The concept of far lateral lumbar disc herniation was firstly reported by Abdullah in 1974. The diagnosis of far lateral lumbar disc herniation is based on the discography findings as well as on clinical manifestations. Far lateral lumbar disc herniation is a special type of lumbar disc herniation. Clinically, far lateral lumbar disc herniation is less seen than other types of lumbar disc herniation, it accounts for 0.7%-11.7% of total lumbar intervertebral disc protrusion. Although the incidence of far lateral lumbar disc herniation is lower, its symptoms are usually heavier and its protrusion sites are specific. Its treatment methods are more complex, including mainly conservative treatment, minimally invasive interventional therapy and surgical management, etc. This paper aims to make a review about the recent progress in its corresponding treatment.

Objective To investigate the role of Wnt signal pathway related proteins in the tumorigenesis of sponta-neous breast cancer in TA2 mice. Methods Mammary glands were collected from tissues of normal 5 cases of TA2 mice. Spontaneous breast cancers and relevant mammary glands precancerous lesions were harvested from 5 cases of TA2 mice. Mammary tissue samples from normal TA2 mice, precancerous lesions and cancer tissues of spontaneous breast cancer-bearing TA2 mice were subsequently used to detect the expression of Wnt1,Wnt5a andβ-catenin via immunohistochemical staining. Results ① Results of immunohistochemical staining showed that the positive ex-pression of Wnt1 and Wnt5 a located in cytoplasm in spontaneous breast cancers and mammary gland precancerous lesions from TA2 mice. The normal mammary glands were negative for Wnt1 and Wnt5a staining. The cytoplasm of precancerous lesions showed higher expression for Wnt1 and Wnt5a than them in the breast cancer. β-catenin in breast cancer and precancerous lesions were abnormal cytoplasmic expression. The expression level in breast cancer was higher than in the precancerous lesions. In normal mammary gland, the positive expression ofβ-catenin mainly located in the cytomembrane. ② The positive expression rates of Wnt1, Wnt5a and β-catenin in normal breast group,precancerous group and breast cancer group were ( 4. 46 ± 3. 57 )%, ( 96. 50 ± 6. 30 )%, ( 90. 00 ± 1. 17 )%, ( 2. 27 ± 4. 55 )%, ( 96. 24 ± 6. 00 )%, ( 95. 90 ± 4. 32 )%, ( 4. 78 ± 3. 57 )%, ( 60. 59 ± 5. 63 )%, (84. 87 ± 2. 56)%,respectively. The positive expression rates of the three in precancerous group and breast cancer group were significantly higher than those in normal breast group(P<0. 01). The positive expression rates of Wnt1, Wnt5a in precancerous group were higher than those in the tumor group,and the differences of Wnt1 had statistical significance (P<0. 05) while Wnt5a did not (P>0. 05). Compared with breast cancer group,the precancerous group had lower positive expression rate of β-catenin and the differences also had statistical significance ( P <0. 05 ) . Conclusion Wnt1 , Wnt5 a and β-catenin promote the progression of spontaneous breast cancer in TA2 mice.

Trigeminal neuralgia (TN) is a common cerebral nerve disease. The common methods for treatment of TN include drugs, surgery and minimally invasive intervention. Minimally invasive techniques have been widely used in the treatment of TN for simple operation, definite curative effect, high safety and few postoperative complications, whereas there are diversities of technical levels in different areas. Through summarizing clinical experiences, referring to and absorbing new ideas reported from domestic and overseas in recent years, the clinical operational guidelines for minimally invasive interventional therapy for TN were compiled in this article, in order to standardize clinical treatment and improve therapeutic effect of TN.

Objective To evaluate the clinical effect of uterine arterial embolization (UAE) as a treatment of symptomatic uterine fibroids(UF).Methods Twenty-six patients with clinic symptoms(menorrhagia, pelvic pain, bulk-related symptoms and anemia)caused by uterine fibroids underwent UAE.The embolization with a single catheter using the single-femoral artery approach to bilateral uterine artery was performed, injection of PVA 355～500 ?m and silk particles were used in 20 and 6 cases respectively.Results All cases were followed up for 6 to 18 months after treatment.The symptoma were noticeable improvement in 24 cases but 2 cases whom with injection silk particles.The tumors were marked diminution in size(45%～75%) sonographically after 2～6 months in 13 cases.No severe complication were discovered in all cases.Conclusion Uterine artery embolization is a safe and effective method for the management of symptomatic UF.Longer follow up is needed to evaluate the long term effects.

Objective To investigate the clinical efficacy of ozone injection combined with radiofrequency ablation (RFA) for the treatment of far lateral lumbar disc herniation (FLLDH). Methods A total of 60 patients with FLLDH, who were admitted to authors’ hospital during the period from March 2013 to March 2014, were randomly and equally divided into the study group (n=30) and the control group (n=30). Simple ozone injection treatment was employed for the patients of the control group, while ozone injection combined with radiofrequency ablation was adopted for the patients of the study group. The same other adjunctive medication was used in both groups. All the patients were followed up at one week as well as at one, 3 and 6 months after the treatment. The clinical effect and the complications of both g roups were recorded. Results Successful operation was obtained in all 60 patients, no perioperative complications occurred, and the technical success rate was 100%. The excellent clinical results evaluated at one week, and one, 3 and 6 months after the treatment in the control group and in the study group were 73.3%, 76.7%, 70%, 60% and 70%, 76.7%, 83.3%, 90% respectively. The 3-month and 6-month clinical results of the study group were significantly better than those of the control group. Conclusion For the treatment of FLLDH, ozone injection combined with radiofrequency ablation is safe and effective. This technique should be recommended in clinical practice.

