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 explore the pathogenesis and potential biomarkers of atrial fibrillation based on bioinformatics.Methods:Differentially expressed genes and module genes related to atrial fibrillation were obtained from GSE41177 and GSE79768 datasets(Chinese-origin tissue samples)through differential expression analysis and weighted gene co-expression network analysis.Candidate hub genes were obtained by taking intersections,and hub genes were obtained after gender stratification.Subsequently,functional enrichment analysis and immune infiltration analysis were performed.Four machine learning models were constructed based on the hub genes,and the optimal model was selected to construct a prediction nomogram.The prediction ability of the nomogram was verified using calibration curves and decision curves.Finally,potential therapeutic drugs for atrial fibrillation were screened from the DGIdb database.Results:A total of 67 differentially expressed genes and 65 module genes related to atrial fibrillation were identified.Functional enrichment analysis indicated that the pathogenesis of atrial fibrillation was closely related to inflammatory response,immune response,and immune and infectious diseases.Four common hub genes(TYROBP,FCER1G,EVI2B and SOD2),and two genes specifically expressed in male(PILRA and SLC35G3)and female(HLA-DRA and GATP)patients with atrial fibrillation were obtained after gender-segregated screening.The extreme gradient boosting model had satisfactory diagnostic efficiency,and the nomogram constructed based on the hub genes,male significant variables(PILRA,SLC35G3 and SOD2),and female significant variables(FCER1G,SOD2 and TYRO BP)had satisfactory predictive ability.Immune infiltration analysis demonstrated a disturbed immune infiltration microenvironment in atrial fibrillation with a higher abundance of plasma cells,neutrophils,and γδT cells,with a higher abundance of neutrophils in males and resting mast cells in females.Two potential drugs for the treatment of atrial fibrillation,valproic acid and methotrexate,were obtained by database and literature screening.Conclusions:The pathogenesis of atrial fibrillation is closely related to inflammation and immune response,and the microenvironment of immune cell infiltration of cardiomyocytes in the atrial tissue of patients with atrial fibrillation is disordered.TYROBP,FCER1G,EVI2B and SOD2 serve as potential diagnostic biomarkers of atrial fibrillation;PILRA and SLC35G3 serve as potential specific diagnostic biomarkers of atrial fibrillation in the male population,which can effectively predict the risk of atrial fibrillation development and are also potential targets for the treatment of atrial fibrillation.

Objective:To analyze the clinical phenotype and the associated pathogenic genes in a family exhibiting autosomal dominant inherited optic atrophy (ADOA).Methods:A pedigree analysis was conducted on a Han Chinese family with ADOA comprising two generations and four individuals from Henan Province.The family with two ADOA patients was recruited at Henan Eye Hospital between July and October 2023.Detailed medical histories were collected for the proband and family members.Comprehensive ophthalmologic evaluations were performed, including assessments of visual acuity, visual field, fundus photography, electroretinogram (ERG), visual evoked potential (VEP), and optical coherence tomography.Additionally, hearing, electromyography, and magnetic resonance imaging were performed on the proband to assess the presence of systemic symptoms.Peripheral blood samples were collected from four family members, and whole exome sequencing (WES) was performed on the proband, with subsequent validation via Sanger sequencing for the other family members.The pathogenicity and protein struture of the novel variant were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[15]).Written informed consent was obtained from each subject.Results:The proband was a 15-year-old female with a 4-year history of vision loss in the left eye and optic atrophy, mild thinning of central macular foveal thickness, locally mild thinning of ganglion cell complex layer thickness, low VEP amplitude, and partial visual field defects in both eyes, and no significant hearing impairment or dystonia on systemic examination.The proband's mother had partial optic nerve atrophy and slightly decreased central macular foveal thickness in both eyes, and mild ERG abnormalities, but no significant VEP abnormalities.WES identified a heterozygous nonsense variant c. 676C>T (p.Gln226Ter) in exon 6 of the OPA1 gene of the proband and her mother.This variant has not been previously reported in the literature, nor is it listed in the Human Gene Mutation Database, the Thousand Genomes Project, or the Genome Aggregation Database, which results in a premature termination codon at glutamine position 226.Protein structure analysis showed that p. Gln226Ter of the OPA1 protein induces alterations in the hydrogen bonding of the protein binding to surrounding residues, which in turn leads to protein function alterations.The variant was classified as potentially pathogenic according to the ACMG standards and guidelines. Conclusions:Patients in this ADOA family present with adolescent-onset optic atrophy in both eyes, with a predominance in the left eye.The c. 676C>T variant in OPA1 gene might be the causative variant in this ADOA family.Notably, this is the first report of this specific variant.

