Objective:This study introduces a novel segmented and layered thoracic laminoplasty technique for the treatment of thoracic spinal stenosis (TSS) caused by ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF). The goal is to simplify the surgical procedure, improve safety, reduce iatrogenic injuries, and validate its clinical outcomes through follow-up.Methods:A retrospective analysis was conducted on 23 patients (10 males, 13 females; mean age 58.83±12.01 years) treated at Taizhou People's Hospital Affiliated to Nanjing Medical University from January 2018 to December 2023. Transverse grooves were created at the superior and inferior vertebral pedicle levels, utilizing the intervertebral ligamentum flavum as a segmental demarcation reference. Partial removal of the distal lamina and medial of the inferior articular process was performed through a cortical window. Under direct visualization, complete removal of ossified ligamentum flavum, proximal portion of lamina, superior articular process. The treatment effect was evaluated by clinical symptoms, signs, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), imaging results (CT and MRI) and complications before or after surgery.Results:All 23 procedures were successfully completed with a mean operative duration of 180(150, 220) min, the surgical time for 71 segments were 67.5(53.8, 120.0) minutes and intraoperative blood loss of 200(100, 300) ml, demonstrating a low intraoperative dural tear rate of 8.70% (2/23). Postoperative imaging (CT/MRI) confirmed adequate decompression in all cases, with significant symptom improvement at final follow-up 21(9, 39) months: 47% (7/15) of patients achieved marked relief of lower limb numbness, 82% (14/17) showed substantial motor recovery, and 54% (7/13) exhibited improved gait stability. Functional outcomes revealed significant enhancements, with JOA scores increasing from 8(6, 8) preoperatively to 9(8, 10) postoperatively ( P<0.05; 43.80% improvement rate) and VAS scores decreasing from 6(5, 7) to 2(1, 4) ( P<0.05). The complications were two dural tears and one suture reaction. Conclusions:Ultrasonic osteotome-assisted segmented layered laminectomy is a safe, effective, and straightforward technique for treating thoracic spinal stenosis caused by OPLL and OLF. It offers shorter operative times, minimal complications, and significant clinical improvement, making it a promising technique for broader clinical adoption.

Objective:This study introduces a novel segmented and layered thoracic laminoplasty technique for the treatment of thoracic spinal stenosis (TSS) caused by ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF). The goal is to simplify the surgical procedure, improve safety, reduce iatrogenic injuries, and validate its clinical outcomes through follow-up.Methods:A retrospective analysis was conducted on 23 patients (10 males, 13 females; mean age 58.83±12.01 years) treated at Taizhou People's Hospital Affiliated to Nanjing Medical University from January 2018 to December 2023. Transverse grooves were created at the superior and inferior vertebral pedicle levels, utilizing the intervertebral ligamentum flavum as a segmental demarcation reference. Partial removal of the distal lamina and medial of the inferior articular process was performed through a cortical window. Under direct visualization, complete removal of ossified ligamentum flavum, proximal portion of lamina, superior articular process. The treatment effect was evaluated by clinical symptoms, signs, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), imaging results (CT and MRI) and complications before or after surgery.Results:All 23 procedures were successfully completed with a mean operative duration of 180(150, 220) min, the surgical time for 71 segments were 67.5(53.8, 120.0) minutes and intraoperative blood loss of 200(100, 300) ml, demonstrating a low intraoperative dural tear rate of 8.70% (2/23). Postoperative imaging (CT/MRI) confirmed adequate decompression in all cases, with significant symptom improvement at final follow-up 21(9, 39) months: 47% (7/15) of patients achieved marked relief of lower limb numbness, 82% (14/17) showed substantial motor recovery, and 54% (7/13) exhibited improved gait stability. Functional outcomes revealed significant enhancements, with JOA scores increasing from 8(6, 8) preoperatively to 9(8, 10) postoperatively ( P<0.05; 43.80% improvement rate) and VAS scores decreasing from 6(5, 7) to 2(1, 4) ( P<0.05). The complications were two dural tears and one suture reaction. Conclusions:Ultrasonic osteotome-assisted segmented layered laminectomy is a safe, effective, and straightforward technique for treating thoracic spinal stenosis caused by OPLL and OLF. It offers shorter operative times, minimal complications, and significant clinical improvement, making it a promising technique for broader clinical adoption.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

