Objectives:To evaluate the clinical efficacy of percutaneous transforaminal endoscopic debride-ment combined with irrigation using a custom-designed irrigation and drainage system for the treatment of epidural fluid accumulation with lumbar intervertebral infections following unilateral biportal endoscopic(UBE)decompression surgery.Methods:A retrospective analysis was conducted on 12 cases of lumbar infections af-ter UBE lumbar spinal canal decompression treated at Shanxi Bethune Hospital from October 2020 to April 2025.There were 5 males and 7 females,aged 74-84(79.1±3.4)years old.All the patients underwent trans-foraminal endoscopic debridement combined with irrigation using a custom-designed irrigation and drainage system,with targeted antibiotic perfusion therapy based on bacterial culture results.Follow-up assessments were performed at 3d,1 month,and the final follow-up,including tests for white blood cell count,neutrophil percentage(％),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and interleukin-6(IL-6)levels a-mong cytokines.Additionally,visual analog scale(VAS)scores for low back pain,Oswestry disability index(O-DI),and other relevant clinical scores were recorded at these intervals.Lumbar MRI was performed based on patient recovery to observe postoperative imaging changes.At final follow-up,the postoperative efficacy was evaluated according to the modified MacNab criteria.Results:All 12 cases were followed up for 6-12 months(9.3±3.1 months).The infections were successfully eradicated in all patients,with no recurrence observed and primary wound healing achieved.At the final follow-up,laboratory markers including white blood cell count,neutrophil percentage(％),ESR,CRP,and IL-6 levels had normalized.Lumbar pain VAS scores was 3.67±0.58 points at 1 month after operation,while JOA scores was 24.00±2.00 points and ODI was(27.33±4.16)％.By the final follow-up,VAS scores improved to 2.13±0.68 points,JOA scores to 25.33±1.53 points and ODI to(14.67±2.08)％.The differences from the preoperative values were statistically significant(P＜0.05).At final follow-up,lumbar MRI findings of 12 patients showed significant improvement in the epidural effusion and in-fection from the conditions before debridement,and the outcomes were rated as excellent in 10 cases and good in 12 cases according to the modified MacNab criteria.Conclusions:Percutaneous transforaminal endo-scopic debridement combined with irrigation via a custom-designed irrigation and drainage system technique is a feasible,safe,and effective treatment for lumbar infections following UBE decompression surgery.

Objectives:To evaluate the clinical efficacy of percutaneous transforaminal endoscopic debride-ment combined with irrigation using a custom-designed irrigation and drainage system for the treatment of epidural fluid accumulation with lumbar intervertebral infections following unilateral biportal endoscopic(UBE)decompression surgery.Methods:A retrospective analysis was conducted on 12 cases of lumbar infections af-ter UBE lumbar spinal canal decompression treated at Shanxi Bethune Hospital from October 2020 to April 2025.There were 5 males and 7 females,aged 74-84(79.1±3.4)years old.All the patients underwent trans-foraminal endoscopic debridement combined with irrigation using a custom-designed irrigation and drainage system,with targeted antibiotic perfusion therapy based on bacterial culture results.Follow-up assessments were performed at 3d,1 month,and the final follow-up,including tests for white blood cell count,neutrophil percentage(％),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and interleukin-6(IL-6)levels a-mong cytokines.Additionally,visual analog scale(VAS)scores for low back pain,Oswestry disability index(O-DI),and other relevant clinical scores were recorded at these intervals.Lumbar MRI was performed based on patient recovery to observe postoperative imaging changes.At final follow-up,the postoperative efficacy was evaluated according to the modified MacNab criteria.Results:All 12 cases were followed up for 6-12 months(9.3±3.1 months).The infections were successfully eradicated in all patients,with no recurrence observed and primary wound healing achieved.At the final follow-up,laboratory markers including white blood cell count,neutrophil percentage(％),ESR,CRP,and IL-6 levels had normalized.Lumbar pain VAS scores was 3.67±0.58 points at 1 month after operation,while JOA scores was 24.00±2.00 points and ODI was(27.33±4.16)％.By the final follow-up,VAS scores improved to 2.13±0.68 points,JOA scores to 25.33±1.53 points and ODI to(14.67±2.08)％.The differences from the preoperative values were statistically significant(P＜0.05).At final follow-up,lumbar MRI findings of 12 patients showed significant improvement in the epidural effusion and in-fection from the conditions before debridement,and the outcomes were rated as excellent in 10 cases and good in 12 cases according to the modified MacNab criteria.Conclusions:Percutaneous transforaminal endo-scopic debridement combined with irrigation via a custom-designed irrigation and drainage system technique is a feasible,safe,and effective treatment for lumbar infections following UBE decompression surgery.

Objective To compare the clinical outcomes between proximal femoral nail antirotation (PFNA) combined with zoledronic acid and PFNA only in the treatment of osteoporotic intertrochanteric fracture in the elderly patients.Methods A retrospective analysis was made on 72 patients that completed the follow-up after PFNA for osteoporotic intertrochanteric fracture from November 2011 to May 2014.According to the application of zoledronic acid (5 mg,once a year) after PFNA,the patients were divided into study group (n =30) and control group (n =42).Bone healing and subsequent refracture were assessed with X-ray postoperatively.Harris hip score was recorded.Bone mineral density before operation and one year after operation were compared between the two groups.Adverse effect of zoledronic acid was recorded during hospitalization.Results Mean period of follow-up was 15 months (range,12-26 months).One year after operation,Harris score,new fracture incidence,mean fracture union time were (82.65 ± 6.24) points,3％ (1/30) and (14.26-± 2.24) weeks in study group,while (81.85 ± 5.38) points,14％ (6/42) and (15.26 ± 3.05) weeks in control group.There were no statistical differences between the two groups (P ＞ 0.05),but the subsequent fracture was higher in control group.One year after operation,lumbar and contralateral non-injury hip bone marrow density were (0.78 ± 0.16)g/cm2 and (0.71 ± 0.14)g/cm2 in study group,higher than (0.75 ± 0.13)g/cm2 and (0.69 ±0.13)g/cm2 in control group (P ＜0.05).But there were no significant differences between the two groups before operation.All fractures were healed at postoperative 1 year.No intolerable adverse events occurred in study group.Conclusions PFNA is effective in the treatment of osteoporotic intertrochanteric fracture.In the meantime,the combination with zoledronic acid has no influence on bone healing while increasing bone mineral density,and may decrease the occurrence of subsequent fragile fractures.

The clinical features of 120 severe cases with hand-foot-mouth disease (HFMD) were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of mostsevere cases ranged from 1-3 years. Sustained high fever ( 55% ) , hypertension ( 40% ) , fewer rash (73.3%) were important clinical features. Lethargy, somnolence or restlessness (70. 8% ), vomiting (30. 8% ) were early signs of central nervous system ( CNS) ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm (80% ). High white cell count(75. 8% ) and high blood glucose levels(32. 5% ) were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD ( P < 0. 01 or P < 0. 05 ) . Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.