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.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the effect of varying blood pressure stratification on renal function in the diabetic population.Methods A prospective cohort study was conducted,enrolling 9 489 diabetic patients from a total of 101 510 Kailuan Group employees who underwent health examinations between July 2006 and October 2007.The follow-up period was(8.6±4.0)years.Participants were categorized into four groups based on their baseline blood pressure levels:normal blood pressure(systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg),elevated blood pressure(systolic blood pressure 120-130 mmHg and diastolic blood pressure<80 mmHg),stage 1 hypertension(systolic blood pressure 130-140 mmHg and/or diastolic blood pressure 80-90 mmHg),and stage 2 hypertension(systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg).The incidence density of chronic kidney disease(CKD)was compared among these groups.A multivariate Cox proportional hazards regression model was employed to assess the effects of different blood pressure levels on renal function in diabetic patients,with the stability of the results confirmed using a multivariate time-dependent Cox proportional hazards model.Sensitivity analysis was conducted after excluding cases of cardiovascular disease(CVD)during follow-up,and cases using antihypertensive and antidiabetic medications at baseline.Results(1)At baseline,stage 1 hypertension patients demonstrated statistically significant higher differences with age and body mass index(BMI)compared to normal blood pressure group(P<0.05).(2)By the end of the follow-up,2 294 cases of CKD were identified,including 1 117 cases of estimated glomerular filtration rate(eGFR)decline and 1 575 cases of urinary protein.The incidences density of CKD,eGFR decline and urinary protein for stage 1 hypertension group were 39.4,16.3 and 25.5 per thousand person-years,respectively,all of which were statistically significant different from normal blood pressure group(log-rank test,P<0.01).(3)Multivariate Cox regression analysis revealed that,compared to the normal blood pressure group,stage 1 hypertension was associated with a 29%increased risk of CKD(HR=1.29,95%CI 1.09-1.52)and a 40%increased risk of eGFR decline(HR=1.40,95%CI 1.08-1.80)in diabetic individuals.Conclusion Stage 1 hypertension significantly increases the risk of CKD and eGFR decline in diabetic individuals,with a particularly notable effect on the risk of eGFR decline.

OBJECTIVE AMPK activator,act as exer-cise mimetics,effective in preventing or ameliorating met-abolic diseases,including obesity and diabetes.Systemic activating of AMPK represents an important therapeutic strategy to treat metabolic diseases.However,whether far-infrared(FIR)hyperthermia therapy could be used as exercise mimetic to realize wide-ranging metabolic regu-lation,and its underling mechanisms remain unclear.METHODS The mice were subjected to hyperthermia in the FIR chamber(30±1)℃for 14 d.Exercise endurance was determined using a treadmill.Blood flow were mea-sured by the laser speckle contrast imaging.Combina-tion of microbiomic and metabolomic analysis,diversity of microbiota and metabolic profiling in muscle were detected.The microbiota disorder model via treatment with different cocktails of antibiotics(ABX).RESULTS The material characterization shows that the graphene synthesized by chemical vapour deposition(CVD)is dif-ferent from carbon fi ber,with single-layer structure and high electrothermal transform efficiency.The emission spectra generated by graphene-FIR device would maxi-mize matching those adsorbed by tissues(≈8.0 μm).Gra-phene-FIR improves core and epidermal temperature,and increases blood flow in femoral muscle and abdo-men.The diversity of gut microbiota was increased by graphene-FIR exposure.Graphene-FIR reduced the bac-teroidetes/firmicutes(B/F)ratio and increased the abun-dance of short-chain fatty acids(SCFA)-producing bac-teria,including Allobaculum,Blautia and Anaerostipes.Additionally,graphene-FIR stimulated the expression of SCFAs-sensing receptor(GPR 43),p-AMPK Thr172 and GLUT4,and increased the AMP/ATP ratio,thus enhanc-ing muscle glucose uptake.Metabolomic analyses revealed the significant changes in 25 metabolites,with twenty increased(eg.creatinine and phosphate)and five decreased(eg.lactic acid),and the marked impact of five metabolic pathways,including galactose metabo-lism,glycolysis,gluconeogenesis,fatty acid biosynthesis,butanoate metabolism,pyruvate metabolism.Further-more,a microbiota disorder model also demonstrates that the graphene-FIR effectively restore the exercise endurance with enhanced p-AMPK and GLUT4.CON-CLUSION Our results provide convincing evidence that graphene-based FIR therapy promoted exercise capacity and glucose metabolism via AMPK in gut-muscle axis.These novel insights into graphene-FIR therapy suggest a potential as an exercise mimetic for the treatment of metabolic disease in clinical.

