Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective:To investigate the influencing factors of increased tube bleeding within 24 h after coronary artery bypass grafting(CABG) and its correlation with perioperative complications.Methods:This study was a prospective observational study. The patients with CABG surgery were enrolled in Beijing Anzhen Hospital affiliated to Capital Medical University from May 2018 to December 2021. The age, sex, complications, blood tests and other clinical data of outpatients were collected. Left ventricular ejection fraction(EF) and left ventricular enddiastolic diameter(LVED) were detected by echocardiography. MGF and PI of grafts were recorded during CABG. Perioperative troponin Ⅰ, blood clotting pentathlon, all-cause death, perioperative myocardial fraction, atrial fibrillation and stroke were collected. According to the tube bleeding within 24 h after operation, the patients were divided into increased group(tube bleeding>1 000 ml) and normal group(tube bleeding≤1 000 ml). The preoperative baseline data, intraoperative indexes and perioperative complications were compared between the two groups. Logistic regression, Spearman and linear regression models were used to analyze the correlation between tube bleeding within 24 h and clinical data.Results:304 patients underwent CABG were enrolled. There were 185 cases(60.9%) in the increased group and 119 cases(39.1%) in the normal group. After adjusting for age, sex and BMI, multivariate logistic regression analysis showed that male( OR=2.40, 95% CI: 1.38-4.18, P=0.002), history of stroke( OR=2.37, 95% CI: 1.07-5.26, P=0.034), and history of myocardial infarction( OR=1.81, 95% CI: 1.13-2.91, P=0.014) could significantly increase the risk of tube bleeding within 24 h after surgery. The average blood flow of the anterior descending branch( OR=0.99, 95% CI: 0.99-1.00, P=0.022) and the circumflex branch( OR=0.99, 95% CI: 0.98-1.00, P=0.003) during the operation was significantly negatively correlated with the increase of tube bleeding within 24 h after surgery, while the PI of anterior descending branch( OR=1.81, 95% CI: 1.26-2.61, P=0.001), circumflex branch( OR=1.45, 95% CI: 1.07-1.97, P=0.017), right coronary artery( OR=1.84, 95% CI: 1.29-2.62, P=0.001) were positively correlated with the increase of tube bleeding within 24 h after operation. In addition, prothrombin time significantly increased the risk of increased tube bleeding within 24 h after surgery( OR=1.16, 95% CI: 1.03-1.30, P=0.018). Linear regression analysis showed that there was a significant positive linear correlation between ICU time and tube bleeding within 24 h after surgery( OR=0.17, 95% CI: 0.96-4.58, P=0.003), and a significant negative linear correlation between postoperative ejection fraction and tube bleeding within 24 h( OR=-0.25, 95% CI: -33.18--13.07, P<0.001). Conclusion:Increased tube bleeding within 24 h after CABG is most common in males and patients with a history of cardiovascular and cerebrovascular infarction. Better graft hemodynamic parameters can reduce the tube bleeding within 24 h after the operation, further improve cardiac function and reduce ICU time.

Objective:This study aimed to compare the detection efficacy of transrectal ultrasound-guided transrectal cognitive fusion targeted+ systematic prostate biopsy and transperineal cognitive fusion targeted + systematic biopsy in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated.Methods:A total of 385 patients with suspected prostate cancer in the affiliated hospital of Qingdao University from May 2019 to November 2019 were retrospectively analyzed. All patients met the prostate biopsy criterion, who underwent transrectal(n=275)and transperineal(n=110)prostate biopsy respectively. There were no significant differences of mean age [(70.7±7.3)years vs.(69.2±8.4) years], PSA [(55.12±116.96)ng/ml vs. (63.41±315.34)ng/ml], prostate volume [(55.96±35.26)ml vs. (64.35±55.99)ml] between two groups. According to preoperative prostate magnetic resonance imaging combined with intraoperative ultrasound, 2-4 needles targeted puncture of suspected lesion were performed, followed by 12 needle systematic prostate biopsy. The detection rate of prostate cancer between two biopsy ways were compared. The related factors of PCa including age, prostate volume and PSA level were collected for univariable and multivariable logistic analysis. The cancer detection rate was compared and logistic regression was used to assess the impact of patient characteristics on PCa detection.Results:For all patients, the detection rate with cancer between transrectal group and transperineal group were 121/275(40.0%) and 67/110(60.9%), respectively. The transperineal group detected a higher rate of PCa ( P=0.003)and more clinically significant prostate cancers (csPCa) (54.6% vs.36.7%, P=0.001) than that of the transrectal group, there were significant differences between two groups ( P<0.05). Univariate and multivariate logistic regression analysis revealed that PSA( OR=1.025, P=0.001) and prostate volume( OR=0.984, P=0.001)were two independent factors for the detection rate of prostate cancer between two biopsy ways( P<0.05). The effect of age on the detection rate of PCa in the transperieal group was significantly lower than that of the transrectal group( OR=0.037, P=0.238 vs. OR=0.053, P=0.002). Conclusion:The transperieal biopsy could find more PCa than the transrectal biopsy. PSA level and prostate volume could affect the detection rate of cancer between two prostate biopsy ways.

