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.

The development of cholangiocarcinoma is slow, but its metastasis is extremely quick.When the tumor is found, the patients often have missed optimal operation period, and there is a lack of effective diagnostic indexes at present.In recent years, with the rapid development of molecular biology, studies find that microRNAs (miRNAs) are closely associated with cholangiocarcinoma.Because of miRNAs have great stability in various types of body fluids, so miRNAs in serum/plasma and bile are expected to become potential biomarkers in the diagnosis of cholangiocarcinoma.

Objective To establish a method of inducing dendritic cells(DC)from rat bone marrow cells in vitro,and identify the phenotype and function characteristics.Methods The rat bone malToW cells were collected and cultured in vitro under the condition of recombinant rat GM-CSF(rrGM-CSF)and recombinant rat IL-4(rrIL-4).After 2 weeks,the morphological character of DCs was observed under light microscope and scanning electron microscope.Expression of MHC-Ⅱ,CD80 and CD86 were detected by flow cytometry.The ability to stimulate allogenic T cells of the cultured DCs was detected by mixed lymphocyte reaction.Results DCs showed typical morphology with elongated dendritic processes under inversion microscope and scanning electron microscope.DCs at day 6 revealed immature phenotype,including MHC-Ⅱ(29.03 ±4.39)%,CD80(21.98±7.08)%and CD86(25.94±6.80)%.DCs at day 12 showed higher expression of MHC-Ⅱ(74.05±5.97)%,CD80(79.85±6.53)%and CD86(81.00±7.47)%,and stimulatory capacity of allogenic T cells,compared with that in DCs at day 6.Conclusion Matured DCs could be generated from rat bone marrow cells and attendance with rrGM-CSF and rrIL-4,which present the feasibility for further research on its application to allograft immunorejection.

BACKGROUND: Kadsurenone is characterized by obvious anti-oxidation and calcium ion resistant effect and can effectively clear oxygen-derived free radicals, decrease activity of pancreatic enzyme, and relieve self-digestion of pancreatic tissue.OBJECTIVE: To observe the effects of kadsurenone on the splanchnic blood flow in rats with severe acute pancreatitis (SAP), especially the mechanism of pancreatic blood flow.DESIGN: Contrast observational animal study.SETTING:Laboratory of General Surgery and Central Laboratory of Tangdu Hospital, the Fourth Military Medical University of Chinese PLA.MATERIALS: A total of 40 male Sprague-Dawiey (SD) rats, of clean grade and weighing 200-280 g, were selected in this study. Kadsurenone (150 mg) was provided by Pharmacological College of Peking University (batch number: 20050347); sodium taurocholate by Sigma Company (batch number: 86339); amylase reagent by Roche Company (batch number: irp 170505); Imexlab9100 Doppler ultrasound diagnostic meter by Imex Company; 8 mHz probe privated by Doppler ultrasound diagnostic meter by Imex Company, USA (number: X1-M0008).METHODS: The experiment was carried out in the Laboratory of General Surgery, Tangdu Hospital, Fourth Military Medical University of Chinese PLA from April to October 2006. Eight rats were randomly selected as sham operation group, and other rats were used to establish SAP models at 12 hours after fasting. Continuously, 32 SAP rats were randomly divided into two subgroups after model establishment, including kadsurenone group (n =16) and model group (n =16). In addition, all rats in the two subgroups were observed at 12 and 24 hours after operation with 8 rats at each time point. However, rats in the sham operation group did not give any treatment. At 3 hours after operation, rats in kadsurenone group were given 10 mg/kg kadsurenone through jejunum fistula once every 6 hours for one or two times in total. Kadsurenone was dissolved in 25 g/L dimethyl sulfoxide. In addition, rats in model group were given the same dosage of dimethyl sulfoxide through jejunum fistula; furthermore, rats in sham operation group were only opened their abdomens. Blood starch was respectively measured in sham operation group at 12 hours after abdominal operation, model group at 12 hours and kadsurenone group at 24 hours after acute pancreatic operation; meanwhile, Doppler ultrasound was used to detect local artery of pancreas (relative to the crossed site between head and body of pancreas), blood flow of portal vein, splenic artery and blood flow of superior mesenteric artery.MAIN OUTCOME MEASURES: Changes of plasma amylase and blood flow at various time points.RESULTS : All 40 SD rats were involved in the final analysis.①Measuring results of plasma amylase: Level of plasma amylase was increased in both model group and kadsurenone group at various time points as compared with that in sham operation group (P＜0.01 ). With the time passing by, level of plasma amylase was still increased in model group, and there was significant difference from that at 12 hours after operation (P＜0.05). ②Blood flow of local pancreatic artery: At 12 and 24 hours after operation, blood flow was lower in kadsurenone group and model group than that in sham operation group (P＜0.01). With the development of illness course, blood flow was still decreased in kadsurenone group (P＜0.05); however, blood flow was obviously higher than that in model group at various time points (P＜0.01 ). ③ Blood flow of superior mesenteric arterial root, portal vein and splenic artery: Blood flow was lower in kadsurenone group and model group than that in sham operation group at 12 and 24 hours after operation, respectively (P＜0.01). In addition, blood flow was remarkably increased in kadsurenone group as compared with that in model group at various time points (P＜0.01).CONCLUSION: Kadsurenone can increase the pancreatic blood flow and relieve pathological injury in SAP rats.