Objective:To observe the effects of TCM compounds for eliminating phlegm and removing blood stasis on the ultrastructure of atrial myocardium in atrial fibrillation (AF) rats; To explore its possible mechanism.Methods:Totally 60 male SD rats were divided into blank group (10 rats) and model group (50 rats) according to random number table method. The atrial fibrillation model was established by tail vein injection of ACh-CaCl 2 mixture for 7 consecutive days, and then the rats with successful modeling were divided into model group, verapamil group, TCM compounds high-, medium- and low-dosage groups according to random number table method, with 10 rats in each group. TCM compounds high-, medium- and low-dosage groups were given Chinese herbal decoction 41.25, 20.63, 10.31 g/(kg?d) by gavage, respectively, and the verapamil group was given verapamil solution 25 g/(kg?d). The blank group and the model group were given an equal volume of normal saline by gavage for consecutive 14 days. After 14 consecutive days, electrophysiological recorder was used to measure the duration of atrial fibrillation in each group of rats; the changes of ultrastructure of atrial myocytes in each group were observed under transmission electron microscope; serum ROS, SOD and GSH-Px levels of rats were detected by ELISA. Results:Compared with the model group, the duration of atrial fibrillation in TCM compounds high-, medium- and low-dosage groups and verapamil group decreased ( P<0.05); the ultrastructural damage of atrial myocytes was improved; the content of ROS [(139.20±3.34) ng/ml,(139.00±3.28) ng/ml, (139.25±3.82) ng/ml vs. (155.60±7.32) ng/ml] in TCM compounds high- and medium-dosage groups and verapamil group decreased; the contents of SOD [(2.41±0.26) ng/ml, (2.40±0.12) ng/ml, (2.37±0.06) ng/ml vs.(2.12±0.21) ng/ml] increased ( P<0.05); the content of GSH-Px [(3.61±0.06) ng/ml, (3.60±0.08) ng/ml, (3.47±0.15) ng/ml, (3.51±0.19) ng/ml vs.(3.27±0.12) ng/ml] in TCM compounds high-, medium- and low-dosage groups and verapamil group increased ( P<0.05). Conclusion:TCM compounds for eliminating phlegm and removing blood stasis can shorten the duration of atrial fibrillation in rats, reduce the damage of ultrastructure of atrial myocytes in AF rats, regulate the expressions of serum ROS, SOD and GSH-Px in AF rats, and inhibit oxidative stress, which may be one of its mechanisms of action in the treatment of atrial fibrillation.

