Objective:To analyze the efficacies of unilateral biportal endoscopy(UBE)and percutaneous endoscopic transforaminal discectomy(PETD)in treatment of lumbar disc herniation(LDH),and to explore the optimal selection of minimally invasive surgical approaches for the The LDH patients.Methods:A retrospective analysis was performed on the clinical data of 64 LDH patients who underwent surgery at Liwan Central Hospital of Guangzhou City in Guangdong Province,between January 2020 and June 2024.The surgical approaches were determined through physician-patient communication,and the patients were divided into UBE group(n=30)and PETD group(n=34).The materials of patients were recorded including gender,age,body mass index(BMI),percentages of affected segments,course of disease,duration of hospitalization,operation duration,intraoperative blood loss,numbers of intraoperative fluoroscopy,total incision length,and time to full weight-bearing(WB).The therapeutic outcomes were evaluated using Oswestry disability index(ODI),Visual Analog Scale(VAS)scores for low back pain and leg pain,MacNab criteria,and spinal canal areas at the affected segment.the postoperative complications of the patients in two groups were analyzed.Results:There were no statistically significant differences in age,gender composition ratio,BMI,course of disease,and percentages of affected segments of the patients between UBE group and PETD group(P＞0.05).Compared with PETD group,the intraoperative blood loss,total incision length,and time to full WB of the patients in UBE group were significantly increase(P＜0.01),while the number of intraoperative fluoroscopy time was decreased(P＜0.01).Compared with pre-operation,the ODI scores and VAS scores for low back and leg pain of the patients at final follow-up in both groups were decreased(P＜0.01),and the spinal canal areas at the affected segments of the patients were increased(P＜0.01).At final follow-up,compared with PETD group,the ODI score and VAS scores for low back and leg pain of patients in UBE group were decreased(P＜0.01),while the spinal canal areas at the affected segments of the patients was increased(P＜0.01).According to MacNab criteria,the percentages of excellent and good had no significant difference between two groups(P＞0.05).The incidence of complication showed no statistical difference between two groups(P＞0.05).Conclusion:Both UBE and PETD yield satisfactory outcomes in the treatment of single-segment LDH.PETD is less invasive and permits earlier time to full WB,whereas UBE provides more extensive decompression and superior long-term efficacy.The surgical approach selection should be individualized based on specific factors in the clinic.

BACKGROUND:Previous studies of our research group have confirmed that the texture of porcine reticular dermis at lateral ventral part is softer and has more extensibility than other parts. Therefore, it may serve as the raw material of xenogenic aceluar dermal matrix. However, its comparison with human and rat reticular dermis has not been reported systematicaly in aspects of histomorphology and material characterization. OBJECTIVE:To compare the reticular dermis from the lateral region of porcine abdomen and rat dorsal part with the reticular dermis from human in histology, biomechanics, molecular structure, thermal stability and other properties. METHODS:The reticular dermis samples were taken from adult human, the lateral region of porcine abdomen, the back of rats, for gross observation. Paraffin sections were observed by hematoxylin and eosin staining and sirius red staining under a light microscopy. The relevant data of micrograph were measured by imagine analysis software. These samples were also vacuum-freezing dried and rehydrated, and then their mechanical properties were tested with a electronic tensile machine to calculate the Young’s modulus. Some vacuum-freezing dried samples were powdered and detected by Fourier transform infrared spectrometer and simultaneous thermal analyzer. RESULTS AND CONCLUSION:There were no differences in colagen fiber bundle diameter of the reticular dermis from adult human and the lateral region of porcine abdomen, but the reticular dermis from the back of rats was thinner than that from adult human (P < 0.01). The gap between the reticular layer of the dermis of the lateral region of porcine abdomen was lower than that from adult human (P < 0.0.1); however, there was no difference in the gap between the reticular layers of the dermis of the rat back and adult human (P=0.17). Colagen fibers of porcine reticular dermis were arranged tightly in disorder; the content of type I colagen and ratio of type I/III colagen were higher than those in the reticular dermis from adult human (P < 0.05), but the content of type III colagen was less than that in the reticular dermis from adult human (P < 0.05). Contents of type I and III colagen and their ratio were similar between the reticular dermis of rats and adult human (P > 0.05). There was no significant difference in the Young’s modulus of the three kinds of reticular dermises. Hydrogen bonds involved in the reticular dermal colagen molecules ranged as folows: rats > swine > human. Rat reticular dermis has better thermal stability than that of swine and adult human.

