Objective To study the effect of selection of indications in percutaneous laser disc decompression(PLDD).Methods Lumbar disc herniation treated by PLDD with satisfactory and unsuited indications in 34 cases respectively were matched studied.Results The curative effect was 85.3% and 55.9% in satisfactory indication group and unsuited indication group respectively (?~2=5.06,P

BACKGROUND: Percutaneous laser disc decompression(PLDD) is a new technology developed to treat lumbar herniated disk inrecent years; however,only limited literature has been reported about cohort study on its indications.OBJECTIVE: To treat patients with lumbar disc herniations by PLDD and evaluate the effects of PLDD in releasing painandimproving lumbar function after operation.DESIGN: Non-randomized concurrent controlled trial based on thepatients.SETTING: Department of Radiology of the 474 Hospital of Chinese PLA.PTICIPANTS: This study recruited totally 173 patients ( 101 males and 72 females aged from 18 to 75 years) who received PLDD in the Department of Radiology of the 474 Hospital of Chinese PLA from July 1998 to August 2002 and were followed up for over one year.METHODS:The 173 patients were divided into good indication group (Group A, n = 139) and poor indication group(Group B, n =34). Group B was further divided into extrusion group(Group B1 of 8 patients),lumbar canal stenosis group(Group B2 of 15 patients) and other conditions group (Group B3 of 11 patients). VAS scoring criteria and modified Macnab criteria were used to evaluate the curative effects.MAIN OUTCOME MEASURES: Primary results: the degree of pain and lumbar function. Secondary results:the success rate of puncture as well as adverse events and side effects.RESULTS: The success rate of puncture was 96. 3％ for performing through L5 - S1 and 100％ through L3-4 and L4-5. In Group A, excellent postoperative effects were seen in 63 cases, good in 51 cases, fair in 20 cases and poor in 5 cases, with 82.0％ excellent and good rates. The excellent and good rate in Group B was 55.9％. Postoperative back pain could be relieved several days later. Other complications such as disc infection,psoas hematoma,rupture of colon,injuries of nerve roots and bloodvessels did not occur. There was a significant difference between Group A and Group B(x2=10.38, P ＜0.05).CONCLUSION: (① PLDD is a convenient, safe and reliable procedure in treating lumbar disc herniation because of its high success rate, satisfactory results and fewer complications.② Proper selection of indications helps improve the curative effects of lumbar disc herniation.

Objective To study of percutaneous laser disc decompression(PLDD)in the patients of lumbar disc herniations.Methods 66 patients were treated with PLDD.The mean age of the 48 male and 18 female patients was 39.3 years old.Results 58 patients of all,or 87.9% showed excellent or good result.15 patients(78.9%)showed excellent and 2 patients(10.5%) were good,2 patients(10.6%) were fair or poor under 30 year old.15 patients(44.1%)showed excellent and 17(50.5%)patients were good,2(5.9%)patients were fair in 31~50 years old.2(15.4%) patients showed excellent and 7(53.8%)patients were good,4(29.8%)patients were fair or poor over 51 years old.Conclusion PLDD is safe and convenient method of treating lumbar disc herniations.

