OBJECTIVES: In the early stage of central cervical disc herniation, clinical symptoms may be mild. However, as the spinal cord becomes compressed by herniated nucleus pulposus tissue, progressive edema and degeneration may occur, resulting in more severe clinical manifestations, including limb weakness, bladder and bowel dysfunction, spastic paraplegia of the lower extremities, and even respiratory difficulty. The spinal endoscopic Key-hole technique is widely applied in treating radiculopathic cervical spondylosis and has demonstrated good clinical outcomes. This study aims to analyze and summarize the technical points and therapeutic efficacy of the far lateral Key-hole technique in the treatment of central cervical disc herniation, providing reference for clinical application. METHODS: Eight patients with central cervical disc herniation treated with the far lateral Key-hole technique were included as the experimental group. Another 8 patients who underwent single-level anterior cervical diskectomy and fusion (ACDF) during the same period were selected as the control group. Data collected included gender, age, intraoperative blood loss, incision length, and length of hospitalization. Pain severity was evaluated using the Visual Analogue Scale (VAS); cervical function was assessed using the Japanese Orthopaedic Association (JOA) score; and cervical disability was measured by the neck disability index (NDI). Radiological outcomes were assessed using disc height index (DHI), cervical Cobb angle, and operative segment Cobb angle. RESULTS: Compared with the control group, the experimental group had significantly less intraoperative blood loss, shorter incision length, and shorter hospital stay (all P<0.05), while there was no significant difference in operation time (P>0.05). Postoperative VAS and NDI scores in both groups were significantly lower than preoperative values, and JOA scores significantly improved (P<0.05). No significant differences were noted between the two groups preoperatively (P>0.05). Postoperatively, the experimental group showed significantly lower VAS and NDI scores and higher JOA scores than the control group (P<0.05). There was no statistical significance in DHI before and after surgery in the experimental group (P>0.05), while the DHI increased significantly postoperatively in the control group (P<0.05). Postoperative DHI in the experimental group was significantly lower than in the control group (P<0.05). No significant differences were observed in the cervical Cobb angle either within or between groups (all P>0.05). The operative segment Cobb angle increased significantly after surgery in the control group (P<0.05), while no other operative segment angle changes were statistically significant (all P>0.05). CONCLUSIONS The far lateral Key-hole technique offers advantages in treating central cervical disc herniation, including reduced intraoperative bleeding, smaller incision length, shorter hospitalization, and improved postoperative pain relief. Additionally, the technique does not affect cervical physiological curvature or stability in the short term, making it suitable for clinical application.
Humans ; Intervertebral Disc Displacement/surgery* ; Cervical Vertebrae/surgery* ; Male ; Female ; Middle Aged ; Adult ; Diskectomy/methods* ; Treatment Outcome ; Spinal Fusion/methods* ; Endoscopy/methods*

Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.

Objective:The aim of this study was to analyze the registration status of osteoporosis drug clinical trials in China, providing a reference for the research and development of therapeutic drugs for osteoporosis.Methods:Using the Drug Clinical Trial Registration and Information Publication Platform on the website of the State Drug Administration as the search platform, we retrieved the information on the public announcement of drug clinical trials with osteoporosis as an indication, and the search period was limited from 2013 to February 2025.Researchers extracted the key information and performed statistics.Results:A total of 182 registered osteoporosis drug clinical trial projects were collected.The main target indications were predominantly osteoporosis in postmenopausal women, and there were relatively few trials targeting the elderly subjects.56.0%(102/182)of the registered trials were bioequivalence studies, and 21.4%(39/182)were phase I clinical studies.Conclusions:The number of registered trials and the research and development process of domestic osteoporosis drug clinical trials in China have shown a stable trend in general, and the types of trials are mainly concentrated in bioequivalence studies and early clinical studies.In order to further meet the medication needs of domestic patients, China still needs to increase the research and development efforts of innovative osteoporosis drugs.

