Objective:To investigate the efficacy and complications of ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus in children.Methods:This study was a retrospective analysis. A total of 120 children with hydrocephalus admitted to Xi'an Children's Hospital from January 2021 to March 2024 were selected. Among them, 49 children who underwent VPS treatment were included in the VPS group, and 71 children who underwent ETV treatment were included in the ETV group. Perioperative indicators, complication rates, postoperative recovery outcomes, levels of neurological injury markers, and developmental status at 6 months postoperatively were compared between the two groups. Measurement data with normal distribution were expressed as Mean ± SD, and intergroup comparisons was performed by independent samples t-test; counting data were expressed as case (%), and intergroup comparisons were performed by χ2 test. Results:The operation time [(83.26±10.67) min], time to first flatus [(2.58±0.44) days], and total complication rate [24.49% (12/49)] in the VPS group were all higher than those in the ETV group [(74.68±8.64) min, (2.21±0.42) days, and 9.86% (7/71)], while the one-time success rate [81.63% (40/49)] was lower than that in the ETV group [95.77% (68/71)]. The differences between the groups were statistically significant ( t=4.85, P<0.001; t=4.65, P<0.001; χ2=4.66, P=0.031; χ2=4.97, P=0.026, respectively). On postoperative day 3, the Glasgow Coma Scale score in the VPS group [(12.46±0.72) points] was lower than that in the ETV group [(12.89±0.67) points], and on postoperative day 7, the National Institutes of Health Stroke Scale score in the VPS group [(8.96±1.09) points] was higher than that in the ETV group [(8.54±1.02) points], with statistically significant differences ( t=3.35, P=0.001; t=2.16, P=0.033, respectively). On postoperative day 3, the levels of central nervous system-specific protein [(12.57±2.51) mg/L], high mobility group box 1 protein [(28.83±3.77) μg/L], and neuron-specific enolase [(21.47±2.56) μg/L] in the VPS group were all higher than those in the ETV group [(10.54±2.11) mg/L, (25.63±3.26) μg/L, (19.27±2.31) μg/L], and the differences were statistically significant ( t=5.04, P<0.001; t=4.96, P<0.001; t=4.91, P<0.001, respectively). At 6 months postoperatively, the developmental quotient score in the VPS group [(84.15±3.14) points] was lower than that in the ETV group [(86.51±3.27) points], and the difference was statistically significant ( t=3.93, P<0.001). Conclusion:Both VPS and ETV can be used for the treatment of hydrocephalus in children. However, ETV has a higher one-time success rate, better perioperative indicators, fewer complications, and superior postoperative neurological recovery compared to VPS.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Objective:To investigate the efficacy and complications of ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus in children.Methods:This study was a retrospective analysis. A total of 120 children with hydrocephalus admitted to Xi'an Children's Hospital from January 2021 to March 2024 were selected. Among them, 49 children who underwent VPS treatment were included in the VPS group, and 71 children who underwent ETV treatment were included in the ETV group. Perioperative indicators, complication rates, postoperative recovery outcomes, levels of neurological injury markers, and developmental status at 6 months postoperatively were compared between the two groups. Measurement data with normal distribution were expressed as Mean ± SD, and intergroup comparisons was performed by independent samples t-test; counting data were expressed as case (%), and intergroup comparisons were performed by χ2 test. Results:The operation time [(83.26±10.67) min], time to first flatus [(2.58±0.44) days], and total complication rate [24.49% (12/49)] in the VPS group were all higher than those in the ETV group [(74.68±8.64) min, (2.21±0.42) days, and 9.86% (7/71)], while the one-time success rate [81.63% (40/49)] was lower than that in the ETV group [95.77% (68/71)]. The differences between the groups were statistically significant ( t=4.85, P<0.001; t=4.65, P<0.001; χ2=4.66, P=0.031; χ2=4.97, P=0.026, respectively). On postoperative day 3, the Glasgow Coma Scale score in the VPS group [(12.46±0.72) points] was lower than that in the ETV group [(12.89±0.67) points], and on postoperative day 7, the National Institutes of Health Stroke Scale score in the VPS group [(8.96±1.09) points] was higher than that in the ETV group [(8.54±1.02) points], with statistically significant differences ( t=3.35, P=0.001; t=2.16, P=0.033, respectively). On postoperative day 3, the levels of central nervous system-specific protein [(12.57±2.51) mg/L], high mobility group box 1 protein [(28.83±3.77) μg/L], and neuron-specific enolase [(21.47±2.56) μg/L] in the VPS group were all higher than those in the ETV group [(10.54±2.11) mg/L, (25.63±3.26) μg/L, (19.27±2.31) μg/L], and the differences were statistically significant ( t=5.04, P<0.001; t=4.96, P<0.001; t=4.91, P<0.001, respectively). At 6 months postoperatively, the developmental quotient score in the VPS group [(84.15±3.14) points] was lower than that in the ETV group [(86.51±3.27) points], and the difference was statistically significant ( t=3.93, P<0.001). Conclusion:Both VPS and ETV can be used for the treatment of hydrocephalus in children. However, ETV has a higher one-time success rate, better perioperative indicators, fewer complications, and superior postoperative neurological recovery compared to VPS.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.