Objective:To explore the clinical efficacy and safety of unilateral biportal endoscopic (UBE) and percutaneous transforaminal endoscopic discectomy (PTED) techniques in treating recurrent lumbar disc herniation (RLDH).Methods:This study is a retrospective cohort study. The clinical data were retrospectively collected from 68 patients who underwent surgical treatment for RLDH at Department of Mini-invasive Spinal Surgery, the Third People′s Hospital of Henan Province from June 2020 to June 2023. The patients were divided into the UBE group (38 cases) and the PTED group (30 cases) based on the surgical technique used. The drainage volume, surgery duration, and postoperative complications for revision surgeries in both groups were recorded. Visual analogue scale(VAS) and Oswestry disability index (ODI) were used to assess back pain and leg pain degrees and improvements preoperatively, 3 days postoperatively, 3 months postoperatively, and at the final follow-up. The modified Macnab criteria were used to evaluate outcomes at the final follow-up. The data comparison was conducted using independent sample t-test, repeated measures analysis of variance, χ2 test or Fisher's exact test. Results:All surgeries were successfully completed. The surgery duration in the UBE group was significantly shorter than in the PTED group, with statistically significant differences ((50.9±10.5)minutes vs.(55.9±12.5)minutes, t=1.234, P=0.001). All patients were followed up for more than 1 year, with a follow-up period of (18.1±5.6) months (range: 12 to 29 months). Both groups showed a significant reduction in VAS and ODI for back and leg pain at all postoperative time points compared to preoperative scores (all P<0.05). However, there were no statistically significant differences in VAS of low back pain, lower limb pain score and ODI score over time between the groups (all P>0.05). At the final follow-up, the UBE group had an excellent and good rate of 92.1% (35/38); the PTED group had an excellent and good rate of 86.6% (26/30)( χ2=0.727, P=0.867). One patient in the UBE group and three in the PTED group experienced cerebrospinal fluid leaks, and one patient in the PTED group experienced postoperative leg numbness; all were discharged after conservative treatment. At the final follow-up, lumbar X-rays, CT, and MRI evaluations showed no recurrence or instability at the surgical segments. Conclusions:Both UBE and PTED can achieve good clinical outcomes in the treatment of RLDH through continuous visualization. The choice of surgical method for RLDH should be more precisely tailored to the individual.

Objective:To explore the clinical efficacy and safety of unilateral biportal endoscopic (UBE) and percutaneous transforaminal endoscopic discectomy (PTED) techniques in treating recurrent lumbar disc herniation (RLDH).Methods:This study is a retrospective cohort study. The clinical data were retrospectively collected from 68 patients who underwent surgical treatment for RLDH at Department of Mini-invasive Spinal Surgery, the Third People′s Hospital of Henan Province from June 2020 to June 2023. The patients were divided into the UBE group (38 cases) and the PTED group (30 cases) based on the surgical technique used. The drainage volume, surgery duration, and postoperative complications for revision surgeries in both groups were recorded. Visual analogue scale(VAS) and Oswestry disability index (ODI) were used to assess back pain and leg pain degrees and improvements preoperatively, 3 days postoperatively, 3 months postoperatively, and at the final follow-up. The modified Macnab criteria were used to evaluate outcomes at the final follow-up. The data comparison was conducted using independent sample t-test, repeated measures analysis of variance, χ2 test or Fisher's exact test. Results:All surgeries were successfully completed. The surgery duration in the UBE group was significantly shorter than in the PTED group, with statistically significant differences ((50.9±10.5)minutes vs.(55.9±12.5)minutes, t=1.234, P=0.001). All patients were followed up for more than 1 year, with a follow-up period of (18.1±5.6) months (range: 12 to 29 months). Both groups showed a significant reduction in VAS and ODI for back and leg pain at all postoperative time points compared to preoperative scores (all P<0.05). However, there were no statistically significant differences in VAS of low back pain, lower limb pain score and ODI score over time between the groups (all P>0.05). At the final follow-up, the UBE group had an excellent and good rate of 92.1% (35/38); the PTED group had an excellent and good rate of 86.6% (26/30)( χ2=0.727, P=0.867). One patient in the UBE group and three in the PTED group experienced cerebrospinal fluid leaks, and one patient in the PTED group experienced postoperative leg numbness; all were discharged after conservative treatment. At the final follow-up, lumbar X-rays, CT, and MRI evaluations showed no recurrence or instability at the surgical segments. Conclusions:Both UBE and PTED can achieve good clinical outcomes in the treatment of RLDH through continuous visualization. The choice of surgical method for RLDH should be more precisely tailored to the individual.

