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.

To compare changes in platelet related parameters in obese patients before and after sleeve gastrectomy (SG), we retrospectively analyzed the clinical data of 31 obese patients who underwent SG in Peking Union Medical College Hospital from December 2012 to September 2020. Results showed that compared with those before surgery, platelet count (PLT) decreased significantly at 2-12 weeks of follow-up ( P=0.009), while platelet distribution width (PDW), mean platelet volume (MPV), and large platelet ratio (P-LCR) increased significantly at the same periods of follow-up after operation ( P<0.001). However, the levels of PDW, MPV, and P-LCR began to decrease at 16-55 weeks when compared with those at 2-12 weeks of follow-up ( P<0.01). PLT was positively correlated with white blood cells and neutrophils at 2-12 weeks of follow-up and positively correlated with high sensitivity C-reactive protein at 16-55 weeks of follow-up after operation ( P<0.05).

Objective:To examine the clinical characteristics, the potential relative factors for postoperative abdominal septic complications, and prognosis factors of surgical recurrence of Crohn disease (CD) patients after the first surgery.Methods:All the CD patients from Department of General Surgery, Jinling Hospital, Medical School of Nanjing University who had undergone at least one abdominal surgery from January 2007 to December 2017 were included for retrospective analysis. Hospital records were reviewed for information on clinical characteristics. Relative factors of postoperative abdominal septic complications were accessed by Logistic regression models, and prognosis factors of surgical recurrence were accessed by Cox proportional hazards regression models.Results:There were 1 048 patients included (733 males and 315 females), accounting for 1 513 operations. The age was 31(17) years and the length of resected small bowel was 30.0(40.0) cm at the first resection, 20.0(35.0) cm at the second resection, and 20.0(23.5) cm at the third resection. The length of resected small bowel was 25.0(40.0) cm at any resection. At the first abdominal surgery, 70.99%(744/1 048) patients were aged between 17 and 40 years, 66.98%(702/1 048) patients had ileocolonic disease, and 60.40%(633/1 048) patients had penetrating behavior. Penetrating behavior ( OR=8.594, 95% CI: 3.397 to 21.740, P<0.01) and current smoking status ( OR=2.671, 95% CI: 1.044 to 6.832, P=0.040) were significantly associated with an increased risk of postoperative septic complications, whereas staged operation ( OR=0.360, 95% CI: 0.184 to 0.707, P=0.003) was associated with a decreased risk. Male gender ( HR=1.500, 95% CI: 1.128 to 1.995, P=0.005), upper gastrointestinal disease ( HR=1.526, 95% CI: 1.033 to 2.255, P=0.034), penetrating behavior ( HR=1.506, 95% CI: 1.132 to 2.003, P=0.005) and emergency surgery ( HR=1.812, 95% CI: 1.375 to 2.387, P<0.01) were significantly associated with an increased risk of postoperative surgical recurrence, whereas staged operation ( HR=0.361, 95% CI: 0.227 to 0.574, P<0.01) was significantly associated with a decreased risk. Conclusions:In this cohort of CD patients receiving abdominal surgery from an inflammatory bowel disease center, the median age was 31 years and the median length of resected small bowel was 30 cm, at first resection. Patients who have risk factors of adverse postoperative outcome may be benefited from staged surgical approach.

Objective:To examine the clinical characteristics, the potential relative factors for postoperative abdominal septic complications, and prognosis factors of surgical recurrence of Crohn disease (CD) patients after the first surgery.Methods:All the CD patients from Department of General Surgery, Jinling Hospital, Medical School of Nanjing University who had undergone at least one abdominal surgery from January 2007 to December 2017 were included for retrospective analysis. Hospital records were reviewed for information on clinical characteristics. Relative factors of postoperative abdominal septic complications were accessed by Logistic regression models, and prognosis factors of surgical recurrence were accessed by Cox proportional hazards regression models.Results:There were 1 048 patients included (733 males and 315 females), accounting for 1 513 operations. The age was 31(17) years and the length of resected small bowel was 30.0(40.0) cm at the first resection, 20.0(35.0) cm at the second resection, and 20.0(23.5) cm at the third resection. The length of resected small bowel was 25.0(40.0) cm at any resection. At the first abdominal surgery, 70.99%(744/1 048) patients were aged between 17 and 40 years, 66.98%(702/1 048) patients had ileocolonic disease, and 60.40%(633/1 048) patients had penetrating behavior. Penetrating behavior ( OR=8.594, 95% CI: 3.397 to 21.740, P<0.01) and current smoking status ( OR=2.671, 95% CI: 1.044 to 6.832, P=0.040) were significantly associated with an increased risk of postoperative septic complications, whereas staged operation ( OR=0.360, 95% CI: 0.184 to 0.707, P=0.003) was associated with a decreased risk. Male gender ( HR=1.500, 95% CI: 1.128 to 1.995, P=0.005), upper gastrointestinal disease ( HR=1.526, 95% CI: 1.033 to 2.255, P=0.034), penetrating behavior ( HR=1.506, 95% CI: 1.132 to 2.003, P=0.005) and emergency surgery ( HR=1.812, 95% CI: 1.375 to 2.387, P<0.01) were significantly associated with an increased risk of postoperative surgical recurrence, whereas staged operation ( HR=0.361, 95% CI: 0.227 to 0.574, P<0.01) was significantly associated with a decreased risk. Conclusions:In this cohort of CD patients receiving abdominal surgery from an inflammatory bowel disease center, the median age was 31 years and the median length of resected small bowel was 30 cm, at first resection. Patients who have risk factors of adverse postoperative outcome may be benefited from staged surgical approach.

