Objective: To analysis the efficacy of percutaneous transforaminal endoscopic discectomy on the treatment of lumbar disc herniation. Methods: A total of 86 patients with lumbar disc herniation were randomly divided into experimental and control groups. They were given percutaneous transforaminal endoscopic discectomy and laminectomy decompression therapy. The clinical effi?cacy, VAS, JOA, Lehmann score and other relevant circumstances before and after surgery were compared. Results: The total effec?tive rate in the experimental group was higher than that in the control group. Postoperative JOA score and Lehmann score were higer than those in the control group. VAS scores were lower than that in the control group, bleeding amount, incision size, length of hospi?talization, complication rates lower than that in the control group, the differences were statistically significant ( P<0?05) . But there was no signifiant difference in operative time ( P>0?05) . Conclusions: Percutaneous transforaminal endoscopic discectomy for lum?bar disc herniation can improve clinical outcomes and reduce pain, improve function, reduce blood loss, shorter hospital stay and pro?mote postoperative recovery, reduce complications. It is worth further clinical application.

Objective:To investigate the cardiac presentations and the possible influencing factors of severe and critical coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with severe and critical COVID-19 admitted to the Eighth People's Hospital of Guangzhou from January 21st to February 24th 2020 were enrolled. According to the clinical classification, the patients were divided into severe group and critical group. The myocardial injury markers, such as lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatine kinase (CK), cardiac troponin I (cTnI), myoglobin (MYO), MB isoenzyme of creatine kinase (CK-MB), B-type natriuretic peptide (BNP) and electrocardiogram (ECG) changes were compared between the two groups.Results:A total of 55 COVID-19 patients were selected, including 15 critical cases and 40 severe cases. The patients with severe and critical COVID-19 were male-dominated (61.8%), the average age was (61.2±13.0) years old, 83.6% (46 cases) of them had contact history of Hubei, 38.2% (21 cases) of them were complicated with hypertension. There was no significant difference in baseline data between the critical group and the severe group. Myocardial injury markers of critical and severe COVID-19 patients were increased in different proportion, LDH increased in most patients (20 severe cases and 7 critical cases), followed by AST (16 severe cases and 5 critical cases). There was significant difference in the number of patients with elevated CK between severe group and critical group (cases: 1 vs. 4, P = 0.027). Abnormal ECG was found in 39 of 42 patients with ECG examination. Nonspecific change of T wave was the most common. Before and after treatment, 9 of 15 patients with changes of ECG and myocardial injury markers had oxygenation index less than 100 mmHg (1 mmHg = 0.133 kPa), and the prominent changes of ECG were heart rate increasing and ST-T change. Conclusions:The increase of myocardial injury markers and abnormal ECG were not specific to the myocardial injury of severe and critical COVID-19 patients. At the same time, the dynamic changes of myocardial injury markers and ECG could reflect the situation of myocardial damage.