conduct online voting. The significance, the institutional composition, the operating mode, the clinical practice and the MDT integrated management are discussed in detail. Through the formulation and publication of this consensus, we hope that it can promote the development of standardized IBD-MDT, improve the therapeutic efficacy of IBD in China, and strengthen the training of professionals.

Objective: This study aimed to analyze the relationship between cerebral ischemia and cerebral blood flow dynamics (cerebrovascular function score), related physiological, and biochemical indexes. Methods: We selected 366 patients who underwent regular physical examination, cerebrovascular hemodynamics test, and head MRI in the health management center of Shandong Electric Power Central Hospital from May 2016 to April 2019. The patients with cerebral ischemia were selected as the case group (264 cases), and those without cerebral ischemia as the control group (102 cases) to analyze the differences in cerebrovascular function scores, blood pressure, body mass index, and related biochemical indexes between the two groups. The risk factors were also analyzed by multiple logistic regression analysis. Results: The average age of cerebral the ischemia group was (53.0±7.6) years, which consisted of 211 men and 53 women. The average age of the control group was (48.7±7.3) years, which consisted of 87 men and 15 women. The comparison of the mean of continuous variables between the two groups of subjects shows that the mean age [(53.0±7.6) years old vs. (48.7±7.3) years old] and systolic blood pressure [(127.70±17.06) mmHg vs. (122.36±14.75) mmHg] (1 mmHg=0.133 kPa) of cerebral ischemia group were significantly higher than that of control group. The high-density lipoprotein level [(1.29±0.26) mmol/L vs. (1.37±0.30) mmol/L] and cerebrovascular function score [(86.55±18.41) vs. （92.16±10.77）] were significantly lower than those in the control group. The exposure rate of systolic blood pressure ≥140 mmHg and cerebrovascular function score <75 [16.7%(44 cases) vs. 2.9%(3 cases)] in the ischemic group was significantly higher than that in the control group, with statistically significant differences (P<0.05). Multivariate logistic regression results showed that the variables included in the regression equation of the numeration data model were age and cerebrovascular function score, and the OR (95%CI) were 1.062 (1.020-1.105） and 6.838 (1.583-29.547). Conclusion Aging, low high-density lipoprotein cholesterol level, and low cerebrovascular function score may be the risk factors affecting MRI-defined cerebral ischemia.