BACKGROUND: Percutaneous laser disc decompression (PLDD) and automated peroutaneous lumbar discectomy (APLD) have been widely used in the treatment of lumbar intervertebral disc prolapse.OBJECTIVE: To compare the symptoms and improvements of patients after receiving PLDD and APLD and analyze the characteristics of the two operations.DESIGN: A non-randomized concurrent controlled observation.SETTING: The 474 Hospital of Chinese PLA.PARTICIPANTS: Totally 106 inpatients with lumbar and leg diseases of different extent were selected from the 474 Hospital of Chinese PLA as the subjects. The patients were divided into APLD group( n =46) and PLDD group( n = 60) according to different intervention measures.INTERVENTIONS: APLD group: The dilating tube was probed at different levels, and working cannula of 4.8 mm was retained at last. The fenestration was made at the fibrous rings with the trepan, then nucleus pulposus of about 1 - 5 g was clipped by the pliers for nucleus pulposus. Electric discectomy apparatus was used to aspirate the nucleus pulposus of about 0.5 - 1.5 g at 600 - 300 rounds per minute. The electric discectomy apparatus and working cannula were pulled out after operation. PLDD group: The stylet was removed and optical fibers were inserted with the naked front segment (5 mm) com pletely going beyond the needle end. Cautery was made with 15 W laser for 1 s once a time at the interval of 4 s. The total output power of laser was adjusted between 1 200 - 1 700 joules. The patients lay at supine position to be examined for pain relief and functional recovery, and then they were sent back to the ward with flatbed cart for bed rest of 3 days. Therapeutic effects were evaluated according to modified Macnab' s criteria. The curative effect was presented as percentage.operations.excellent(47.8% ), 18 good(39. 1% ), 5 passable (10.9%), and 1 poor APLD group, there were 29 cases of excellent(48.4% ), 20 good (33.3%), 9 passable (15.0%), and 2 poor(3.3% ), with 81.7% excellent the two groups. Pain in the lumbar part usually sustained for several days,then was relieved and disappeared gradually. One patient in APLD group had infection of intervertebral disc. No complications occurred in PLDD group.CONCLUSION: PLDD and APLD do not differ significantly in excellent and good rate of treating prolapse of lumbar intervertebral disc. Compared with APLD, PLDD is a more convenient and minimally invasive technique causing fewer complications.

Objective To investigate the CT and MRI findings of primary hepatic neuroendocrine carcinomas.Methods Imaging findings of 6 patients with pathologically confirmed hepatic neuroendocrine carcinomas were retrospectively analyzed.Four patients underwent plain CT and contrast enhanced CT examinations.The other 2 patients underwent plain MRI and contrast enhanced MRI.Results One out of the 6 cases manifested multicentric tumor which appeared as one large tumor surrounded with multiple small nodules peripherally,and the tumors of the other 5 cases were solitary.On plain CT images,all lesions were well-defined and hypoattenuating with central areas of even lower density except punctuate calcifications at tumor periphery in 1 case.On pre-contrast MRI,the cases manifested heterogeneous low signal intensity on T1 wI and slightly high intensity on T2 WI.On dynamic contrast enhanced CT and MRI,Tumors manifested slight to mild enhancement in arterial phase,slight enhancement in portal venous phase or delayed phase with no enhancement in the center,accompanied by dislocation of surrounding vessels.There Was no lymphadenopathy in peritoneal cavity and retroperitoniurm. Conclusion CT and MRI scanning can demonstrate specific features of primary hepatic neuroendocrine carcinoma,which may help the diagnosis and differential diagnosis of the tumor.

Objective To screen, analyze and predict microRNAs (miRNAs) related to systemic scle-roderma (SSc). Methods Differentially expressed miRNAs between tissue samples from 3 patients with SSc and 3 normal human controls were screened with a gene chip including 924 miRNAs. Target genes regulated by differentially expressed miRNAs were searched with bioinformatics method. Finally, miRNAs related to SSc were predicted. Results There were 24 miRNAs differentially expressed between tissue samples of SSc and normal controls, including 9 up-regulated miRNAs and 15 down-regulated miRNAs. Literature review disclosed that SSc was associated with target genes regulated by hsa-miR-206, has-let-7g, hsa-miR-133a, hsa-miR-125b, hsa-miR-40-5p and hsa-miR-23b. In particular, 15 target genes regulated by hsa-miR-206 were closely correlated with the pathogenesis of SSc. Conclusions In lesions of SSc, there is an expression of miRNAs related to the pathogenesis of SSc, which may include hsa-miR-206 as well as 5 other miRNAs.

Objective To investigate the CT imaging features and its diagnostic value in patients with epibulbar dermoid and dermolipoma. Methods Twelve cases with epibulbar dermoids and dermolipomas were retrospectively analyzed. There were 5 dermoids and 7 dermolipomas, and a distinct female predominance (11/12). The lesions located at the external canthus, and were almost always uniocular and single (right=9, left=3). Transverse plain CT scan was performed in all patients, contrast enhanced CT scan in 5 cases. The clinical aspects, pathological features, and CT findings were then described. Results Crescent-shaped hypodensity lesion attached to the epibulbar was detected in all cases on CT scan. The diameter ranged from 8 mm?5 mm to 25 mm?15 mm. The lesion had a thin wall (1- 3 mm) under the conjunctiva lateral, and could have middle enhancement. Conclusion CT can show the lesion′s range and characteristics, as well as the relationship with the adjacent structures. CT has great directive value for operating on these tumors, and reducing the complications.