Objective: To explore the effect of chest physical therapy guided by ultrasound in patients with severe pneumonia. Methods: One hundred patients with mechanical ventilation in the ICU were divided into a control group and a test group according to the occupancy time. The control group was given chest physical therapy according to routine imaging data and pulmonary auscultation. The experimental group was given physical therapy of the chest according to the routine imaging and pulmonary auscultation, also according to the BLUE ultrasound protocol. The mechanical ventilation time, ICU hospitalization time and the drainage capacity of 1 day, 2 days, 4 days, and 7 days after treatment were observed. Results: The mechanical ventilation time was (7.82±1.38) days and ICU hospitalization time were (10.16±1.88) days in the test group. The mechanical ventilation time was (10.14±1.73) days and ICU hospitalization time were (12.78±2.11) days in the control group. There were significant differences between the two groups (t=7.42, 6.56, P<0.05). There was a significant difference in the ability of spontaneous drainage on the 4th and 7th day after treatment between the two groups (Z=-2.47, -2.52, P<0.05). The sputum ability on the first and second day after treatment were not statistically significant between the two groups (P>0.05). Conclusions Pulmonary ultrasound can continuously monitor lung changes. Nurses can perform targeted nursing treatment on the basis of ultrasound.

Objective: To investigate the status and trend of low vision of junior and senior high school students in Beijing from 2009 to 2018, and to provide evidence for myopia prevention. Methods: Data came from the results of physical examination of eyesight in 2009-2018 in Beijing, which were cdlected among juncor and senior high school students in March every year. Detection rate of low vision of students and the difference across different districts and counties were analyzed. Results: From 2009 to 2018, the rate of low vision of high school and college entrance examination students in Beijing was on the rise, with the average rate of low vision of 86.07% and 76.36% respectively. Similar trend was found in the rate of high myopia(16.39% and 18.64%,respectively), while that of light and medium myopia tends to be stable. The highest rate of low vision among junior middle school students was in Xicheng (84.75%) District and Chaoyang District (84.03%), and for high middle school students,the highest rate of myopia was found in Fengtai District (91.17%) and Dongcheng District (89.92%). Conclusion In Beijing, the detection rate of low vision of middle school and college entrance examination students increased steadily, especially the high myopia. The health education of eyesight protection is of great significance to students. It is necessary to strengthen the extensive intervention of eyesight protection in middle and college entrance examination students.

Background:Acute severe gastrointestinal bleeding is one of the severe complications of Crohn's disease (CD),and clinical data conceming its mechanism,characteristics and treatment are rare.Aims:To analyze the clinical characteristics and prognosis of acute severe gastrointestinal bleeding in CD.Methods:Clinical data of CD patients with acute severe gastrointestinal bleeding from January 2009 to April 2017 at Jinling Hospital were retrospectively analyzed,and the effect of various factors on rebleeding rate was analyzed.Results:Altogether 44 cases had acute severe gastrointestinal bleeding.Small intestine,ileocecum and anastomosis were the main bleeding sites,and 17 cases occurred with obscure bleeding site.History of enterectomy was found in 20 cases.Surgery was performed in 22 cases.Rebleeding occurred in 13 cases,including 11 cases within 1-year.No significant differences in rebleeding rate and 1-year rebleeding rate were found between patients received surgery and non-surgery treatment,patients with emergency surgery and selective surgery (P ＞0.05).Rebleeding rate was significantly lower in patients with bleeding site resected than in paitents with obscure bleeding stie (P ＜ 0.05),however,no significant difference in 1-year rebleeding rate was found betwwen the two groups (P =0.083).Conclusions:The incidence of acute severe gastrointestinal bleeding in CD is rather low,and the major bleeding sites are small intestine (among patients without enterectomy history) and anastomosis (among patients with enterectomy history).Surgery with bleeding site resected can decrease the recurrence of bleeding,which might be a protective factor for preventing rebleeding in CD patients.