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.
Humans ; Angioedemas, Hereditary/drug therapy*

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.
Humans ; Angioedemas, Hereditary/drug therapy*

The "triple combination" review system provides an opportunity for the transformation of human use experience into new Chinese drugs. However, there are some methodological and technical limitations in the assessment of human experience. Hence, the efficacy and safety evaluation methods should be established in accordance with the characteristics of Chinese herbs. This study summarized some evidence-based methodology to promote the transformation of human use experience to new Chinese drugs, mainly including the individualized pragmatic randomized controlled trial(RCT), cluster RCT, single-case RCT, single arm RCT with objective performance criteria, and partially nested RCT. As the real world data can be used to support the transformation of human experience, attention should be paid to convenient and efficient collection of data, prudent selection of design types, and adoption of appropriate ana-lysis methods to deal with confounding bias, including multi-factor regression model and propensity score. The newly proposed mixed research method can also be utilized to assess the human use experience, which is suitable for mining the theory of traditional Chinese medicine(TCM) and expert experience from different aspects. Meanwhile, considering the study design requirements and TCM cha-racteristics, this study put forward the common problems and solutions in the development of new Chinese drugs based on human use experience, including how to select the feasible outcome indicators, how to collect prescription data in the case of herb and dosage adjustment, and how to evaluate the comprehensive effectiveness of TCM from the perspective of "combination of disease and syndrome".
China ; Drug Development ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Research Design

Background and Objectives: Chronic inflammation of bone tissue often results in bone defects and hazards to tissue repair and regeneration. Cannabidiol (CBD) is a natural cannabinoid with multiple biological activities, including anti-inflammatory and osteogenic potential. This study aimed to investigate the efficacy and mechanisms of CBD in the promotion of bone marrow mesenchymal stem cells (BMSCs) osteogenic differentiation in the inflammatory microenvironment. Methods: and Results: BMSCs isolated from C57BL/6 mice, expressed stem cell characteristic surface markers and pre-sented multidirectional differentiation potential. The CCK-8 assay was applied to evaluate the effects of CBD on BMSCs’ vitality, and demonstrating the safety of CBD on BMSCs. Then, BMSCs were stimulated with lipopolysaccharide (LPS) to induce inflammatory microenvironment. We found that CBD intervention down-regulated mRNA expression levels of inflammatory cytokines and promoted cells proliferation in LPS-treated BMSCs, also reversed the protein and mRNA levels downregulation of osteogenic markers caused by LPS treatment. Moreover, CBD intervention activated the cannabinoid receptor 2 (CB2) and the p38 mitogen-activated protein kinase (MAPK) signaling pathway. While AM630, a selective CB2 inhibitor, reduced phosphorylated (p)-p38 levels. In addition, AM630 and SB530689, a selective p38 MAPK inhibitor, attenuated the enhancement of osteogenic markers expression levels by CBD in inflammatory microenvironment, respectively. Conclusions CBD promoted osteogenic differentiation of BMSCs via the CB2/p38 MAPK signaling pathway in the inflammatory microenvironment.