Objective: To observe the expressions of NMDAR2 and GLAST in the hippocampal gyrus and supraoptic nucleus(SON) under sleep deprivation in young rats.Methods: The changes in expressions of NMDAR2 and GLAST in SON and hippocampal gyrus under sleep deprivation in younger rats were observed by immunohistochemistry method. Results:The expressions of NMDAR2 and GLAST in SON and the hippocampal gyrus were significantly increased on the 3rd day of sleep deprivation,even more sigificantly on the 5th day,decreased gradually on 7th day,and became similar to those of control group on the 14th day.Conclusion: Sleep deprivation can affect the expressions of NMDAR2 and GLAST in the hippocampal gyrus and supraoptic nucleus,but the effect diminisshes gradually with prolonged time,which may be associated with self-regulation and self-protection of the central nervous system.

Objective: To construct and identify the eukaryotic expression vector targeting the CD40 gene in rats.Methods: Two sequences corresponding to the rat CD40 gene were designed on Ambion's Web.The two complementary oligonucleotide strands of DNA fragments were synthesized by chemosynthesis.After annealing of the complementary strands,the DNA fragments were connected to the polyclone sites of the pSilencer 4.1-CMV neo vector,followed by transformation,amplification,plasmid extraction and identification of the recombinant plasmids by BamH Ⅰ and Hind Ⅲ digestion and DNA sequence analysis.Results: The connections between the DNA fragments encoding CD40-targeted siRNA and the pSilencer 4.1-CMV neo vector were correct,as confirmed by agarose gel electrophoresis and DNA sequence analysis.Conclusion: The two recombinant plasmids expressing siRNA of the rat CD40 gene were successfully constructed,which prepared the groundwork for future research on the role of the CD40 gene in homograft rejection.

Objective To investigate the causes,diagnosis and treatment of postoperative acute cholecystitis. Methods Clinical data of 9 cases with postoperaive acute cholecystitis were analyzed retrospectively. Results7 cases was confirmed by ultrasonography, 1 case was confirmed by CT, and 1 case died of gallbladder perforation, no operative mortality in emergency cholecystectomy. Conclusion The prevalent etiology is biliary stasis. Early diagnosis and treatment is the key point to decrease the death rate.

Objective　To evaluate the results and feasibility of US-guided radio-frequency(RF) ablation for the treatment of primary or secondary liver tumors.Method　180 patients with liver tumor were treated with percutaneous ultrasound-guided RF ablation.RF was applied by a frequency at 10W with an increase of 10W every other minute until 90W for a total of 15 minutes,using single or multi puncture method.After RF treatment,the α-fetoprotein(AFP) level was examined,the ultrasonograph,computered tomography(CT),biopsy were performed.Results　In those with abnormal pretreatment AFP level,1 week after RF treatment AFP returned to normal in 119/153(77.8%)patients;2-4 weeks later or after the second treatment AFP drops to normal in 144/153(94.1%) patients.Tumors failed to grow or shrank in size,some underwent liquefaction on CT and ultrasound follow-up.The biopsy results of the treated lessions showed necrosis accompanied with microvessel thrombosis.Abdominal pain disappeared or relieved in 121/142(85.2%) patients.Ascites and temporary jaundice occured in 26/180(14.4%),and 16/180(8.9%) patients,respectively.Conclusion　RF ablation is a mini-invasive,safe,effective treatment for primary and secondary liver tumor.

Objective To evaluate the efficacy of ultrasonically guided radiofrequency (RF) thermal ablation of hepatic carcinoma (HC) with a clustered electrode. Methods Clinical records on 245 consecutively admitted HC patients who underwent RF tissue ablation therapy were analyzed. The tumor supplying blood flow, changes of tumor size, clinical manifestation, and AFP level were analyzed. Results AFP value decreased significantly in 50% of patients one week after ablation. Tumors less than 5*!cm in diameter became avascularized 1 to 6 months after the therapy, and it was noted that all tumors shrank in size after the therapy. For tumors more than 5*!cm in diameter, RF ablation was used in conjunction with intraarterial chemotherapy and embolization. Conclusion Ultrasound guided RF thermal ablation is an effective, safe, minimally invasive technique for treating malignant hepatic tumors.

Objective To investigate and evaluate the changes of T lymphocytes and red cell immunity of peripheral blood in patients with primary hepatocyte carcinoma (PHCC) after radiofrequency ablation(RFA) treatment. Methods The pre- and post- RFA(3d,7d,14d) peripheral blood T lymphocyte subsets(T3,T4,T8,T4/T8) and red cell immunity (RBC C3 receptor flower and RBC-immuocomplex formation rate) were investigated in 120 patients with PHCC treated by RFA. Results On 7d, 14d after RFA, T3, T4 lymphocytes and T4/T8 were higher than those on preoperative day significantly(P