Objective: To investigate the expression and clinical significance of microRNA-34a (miR-34a) in human breast cancer tissues, and to analyze the correlation of methylation status of miR -34a gene promoter with the expression of mature miR-34a and the survival of patients with breast cancer. Methods: The expression level of mature miR-34a in breast cancer tissues (n = 93) and benign breast lesions (n = 5, as the control) was detected by TaqMan probe-based real-time fluorescent quantitative PCR (TaqMan® MicroRNA Assay Kit). The bisulfite conversion and purification of genomic DNA from each formalin-fixed and paraffin-embedded breast cancer samples were performed by EpiTect Fast FFPE Bisulfite Kit. The methylation status of miR-34a gene promoter in breast cancer samples was assessed by methylation-specific PCR. The relationship between miR-34a expression and miR -34a gene methylation was statistically analyzed. The prognostic value of miR -34a gene methylation was analyzed by Kaplan-Meier curve. Results: The expression level of miR-34a in breast cancer was significantly lower than that in benign breast lesions (P = 0.006). The expression of miR-34a was negative correlated with tumor size (r = -0.312, P = 0.021), lymph node metastasis (r = -0.378, P = 0.004) and tumor grade (r = -0.341, P = 0.011). However, the expression of miR-34a was not associated with estrogen receptor (ER), progesterone receptor (PR) or human epidermal growth factor receptor-2 (HER-2) (all P>0.05). The level of mature miR-34a in unmethylated group was significantly higher than that in methylated/unmethylated group or methylated group (both P<0.001). Compared with unmethylated group and methylated/unmethylated group, the recurrence-free survival (P<0.001, P = 0.019) and overall survival (P = 0.002, P<0.001) of patients with breast cancer were significantly reduced in miR -34a gene methylated group. Conclusion: In some patients with breast cancer, the methylation of miR -34a gene may lead to the down-regulation of mature miR-34a expression. Furthermore, the methylation status of miR -34a gene is associated with the risk of tumor recurrence and poor prognosis in patients with breast cancer.

OBJECTIVE: To describe our experience in the clinical manifestation and treatment of malignant tumors of the external and middle ear. METHOD: The study reviewed 39 patients between 1994-2011 in our hospital, including 15 pinna tumors, 18 external canal tumors and 6 middle ear tumors. 23 males and 16 females were enrolled in this study. The mean age of patients at the time of surgery was 59. Radiotherapy or radiotherapy and chemotherapy were the only possible treatment in 6 cases. Thirty-three patients were treated surgically, and 9 patients also received radiotherapy after surgery. RESULT: All of the patients had been followed up over 3 years, except for 1 case of external canal and 1 case of middle ear tumor. The 3-year survival of pinna, external canal and middle ear tumors were 86.7%, 82.4% and 60.0% respectively. At the last follow up, the pinna tumors showed that the survival rate was 100% in T1, T2 and Tx stage, and 0% in T4 stage; the external canal tumors showed that the survival rate was 90% in T1 stage, and 66.7% in T2, T3 stage; the middle ear tumors showed that the survival rate was 100% in T1 and T2 stage, 0% in T3 stage. CONCLUSION The T staging system is for an important prognostic factor, and it is important for an early diagnosis and radical surgery to achieve a better therapeutical result.
Ear Auricle ; pathology ; Ear Canal ; pathology ; Ear Neoplasms ; pathology ; Ear, Middle ; pathology ; Female ; Humans ; Male ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

Objective To investigate the effects of hedysarum polybotys saccharide (HPS) on lipid metabolism and the expression of stearoyl-CoA desaturase-1(SCD-1) gene in rats with non-alcoholic fatty liver disease (NAFLD). To discuss the interfering effects of HPS on NAFLD. Methods The SD rats were randomly divided into the blank control group and the experiment group. Rats in the experiment group were fed with lipid rich food for 8 weeks to establish model and were randomly divided into model group, drug positive group and HPS group. After 8 weeks of drug intervention, the level of ALT, AST, TC, TG, HDL-c and LDL-c were measured with automatic chemistry analyzer, and expression of SCD-1 gene was measured by semi-quantitative polymerase chain reaction.Results Compared with blank control group, serum ALT, AST and TC, TG, LDL-c of model group were higher (P<0.05,P<0.01), the level of HDL-c of model group and the expression of SCD-1 gene were lower (P<0.01). Compared with model group, HPS was useful to decrease serum ALT, AST, LDL-c, TC and TG (P<0.05,P<0.01), and increase the level of HDL-c (P<0.01) and the expression of SCD-1 gene (P<0.01).ConclusionHPS had a positive effect on regulating lipid metabolic disturbance of NAFLD rats and promoting the expression of regulatory gene SCD-1.