Objective:The effect of three-dimensional(3D)printed bone-attached guide plate assisted cannulated screw fixation of pelvic fracture is reliable,but extensive soft tissue dissection is still required when installing the guide plate.This study aims to compare the efficacy of posterior pelvic ring fracture fixation with iliosacral screw insertion between the assistance of modified percutaneous patient specific 3D printed guide template and conventional fluoroscopy. Methods:From May,2019 and September 2021,28 patients sustained posterior pelvic ring fractures were randomized into 2 groups:A guide template group,in which the iliosacral screw was inserted for fixation of the posterior pelvic ring fracture with the assistance of modified percutaneous patient specific 3D printed guide template,and a fluoroscopy group,in which the iliosacral screw was inserted under the guidance of conventional fluoroscopy.The operation time,fluoroscopic frequency,intraoperative blood loss,and incision length were recorded for each screw insertion.Fracture reduction was evaluated according to the Matta criteria.The screw position was evaluated according to the modified Gras classification,and the functional outcome was evaluated according to Majeed score.The parameters of both groups were compared,and statistical analysis was performed. Results:All the 28 patients were followed up for 12-24 months.Of them,15 iliosacral screws were inserted in 14 patients in the guide template group,and 14 iliosacral screws were inserted in 14 patients in the fluoroscopy group.The operation time,fluoroscopic frequency,screw deviation,incision length,and blood loss in the guide template group were 20-30(25.8±2.8)min,9-15(12.2±1.9),2-4(2.6±0.7)mm,4-5(4.6±0.5)cm,and 5-10(7.8±1.7)mL,respectively,whereas those in the fluoroscopy group were 30-60(48.1±7.5)min,40-96(64.7±16.3),3-6(4.2±0.9)mm,0.8-1.2(1.0±0.1)cm,and 2-5(3.1±1.3)mL,respectively,and there were statistical significance(all P<0.001).Fracture reduction was evaluated according to the Matta criteria,and all the patients reached excellence and good(P=0.584)in the 2 groups.According to modified Gras classification,there were 12 Grade Ⅰ screws,3 Grade Ⅱ screws,and 0 Grade Ⅲ screws in the guide template group,and 10 Grade Ⅰ screws,3 Grade Ⅱ screws,and 1 Grade Ⅲ screw in the fluoroscopy group,with no statistical significance(P=0.334).The functional outcome was evaluated according to Majeed score at the last follow-up,without significant difference between the guide template group and the fluoroscopy group(P=0.908). Conclusion:Compared with the conventional fluoroscopy,it would cost less operation time,less fluoroscopic frequency and increase more accurate screw insertion to fixate the posterior pelvic ring fracture with the assistance of modified percutaneous patient specific 3D printed guide template.

Objective:To study the value of shear wave elastography (SWE) combined with contrast-enhanced ultrasound (CEUS) in diagnosing the invasiveness of papillary thyroid microcarcinoma (PTMC), and analyze its risk factors.Methods:This study included 200 patients with pathologically confirmed PTMC who underwent surgery in Fenyang Hospital from January 2019 and June 2021. All were diagnosed with SWE and CEUS before surgery. The value of the two methods in diagnosing the invasiveness of PTMC was explored. The patients′ data were collected to screen the risk factors for the invasiveness of PTMC.Results:It was pathologically confirmed that among the 200 patients with PTMC, there were 112 cases with malignant nodules, 88 cases with benign nodules, 75 cases with cervical lymph node metastasis (including 71 cases with capsular invasion) and 125 cases without lymph node metastasis. CEUS parameters of malignant nodules were significantly higher than those of benign nodules ( P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE combined with CEUS to diagnose capsular invasion were 94.66%, 85.60%, 89.00%, 79.77% and 96.39%, with high consistency with the pathological results ( Kappa>0.75). Multivariate Logistic regression analysis showed that multiple foci, irregular shape, breakthrough capsule and small calcification were independent risk factors for the invasiveness of PTMC (VIF<3). The ROC curve results showed that the AUC of SWE combined with CEUS to diagnose capsular invasion was 0.772, and the diagnostic sensitivity and specificity were 73.91% and 80.56%. Conclusions:SWE combined with CEUS can significantly improve the diagnostic accuracy for the invasiveness of PTMC.

ObjectiveTo investigate the correlation of serum high-mobility group box 1 (HMGB1) level with hepatic inflammatory activity, liver fibrosis degree, and liver function parameters in chronic hepatitis B patients. MethodsA total of 73 patients with chronic hepatitis B and liver cirrhosis were enrolled as subjects. Liver biopsy was performed to determine inflammatory activity and liver fibrosis degree, liver function parameters and serum HMGB1 level were measured, and the correlation between HMGB1 level and other indices was analyzed. The t-test was used for comparison between two groups, and a linear correlation analysis was performed to investigate the correlation between two indices. ResultsThe patients with chronic hepatitis B and liver cirrhosis had a significantly higher HMGB1 level than the healthy control group (29.46±7.54 ng/ml vs 16.86±3.48 ng/ml, t=5.668, P＜0.01). The G3-G4 group had a significantly higher HMGB1 level than the G1-G2 group (t=4.441, P＜0.01), while there was no significant difference in HMGB1 level between the S1-S2 group and the S3-S4 group (t=0.658, P＞0.05). Serum HMGB1 level was positively correlated with alanine aminotransferase (r=0.256 6, P=0028 4) and aspartate aminotransferase (r=0.471 9, P＜0.000 1), while it was not correlated with albumin or total bilirubin (both P＞005). ConclusionSerum HMGB1 level is closely correlated with hepatic inflammatory activity.