A micro silicone oil liquid spring was designed and manufactured in this article. The performance of the liquid spring was studied by simulation analysis and mechanical test. A self-force source power-assisted knee orthosis was designed based on the liquid spring. This power-assisted knee orthosis can convert the kinetic energy of knee flexion into the elastic potential energy of liquid spring for storage, and release elastic potential energy to generate assisted torque which drives the knee joint for extension. The results showed that the average maximum reset force of the liquid spring was 1 240 N, and the average maximum assisted torque for the knee joint was 29.8 N·m. A musculoskeletal multibody dynamic model was used to analyze the biomechanical effect of the knee orthosis on the joint during knee bending (90°knee flexion). The results showed that the power-assisted knee orthosis could effectively reduce the biomechanical load of the knee joint for the user with a body weight of 80 kg. The maximum forces of the femoral-tibial joint force, patellar-femoral joint force, and quadriceps-ligament force were reduced by 24.5%, 23.8%, and 21.2%, respectively. The power-assisted knee orthosis designed in this article provides sufficient assisted torque for the knee joint. It lays a foundation for the subsequent commercial application due to its small size and lightweight.
Biomechanical Phenomena ; Knee Joint ; Femur ; Ligaments ; Orthotic Devices

This study aims to systematically evaluate the efficacy and safety of Chinese medicine injections in the treatment of rheumatoid arthritis. Specifically, randomized controlled trial(RCT) in the treatment of rheumatoid arthritis with Chinese medicine injections was retrieved from PubMed, EMbase, Cochrane Library, Web of Science, Wanfang, CNKI, VIP, and SinoMed(from inception to February 16, 2022). RevMan 5.3 and Stata 15.0 were employed for data analysis. Finally, 53 RCTs, involving 4 280 patients were included. The experimental groups involved the following injections: including Danshen Chuanxiongqin Injection, Tanshinone Ⅱ_A Sodium Sulfonate Injection, Danhong Injection, Dengzhan Xixin Injection, Gugua Extract Injection, Honghua Injection, Lugua Polypeptide Injection, Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection, Shuxuetong Injection, Zhengqing Fengtongning Injection, Compound Danshen Injection, and Xuebijing Injection. The network Meta-analysis showcased the following trends.(1) As for improving total clinical effective rate, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Gugua Extract Injection > combined with Compound Danshen Injection > combined with Danshen Chuanxiongqin Injection > combined with Honghua Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Lugua Polypeptide Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Dengzhan Xixin Injection.(2) As for improving erythrocyte sedimentation rate(ESR), SUCRA followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Shuxuetong Injection > combined with Honghua Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Gugua Extract Injection > combined with Danhong Injection > combined with Lugua Polypeptide Injection > combined with Dengzhan Xixin Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Danshen Chuanxiongqin Injection > combined with Zhengqing Fengtongning Injection.(3) As for improving rheumatoid factor(RF), SUCRA followed the order of conventional treatment of western medicine combined with Lugua Polypeptide Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Gugua Extract Injection > combined with Danshen Chuanxiongqin Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Dengzhan Xixin Injection.(4) As for improving C-reactive protein(CRP), SUCRA followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Honghua Injection > combined with Danshen Chuanxiongqin Injection > combined with Dengzhan Xixin Injection > combined with Gugua Extract Injection > combined with Lugua Polypeptide Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection.(5) As for alleviating morning stiffness, SUCRA followed the order of conventional treatment of western medicine combined with Shuxuetong Injection > combined with Lugua Polypeptide Injection > combined with Dengzhan Xixin Injection > combined with Xuebijing Injection > combined with Gugua Extract Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Honghua Injection.(6) As for improving disease activity score(DAS28), SUCRA followed the order of conventional treatment of western medicine combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection > combined with Zhengqing Fengtongning Injection > combined with Honghua Injection > combined with Gugua Extract Injection > combined with Dengzhan Xixin Injection. The experimental groups had lower incidence of adverse reactions than the control group. The results of network Meta-analysis suggest that on the combination of conventional treatment of western medicine with Chinese medicine injections can improve the efficacy on rheumatoid arthritis. However, in view of the great differences in the quality and number of studies included for different therapies, the SUCRA of Chinese medicine injections need to be further verified with high-quality multi-center, large-sample, randomized double-blind trials.
Humans ; Medicine, Chinese Traditional ; Network Meta-Analysis ; Drugs, Chinese Herbal/therapeutic use* ; Salvia miltiorrhiza ; Arthritis, Rheumatoid/drug therapy* ; Sodium ; Randomized Controlled Trials as Topic