Objective: To compare the effectiveness of the uniportal bichannel dual-media spinal endoscopic technique (UBD-TLIF) with open transforaminal lumbar interbody fusion (O-TLIF) for the treatment of lumbar disc herniation (LDH) with lumbar instability in older patients aged ≥65 years. Methods: This retrospective study included 64 older patients with LDH and lumbar instability who were admitted to Shanghai Tenth People Hospital between January 2023 and June 2025. General surgical parameters, perioperative pain levels, pre- and postoperative back and leg pain scores, functional outcomes, complication status, and lumbar spine stability were recorded and analyzed. Results: In the UBD-TLIF group, intraoperative blood loss was significantly lower than in the O-TLIF group. The UBD-TLIF group also demonstrated shorter incision length, reduced bed rest duration, and a shorter hospital stay compared with the O-TLIF group (p<0.05). Postoperatively, patients in the UBD-TLIF group showed significant improvement in visual analogue scale and Oswestry Disability Index scores (p<0.001). No complications were observed in either group. Conclusion Both UBD-TLIF and O-TLIF improved lumbar function in older patients with LDH and lumbar instability and demonstrated acceptable safety profiles. Compared with O-TLIF, UBD-TLIF, characterized by a smaller incision, was associated with reduced intraoperative blood loss, decreased early postoperative pain, and accelerated early recovery.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To investigate the effects of human chorionic gonadotropin (hCG) trigger and dual trigger on the outcome of in vitro fertilization and embryo transfer (IVF-ET) during superovulation with an antagonist regimen in individuals with normal ovarian reserve function. Methods:A retrospective cohort study was carried out. A total of 239 patients with normal ovarian reserve undergoing IVF-ET from January 2019 to November 2022 at the Reproductive Medicine Center of Sichuan Provincial Women's and Children's Hospital were enrolled. The patients were divided into two groups based on the types of the trigger, group A ( n=143) was given 250 μg recombinant hCG (rhCG), group B ( n=96) was given a dual trigger comprising 0.2 mg gonadotropin releasing-hormone agonist and 2 000 U hCG. The quality of oocytes and embryos, outcomes of pregnancy between the two groups were compared. Results:There were no statistically significant differences in mature oocyte rate, normal fertilization rate, embryo formation rate on day 3 (D3), high-quality embryo rate, blastocyst formation rate, or high-quality blastocyst rate between the two groups (all P>0.05). The incidence of moderate ovarian hyperstimulation syndrome (OHSS) in group A was 1.40% (2/143), which was higher than that of group B [0 (0/96)], but the difference was not statistically significant ( P>0.05). There were no statistically significant differences in embryo implantation rate and clinical pregnancy rate between the two groups during the fresh and frozen-thawed embryo transfer cycles (all P>0.05). Conclusion:In patients with normal ovarian reserve function, there are no significant differences in oocyte and embryo quality, and pregnancy outcome between the dual trigger and hCG trigger. The dual trigger has a tendency to reduce the incidence of OHSS.

Objective:To investigate the effects of human chorionic gonadotropin (hCG) trigger and dual trigger on the outcome of in vitro fertilization and embryo transfer (IVF-ET) during superovulation with an antagonist regimen in individuals with normal ovarian reserve function. Methods:A retrospective cohort study was carried out. A total of 239 patients with normal ovarian reserve undergoing IVF-ET from January 2019 to November 2022 at the Reproductive Medicine Center of Sichuan Provincial Women's and Children's Hospital were enrolled. The patients were divided into two groups based on the types of the trigger, group A ( n=143) was given 250 μg recombinant hCG (rhCG), group B ( n=96) was given a dual trigger comprising 0.2 mg gonadotropin releasing-hormone agonist and 2 000 U hCG. The quality of oocytes and embryos, outcomes of pregnancy between the two groups were compared. Results:There were no statistically significant differences in mature oocyte rate, normal fertilization rate, embryo formation rate on day 3 (D3), high-quality embryo rate, blastocyst formation rate, or high-quality blastocyst rate between the two groups (all P>0.05). The incidence of moderate ovarian hyperstimulation syndrome (OHSS) in group A was 1.40% (2/143), which was higher than that of group B [0 (0/96)], but the difference was not statistically significant ( P>0.05). There were no statistically significant differences in embryo implantation rate and clinical pregnancy rate between the two groups during the fresh and frozen-thawed embryo transfer cycles (all P>0.05). Conclusion:In patients with normal ovarian reserve function, there are no significant differences in oocyte and embryo quality, and pregnancy outcome between the dual trigger and hCG trigger. The dual trigger has a tendency to reduce the incidence of OHSS.