Objective To assess the efficacy of radiofrequency therapy combined with ozone injection in the treatment of lumbar disc protrusion. Methods A total of 202 patients with lumbar disk protrusion were included and divided into three groups:radiofrequency (RF) group, ozone (Oz) group, and combination (Co) group. The efficacy was evaluated by visual analogue scale (VAS), Macnab curative effect evaluation, and oswestry disability index (ODI) at 1d, 1m and 6m after treat?ment. Results There were no significant differences in gender, age, the course of disease, preoperative VAS scores and ODI scores (P>0.05). All patients were operated successfully. There were no infection of the intervertebral disc, no compli?cations of spinal cord, nerve and no blood vessel injury. There were no significant differences in preoperative VAS and ODI scores between three groups. The VAS and ODI scores were significantly lower at 6 month and 12 month after operation in Co group combined with those of RF group and Oz group. There were no significant differences in these two scores between RF group and Oz group (P>0.05). There were no significant differences in effective rates at 1d, 6 month and 12 month after operation between three groups (P>0.05). But the excellent and good effective rates were higher in Co group than those of RF and Oz groups. There were no significant differences in excellent and good effective rates between RF group and Oz group. Conclusion The therapy of radiofrequency combined with ozone injection is an efficient and mini-invasive tech?nique for the treatment of lumbar disc protrusion and worth promoting.

Objective To analyze the efficacy of early management of eomplications in patients with multi-ple traumas by applying the damage control theory. Method All total of 116 patients admitted to Wuhan Tongji Hospital between Jan 2006 and Jan 2008 were included in this retrospective study and were classified according to treatment method. Overall, 55 cases underwent damage control operations and 61 cases underwent conventional management. The groups of patients were compared in terms of parameters such as length of operation time, time to resuscitate from shock, lethal triad of death (LTD), complications and treatment outcomes after operation. Results The length of operation time was (67.43±19.52) min, resuscitation time from shock was (6.77±3.16) h and LTD was (11.54±4.10) h in the damage control group, and (163.95±55.41) min, (22.51±11.65) h and (34.55±5.63) h, respectively, in the conventional group, with significant differences between the two groups (P< 0.01). The per capita complication and mortality rates were 227.27 % and 3.64 %, respectively, in the dam-age control group and 363.93 % and 9.84%, respectively, in the conventional group (P <0.05). Couclusions Here, we demonstrated that early management of patients with multiple traumas undergoing operations by apply-ing the damage control theory significantly decreased the operation time, and decreased time to resuscitation from shock and LTD. Furthermore, this approach significantly reduced the incidence of comphcations and the mortality rate of patients with severe multiple traumas.

Pancreatitis is one of the most common inflammatory diseases of the pancreas caused by autodigestion induced by excessive premature protease activation. However, recognition of novel pathophysiological mechanisms remains a still challenge. Both genetic and environmental factors contribute to the pathogenesis of pancreatitis, and the gut microbiota is a potential source of an environmental effect. In recent years, several new frontiers in gut microbiota and genetic risk assessment research have emerged and improved the understanding of the disease. These investigations showed that the disease progression of pancreatitis could be regulated by the gut microbiome, either through a translocation influence or in a host immune response manner. Meanwhile, the onset of the disease is also associated with the heritage of a pathogenic mutation, and the disease progression could be modified by genetic risk factors. In this review, we focused on the recent advances in the role of gut microbiota in the pathogenesis of pancreatitis, and the genetic susceptibility in pancreatitis.

Objective:To analyze and summarize the clinical characteristics of autoimmune pancreatitis (AIP) patients in China from 2009 to 2018.Methods:Studies published from January 2009 to December 2018 were searched in CNKI, Wanfang and VIP databases by using " autoimmune pancreatitis" , " immune pancreatitis" and " IgG related pancreatitis" as search items, respectively. One hundred and ten articles were finally included, and a total of 2 364 AIP patients were involved. The gender, age, clinical manifestations, laboratory tests, radiological examination, treatment and prognosis of these AIP patients were analyzed and summarized.Results:Among the 2 364 AIP patients, there were 1 777 males and 587 females, with an average age of 58 years. The main clinical manifestations were jaundice(61.31%), abdominal pain(52.45%), abdominal discomfort(34.78%) and body weight loss(22.62%). 50.13% of the patients suffered from extrapancreatic manifestations. Serological examination detected significantly increased levels of IgG4 (74.14%), CRP (73.68%), IgG (71.41%), erythrocyte sedimentation (67.34%), total bilirubin (62.44%), ALT/AST(50.83%), CA19-9(43.85%) and positive rheumatoid factor (42.04%). Pancreatic diffuse (46.87%) and regional enlargement (21.87%) was found in AIP patients by imaging examination. The pancreatic pathological manifestations mainly included lymphoplasmic cell infiltration, pancreatic acinar destruction and atrophy, fibrous tissue proliferation, and positive IgG4 deposition by immunohistochemistry. 282 patients (11.92%) were misdiagnosed, while 70.12% of AIP patients were attenuated by hormones therapies.Conclusions:AIP, which is more common in male in China, is often accompanied by extrapancreatic manifestations. Although imaging examinations were helpful for diagnosis, the misdiagnosis rate remains high. Clinicians need to raise awareness, enhance the ability to diagnose and treat AIP, thus reducing misdiagnosis.