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.

Influenza,caused by influenza virus,is a respiratory infectious disease with a serious hazard to human health.Prevention of influenza through vaccine development is the most effective strategy.It is important to build a rapid response platform for research and production of influenza vaccine.As virus vectors,live vaccine provides a new prevention and treatment way for infectious disease.Modified vaccinia virus Ankara(MVA) is a replication-deficient viral vector that is safe and can encode one or more foreign antigens and induce humoral and cellular immune response.MVA holds great promise as a vaccine platform.In this review,we discuss the use of MVA for vaccine development against influenza virus.

Objective To observe the safety and severity of heat-sensitive moxibustion in treating poisonous snakebites-induced bladder dysfunction of different degrees.Method Twenty-six patients diagnosed with bladder dysfunction due to poisonous snakebites were examined by type-B ultrasonic scanning for residual urine volume and uroflowmetry. The patients were treated with heat-sensitive moxibustion. The residual urine volume and uroflowmetry parameters were compared between different severity degrees of bladder dysfunction before and after treatment.Result The residual urine volumes were changed significantly in the mild group and moderate group after treatment (P<0.01); the residual urine volume showed insignificant change after treatment in the severe group (P>0.05). The maximum urine flow rate (Qmax) was significantly changed in the mild group after the treatment (P<0.05); the Qmax was insignificantly changed in the moderate and severe groups after treatment (P>0.05).Conclusion Heat-sensitive moxibustion is significantly effective in treating mild-moderate bladder dysfunction due to poisonous snakebites, and it’s safe and reliable.

Glucocorticoid is an important treatment for many pediatric diseases and it often leads to osteoporosis, osteonecrosis of the femoral head, and growth retardation. Among them, glucocorticoid-induced growth retardation has been a particular focus in the treatment of children patients, which leads to a decrease in final height. The mechanism of glucocorticoid-induced growth retardation is complex, and there is no safe and effective treatment.This article summarized the mechanisms underlying glucocorticoid-inhibited longitudinal bone growth and reviewed the potential therapeutic targets discovered in recent years.

Objective To investigate the effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level.Methods 92 patients with coronary heart disease were selected as research subjects.They were randomly divided into the observation group and the control group,46 cases in each group.The control group was treated with anti-thrombotic,nitrates and other conventional western medicine.The observation group was treated with tirofiban hydrochloride based on the conventional treatment.Results The total effective rate of the observation group was 95.65%,which was higher than 82.61% of the control group,the difference was significant (χ2=4.039,P<0.05).And the homocysteine level in the observation group was (5.38±1.02)μmol/L,which was lower than (7.27±1.19)μmol/L in the control group,the difference was statistically significant (t=8.179,P<0.01).After treatment,the cardiac function CO level[(4.96±0.98)L/min],EF level[(62.48±11.16)%]and SV level[(86.37±11.47)mL]in the observation group were higher than those in the control group,the differences were statistically significant (t=2.271,2.954,2.911,all P<0.05).After treatment,the hs-CRP level[(4.25±1.32)mg/L]and Fib level[(3.14±0.73)g/L] in the observation group were lower than those in the control group,the differences were statistically significant (t=7.981,3.174,all P<0.01).ConclusionTirofiban hydrochloride in the treatment of coronary heart disease can effectively contribute to the reduction of homocysteine levels and alleviate atherosclerosis lesion progression,not only can reduce severity of myocardial ischemia and fibrinogen and high-sensitivity C-reactive protein levels,but also can reduce the thrombosis and inflammation produced by the degree of harm to the patients.

Objective To investigate the effect of Tianqi Jiangtang capsules combined with metformin on blood viscosity, cognitive disorder in elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions.Methods 76 patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions were divided into the observation group and the control group according to odd and even numbers, 38 cases in each group.The observation group were given Tianqi Jiangtang capsules combined with metformin while the control group were received metformin alone.The clinical curative effect, adverse reactions were compared between the two groups.The total score of TCM symptoms, blood glucose, blood lipid, high-sensitivity C reactive protein(hs-CRP), hemorheology and Mini Mental State Examination(MMSE)scores were determined before and after treatment.Results The total effective rate in the observation group(89.47%)was significantly higher than that in the control group(71.05%)(P< 0.05);After treatment, the total score of TCM symptoms, FPG, 2 h PG, hs-CRP, TC, TG, LDL-C, whole blood viscosity at high shear, whole blood viscosity at low shear, plasma viscosity and hematocrit were significantly lower than those before treatment, while MMSE scores were significantly higher(P< 0.05), and the above indexes in the observation group after treatment were significantly better than those in the control group(P< 0.05).There were no significant adverse reactions in the 2 groups.Conclusion Tianqi Jiangtang Capsules combined with metformin is safe and effective in the treatment of elderly patients with type 2 diabetes mellitus complicated with cerebral microvascular lesions.It can significantly improve lipid metabolism and hemorheology, reduce blood viscosity, and alleviate cognitive disorder.