Background and purpose: As a member of Catenin family, little is known about expressive signiifcance and mechanism of Delta-catenin in numerous tumors. In present study, we investigated the expression of Delta-catenin in breast cancer tissues and its correlation with the prognosis of patients. Methods:We examined the expression of Delta-catenin and its correlation with clinicopathological factors of patients by immunohistochemistry in 92 cases of breast cancer tissues with tissue micro-array. The mRNA and protein expression of Delta-catenin were also detected in another 32 cases of frozen paired breast cancer tissues and normal breast tissues. Results:Compared with normal breast tissues, the mRNA and protein expression of Delta-catenin were increased in breast cancer tissues, and expression of Delta-catenin was closely associated with histological grade and lymph node metastasis (P=0.016 and 0.022, respectively). Moreover, Kaplan-Meier survival analysis revealed that patients with high Delta-catenin expression had shorter survival than patients with low expression (P=0.015), and multivariate Cox analysis revealed that high Delta-catenin expression was also an independent prognostic factor (P=0.017). Conclusion:Our results suggest that Delta-catenin acts as an oncoprotein when overexpressed in breast cancer, and its expression is associated with poor prognosis of patients.

Objective To explore the relationship between T-cell acute lymphoblastic leukemia and the Notch signaling pathway.Methods Human T-cell acute lymphoblastic leukemia SupT1 cells were infected with the lentiviral vector made up specific Notch1-shRNA gene and nonspecific Notch1-shRNA gene.The inhibitive rate of SupT1 cells was detected by CCK-8.The rates of early apoptotic cells (Annexin V+/ 7-AAD-) and late apoptotic cells (Annexin V+/7-AAD+) were analyzed by flow cytometry and the expression levels of Notch1 receptor gene and downstream target genes were assessed by quantitative reverse transcription and polymerase chain reaction (QT-PCR).Results The cell inhibition rates of Notch1 interference group,control group and empty vector group at 96 h were 0.902±0.013,0,and 0.486±0.084,respectively,and it was increased obviously in Notch1 interference group (both P ＜ 0.05).The cell early apoptosis rates of the three groups were (15.27±0.31) ％,(5.57±0.25) ％,(5.80±0.20) ％,respectively.The cell early apoptosis rate of Notch1 interference group was increased obviously compared with the control group and empty vector group (both P ＜ 0.05).While the cell late apoptosis rates had no significant difference among the three groups (P ＞ 0.05).The mRNA expression levels of Notch1 receptor gene and its target genes (Hesl,c-myc,NF-κB) at 48 h,72 h and 96 h were higher than those in the control group and empty vector group (all P ＜ 0.05).Conclusions The specificity of Notch1-shRNA can effectively decrease the Notch1 mRNA expression,and reduce the expression level of downstream target genes.Notch1 cut can inhibit the proliferation of SupT1 cells,and promote the early apoptosis.

Objective To explore the types, degree and distribution regularities of axial direction in astigmatism preschool children and the relationship of astigmatism and amblyopia. Methods Mydriasis optometry was performed for preschool children in our hospital outpatient reception from 2010 to 2011,and the astigmatism in 831 eyes of 477 cases were statistically analyzed. Results The compound hyperopic astigmatism was the most, accounting for 65.8%,followed by mixed astigmatism (13.8%),simple hyperopia astigmatism (9%),compound myopia astigmatism (8.7%) and simple myopia astigmatism (2.3%). Preschool children astigmatism degree distribution was distributed among 0.50 D and 2.00 D, accounting for 42%. For astigmatism axial, the astigmatism with rule, astigmatism against the rule and oblique astigmatism was accounted for 95.9%, 2.4% and 1.7%, respectively. Conclusion Compound hyperopic astigmatism is a main type of astigmatism in preschool children, and astigmatism is closely related to the formation of amblyopia.