Objective:The aim of this study was to analyze the registration status of osteoporosis drug clinical trials in China, providing a reference for the research and development of therapeutic drugs for osteoporosis.Methods:Using the Drug Clinical Trial Registration and Information Publication Platform on the website of the State Drug Administration as the search platform, we retrieved the information on the public announcement of drug clinical trials with osteoporosis as an indication, and the search period was limited from 2013 to February 2025.Researchers extracted the key information and performed statistics.Results:A total of 182 registered osteoporosis drug clinical trial projects were collected.The main target indications were predominantly osteoporosis in postmenopausal women, and there were relatively few trials targeting the elderly subjects.56.0%(102/182)of the registered trials were bioequivalence studies, and 21.4%(39/182)were phase I clinical studies.Conclusions:The number of registered trials and the research and development process of domestic osteoporosis drug clinical trials in China have shown a stable trend in general, and the types of trials are mainly concentrated in bioequivalence studies and early clinical studies.In order to further meet the medication needs of domestic patients, China still needs to increase the research and development efforts of innovative osteoporosis drugs.

Objective:To analyze the value of marginal donor livers in liver transplantation for patients with acute-on-chronic liver failure (ACLF).Methods:Clinical data of 58 patients with ACLF undergoing liver transplantation at the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2023 were retrospectively analyzed, including 33 males and 25 females, aged (40.4±14.4) years. According to the source of donor (marginal or standard), recipients were divided into the marginal group ( n=28), and standard group ( n=30). The preoperative model for end-stage liver disease (MELD) score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, intensive care unit (ICU) stay, liver function, renal function, coagulation function, postoperative complications, and survival situation were compared between the groups. Results:The MELD score, cold/warm ischemia time, intraoperative blood loss, postoperative tracheal intubation time, length of ICU stay, alanine transaminase, aspartate transaminase, total bilirubin, serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, fibrinogen, postoperative infection, primary graft nonfunction, biliary complications, and vascular complications were compared between the groups (all P>0.05). The incidence of delayed graft function (DGF) recovery was 28.6%(8/28) in marginal group, higher than that in standard group 6.7%(2/30) ( χ2=5.13, P=0.038). The one-year cumulative survival rates were 89.3% and 93.3% in marginal group and standard group, respectively ( P=0.580). Conclusion:The therapeutic effect of marginal donor liver in ACLF recipients is comparable to that of standard donor liver. The incidence of DGF is higher in recipients with marginal donor liver.

Objective To analyze the evaluation indicators of pre-hospital first aid for adult patients with acute severe trauma to provide the evidence-based basis for the initiation of "zero channel" in first aid work.Methods The literatures such as expert consensus,clinical research,guideline and systematic review were retrieved from PubMed,Medline,Embase,Cochrane Central Register of Controlled Trials,and China Knowledge Network by computer.The retrieval time was from January 2013 to November 2023.After screen-ing the literatures according to the standard,the quality evaluation and evidence grading were conducted by a-dopting different tools.Results A total of 8 literatures were included,including 4 clinical studies,2 expert consensus and 2 systematic reviews.Finally,10 evidence-based evidences for the initiation of "zero channel" in adult patients with acute severe trauma were summarized.Conclusion This study summarizes the relevant in-dicators of "zero channel" initiation in the adult patients with acute severe trauma,which is helpful for clinical medical staff to start the first aid "zero channel" in time and increase the success rate of rescue.

Objective To understand the patterns of outpatient prescription medications in the hospital's elderly patients.Methods Data for all outpatient prescriptions at our hospital written for seniors (≥60 years old) between 2013 and 2014 were collected and medications were ranked based on the price.The top 100 medications were chosen for analysis.Results The most expensive and most frequently prescribed three therapeutic groups were drugs for cardiovascular,endocrine & metabolic,and bone & joint disorders.Medication numbers and prices varied among different age groups,with the 60-64 and 75-79 groups representing the highest numbers and prices.The average price (460.3 yuan) per prescription for male patients was higher than that (399.3 yuan) for female patients.Conclusions The cost of prescription drugs in elderly patients is higher than in middle-aged patients,with drugs for non communicable chronic diseases accounting for most of the expenses.Polypharmacy is also a prominent issue.Prescriptions for chronic illnesses in the elderly should follow well established guidelines and appropriately managed.