Objective: To establish a microwave scattering parameter acquisition system to detect cerebral hemorrhage and cerebral ischemia animal models, and to study the non-contact rapid identification methods for the two stroke types. Methods: Rabbits were selected for modeling. Eight rabbits in the cerebral hemorrhage group were injected with autologous blood. Six rabbits in the cerebral ischemia group were treated with bilateral common carotid artery clamping and femoral artery bleeding. The measurement excitation source has a scanning frequency range of 300 kHz to 3 GHz and an intermediate frequency bandwidth of 30 kHz. The signal of the S21 phase was acquired. The collected microwave scattering signals were subjected to mean filtering, principal component analysis dimension reduction, and mean clustering and nearest neighbor analysis to realize the identification of stroke types. Results: The microwave scattering measurement method can reflect the changes of cerebral hemorrhage and cerebral ischemia. The phase of S21 decreases with the increase of blood loss and increases with the increase of ischemic duration. The results of the differential experiment showed that all 14 models were correctly identified. Conclusions The stroke identification system based on microwave scattering measurement can effectively distinguish rabbit cerebral hemorrhage model and ischemic model. This technology is low cost, portable non-invasive, simple operation and fast, which make it be a promising method for identifying pre-hospital stroke types.

Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte ( PEG ) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7:30 pm the day before colonoscopy, followed by 1500 mL PEG at 8:00 pm before the test, and 1500 mL PEG at 5:00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8:00 pm the day before colonoscopy, followed by 1500 mL PEG at 5:00 am the day of colonoscopy. The group C was given 1500 mL PEG at 8:00 pm the day before colonoscopy, and another 1500 mL PEG at 5:00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale ( BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearsonχ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource ( P>0. 05) . The time of first defecation after taking medication for the group A, B and C was (2. 25±2. 32) h, (2. 43±2. 39) h and (3. 36±2. 79) h respectively, with statistical difference (F=3. 36, P=0. 037). The time of first defecation was longer in the group C than that of the group A and B ( P = 0. 016 and P = 0. 046, respectively). The number of defecation before sleep for the group A, B and C was 3. 47±2. 09, 3. 24±1. 76 and 2. 49±1. 58 respectively, with statistical difference (F=4. 65, P=0. 011). The number of defecation before sleep was lesser in the group C than that of the group A and B ( P=0. 004, P=0. 027, respectively) . The total number of defecation for the group A, B and C was 7. 20 ± 2. 67, 6. 81 ± 2. 31 and 5. 64 ± 2. 22 respectively. The difference among the three groups was statistically significant ( F=6. 68, P=0. 002) . For the group A and B, the total number of defecation was both more than that of the group C ( P=0. 001, P=0. 010) . There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the total BBPS score ( all P>0. 05) . The BBPS score of the right colon for the group A, B and C was 2. 03 ± 0. 82, 1. 95 ± 0. 87 and 1. 53 ± 0. 80 respectively, with statistical difference ( F=6. 38, P=0. 002) , and was lower in the group C than that of the group A and B ( P= 0. 001, P= 0. 006, respectively) . Adverse reactions after taking medication including nausea, vomiting, abdominal pain, and bloating were respectively reported in 7, 3, 0 and 3 cases in the group A, 5, 3, 0 and 6 in the group B, and 4, 2, 1 and 4 in the group C, and there was no statistical difference among the three groups (χ2=4. 35, P=0. 824) . Conclusion Administration of olive oil compared with PEG can improve the cleanness of right colon for chronic constipation patients, shorten the time of first defecation after taking medication, and increase the number of defecation before sleep and the total number of defecation during bowel preparation. Taking olive oil before or after PEG at the night before colonoscopy has no significantly effect on bowel preparation and adverse reactions.

Objective    To evaluate the efficacy and clinical significance of bipolar radiofrequency ablation in the treatment of left ventricular aneurysm with ventricular arrhythmias guided by CARTO mapping system. Methods    From September 2009 to December 2015, 56 patients with ventricular aneurysm following myocardial infarction were enrolled. All patients suffered different levels of angina pectoris symptoms evaluated by Holter (the frequencies of ventricular arrhythmias more than 3 000 per day). They were divided into two groups according to random ballot and preoperative communication with patients' family members: a bipolar radiofrequency ablation group (n=28, 20 males, 8 females, mean age of 61.21±1.28 years) receiving off-pump coronary artery bypass grafting (OPCABG), ventricular aneurysm surgery combined with bipolar radiofrequency ablation, and a non-bipolar radiofrequency ablation group (n=28, 22 males, 6 females, mean age of 57.46±1.30 years) receiving OPCABG and single ventricular aneurysm surgery. The grade of cardiac function and ventricular arrhythmia was compared between the two groups during pre-operation, discharge and   follow-up. Results    All patients were discharged successfully. There was no in-hospital death in both two groups. One patient in the non-radiofrequency group had cerebral infarction. All patients were re-checked with Holter before discharge and the frequency of ventricular arrhythmias significantly decreased compared to that of pre-operation in both groups, and was more significant in bipolar radiofrequency ablation group (1 197.00±248.20 times/24 h vs. 1 961.00±232.90 times/24 h, P<0.05). There was significant difference in duration of mechanical ventilation and ICU stay between the two groups (P<0.05). The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) significantly improved (P<0.05) after operation in both groups. Conclusion    The clinical efficacy of bipolar radiofrequency ablation in the treatment of ventricular aneurysm with ventricular arrhythmia guided by CARTO mapping is safe and effective, but its long-term outcomes still need further follow-up.