To summarize the nursing experience of a pediatric patient with multiple organ burns in the abdominal cavity and liver laceration caused by a fireworks explosion.The following nursing points were implemented:immediate activation of a multidisciplinary trauma rescue team upon admission to initiate emergency measures for traumatic shock;implementation of target-oriented fluid management to expedite postoperative intestinal function recovery;active control of abdominal infection to minimize the risk of septic shock;thorough and accurate assessment was conducted to prevent postoperative complications such as gastrointestinal hemorrhage,bile-leakage,gallbladder perforation,and delayed intestinal necrosis;nutritional screening and assessment was performed to develop personalized nutritional support programs;emphasis should be placed on pain assessment to implement individualized analgesia measures;the provision of high-quality psychological support focusing on addressing psychological trauma.The child was successfully discharged 36 days after surgery and exhibited satisfactory recovery during the two-month follow-up period.

Objective:Reflux esophagitis (RE) may be negatively correlated with Helicobacter pylori ( H. pylori) infection, but the conclusion and relevant mechanism is still controversial. This study proposed to explore the correlation between RE and H. pylori infection based on natural population. Methods:From July 2013 to December 2014, 3 940 residents aged 40-69 years were recruited in Linqu County of Shandong Province and Hua County of Henan Province by the whole sampling method. All the subjects underwent gastroscopy, and gastric mucosa biopsy specimens were collected for pathological diagnosis and Warthin-Starry (WS) staining to identify H. pylori infection. Venous blood samples of some subjects were collected for H. pylori immunoglobulin G ( H. pylori-IgG) detection. Also, demographic and sociological data were collected. Chi-square test and logistic regression were used to analyze the correlation between RE and H. pylori infection. Results:A total of 359 cases of RE were detected. Excluding RE and other upper gastrointestinal organic diseases, 3 382 cases were considered as controls. Chi-square test showed that WS staining positive rate in RE group was significantly lower than that in control group ( P=0.023), but there was no significant difference in the positive rate of H. pylori-IgG between the two groups ( P=0.281). There were significant differences between RE group and control group in gender composition, age, body mass index (BMI), smoking, alcohol consumption, education level and mucosal active inflammation. Multivariate regression analysis showed that RE was negatively correlated with gastric mucosa active inflammation [ OR=0.754 (95% CI 0.600-0.949), P=0.016], and positively correlated with male [ OR=4.231 (95% CI 3.263-5.486), P<0.001], age ≥60 years, BMI≥24 kg/m 2 [ OR=1.540 (95% CI 1.220-1.945), P<0.001]. Compared to those aged 40-49 years and 50-59 years, the odds ratio ( OR) of RE in these aged ≥60 years were 1.566 (95% CI 1.144-2.143, P=0.005) and 1.405 (95% CI 1.093-1.805, P=0.008). Conclusion:RE is more closely related to H. pylori present infection. Multivariate analysis showed that RE is negatively correlated with active inflammation of gastric mucosa caused by H. pylori infection, and positively correlated with male, overweight and aged ≥60 years.

Objective:To investigate the differences in virological and immunological indicators of HIV-1 infected individuals with different degrees of immunosuppression, analyze the correlation between the sample/cutoff ratio (S/CO), viral load (VL), Western blot (WB) band type and immune status of HIV-1 infected individuals.Methods:A total of 639 HIV-1 antibodies positive and treatment-naive samples from Henan, Beijing and Yunnan during the period of 2017-2019 were divided into three groups: no immunosuppression (CD4≥500 cells/μl), mild immunosuppressive (350cells/μl≤CD4<500cells/μl), moderate immunosuppression (200 cells/μl≤CD4<350 cells/μl), severe immunosuppression (CD4<200 cells/μl). Chi-square test was used to compare S/CO, WB band type among different immunosuppression groups, analyze the relationship between various indicators and immune status.Results:In each immunosuppressive group, S/CO>20 had the highest occurrence rate (>37%), and showed a decreasing trend with the enhancement of immunity ( P<0.05), the occurrence rate of 119%), the occurrence rate of 078%), while the occurrence rates of p55 (<40%) and p39 (<3%) were the lowest, the differences of the occurrence rates of gp41 and p51 among different immunosuppression groups were statistically significant ( P<0.05). The area under the curve determined by S/CO value combined with viral load for no, mild, moderate and severe immunosuppression groups were respectively 0.651 (95% CI: 0.600-0.702; P<0.05), 0.587 (95% CI: 0.540-0.635; P<0.05), 0.605 (95% CI: 0.560~0.650; P<0.05), 0.647 (95% CI: 0.586-0.708; P<0.05). Conclusions:The S/CO value viral load was the best for the determination of non-immunosuppressive status; The absence of gp41 and p51, S/CO>20 suggest that the patient may be in non or severe immunosuppressed state, respectively.