Objective To study the clinical effect of percutaneous laser disc decompression(PLDD) combined with ozone injection in the treatment of cervical spondylosis.Methods 183 cases of cervical spondylosis were randomly divided into two groups.One group of 80 cases with 118 cervical discs herniation were treated with PLDDonly.while the other group of 103 cases with 142 cervical discs herniation were treated with PLDD combined with ozone injectlon.The patients were followed up for 3 to18 months(mean 7 months).The clinical effects were assessed according to the Japanese Orthopaedic Association scoring system(JOA score)and the improvement rates of the two groups were compared.Results 167 cases were followed up.The average point of the group treated with PLDD is 15.2 and the improvement rate is 74.7%.The average point of the group treated with PLDD combined with ozone injection is 16.3 and the improvement rate is 91.3%.The difference between two groups has statistical significance(P＜0.05).Conclusion The treatment of cervical spondylosis with PLDD combined with ozone injection is safe.painless and minimally invasive.The clinical effect is impmved tremendously and much better than monotherapy.

Objective To explore the clinical effect of lubar intervertebral disc protrusion treatment with ozone injection combined radiofrequency thermocoagulation. Methods 36 patients with lubar intervertebral disc protrusion confirmed by clinical and imaging examination were underwent radiofrequency thermocoagulation followed ozone injection guided with CT. Results All the patients were followed up for 3 ～6 months,and statistic the improvement rate was evaluated according to Macnab standard. The total effective rate was 94.4%, and the improvement rate was 86.1%. Conclusion CT guided treatment could greatly elevate the accuracy of puncture. Radiofrequency target point thermocoagulation combined with ozone injection was a minimally invasive、safet and markedly effective method for lubar intervertebral disc protrusion treatment.

Objective To explore the appropriat.e treatment process for elderly patients with intertrochanteric fracture in primary hospitals.Methods According with the evaluation system and the characteristics of the grassroots hospitals and elderly patients with intertrochanteric fractures,the treatment standards for risk assessment was established,and the appropriate treatment process for intertrochanteric fracture in elderly patients in primary hospitals was initially formed and tried to promote applications in three primary hospital from December 2010 to January 2012,and its feasibility and effectiveness were tested.Results 66 elderly patients with intertrochanteric fracture were treated in three primary hospital,and 38 cases were hospitalized in primary hospital,including 24 cases of osseous union in 27cases treated with expectant treatment,11 cases of surgical treatment,and the cure rate was 89.5％.Sent on the operation rate of 90.3％ cases,54.8％ of cases occurred within 2 days.The incident of complications in early stage was 25.8％.Conclusion The diagnosis and treatment process and assessment criteria of treatment risk for elderly patients with intertrochanteric fracture in the primary hospital which is initial established is simple,practical,practicable,and has good effect and certain clinical value.

Objective:To evaluate the efficacy and safety of intensity modulated radiotherapy (IMRT) and programmed death-1 (PD-1) immunotherapy combined with single-agent chemotherapy for patients with local failure of esophageal cancer after initial radical chemoradiotherapy.Methods:Clinical data of 80 patients with local failure of esophageal cancer after initial radical chemoradiotherapy treated with IMRT or PD-1 immunotherapy combined with single-agent chemotherapy in People's Hospital of Xinghua between June 2014 and June 2023 were retrospectively analyzed. IMRT was delivered at 1.8-2.0 Gy per fraction, 5 fractions per week, with a total dose of 45.0-60.0 Gy in 40 patients (IMRT group). The other 40 patients received PD-1 immunotherapy combined with single-agent chemotherapy (PD-1 immunotherapy combined with single-agent chemotherapy group). Kaplan-Meier method was used for univariate analysis and the cumulative survival probability. Log-rank test was used for survival significance test. Cox proportional hazards model was used for multivariate analysis of related factors affecting overall survival (OS), progression-free survival (PFS) and local control (LC).Results:By December 2023, the follow-up rate was 100%. The 1- and 2-year OS rates in the IMRT group were 66.1% and 18.9%, with a median OS time of 10.1 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year OS rates were 72.3% and 36.9%, with a median OS time of 12.4 months. There was a significant difference in OS rates between two groups ( χ2=3.89, P=0.049). The 1- and 2-year PFS rates in the IMRT group were 47.4% and 31.6%, with a median PFS time of 8.5 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year PFS rates were 70.0% and 64.2%, with a median PFS time of 11.9 months. There was no significant difference in the PFS rates between two groups ( χ2=2.66, P=0.103). The 1- and 2-year LC rates in the IMRT group were 68.6% and 62.3%, with a median LC time of 8.9 months. In the PD-1 immunotherapy combined with single-agent chemotherapy group, the 1- and 2-year LC rates were 72.8% and 66.7%, with a median LC time of 12.0 months. There was no significant difference in LC rates between two groups ( χ2=0.18, P=0.672). Grade 2 radiation esophagitis and radiation pneumonitis developed in 82.5% (33/40) and 32.5% (13/40) in the IMRT group, respectively. The incidence of grade 1-2 peripheral blood leukopenia was 40.0% (16/40), 50.0% (20/40) for grade 1-2 peripheral blood thrombocytopenia, 27.5% (11/40) for moderate to severe anemia, and 20.0% (8/40) for grade 1-2 thyroid dysfunction in the PD-1 immunotherapy combined with single-agent chemotherapy, respectively. Single- and multi-factor analysis showed that the failure site ( χ2=9.01, P=0.011) and short-term efficacy ( χ2=7.78, P=0.005) were the independent prognostic factors affecting OS. The short-term efficacy was the independent prognostic factor for PFS ( χ2=31.63, P<0.001). The short-term efficacy was the independent prognostic factors affecting LCS ( χ2=17.64, P=0.001) too. Conclusion:For the patients with local failure of esophageal cancer after initial radical chemoradiotherapy, the combination of PD-1 immunotherapy with single-agent chemotherapy yields better survival prognosis than re-irradiation alone, but it is still necessary to pay attention to the related drug toxicities.