Percutaneous Endoscopic Suprapedicular Decompression in the Treatment of Down-Migrated Lumbar DiscHerniation.

OBJECTIVE: This study aimed to investigate the clinical efficacy of percutaneous endoscopic suprapedicular decompression in treatment of down-migrated lumbar disc herniation. METHODS: The clinical data of 43 patients with down-migrated lumbar disc herniation treated with endoscopic surgery at our hospital between January 2022 and January 2023 were retrospectively analyzed. Twenty-two and 21 patients underwent percutaneous endoscopic decompression using the suprapedicular and transforaminal endoscopic surgical system approaches, respectively. The perioperative, follow-up, and imaging data of the groups were compared. RESULTS: Surgery was uneventful in both groups. The number of intraoperative fluoroscopies and duration of surgery were significantly lower in the suprapedicular group (P < 0.05). The patients in both groups were followed up for at least 12 months. At the last follow-up, lumbar pain and leg pain visual analog scale, Oswestry Disability Index, and 36-Item Short Form Health Survey scores were significantly improved in both groups compared with preoperative values (P < 0.05); the differences in these indexes between the 2 groups were not significant preoperatively (P > 0.05). However, at the last postoperative follow-up, lumbar pain visual analog scale scores were significantly better in the suprapedicular group (0.83 ± 0.85 vs. 2.54 ± 1.32, P < 0.05). There was no significant change in intervertebral space height or lumbar lordotic angle compared with preoperative values in either group at the last follow-up (P > 0.05). However, the spinal canal cross-sectional area significantly increased (P < 0.05). CONCLUSIONS: The treatment of down-migrated lumbar disc herniation via a suprapedicular approach enabled the incision of the superior margin of the pedicle as needed under direct vision, involved less fluoroscopy while preserving facet joint stability, and enabled targeted removal of the herniated nucleus pulposus, thus greatly reducing residual nucleus pulposus. This surgical procedure was safe, rapid, and showed satisfactory therapeutic efficacy.

[Application of ultrathin transnasal gastroscopy in percutaneous endoscopic gastrostomy].

OBJECTIVE: To assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy (nPEG) in patients with trimus and/or pharyngeal narrowing. METHODS: Nine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy (5 cases) or ultrathin transnasal gastroscopy (4 cases). Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated. RESULTS: The average procedure time of PEG was 17+/-3.5 min in conventional gastroscopy group and 17+/-3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure. CONCLUSIONS: Ultrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.

[Evaluation on reducing effect of eye drop on herpes simplex virus-I in vitro].

OBJECTIVE: To observe the effect of herbal eye drop Reduqing (clearing toxic heat) on herpes simplex virus (HSV) on the cytopathic effect in cell culture in vitro. METHODS: The maximal non-toxic Reduqing eye drop concentration added to cell culture infected with 100 and 10TCID50 of herpes simplex virus? (HSV-1) to observe the inhibitory effect of the medicine on HSV-I induced cytopathic effect. RESULTS: The Reduqing eye drop at maximal non-toxic concentration could obviously inhibit the cytopatic effect induced by 100TCID50 and 10TCID50 HSV-I. No statistically significant difference was found when compared with 0.1% acyclovir eye drop (P>0.05), on cytopathic effect occurred with boty eye drops. However, there was significant difference when compared with control group(P<0.05). The inhibitory effect of concentrations of Reduqing at 500,000 and 63,000 microg/L was stronger than that of 2,000,000 and 1,000,000 microg/L (P 0.01). The maximal tolerable concentration of Reduqing eye drop by the cell was 2,000,000 microg/L (1:80 dilution), which was higher than that of 5,000 microg/L(1:400 dilution) acyclovir eye drop. CONCLUSIONS: These results suggest that Reduqing eye drop could markedly inhibit the cytopathic effects caused by HSV-I. The Reduqing eye drop showed remarkably low toxic effect to the cells as compared to acyclovir eye drop.