Objective To investigate the clinical effect of free electromyography(fEMG)monitoring as-sisted unilateral biportal endoscopy(UBE)in the treatment of lumbar disc herniation.Methods Forty pa-tients with lumbar disc herniation were included.The UBE lumbar nucleus pulposus resection under general anesthesia was performed.The operation whole process was completed under the fEMG monitor.The recorded potential was displayed on the monitor screen and the myoelectrical activity was played through speaker.The treatment effect was evaluated by the Visual Analogue Scale(VAS)score and Oswestry Disability Index(ODI).Results All 40 patients completed the surgery successfully,and the postoperative symptoms were im-proved significantly.The VAS scores before operation and in postoperative 3 months were 7(6,8)points and 0(0,1)points respectively,and the difference between the two time points was statistically significant(P＜0.05).The ODI before operation and in postoperative 3 months were(58.30±11.58)and(13.28±5.20)re-spectively,and the difference between the two time points also was statistically significant(P＜0.05).The VAS score and ODI in postoperative 1 year were 1(0,1)points and(13.13±0.40)respectively,showing sta-tistically significant difference compared with before surgery(P＜0.05),but there was no statistically signifi-cant difference compared with postoperative 3 months(P＞0.05).There were 8 cases developing the abnor-mal EMG changes such as spike,burst or tonic fEMG during surgery,with an incidence rate of 20％.After surgery in 8 cases,7 cases had burning radiculalgia and paresthesia of lower extremity,and 1 case had no obvi-ous neuralgia,with a false positive rate of 12.5％.The patients without abnormal fEMG reaction during sur-gery had no significant postoperative neuralgia,and the false negative rate was zero.Conclusion fEMG moni-toring assisted UBE under general anesthesia is a safe and easy method for the treatment of lumbar disc herni-ation.

Objective To explore the efficacy and toxicities of S-1 in the maintenance treatment of advanced esophageal cancer. Methods A total of 52 advanced esophageal cancer patients who benefited from the first-line treatment were randomly divided into experimental group (26 cases received S-1 orally as maintenance treatment) and control group (26 cases received placebo orally) by means of coin toss. After treatment, the efficacy and toxicities of the two groups were observed comparatively. Results The overall response rates (ORR) in experimental group and control group were 84.6% (22/26) and 76.9% (20/26), respectively, and there was significant difference between the two groups (χ2=3.885, P=0.049). The median progression free survival (PFS) time of experimental group was 14.4 months, and that of control group was 12.5 months (χ2= 3.885, P= 0.049). The main adverse reactions of the two groups were grade 1-2, and grade 4 adverse reactions did not appear in all patients. Conclusion S-1 is effective and well-tolerated in the maintenance treatment of advanced esophageal cancer.

There are 1?024 cases of severe head injury hospita lized． 917 of them were closed head injury (89, 55%), 107 of them were opening head injury(10.45%)． Results: good recover: 326(31.83%)．moderate disability: 185(18.07%), severe inability 139(13.50%), persistent vegetative state　59(5.75%), death 315 (30.76%)． Conclusion: The early diagn osis and treatment of sever head injury is beneficial to the outcome of these patients． Special trea tment to different phrase of severe head injury, especially the moderate hypothermia treatment, co uld improve the outcome of these patients．