Objective To evaluate the effects of gender and age on median-effective target plasma concentration(EC50)of propofol administered by target controlled infusion(TCI)causing respiratory depression.Methods Eighty ASA Ⅰ or Ⅱ patients aged 40-79 yr,with body mass index 18-25 kg/m2.undergoing general anesthesia were divided into 4 groups(n=20 each):1 middle-aged male group(MA);Ⅱ middle-aged female group(FA);Ⅲold male group(MO) and Ⅳo ld female group(FO).No premedication was administered.Propofol Was administered by TCI for 15 min,using TCI system incorporating Marsh pharmacokinetic model.EC50 Was determined by up-end-down sequential trial.The target plasma concentration(Cr)was set at 3.1μg/ml in the first Patient in each group.Each time Cr increased/decreased by 10%in the next patient depending on whether or not the respiratory depression occurred.Respiratory depression was defined as RR<8 bpm,Vr≤5 ml/kg,end-tidal PCO2≥50 mm Hg,SaO2≤94%and/or apnea≥15s.Results The EC50 and 95%confidence interval of propofol TCI causing respiratory depression were 6.40(6.09-6.72)μg/ml in group MA,5.93(5.54-6.34)μg/ml group FA,4.58(4.32-4.91)μg/ml in group MO and 4.37(4.14-4.61)μg/ml in group FO.EC50 was significantly lower in group FO than in group FA and in group MO than in group MA,but there Was no significant difference in EC50 between group MA and group FA or between group MO and FO. Conclusion The potency of propofol given by TCI causing respiratory depression is increased in the old patients as compared with the middle-aged patients and is not related to sex.

OBJECTIVETo explore the influence of recombinant human growth hormone (rhGH) on the apoptosis and intestinal mucosal structure in severely scalded rats.

METHODSThirty male Wistar rats were randomly divided into three groups, i.e. control, scalding and rhGH groups. The rats in scalding and rhGH groups were inflicted with 25% TBSA III degree scalding on the back and immediately followed by intraperitoneal injection of dexamethasone (80 mg/kg). The scalded rats were administered with normal saline and rhGH (1.33 IU.kg(-1).d(-1)) since 2 postburn hours (PBHs), respectively in the last two groups. The changes of the apoptosis rate, the intestinal mucosal proliferative index (PI) and epithelial ultrastructure and the intestinal mucosal pathomorphology of the distal end of ileal mucosal tissue were observed on 30 and 96 PBHs.

RESULTSThe intestinal mucosa morphology and epithelia in scalding group were severely injured but were significantly ameliorated by rhGH to near those in control group. The PI in rhGH and scalding groups at 30 PBHs was evidently higher that that in control group (P < 0.05 - 0.01). But the PI exhibited no obvious difference between scalding and rhGH groups. While the PI in rhGH group at 96 PBHs was obviously higher than that in both scalding and control groups (P < 0.01). The intestinal mucosal epithelial apoptotic rate in scalding group was significantly higher than that in control group (P < 0.01), while that in rhGH group was evidently lower than that in scalding and control groups (P < 0.05 - 0.01).

CONCLUSIONrhGH could promote postburn intestinal mucosa epithelial proliferation in slow - action manner and inhibit intestinal mucosal epithelial apoptosis with rapid and obvious effects. As a result, the intestinal mucosal epithelial injury could be ameliorated by rhGH by means of its inhibiting roles and the normal morphological structure of intestinal mucosa was maintained ad hoc.

Animals ; Apoptosis ; Burns ; pathology ; Human Growth Hormone ; genetics ; pharmacology ; Intestinal Mucosa ; drug effects ; pathology ; Male ; Rats ; Rats, Wistar ; Recombinant Proteins ; pharmacology