ObjectiveTo introduce the design of the instrument for percutaneous posterolateral foraminoplasty and analyze long-term outcomes of percutaneous foraminoplasty and transforaminal endoscopic discectomy in the treatment of non-contained lumbar disc herniation.MethodsFifty-six patients with noncontained lumbar disc herniation confirmed by symptom,physical sign and concordant imaging underwent percutaneous foraminoplasty and transforaminal endoscopic discectomy,including 7 cases of L3-4,30 of L4-5 and 19 of L5S1.The visual analogue scales(VAS) of pre- and post-operative low back pain and sciatica were compared,and the Macnab scores were also evaluated.ResultsAll of the procedures were performed successfully,with mean operation time of 60 min(range,40-120 min),and a mean blood loss of 30 ml (range,20-50 ml).The follow-up time was more than 36 months.Postoperative VAS of low back pain and sciatica were significantly decreased compared with preoperative VAS (P＜0.01).There were 44 cases of excellent,10of good,and 2 of fair according to Macnab score system,with total successful rate (excellent and good) up to 96.4％.Only 5 cases with L5S1 disc herniation were found complicated with sun-burn syndrome,which were relieved by pulsed electro-stimulant therapy for 1 week.ConclusionPercutaneous foraminoplasty and transforaminal endoscopic discectomy is an effective and safe minimally invasive treatment alternative for non-contained lumbar disc herniation.

Objective To study the HPLC fingerprints of isoflavones from different medicinal plants of G.max and establish a sensitive and specific method for controlling the quality of the soybean isoflavone.Methods The gradient elution mode was applied in chromatographic separation.A C_(18) column(250 mm?4.6 mm,5 ?m) was used with the mobile phase: ice acetic acid water solution(pH value 3.2)-methanol,flow rate: 0.6 mL/min,detecting wavelength: 261 nm,and the column temperature: room temperature.All 25 samples collected from different species were determined.The clustering analysis and the software of similarity analysis were applied for datum analysis.Results This method had a good repeatability and reproducibility.The ratio of peaks′ area from distinct samples were different.Conclusion The method can show the difference of chemical compositions among species completely and can be used as a quality control method for soybean.

In this study the relation between the extent and type of disc protrusion and the clinical severity of symptoms of low back pain was observed. Our series consisted of 300 consecutive cases of lumbar disc protrusion,with their diagnosis confirmed by intraoperative observation. Preoperative pain severity was assessed using a back pain scale that combined the symptoms of back pain and sciatica. Intraoperaative pathological findings of disc were documented and comparesd with preoperative symptoms and signs. The pathological changes of disc were classified as following four subtypes: bulging disc (85 cases), protruding disc (104 cases), extruded disc (72 cases) and sequestered disc (39 cases). Our results suggest that severity of pain in patients with herniated lumbar disc is related to position of herniation rather than magnitude and exent of herniation. Inflammed intraspinal tissues are significantly associated with low back pain and sciatica.

Objective To retrospectively analyze the results of unilater al external fixators in the treatment of the distal third fractures of humeral s hafts. Methods From October 1997 to October 2002, 33 patients from 15y-70y (ave rage 31y) with the distal third fractures of humeral shafts were treated with un ilateral external fixators. They included 3 transverses fractures, 1 oblique fra cture, 9 spiral fractures and 20 comminuted fractures. 15 cases were treated wit h open reduction and fixation with external fixators and limited internal fixati on, 10 cases were treated with open reduction and fixation with external fixator s, and 9 cases were treated with closed reduction and fixation with external fix ators. 9 cases with radial nerve injury undewent nerve exploration. External fix ators were removed after bone healing. Duration of follow-up was 8 to 24 m (ave rage 18 m). Results The time of bone healing was 11 to 22 w (average 14 w). At t he latest follow-up, the function of injured radial nerves in 9 preoperative ca ses and 2 postoperative cases and the motion function of elbow were restored to normal. There were only 7 cases of superficial pin site infection which were cur ed with oral antibiotics and pin site care with mild disinfectants. Conclusion U nilateral external fixators can play special roles and have good results in the treatment of the distal third fractures of humeral shafts, combined with open re duction and limited internal fixation.

Objective Non-traumatic and posteromedial subchondral osteonecrosis of trochlea tali (NTPSOTT) is a special type of necrosis of the talus , for which early diagnosis and treatment are particularly important .This study investigated the clinical ef-fectiveness of autogeneic cancellous bone transplantation in the treatment of NTPSOTT . Methods We retrospectively analyzed 21 cases of NTPSOTT treated by autogeneic cancellous bone transplantation and evaluated using the Clinical Rating System of the American Orthopedic Foot and Ankle Society ( AOFAS) , Visual Analogue Scale ( VAS) , and X-ray and CT examinations . Results The pa-tients were followed up for 12-26 months and all healed desirably , with the graft well integrated into the surrounding tissue , but no as-similation, collapse of the articular surface , or narrowing of the joint space .The last follow-up visit revealed significantly improved AOFAS score (90.55 ±6.73 vs 50.87 ±11.42, P=0.009) and VAS score (1.32 ±0.81 vs 6.43 ±1.66, P=0.027) as compared with the baseline . Conclusion Autogeneic cancellous bone transplantation is preferable for the treatment of NTPSOTT , which can effectively reduce the pain in the ankle , maintain the joint space , and protect the function of the ankle .

OBJECTIVETo investigate the epidemiological characteristics of lower back pain of truck drivers in plateau areas with an analysis of the causes and evaluated the effects of the protective measures.

METHODSThe self-reported lower back symptom was investigated by questionnaire in 1,132 male drivers in plateau areas. Vibration of the driver lumbar back was measured real time with or without wearing corset. Study the effect of the special corset for drivers and the massage on back by self-control design of big sample intervention experiments.

RESULTSThe prevalence of lower back pain of drivers in plateau areas was 86.1%. High level of its prevalence is due to many factors. Special corset for drivers and massage on back by themselves can reduce the degree of the pain.

CONCLUSIONDriving in plateau areas is a special occupational work with high level of prevalence of lower back pain which can be prevented.

Automobile Driving ; Humans ; Low Back Pain ; epidemiology ; etiology ; prevention & control ; Male ; Occupational Diseases ; etiology ; prevention & control ; Prevalence ; Surveys and Questionnaires

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.