Objective To evaluate the visual quality and functions of the civil pilots after corneal refractive surgery (CRS) and to explore the safety and long-term stability of CRS.Methods Two hundred and ninety-seven pilots,who were treated in Ophthalmology Department of West China Hospital,Sichuan University,were selected as subjects in this study.Their visual acuity,refraction,corneal topography,contrast sensitivity and break-up time (BUT) were detected and the subjective questionnaires were surveyed.The pilots were divided by spherical equivalent (SE) into emmetropia group:the SE of any eye was ≤+0.50 D or ≥-0.50 D,refractive error group:the SE of any eye was-0.75--6.00 D and CRS group:the pilots had the history of CRS.Results ①There were 99 pilots (198 eyes) in emmetropia group [SE (0.00±0.50) D];90 pilots (180 eyes) in refractive error group [SE (-2.06±1.75) D];108 pilots (216 eyes) in CRS group [SE (0.00±0.74) D].The SE of 68.1％ pilots in CRS group was within ±0.50 D,90.3％ pilots was with in ±1.00 D.②The uncorrected visual acuity of 85.6％ pilots (185 eyes) of CRS group was ≥1.0 while 98.6％ pilots (213 eyes) achieved ≥0.5.③There were significant differences on BUT,glare contrast sensitivity function-12,corneal astigmatism,surface asymmetry index (SAI) among 3 groups (H =6.910-26.075,P ＜ 0.05).There were no significant differences in the index of visual quality between emmetropes and CRS group except BUT and SAI (H =2.465,4.449,P＜0.017).There were no significant differences in symptom,social activity,mental and psychology domains between emmetropes and CRS group (P＞0.017).Conclusions The long-term visual quality and functions of the pilots by CRS show stable effects and compatible to the criteria of emmetropic pilots.

Objective To evaluate the visual quality and functions of the civil pilots after corneal refractive surgery (CRS) and to explore the safety and long-term stability of CRS.Methods Two hundred and ninety-seven pilots,who were treated in Ophthalmology Department of West China Hospital,Sichuan University,were selected as subjects in this study.Their visual acuity,refraction,corneal topography,contrast sensitivity and break-up time (BUT) were detected and the subjective questionnaires were surveyed.The pilots were divided by spherical equivalent (SE) into emmetropia group:the SE of any eye was ≤+0.50 D or ≥-0.50 D,refractive error group:the SE of any eye was-0.75--6.00 D and CRS group:the pilots had the history of CRS.Results ①There were 99 pilots (198 eyes) in emmetropia group [SE (0.00±0.50) D];90 pilots (180 eyes) in refractive error group [SE (-2.06±1.75) D];108 pilots (216 eyes) in CRS group [SE (0.00±0.74) D].The SE of 68.1％ pilots in CRS group was within ±0.50 D,90.3％ pilots was with in ±1.00 D.②The uncorrected visual acuity of 85.6％ pilots (185 eyes) of CRS group was ≥1.0 while 98.6％ pilots (213 eyes) achieved ≥0.5.③There were significant differences on BUT,glare contrast sensitivity function-12,corneal astigmatism,surface asymmetry index (SAI) among 3 groups (H =6.910-26.075,P ＜ 0.05).There were no significant differences in the index of visual quality between emmetropes and CRS group except BUT and SAI (H =2.465,4.449,P＜0.017).There were no significant differences in symptom,social activity,mental and psychology domains between emmetropes and CRS group (P＞0.017).Conclusions The long-term visual quality and functions of the pilots by CRS show stable effects and compatible to the criteria of emmetropic pilots.

OBJECTIVE:To provide reference for the standardization of package insert of common drugs for elderly patients. METHODS:Outpatient prescriptions in our hospital from 2013 to 2014 were collected,and common drugs of elderly patients(≥60 years old)were ordered by consumption sum,and package inserts of top 100 drugs were statistically analyzed for absent items. RESULTS:The 100 common drugs for elderly patients included 28 Chinese traditional drugs and 72 chemical drugs. The Chinese traditional drug had more absent items,mostly were pharmacokinetics and drug overdose(92.9%),medication of elderly patients (85.7%),drug interactions(78.6%)and pharmacological actions(50.0%);the proportion of contraindications(16/28),adverse re-actions(15/28) and precaution(9/28) with uncertainty was relatively high. Items of chemicals package insert were better than Chi-nese traditional drug,absent items were pharmacokinetics and drug overdose(5.6%),medication of elderly patients and pharmaco-logical actions (2.8%) and drug interactions (1.4%);the proportion of medication of elderly patients (16/72),drug interaction and drug overdose(12/72)with uncertainty was relatively high. CONCLUSIONS:The common problem existing in the drug manu-al is characterized by absence of usage for elderly,drug descriptions is not clear,etc. Package inserts should be further improved to strengthen its standardization.