Objective To investigate the impact of the surgeon’s dominant hand-side on the operational efficiency and safety of primary lumbar discectomy under unilateral biportal endoscopy (UBE). Methods A prospective cohort study was conducted in 60 patients with single-level lumbar disc herniation who underwent UBE lumbar discectomy between August 2024 and August 2025 by the same right-handed surgeon, including 30 patients with non-dominant (right approach) (non-matched group) and 30 patients with dominant (left approach) (matched group). No significant difference was observed between the two groups in baseline data including gender, age, body mass index, herniated segment distribution, disease duration, and preoperative visual analogue scale (VAS) score and Oswestry disability index (ODI) (P>0.05). The total operation time, core endoscopic operation time, intraoperative blood loss, and related complications were recorded and compared between the two groups. A self-developed surgeon’s operational fluency assessment score was used for auxiliary subjective evaluation. VAS score and ODI were used to assess pain and functional improvement preoperatively and at 1 and 3 months postoperatively. The modified MacNab criteria was used to evaluate overall surgical outcomes at 3 months postoperatively. Results There was no significant difference in the total operation time and intraoperative blood loss between the two groups (P>0.05). The core endoscopic operation time of the matched group was significantly shorter than that of the non-matched group, and the operational fluency assessment score of the matched group was significantly higher than that of the non-matched group (P<0.05). All patients were followed up 3-6 months, with an average of 4.2 months. Complications occurred in 2 cases (6.7%) in the matched group, including 1 case of dural tear and 1 case of postoperative transient nerve root palsy, and 1 case (3.3%) in the non-matched group, which was postoperative epidural hematoma. There was no significant difference in the incidence of complications between the two groups (P>0.05). The VAS scores and ODI of the two groups decreased at 1 and 3 months after operation, and improved further at 3 months after operation compared with 1 month after operation, and the differences were significant (P<0.05), but there was no significant difference between the two groups after operation (P>0.05). Modified MacNab standard was used to evaluate the curative effect at 3 months after operation, and there was no significant difference in the evaluation grade and excellent and good rate between the two groups (P>0.05). Conclusion Consistency between the surgeon’s dominant hand side and the surgical approach side significantly improves core endoscopic operational efficiency and surgical fluency in UBE lumbar discectomy, without compromising clinical efficacy or safety. It is suggested that this matching factor should be prioritized in surgical scheduling and beginner training to optimize the operative experience and shorten the learning curve.
Objective To investigate the initial drug resistance of Mycobacterium tuberculosis ( M.tuberculosis) in patients with culture positive pulmonary tuberculosis. Methods 1184 patients who hospitalized in Shandong Provincial Chest Hospital with culture positive pulmonary tuberculosis were enrolled. The absolute density method was used to assess the drug resistance of M. tuberculosis. Results M.tuberculosis were sensitive to all anti-tuberculosis drugs in 834 cases( 70. 44% ) , and resistant in 350 cases( 29. 56% ) , in which initial resistance and secondary resistance accounted for 44. 86% ( 157/350) and 55. 14% ( 193 /350) respectively. In 157 cases with initial resistance, 53 cases ( 33. 8% ) were mono-drug resistant tuberculosis( MonoDR-TB) , of which 38 cases were resistance to Streptomycin( 24. 2% ) ; 72 cases( 45. 9% ) were polydrug-resistant tuberculosis ( PDR-TB) ; 20 cases ( 12. 7% ) were multidrug-resistant tuberculosis ( MDR-TB) ; 12 cases ( 7. 6% ) were extensively drug resistant tuberculosis ( XDR-TB) . There was no totally drug-resistant tuberculosis ( TDR-TB) . Conclusions The initial drug resistance of M.tuberculosis in patients with pulmonary tuberculosis is still serious. Unified management of TB control programs and full supervision of chemotherapy are very imperative.
ObjectiveTo detect the 2019 novel coronavirus (2019-nCoV) in various biological specimens of novel coronavirus pneumonia (NCP), and preliminarily observe the status of 2019-nCoV in different systems of the body and its clinical significance.MethodsThe study design was a small-scale cross-sectional observational study. All the confirmed NCP cases being treated in the Second People’s Hospital of Yibin · West China Yibin Hospital, Sichuan University on February 2nd, 2020 were enrolled in this study. Two sets of primers were designed for 2019-nCoV-1ab and N regions using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The 2019-nCoV in upper respiratory specimens, blood, feces and urine specimens of the NCP cases were detected on the single day.ResultsA total of 7 imported NCP cases (mild type) were included. The 7 patients were confirmed by the positive results of 2019-nCoV nucleic acid tests of upper or lower respiratory specimens between the 3rd day and the 7th day after fever onset, while 2 patients were found positive on the 3rd day after onset. The 2019-nCoV nucleic acid tests of the 7 patients were detected again on a single day between the 7th day and the 15th day after onset, and the results showed: the upper respiratory specimens of 5 patients were found negative (1 case was on the 7th day after onset); 2019-nCoV was not detected in the blood, feces or urine specimens of the 7 patients.ConclusionsFor mild type NCP patients, real-time RT-PCR test could detect 2019-nCoV between the 3rd day and the 7th day after onset, while 2019-nCoV might become negative since the 7th day after onset. 2019-nCoV was not detected in the blood, feces or urine of mild type NCP patients on the single day between the 7th day and the 15th day after onset. This study was only a preliminary observational study, which needed high-qualified studies to obtain more definitive conclusions.