Objective To explore the effect and complications of ventricle peritoneal shunt n pediatric hydrocephalus. Methods The clinical data was analysed in 30 cases of pediatric hydrocephalus. Results A total of 27 cases (90%) of pediatric hydrocephalus were found reduction of ventricle. 3 cases were found no obvious reduction of ventricle. Post-operative complications in 3 cases (10%), subcutaneous liquid collection in 2 cases (6.67%), diverter pump in 1 case (3.33%). No patients were found infection. Conclusion Strict sterilizing procedures andhigh quality and attention-to-detail is the key to reduce postoperative complications and improve surgical outcomes.

Objective To explore the predictive value of systemic immune inflammatory index(SII),systemic inflammatory response index(SIRI),neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR),platelet to lymphocyte radio(PLR),albumin to globulin(AGR)and heat shock protein 90α(HSP90α)in Fuhrman grade of clear cell renal cell carcinoma(ccRCC).Methods From October 2019 to August 2022,212 patients who underwent surgical treatment for ccRCC were divided into low-grade tumor group and high-grade tumor group according to Fuhrman grade.The independent influencing factors of Fuhrman grading were determined by univariate and multivariate Logistic regression analysis,and the predictive value of each inflammatory index to Fuhrman grading was evaluated by drawing Receiver operating characteristic curve(ROC).We constructed the line chart prediction model and evaluated the effectiveness of the model.Results The preoperative levels of SII,PLR,AGR,HSP90α and the maximum diameter of tumor were significantly different between high-grade group and low-grade group(P＜0.05).Logistic regression analysis showed that the maximum diameter of tumor,PLR,AGR and HSP90α were independent influencing factors of Furhman grade.By drawing the ROC curve,it was found that the area under the curve(AUC)of PLR,AGR and HSP90α to predict Furhman grade were 0.641,0.675 and 0.696.In addition,the Furhman grade line chart prediction model had good prediction ability,the AUC was 0.789(95％CI:0.717～0.862),the sensitivity was 61.80％,and the specificity was 85.40％.Conclusions There was a significant correlation between inflammation-related indexes in peripheral blood and Furhman grade of clear cell renal cell carcinoma.The Furhman grade line chart prediction model based on the maximum diameter of tumor and peripheral blood inflammation index has good predictive ability.

Toxoplasmosis is a worldwide zoonosis caused by an intracellular protozoan parasite, Toxoplasma gondii. We report here a diabetic patient who was diagnosed as toxoplasmosis with multiple cranial nerve palsies and cavernous sinusitis. A 37-year-old male presented with an 11-day history of gingival pain, one day history of ptosis and diplopia. He has been having diabetes mellitus for 6 years, and has a history of contact with cats. After admission, his symptoms worsened with right 3rd to 7th cranial nerve palsies. The brain magnetic resonance imaging (MRI) showed cavernous sinusitis in the right sellar region. Serology for toxoplasma was positive for IgM and negative IgG. The patient was treated with oral clindamycin (900 mg/day) and dexamethasone (15 mg/day). The right visual acuity and lid-conjunctival swelling improved after 3 days. At follow-up after a month, the movement of the right eye significantly improved. This case demonstrate the rare occurrence of multiple cranial nerve (3rd to 7th) palsies from toxoplasmosis cavernous sinusitis, which is a potentially treatable condition.

Post-stroke depression often seriously affects the prognosis and quality of life of patients and many clinical trials had shown that Chai Hu Shu Gan San (柴胡疏肝散) combined with selective serotonin reuptake inhibitors (SSRIs) had good efficacy and minor side effects. We aimed to conduct this metaanalysis to evaluate the efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for SSRI in treating post-stroke depression. We searched PubMed, EMBASE, Cochrane Library, Wanfang, China Biology Medicine disc (CBM), Chongqing VIP, and CNKI (China National Knowledge Infrastructure) from their date of foundation to December 15, 2018. Literature screening, data extraction and quality assessment were conducted by two authors independently. The data synthesis and analysis were performed by using Review Manager (RevMan) 5.3 software and sensitivity analysis was conducted to assess the robustness of the results. Finally, a total of 22 articles were included. The meta-analysis confirmed the advantages of the combination of SSRI and Chai Hu Shu Gan San, mainly from four aspects: the Hamilton Depression (HAMD) scale score (MD=3.66; 95% DI=2.33-4.98; p<0.001), the Modified Edinburgh Scandinavian Stroke Scale (MESSS) score (MD=4.87; 95% CI=2.32-7.43; p<0.001), the efficacy rate (OR=3.50; 95% CI =2.61-4.69; p<0.001) and the incidence of adverse reactions (OR=0.28; 95% CI=0.17-0.46; p<0.001). No significant publication bias was observed, and sensitivity analysis suggested a good stability of the results. According to the present evidence, we concluded that Chai Hu Shu Gan Sa