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 effect of menthol compound decoction on the growth and acid metabolism of cariogenic bacteria and to find out the anticariogenic mechanism of Menthol compound decoction .Methods Streptococcus mutans ,Streptococ‐cus sanguinis and Porphyromonas gingivalis were chosen as the experimental bacteria .Firstly ,slip diffusion method was used to ex‐amine the inhibitory effect of menthol compound decoction on cariogenic bacteria .Secondly ,observing the effect of menthol com‐pound decoction of different concentration on acid metabolism .Results Menthol compound decoction could inhibit the growth of Streptococcus sanguinis and Porphyromonas gingivalis .And it also inhibited the acid production of cariogenic bacteria ,but the con‐centration of menthol compound decoction were different .Conclusion Menthol compound decoction may have an inhibitory effect on the growth and acid metabolism of cariogenic bacteria .

Objective To study the effects and mechanism of focal mild hypothennia on brain inflarnmation response during the early stage of tranrntic brain injury(TBI)in rats.Method Traumatic brain injury wag produced in anesthetized rats by using free-falling impact model.Sixty-three male Sprague Dawley rats were randomly divided into three groups:TBI group,focal hypothermia group,and sham group.each group with 7 SD rats.Then all groups Wag further subdivided into three subgroups according to different intervals after TBI.Myeloperoxiduse (MPO)activity assay,immunohistochemical staining for the detennination of intercellular adhesion molecule-1(ICAM-1)expression and the number of ICAM-1 positive blood vessels were counted up in the traumatic brain tissues.All data were analyzed by SNK-q test Using SPSS 10.0 sofeware program.Results The number of ICAM1 positive blood vessels was significantly fewer in the rats of focal hypothermia group than those in the rats of TBI group at different intervals after TBI(P<0.01).Similarly,the MPO activity was significantly lower in the rats of focal hypothermia group than that in the rats of TBI group(P<0.01).Conclusions Focal mild hypothermia could significantly decrease neutrophil infdtration and ICAM-1 expression in the traumatized areas.It might be one of the mechanisms of focal mild hypothermis for TBI.

Objective To find the optimal perfusion temperature of focal hypothermia in rats with traumatic brain injury(TBI).Methods Modified Feeney's free-falling model was used in the study.Forty-nine male Sprague-Dawley(SD)rats were randomly divided into seven groups:TBI group,systemic hypothermia group,focal hypothermia groups(including 0℃,10℃,20℃ or 25℃ subgroups,respectively)and control group.The contents of total sodium,potassium and water of traumatic brain were measured,and pathological changes were examined in the seven groups.Results The damaged neurons were significantly fewer in focal hypothermia groups(including 10℃,20℃ or 25 ℃ subgroups,respectively)than those in systemic hypothermia group at 72 hours after TBI(P