Objective To evaluate the effect of three different doses of oxycodone hydrochloride injection on uterine cramping pain and emotion in patients of artificial abortion.Methods Four hundred female patients, aged 17-38 years, BMI 18.5-23.9 kg/m2, falling into ASA physical statusⅠ orⅡ, undergoing elective artificial abortion were randomized into four groups using a random number table:group O1 (oxycodone 0.06 mg/kg), group O2 (oxycodone 0.08 mg/kg), group O3 (oxycodone 0.1 mg/kg), and group F, 100 cases in each.In group O1, group O2 and group O3, oxycodone 0.06, 0.08, 0.1 mg/kg were intravenously injected respectively, while in group F fentanyl1μg/kg was intravenously injected.Then, propofol 2.5 mg/kg was intravenously injected as induced dose.The operation was started when eyelash reflexes disappeared, propofol 0.4 mg/kg was intravenously injected when body movement appeared during the operation.The propofol doses, operation time and recovery time were recorded.HR, MAP, RR before anesthesia (T0), when loss of eyelash reflex (T1), operation (T2) and recovery (T3) were recorded.The uterine cramping pain was assessed with numerical rating scale (NRS) at recovery, 10, 30, 60 min after operation.Patients'satisfaction was recorded after operation.Patients'emotion was assessed with positive and negative affect scale (PANAS) both before and after operation in one hour.Rescue analgesia, nausea and vomiting, dizziness, respiratory depression, pruritus, uroschesis, cognitive dysfunction, sweatiness were recorded.Results The propofol doses and recovery time in groups O2, O3 and F were significantly lower than those in group O1 (P<0.05).The NRS score of uterine cramping pain in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).Patients'satisfaction in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05).The positive affective score after operation in one hour among the four groups were significantly higher than that before operation (P<0.05), and the negative affective score after operation in one hour among the four groups were significantly lower than that before operation (P<0.05).The positive affective score after operation in one hour in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05), and the rescue analgesia in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).There were no significant differences among the four groups as to the dizziness, nausea and vomiting.No respiratory depression, pruritus, emergence agitation, cognitive dysfunction, uroschesis and sweatiness were reported.Conclusion Oxycodone 0.08 mg/kg combined with propofol in patients undergoing artificial abortion is effective in preventing uterine cramping pain.Furthermore, the patients'satisfaction and positive affective score can also be improved.

Objective To evaluate the effectiveness and safety of three different doses of oxycodone hydrochloride injection in treatment of postoperative uterus contraction pain after painless artificial abortion surgery.Methods A total of 150 early pregnancy patients with painless artificial abortion surgery were randomly divided into Q1 group (oxycodone 0.04 mg/kg),Q2 group (oxycodone 0.07 mg/kg) and Q3 group (oxycodone 0.1 mg/kg),50 cases in each group.Another 50 patients refused to sign the informed consent were selected as group N.The uterine contraction pain score at the time points of immediately after recovery and 10,30,and 60 min after recovery were recorded in four groups,and postoperative satisfaction degree were recorded as well.Preoperative degree of dysmenorrhea,surgery time,propofol dosage,postoperative recovery time,agitation and strength were recorded.At the time points of before administration (To),loss of eyelash reflex (T1),uterine cavity operation (T2),postoperative wake (T3),the heart rate (HR),mean arterial pressure (MAP),respiratory rate (RR) and pulse oxygen saturation (SpO2) were recorded.The incidence of adverse reactions such as dizziness,nausea and vomiting,cognitive impairment,sweating,skin itching,urinary retention,respiratory suppression were recorded.Results The VAS of uterus contraction pain in Group Q2 and Q3 were significantly lower than Group Q1 and Group N (P ＜ 0.05).The satisfaction degree of the patients after surgery in Group Q2 and Q3 were significantly higher than Group Q1 and Group N (P ＜ 0.05).The dose of propofol and recovery time in Group Q2 and Q3 were significantly lower than Group Q1 and group N (P ＜ 0.05).There was no significant difference between the four groups in the age,weight,dysmenorrhea,operation time,nausea and vomiting,vital signs,dizziness and cognitive dysfunction (P ＞ 0.05).There were no adverse reactions such as restlessness,pruritus,sweating,urinary retention,respiratory depression in the 4 groups.Conclusion 0.07 mg/kg oxycodone hydrochloride injection for patients with painless artificial abortion surgery can get perfect analgesic effect and high satisfaction degree,so it is worthy of clinical application.

