Xiang Xi Tu Jia Zu Miao Zu Zi Zhi Zhou

Chronic subdural hematoma (CSDH) is a common neurosurgical condition where fluid builds up between the brain coverings, causing brain compression and neurological problems. The best treatment method is still uncertain, and this trial aims to compare two surgical approaches to find the most effective one. Neuroendoscopy-assisted drainage allows surgeons to directly see and remove the hematoma more thoroughly compared to the conventional burr-hole drainage method, which may reduce recurrence and drainage time. The study compares neuroendoscopy-assisted hematoma drainage with traditional burr-hole drainage. Both procedures involve drilling a single burr hole at the thickest part of the hematoma as seen on CT scan. In the neuroendoscopy group, a bone flap is created and a neuroendoscope guides thorough irrigation and evacuation of the hematoma, followed by drainage for up to 48 hours. In the burr-hole group, the hematoma cavity is irrigated until clear and drainage is also maintained for up to 48 hours after surgery. Participants will be evaluated before and after surgery, with clinical symptoms and imaging confirming CSDH diagnosis. The main outcome measured is the recurrence rate of hematoma within three months after surgery. Continuous monitoring will occur until drainage ends or the tube is removed. Follow-up visits will assess neurological status and recovery over three months, ensuring safety and treatment effectiveness throughout the study period.

Researchers are evaluating a new approach to improve language abilities in children aged 2 to 5 years with Global Developmental Delay (GDD), a condition affecting multiple developmental areas including language. The study will compare personalized language training combined with non-invasive repetitive Transcranial Magnetic Stimulation (rTMS) targeting brain regions responsible for language against personalized training with sham stimulation. About 50 children will participate in this randomized, double-blind study conducted at Xiangxi Autonomous Prefecture People's Hospital, with ethics committee approval ensuring safety and oversight. Participants will be divided into two groups: one receiving active rTMS and personalized language training, and the other receiving sham stimulation with the same language training. The rTMS protocol involves high-frequency 10 Hz stimulation at 80% of resting motor threshold, delivered in trains totaling 1800 pulses over 20 minutes. Each rTMS session is given five minutes before language training to potentially enhance the effect. The treatment will last for two weeks, followed by a two-week follow-up period to assess sustained benefits. During the study, children will undergo language assessments using the Gesell Developmental Schedules at baseline, after two weeks of intervention, and at the four-week follow-up. Researchers will measure changes in language development quotient (DQ) to evaluate treatment impact. Careful monitoring will track cooperation, safety, and any adverse effects throughout the one-month study period.