Objective To investigate the efficacy of percutaneous laser disc decompression(PLDD)combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion.Methods Ninety patients with lumbar intervertebral disc protrusion scheduled for discolysis,aged 31-52 yr,weighing 58-70 kg,were randomly divided into 3 groups: PLDD group(group P,n = 29),collagenase injection group(group C,n = 31),PLDD combined with injection of collagenase through a target location group(group PC,n = 30).The puncture was performed under the guidance of CT.Group P was treated using PLDD.Group C was treated with collagenase injection.Group PC was treated with injection of collagenase after PLDD was completed.The therapeutic effect was assessed before operation and on day 7,30,60 and 90 after operation using M-JOA score.Results M-JOA grade was significantly higher at the each time point after operation in group P and PC,and on day 30,60 and 90 after operation in group C than that before operation(P ＜ 0.05).M-JOA grade was significantly lower on day 30 after operation in group P,while higher on day 30,60 and 90 after operation in group C and PC than that on day 7 after operation(P ＜ 0.05).M-JOA grade was significantly lower at the each time point after operation in group P and C than in group PC.Conclusion The therapeutic effect of PLDD combined with collagenase injection through a target location is stable for treatment of lumbar intervertebral disc herniation and better than that of PLDD or collagenase injection alone.

The paper analyzed the challenges for community-based rehabilitation of schizophrenic patients in China' s rural areas,from such six aspects as culture, prevention and control system for mental health, fairness of health resources allocation, shortage of specialists, confidence in treatment,and delay in rehabilitation. These studies aim at providing the government with decision making evidence for enacting rural mental health policies and taking effective intervention measures.

Objective:To analyze the epidemiological and clinical characteristics of hospitalized patients with dengue fever in Guangdong Province in 2019, so as to provide reference for clinical diagnosis and treatment of dengue fever.Methods:The general data, laboratory examination data, clinical manifestations and prognosis data of 480 inpatients with dengue fever admitted to Eight People′s Hospital Affiliated to Guangzhou Medical University between January 4 and October 31, 2019 were analyzed retrospectively. The clinical and onset characteristics of patients with dengue fever were described.Results:Among 480 dengue patients, 442(92.1%) were dengue fever, 38(7.9%) were severe dengue, and 136(28.3%) had underlying diseases. The peak age of onset was mainly in young adults aged 20 to 49 years old, accounting for 66.0%(317/480) in total. The seasonal peak was mainly in August to October. There were 399(83.1%) local cases and 61(12.7%) imported cases. The most common clinical manifestations were fever (98.1%, 471/480), chills (72.9%, 350/480), headache (58.5%, 281/480) and bone/joint/muscle pain (67.1%, 322/480), followed by digestive tract symptoms and respiratory tract symptoms. Among 446 serum samples, 358 (80.3%) were dengue virus (DENV)-1, 54 (12.1%) were DENV-2, 34 (7.6%) were DENV-3. The main laboratory tests of the patients were leucopenia (65.8%, 316/480), low hematocrit (30.2%, 145/480), thrombocytopenia (48.3%, 232/480), neutropenia (44.8%, 215/480), elevated alanine aminotransferase (ALT) (37.7%, 181/480) and aspartate aminotransferase (AST) (59.4%, 285/480). Treatment mainly adopted symptomatic support treatment and active prevention of complications. The length of stay was (5.8±3.1) days (range 1.0-38.0 days). A total of 461(96.0%) patients were cured or improved.Conclusions:In 2019, the majority of dengue fever patients in Guangdong Province are young adults aged 20 to 49 years old, and the proportion of severe patients is high, with DENV-1 infection as the main type. After symptomatic support treatment and active prevention of complications, most of the dengue fever patients have a good prognosis.