Objective To evaluate the effectiveness and safety of three different doses of oxycodone hydrochloride injection in treatment of postoperative uterus contraction pain after painless artificial abortion surgery.Methods A total of 150 early pregnancy patients with painless artificial abortion surgery were randomly divided into Q1 group (oxycodone 0.04 mg/kg),Q2 group (oxycodone 0.07 mg/kg) and Q3 group (oxycodone 0.1 mg/kg),50 cases in each group.Another 50 patients refused to sign the informed consent were selected as group N.The uterine contraction pain score at the time points of immediately after recovery and 10,30,and 60 min after recovery were recorded in four groups,and postoperative satisfaction degree were recorded as well.Preoperative degree of dysmenorrhea,surgery time,propofol dosage,postoperative recovery time,agitation and strength were recorded.At the time points of before administration (To),loss of eyelash reflex (T1),uterine cavity operation (T2),postoperative wake (T3),the heart rate (HR),mean arterial pressure (MAP),respiratory rate (RR) and pulse oxygen saturation (SpO2) were recorded.The incidence of adverse reactions such as dizziness,nausea and vomiting,cognitive impairment,sweating,skin itching,urinary retention,respiratory suppression were recorded.Results The VAS of uterus contraction pain in Group Q2 and Q3 were significantly lower than Group Q1 and Group N (P ＜ 0.05).The satisfaction degree of the patients after surgery in Group Q2 and Q3 were significantly higher than Group Q1 and Group N (P ＜ 0.05).The dose of propofol and recovery time in Group Q2 and Q3 were significantly lower than Group Q1 and group N (P ＜ 0.05).There was no significant difference between the four groups in the age,weight,dysmenorrhea,operation time,nausea and vomiting,vital signs,dizziness and cognitive dysfunction (P ＞ 0.05).There were no adverse reactions such as restlessness,pruritus,sweating,urinary retention,respiratory depression in the 4 groups.Conclusion 0.07 mg/kg oxycodone hydrochloride injection for patients with painless artificial abortion surgery can get perfect analgesic effect and high satisfaction degree,so it is worthy of clinical application.

Objective To study the effect of postoperative patient-controlled intravenous analgegia.using dezocine on uterine contraction-induced pain after cesarean section.Methods Sixty patients undergoing cesarean section were randomly divided into two groups with 30 cases each.Group D received patient-controlled intravenous analgesia(PCIA)with dezocine and tramadol.Group T received PCIA with tramadol.Ten minutes before completion of the operation,loading dose was given:in group D intravenous dezocine 0.1 mg/kg,in group T intravenous tramadol 2 mg/kg.Visual analogue scale(VAS)of wound pain and uterine contraction-induced pain,adverse effects were recorded at 4,8,16 and 24 h during analgesia.Results There was no siguiciant difference on VAS of wound pain between the two groups(P ＞ 0.05).The VASs of uterine contraction-induced pain at the4,8,6 and 24th hour after surgery were(1.53 ±0.37),(2.28 ±0.15),(2.43 +0.56)and (2.01 ±0.64)respectively in Group D,which were significantly lower than those of(4.73 +0.43),(5.86 ±0.35),(5.83 ± 0.27)and(4.18 ± 0.53)in Group T(Ps ＜ 0.05).Ramsay sedation scores were(3.97 ±1.41)and(3.12 ±0.06)at the 4 and 8 h,which were significantly lower than those of(1.12 ±0.49)and (1.09 ±0.73)in Group D(Ps ＜0.01)).However,there was no significant difference between the two groups in adverse effect(P ＞ 0.05).Conclusion Intravenous patient-controlled analgesia with dezocine composite tramadol is not only effective for wound pain scores,but also can suppress uterine contraction-induced pain with less adverse effect in patients underwent cesarean section.