Objective To explore the clinical effects and safety of radiofrequency thermocoagulation combined with ozone injection in the treatment of failed back surgery syndrome (FBSS). Methods A total of 58 patients suffered from FBSS were treated with radiofrequency thermocoagulation and ozone injection from October 2006 to December 2012.The changes of lumbar and leg functions were observed .The evaluation of clinical efficacy was made by visual analogue scale ( VAS) and Oswestry disability index (ODI) at one week, one month, three months, six months, and twelve months postoperatively , respectively. Results The operation was successfully completed in all the 58 patients , without serious complications .All the cases were followed for one year .The ODI was 20.3 ±3.1 at the last follow-up, which was significantly lower than that before operation (79.8 ±2.6, t=96.871, P=0.000).The VAS of back pain was (7.6 ±0.4) points preoperatively and (3.1 ±0.2) points at the last follow-up, which also showed statistical significance (t=45.206, P=0.000).According to the modified MacNab criteria, clinical outcomes showed excellent in 18 cases and good in 23 cases, with an excellent and good rate of operation being 70.7% (41/58). Conclusion Treatment of FBSS by using radiofrequency thermocoagulation and ozone injection is an effective option .

Objective: To determine the changes of upper airway morphology induced by mandible position from central relation to advancement position in patients with obstructive sleep apnea syndrome. Methods: Nineteen patients (17 males and 2 females) suffering from obstructive sleep apnea syndrome were confirmed with polysomnography. Occlusal wax record was made with mandible in advancement position. Helical computed tomography was performed on each patient in central relation and mandibular advancement position with wax record in situ respectively. On each slice, anteroposterior and transverse diameters were obtained. Airway shape was expressed as the anteroposterior/transverse (AP/T) diameter ratio. Paired samples t test was employed to compare the measurements. Results: With mandibular advancement, average and minimal diameters of glossopharynx and hypopharynx were increased significantly. Compared with it, the change of transverse diameter was more prominent. All segments of upper airway were increased significantly except hypophaynx laterally. Moreover, the change of velopharynx shape was observed on axial planes. Ellipse with transversal long axis became more compressed. Conclusion: Upper airway morphology of all segments was influenced by mandibular advancement whether in the sagittal or transverse plane of space, or airway shape. Not only anatomic connection but also regulation of the nerve system and other still unknown mechanism make contribution to the changes of upper airway morphology in patients with obstructive sleep apnea syndrome. The changes of upper airway morphology above mentioned constitute the rationale of treatment of obstructive sleep apnea syndrome with oral appliances.

Objective To explore the effect of minimally invasive spine surgery in the treatment of lumbar disc herniation and analyze its application value. Methods 76 patients with lumbar disc herniation treated in our hospital from August 2015 to September 2017 were selected as subjects. Patients were divided into control group and experimental group according to the order of admission. Each group contained 38 cases. Patients in the control group were treated with conventional open surgery, while patients in the experimental group were treated with minimally invasive spine surgery under diskoscope. The results of treatment were compared between the two groups. Results The results showed that all patients were cured completely after surgery. Intraoperative blood loss, operation time, and length of hospitalization in the experimental group were significantly better than those in the control group (P＜0. 05). The incidence of postoperative complications in the experimental group was less than that of the control group(P＜0. 05). Conclusion The minimally invasive spine surgery for the treatment of lumbar disc herniation can effectively reduced the operation time and hospitalization time of patients. It has a good application prospect and is worthy of promotion.

OBJECTIVETransesophageal echocardiography was performed during closed-chest cardiopulmonary resuscitation (CPR) in in-hospital cardiac arrest to further explore the hemodynamic mechanism of CPR.

METHODSCPR attempts were performed according to advanced cardiovascular life support guidelines in 6 cases of in-hospital cardiac arrest. Multi-plane transesophageal echocardiography was carried out within 15 min of initiation of CPR. Throughout CPR, the motion of the mitral, tricuspid and aortic valves, the changes in the left ventricular cavity size and the thoracic aortic diameter were observed. Trans-mitral and trans-aortic Doppler files of blood flow were also documented.

RESULTSA closure of the mitral and tricuspid valves with simultaneous opening of the aortic valve occurred exclusively during chest compression, resulting in forward blood flow in the pulmonary and systemic circulation. Peak forward aortic flow at a velocity of 58.8 +/- 11.6 cm/s was recorded during the compression phase. Whereas, a closure of the aortic valve and rapid opening of the atrioventricular valves associated with ventricular filling during relaxation of chest compression was noted in all 6 patients. Peak forward mitral flow at a velocity of 60.6 +/- 20.0 cm/s was recorded during the release phase. Mitral regurgitation during the chest compression period was detected in 5 patients, reflecting a positive ventricular-to-atrial pressure gradient. A reduction in the left ventricular chamber and an increase in the thoracic aortic diameter during the compression phase was found in all patients, indicating that direct cardiac compression contributed to forward blood flow.

CONCLUSIONThese observations favor the cardiac pump theory as the predominant hemodynamic mechanism of forward blood flow during CPR in human beings.

Aged ; Aged, 80 and over ; Cardiopulmonary Resuscitation ; Echocardiography, Transesophageal ; Female ; Heart Arrest ; diagnostic imaging ; physiopathology ; therapy ; Hemodynamics ; Humans ; Male ; Middle Aged

Objective:To discuss the practice and application of "artificial intelligence + big data" in the construction of thoracic surgery golden course.Methods:The intern students of the Department of Thoracic Surgery in Harbin Medical University Cancer Hospital were selected as the research objects, and they were randomly divided into 2 groups with 36 cases in each group. The control group was taught with regular courses, and the observation group was taught by the golden course system under "artificial intelligence + big data". After the course, self-made assessment forms were used to assess the academic performance (theoretical knowledge assessment results and skill operation assessment results) of the two groups of medical students. The excellent and good rate of knowledge mastery and the mastery of clinical operation techniques were scored by the teachers, and the evaluation was made from the aspects of learning attitude, the mastery degree of theoretical knowledge and clinical operational techniques, etc. In addition, self-made innovative thinking ability scale was used to assess the medical students. SPSS 22.0 was used for independent samples t test and chi-square test. Results:There was no statistically significant difference between the two groups of theoretical knowledge assessment scores and skill operation assessment scores before the teaching; after the course, the theoretical knowledge assessment scores and skill operation assessment scores of the control group were higher than those before the teaching, with statistically significant differences ( t=5.37, 4.17, P<0.05). After the course, the theoretical knowledge assessment scores and skill operation assessment scores of the observation group were higher than those before the teaching, with significant differences ( t=10.93, 8.24, P<0.05). The results of theoretical knowledge assessment and skill operation assessment in the observation group were significantly higher than those in the control group after the course ( t=7.10, 5.77, P<0.05). In the control group, 17 cases were excellent in knowledge mastery, accounting for 47.22%, and the rate of knowledge mastery was 83.33% (30/36); in the observation group, 26 cases were excellent in knowledge mastery, accounting for 72.22%, and the excellent and good rate of knowledge mastery was 100% (36/36), and the difference was statistically significant ( χ2=4.55, P=0.033). After the course, the innovative thinking ability of the control group was higher than that before the teaching, the innovative thinking ability of the observation group was higher than that before the teaching, and the innovative thinking ability of the observation group was higher than that of the control group, and the difference was statistically significant ( t=7.07, P<0.001). Conclusion:The use of the "artificial intelligence + big data" golden course to build a teaching system can improve the academic performance, knowledge mastery and innovative thinking ability of medical students.