Objective: To observe the therapeutic effect of Angiojet thrombosis aspiration of lower extremity deep vein thrombosis (DVT) after ultrasound-guided antegrade vein puncture. Methods: Data of 63 patients with acute or subacute lower extremity DVT were retrospectively analyzed. Angiography of the lower extremity was followed by implantation of inferior vena cava filter. Ultrasound-guided Angiojet thrombosis aspiration and transcatheter thrombolysis were performed, and the effect and safety were observed. Results: Among 63 patients, 54 recycled filters and 9 permanent filters were implanted. The recovery rate of recycled filters was 88.89% (48/54), and the average recovery time was (5.48±2.10) days. The success rate of ultrasound-guided antegrade vein puncture was 100% (66/66) without complication. The excellent and good treatment rate was 84.13% (53/63). There were 9 cases of hemoproteinuria after thrombus aspiration and 7 cases of mucosal hemorrhage during thrombolysis, and the total incidence of complications was 25.40% (16/63). No serious complication occurred. During (22.74±6.21) months' follow-up, 7 cases were lost and 1 case died due to malignant tumor, and post-thrombotic syndrome occurred in 6 cases (6/55, 10.91%). Conclusion: Ultrasound-guided anterograde vein puncture combined with Angiojet thrombosis aspiration is effective and safe for treatment of lower extremity deep vein thrombosis.

Objective To investigate the effectiveness and safety of AngioJet rheolytic thrombectomy in the treatment of acute limb ischemia (ALI). Methods The clinical data of a total of 19 patients with ALI of lower limbs, who were treated with AngioJet rheolytic thrombectomy, were retrospectively analyzed. The patients included 14 males and 5 females, with a mean age of (77.7±6.8)years old (66-90 years old). The thrombus clearance rate ≥90％ was defined as grade Ⅲ, 50％-90％ as grade Ⅱ, and <50％ as grade I, which was used to evaluate the thrombus clearance effect. The postoperative device-related complication, amputation incidence and the mortality were recorded. Results In all the 19 patients, the technical success rate was 100％. The thrombus clearance rate after initial AngioJet rheolytic thrombectomy was >50％ in all patients, among them grade Ⅲ was obtained in 14 patients (73.7％) and grade Ⅱ in 5 patients (26.3％). The symptoms of lower extremity pain, ischemia, etc. were improved. In 5 patients, macroscopic hemoglobinuria occurred once after the treatment. No serious complications such as bleeding at puncture point, hemorrhage of digestive tract, renal function damage or death occurred. Limb salvage was achieved in17, with a limb salvage rate of 89.5％, the 6-month and one-year limb salvage rates were 84.6％ (11/13) and 80.0％ (8/10) respectively. Conclusion For the treatment of ALI of lower limbs, AngioJet rheolytic thrombectomy is safe and effective, it can rapidly recover arterial blood flow. AngioJet rheolytic thrombectomy is especially suitable for the elderly patients and the patients who have high risk for surgical operation or have contraindications for thrombolysis.

Transjugular intrahepatic portosystemic shunt (TIPS) has been widely used in the treatment of the complications of portal hypertension,and in recent years,with a deepened understanding of TIPS,covered stents have been further developed and applied in clinical practice,among which a special stent for TIPS,Viatorr covered stent,has become a focus of attention.This article reviews the application and effect of Viatorr stent and points out that Viatorr stent can establish intrahepatic shunt and thus significantly improve shunt patency rate.Meanwhile,it can reduce the risk of repeated intervention and rebleeding without increasing the incidence rate of hepatic encephalopathy and improve patients'quality of life.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Objective: To study the constitutional features of diseases spectrum of inpatients with liver disease in infectious diseases department of three comprehensive hospitals to provide resource allocation proposition for the construction of Department of Infectious Diseases. Methods: Inpatients data were extracted from the department of infectious diseases of three comprehensive hospitals (Kunming General Hospital of the People's Liberation Army, Yuxi People's Hospital and Dali People's Hospital) between January 2010 to December 2015, and were retrospectively analyzed. The distribution of patients with viral hepatitis (A, B, C, E) and severe liver disease (Severe hepatitis, cirrhosis, liver cancer) was further analyzed in hospitalized patients. Data were analyzed by one-way analysis of variance. A chi-squared test was used for comparison between groups. The change trends of disease constituent ratio in different years were checked by 2 test. Results: Liver disease, tuberculosis and AIDS were the three common diseases of three comprehensive hospitals in Yunnan, accounting for 58.61% of all admissions. However, an inpatients with liver diseases (17.25%, 3555/20606, 95% CI 16.73%-17.77%) were significantly lower than tuberculosis inpatients (33.98%, 7002/20606, 95% CI 33.34%-34.62%). An observations from different hospitals and at different time points showed that the proportion of patients with liver disease was lower than that of tuberculosis patients. The proportion of inpatients with HBV infection showed a downward trend (P < 0.001), whereas the proportions of inpatients with HCV and severe liver diseases showed an increased trend over time (P < 0.001). Conclusion The proportion of inpatients with liver diseases was lower than tuberculosis inpatients in the Department of Infectious Diseases of three comprehensive hospitals. Hence, the paucity of the disease spectrum should be considered for resource allocation in the construction of infectious disease department.