Advantages and necessity of multi-disciplinary treatment on diabetic lower extremity lesions / 中华内分泌外科杂志

Diabetic lower extremity lesions (DLEL) occur as lower extremity pain, sensory and motor disturbance, ulcers, destruction of deep tissues and subsequent infections related to lower extremity vasculopathy and neuropathy in diabetes. The disease affects multiple organ systems, leading to complicated pathogenesis and difficulty in treatment. This article reviews the pathogenesis and treatments of diabetic lower extremity lesions, hoping to expand new ideas for the multi-disciplinary treatment of DLEL.

Clinical analysis on hyponatremia in acute craniocerebral injury / 中华创伤杂志

Objecfive To explore pathological mechanism and treatment of central hyponatrem-ia. Methods Synchronous assay was made to detect changes of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),endogenous digitalis-like substance(EDLS),antideuretic hormone (ADH),Na+ concentrations in blood and urine as well as osmotic pressure of plasma and urine in 68 pa-tients with traumatic brain injury(TBI). Results Of all,there were 27 patients with hyponatremia,mostly in patients with severe or critical TBI.There found syndrome of inappropriate secretion of antidi-uretic hormone(SIADH)in 7 patients and cerebral salt wasting syndrome(CSWS)in 20. Conclu-sions The central hyponatremia in patients with TBI may be related to the increased secretion of EDLS and ADH.The decrease of ANP and BNP in blood has no direct effect on Na+ concentration in blood.In-travenous injection of extrinsic thyrotropin releasing hormone(TRH)may inhibit dilutional hyponatremia resulted from increased secretion of ADH in TBI patients.

Endoscopic treatment of septated chronic subdural hematoma With a report of 45 cases / 中国微创外科杂志

Objective To evaluate the therapeutic results of neuroendoscopy for the treatmentof of patients with septated Chronic Subdural Hematoma(SCHS). Methods 45 patients with SCSH were operated on under endoscope through a burrhole approach.neomembranes were resected by small microscissors.A closed drainage system was applied temporarily to ensure the efflux of the remaining hematoma. Results Forty-five cases were treated successfully.All patients had a sufficient or complete hematoma evacuation whithout recurrence of subdural hematoma.There was no subdural infection,bleeding,brainedema and cranial aerocele. Conclusions Neuroendoscopy is minimally invasive technique and have the advantages ot simple,effective,safe,less complication,less expensive and shorter hospitalization in the treatment of SCSH.

Clinical study of drainage catheter location during treatment of chronic subdural hematoma / 中华创伤杂志

Objective To determine the best position of the catheter to achieve a low recurrence rate during subdural drainage for chronic subdural hematoma (CSDH). Methods A retrospective study was done on 130 cases with CSDH in regard of preoperative thickness of CSDH, preoperative midline displacement, postoperative locations (forehead, temple, cupula and occiput) of the subdural drainage catheter, postoperative width of the subdural space and the relationship of the accumulated air in ipsilateral subdural space with postoperative relapse. Results The CSDH thickness and the midline displacement on preoperative CT scan had no correlation with the postoperative recurrence rate of CSDH. Seven days after operation, the width of the subdural space over 1 cm or the accumulated air of the subdural space exceeding 20% of the the subdural space volume would result in obvious increase of recurrence rate of CSDH. The catheter locating on the frontal lobe cortex postoperatively had the lowest recurrence rate of CSDH. Conclusions Postoperative recurrence of CSDH can be reduced by placing the tip of the drainage catheter on the frontal lobe cortex to remove subdural air during or after surgery. CT scanning at postoperative day 7 is helpful for determine recurrence rate.