Lumbar peritoneal shunt (LPS) is the standard treatment for nonobstructive hydrocephalus. Shunt infection, overdrainage, bleeding, and cerebrospinal fluid leaks have been reported as LPS complications. We present a 70-year-old man who developed iatrogenic spondylodiscitis 2 weeks after LPS placement, experiencing severe back pain and neurological deficits. Despite the empiric antibiotics, his symptoms persisted. The patient underwent fully endoscopic debridement and drainage (FEDD) to address the infection without LPS removal. After the procedure, the patient experienced a significant reduction in pain. Even though pathogen cultures were negative, the empiric antibiotic treatment continued for 6 full weeks. The patient was able to ambulate with a thoracolumbar orthosis due to the lumbar kyphotic deformity. FEDD, in conjunction with effective antibiotics, offers rapid pain relief and functional improvement in iatrogenic spondylodiscitis, even with LPS placement. However, FEDD may not correct spinal deformities and is unsuitable for advanced spinal disease or instability. Early detection of spondylodiscitis is crucial for improved outcomes.

Extraforaminal lumbar disk herniation (E-LDH) constitutes a challenging subset of lumbar disk herniations. Minimally invasive methods like full-endoscopic lumbar discectomy provide benefits but carry risks of complications, such as postoperative dysesthesia and nerve root injury. A 62-year-old male with comorbidities presented with severe leg pain due to left L3/4 E-LDH. An L3 nerve block, guided by fluoroscopy, was performed with the patient in a right decubitus position. After alleviating the pain, the patient was placed in a prone position to undergo the extraforaminal full-endoscopic procedure under local anesthesia. The tip of the needle was targeted to the base of the superior articular process (SAP). Foraminoplasty was precisely performed with a high-speed diamond burr at the base of the SAP, facilitating the removal of the extraforaminal portion of the herniated disc. The procedure yielded immediate relief (visual analogue scale score reduced from 10 to 0). There was no leg pain or associated back pain at the 6-month follow-up. This approach demonstrates the feasibility of an extraforaminal full-endoscopic technique for E-LDH, overcoming challenges associated with the uncooperative patient due to the severe leg pain. However, the technique demands technical proficiency and warrants further research to establish its broader applicability.

[Objective]To investigate the molecular mechanism of abnormal platelet activation induced by platelet O2 ·- and H2O2 levels in type 2 diabetes mellitus.[Methods]The platelet parameters in patients with type 2 diabetic patients and normal controls were measured;Immunofluorescence technique was used to observe the platelet morphology changing;Flow cytometry was used to detect platelet intracellular O2 ·- and H2O2 content in two groups,then with platelets in normal controls treated with NADH/PMS system and H2O2 respectively,platelet activation positive percentage was observed. Standard Western blot analysis protocols were used to detect expression difference of Catalase and type 2 super-oxide dismutase(Mn-SOD)in platelets.[Results]The MPV in the group of type 2 diabetic patients was significantly higher than in the normal control group(P < 0.001),but there was no statisticdifference in PLT,PDW,PCT between two groups. Immunofluorescence results showed that morphology of platelets in type 2 diabetic patients changed contrast to normal group. Through flowcytometry detection,the content of mitochondrial O2·-and H2O2 of platelet in type 2 diabetic patients were obviously higher than in normal group(P<0.05),whereas no significant difference in cytoplasmic O2·-. We adopted NADH/PMS system and H2O2 to treat platelets of normal group,heightened activated positive percentage were observed which described O2 ·- and H2O2 can significantly promote platelet activation(P<0.01). Western blot results showed that expression of Catalase in platelet of type 2diabetes patients decreased,while the expression and activity of Mn-SOD had no difference.[Conclusion]It is diabetic platelet Catalase expression decreased that may lead to Diabetic platelet mitochondrial O 2 ·- and H2O2 level increased ,thus regulating aberrant activation of diabetic platelet.

Objective To evaluate the practical value of the method of contrast enhanced ultrasoundguided reduced-fine needle aspiration (CEUS-FNA) in decreasing the complications of prostate nodule puncture.Methods Nine hundred patients with suspected prostate cancer(PCa) who underwent traditional 10-point blind transperineal prostate nodule puncture(n =548) or CEUS-FNA(n =352) were collected retrospectively and classfied into normal group or CEUS group,respectively.The ratio of prostate cancer diagnosis,number of punctur and compliations were observed in both groups.Results Altogether 362 PCa were diagnosed from 900 patients.Among these cases the diagnosis ratio of normal group was 38.0％ (208/548) and that of CEUS group was 43.8 ％ (154/352).There was no significant difference in diagnosis ratio between two groups (x2 =2.992,P =0.084).The puncture number of normal group were more than that of CEUS group(P ＜0.01).There were 134 cases occurred infection and other complications in tradition group and 56 cases in CEUS group.The complication rate in normal group was higher than that in CEUS group (24.5 ％ vs 15.9 ％),with significant differences between the two groups (x2 =9.393,P =0.002).Conclusions CEUS-FNA could reduce puncture number,but not decrease the PCa diagnsis rate.And also that could reduce the complication rate of prostate puncture.