Objective: To analyze the influencing factors for the 20-69-year-old residents in Anhui Province with substandard physiques, so as to provide a basis for improving the physiques of population. Methods : The 2014 physical fitness survey data of residents aged 20-69 years in Anhui Province were collected, including demographic information, physical exercise status and physical indicators ( height, weight, vital capacity, blood pressure and so on ). The physiques of residents was rated according to the "National Fitness Standards" ( 2003 edition ) . The multivariate logistic regression model was used to analyze the influencing factors for substandard physiques in different age groups. Results: Among 39 803 residents recruited, 5 081 were rated as substandard physiques and the rate was 12.77%. The rates of substandard physiques in the residents aged 20-<40, 40-<60 and 60-69 years were 11.08%, 13.11% and 16.74%, respectively. The results of multivariate logistic regression analysis showed that age, gender, household registration, education level, occupation and time spent each exercise were the influencing factors for substandard physiques among the residents aged 20-<40 years ( P<0.05 ); age, household registration, education level, occupation and physical exercise were the influencing factors for substandard physiques among the residents aged 40-<60 years ( P<0.05 ); age, gender, education level, occupation, physical exercise and time spent each exercise were the influencing factors for substandard physiques among the residents aged 60-69 years ( P<0.05 ). Conclusions The residents aged 20-69 years in Anhui Province have higher rate of substandard physiques in the 2014 survey. Age, education level, occupation and physical exercise may affect physical fitness and vary in different age groups, thus interventions should be carried out according to age.

Objective: To investigate the molecular transmission network characteristics of HIV-1 among men who have sex with men (MSM) in Shaoxing City, Zhejiang Province, so as to provide insights into AIDS prevention and control among MSM. Methods: Newly reported HIV/AIDS cases among MSM in Shaoxing City were selected from January 2021 to September 2023. Plasma samples before the antiviral treatment were collected. The HIV-1 pol gene was amplified using reverse transcription PCR and nested PCR to construct phylogenetic trees for gene subtype analysis. The HIV-TRACE method was used to construct a molecular transmission network with a genetic distance of 1.5% to analyze clustering and the characteristics of cases within molecular clusters. Results: A total of 216 HIV/AIDS cases among MSM were included, and 179 qualified sequences were obtained. The predominant HIV-1 subtypes were CRF07_BC and CRF01_AE, with 95 and 66 cases, respectively. At 1.5% genetic distance, 20 molecular clusters were formed, with 61 nodes and 58 edges. A total of 61 sequences were connected to the transmission network (34.08%). HIV/AIDS cases among MSM from all the counties (cities, districts) in Shaoxing City were included in the network. There was the largest molecular cluster with ≥10 nodes, involving 12 cases from five counties (cities, districts), 3 medium-sized molecular clusters with 4 to 5 nodes, and the 16 small-sized molecular clusters with 2 or 3 nodes. Seven cases with high risk of transmission, each with ≥4 edges, were all CRF07_BC subtypes. Among them, two cases were from the large molecular cluster, and five cases were from the same molecular cluster composed of cases from Shengzhou City and Xinchang County. Conclusions The predominant HIV-1 subtypes among MSM in Shaoxing City were CRF07_BC and CRF01_AE. There was cross-regional HIV transmission, and potential transmission risk might exist in Shengzhou City and Xinchang County.

Chronic pain is a common clinical manifestation in patients with advanced cancer, and pain treatment is a part of cancer treatment. The titration method of opiod drugs will be recommended for relieving pain in moderate-severe pain in order to improve the quality of life of patients with advanced cancer. Individualized pain control refers to the concept that different patients show different resistance responses to opiod drugs. This article briefly reviews the classification and mechanism of cancer pain, the titration method of opiod drugs in the cancer pain control and individualized application.