Objective To evaluate the effects of different types of acute respiratory distress syndrome (ARDS) on high frequency oscillatory ventilation (HFOV)-improved extravascular lung water and pulmonary vascular permeability in piglets.Methods Twelve healthy piglets,weighing 15-20 kg,were randomly allocated into 2 groups (n =6 each) using a random number table:endogenous ARDS (P group) and exogenous ARDS (EXP group).Anesthesia was induced with midazolam and propofol.The tracheal tube was inserted.Anesthesia was maintained with iv infusion of propofol and fentanyl.ARDS was induced with normal saline infused via the tracheal tube in group P.ARDS was induced with oleic acid 0.05 ml/kg injected intravenously over 45-60 min in group EXP.Then 4 h of HFOV was performed.Before ARDS (T0),immediately after ARDS (Ti) and at 1,2,3 and 4 h of HFOV (T2-5),arterial blood samples were collected for blood gas analysis and the variables such as extravascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),and extravascular lung water (EVLW)/intra thoracic blood volume (ITBV) were monitored.The oxygenation index (PaO2/FiO2) was calculated.Results Compared with the baseline value at T0,the oxygenation index was decreased at T1,and the oxygenation index was less than 200 mm Hg in the two groups (P ＜ 0.05).There was no significant difference in the maximum degree of changes in EVLWI,PVPI and EVLW/ITBV between the two groups (P ＞ 0.05).Conclusion Endogenous and exogenous ARDS disease factor does not affect HFOV-improved extravascular lung water and pulmonary vascular permeability in piglets.

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

Objective To analyze the epidemic characteristics of mushroom poisoning incident in order to find the regularity of outbreak and provide the fundamental guidelines of prophylaxis,control,diagnosis and treatment.Methods According to the reported information from the Management Information System of Public Health Emergency in China mainland,the area-time distribution of mushroom poisoning incidents from 2004 to 2014 was analyzed,and the descriptive analysis of mushrooms poisoning incidents including causes,places,occupation of victims and incidents identification were made from 2010 to 2014.Results In China (excluding Hong Kong,Macao and Taiwan),the top five provinces of mushroom poisoning incidents were Yunnan,Guizhou,Sichuan,Guangxi and Hunan.The epidemic peak was reached in summer-autumn season.The major and significant incidents accounted for 76.56％ of overall mushroom poisoning incidents,and the fatality rate of 3 701 patients accounted for 21.24％ (786 deaths).The causes were mistaking poisonous mushrooms as edible mushrooms or purchasing poisonous mushrooms in the market by accident.About 87.50％ incidents happened at home.Farmers,workers,children and students were easily subjected to mushroom poisoning because of their large range of activities,strong curiosity and lacking related ability for distinguishing edible mushroom from poisonous mushrooms.No identification was done in 200 mushroom poisoning incidents from 2010 to 2014,which accounted for 92.59％ of mushroom poisoning incidents in the corresponding period.Standard species identification was carried out only in two poisonous mushroom incidents.Conclusions Mushroom poisoning incident was one of the most important causes of death in per-oral poisoning incidents.It should to cope with surveillance and meticulous management during high prevalence season and in high-risk provinces.At the same time,it should be strengthened to train doctors and health professionals with the knowledge of identification of mushroom poisoning in key areas as well as to develop the health promotion of mushrooms poisoning prevention.

Objective To evaluate the effect of high-frequency oscillatory ventilation (HFOV) on lung injury in the piglets with acute respiratory distress syndrome (ARDS).Methods Twelve male piglets,aged 6-8 weeks,weighing 14-16 kg,were randomly divided into 2 groups (n=6 each) using a random number table:conventional mechanical ventilation with low tidal volume group (CMV group) and HFOV group.ARDS was induced by bilateral pulmonary lavages with isotonic saline (38 ℃),repeated every 10 min until the oxygenation index＜200 mmHg.After successful establishment of the model,CMV group was ventilated using conventional mechanical ventilation with low tidal volumes.After successful establishment of the model,HFOV group was ventilated using HFOV,lung recruitment was performed,the airway pressure was set at 25 cmH2O and maintained at this level for 30 s,and the airway pressure was then adjusted 5 cmH2O higher than that after successful establishment of the model,with bias flow 25 L/min,inspiratory time ratio 33％,frequency 8 Hz,amplitude 40-80 cmH2O,and inspiratory oxygen fraction 1.0.In both groups,carbon dioxide partial pressure was maintained between 35 and 50 mmHg.Before establishment of the model (baseline),after successful establishment of the model (T1),and at 0.5,1.0,2.0 and 4.0 h after beginning of mechanical ventilation (T2-5),blood samples were collected from the femoral artery and central vein for blood gas analysis,arterial oxygen partial pressure and carbon dioxide partial pressure were recorded,oxygen delivery index,oxygen consumption index,oxygenation index and intrapulmonary shunt were calculated,and the improvement in pulmonary function (oxygenation index ≥ 200 mmHg) was recorded.At T0,T1 and T5,venous blood samples were collected for determination of the concentrations of serum Clara cell secretory protein 16,soluble intercellular adhesion molecule-1,and high-mobility group box 1.Results Compared with CMV group,the arterial oxygen partial pressure at T35 and oxygenation index at T4.5 were significantly increased (P ＜ 0.05),and no significant change was found in the other parameters in HFOV group (P＞0.05).Conclusion Compared with conventional mechanical ventilation with low tidal volumes,although HFOV improves lung oxygenation,the degree is small in the piglets with ARDS.