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OBJECTIVE：To invest igate the medication regulation of Tibetan medicine prescription of Punica granatum seeds， and to analyze the pharmaceutical property of it in the treatment of “Sanweihuo”（Me drod gusm) dysfunction induced-related diseases. METHODS ：Using Clinical Notes of Tibetan Medicine ，Medicine Standard of the Ministry of Public Health ：Tibetan Medicine as standard ，Tibetan medicine prescriptions of P. granatum seeds recorded in Sibu Yidian ，Yuewang Yaozhen and other medical records were collected ，and TCMISS V 2.5 software was used to analyze main indication and medicine frequency statistically. The core medicine combinations of the prescriptions were analyzed with Apriori algorithm （support degree ≥50％， confidence degree ≥90％)，and medication regulations were analyzed. Tibetan medicine “Ro Nus Zhu rJes ”vector model was used to analyze the properties of Tibetan medicine prescription of P. granatum seeds in the treatment of high frequency diseases ，and K-means cluster analysis was carried out for seventeen effectiveness. RESULTS ：A total of 300 Tibetan medicine prescriptions of P. granatum seeds were collected ，involving 104 kinds of main indications ，among which frequency of 18 kinds of indications was more than or equal to 10 times，including“non-indigestion syndrome ”（Ma Zhu ba) （76 times)，“wood cloth disease ”（Smug po) （46 times)，“edema”（Chu nad) （34 times)，etc. Totally 322 kinds of Tibetan medicines were involved. Among them ，21 flavors were more than or equal to 50 in frequency ，including Piper longum （192 times)，Amomum kravanh （164 times) and Carthamus tinctorius（134 times)，etc. Fifty-six core combinations were obtained ，mainly including P. granatum seeds-P. longum （192 times)， P. granatum seeds-A. kravanh （164 times) and P. granatum seeds-C. tinctorius （134 times). The prescriptions （13 pieces) with six flavors as pungent ，sweet and sour ，and with prominent medicinal properties such as roughness ，heat and dry effects could be used to treat “non-indigestion syndrome ”，and then included into type Ⅰ. The prescriptions （13 pieces) with six flavors as bitter ，sweet and pungent ，and with prominent medicinal properties such as cooling ，dull and heavy effects could be used to treat “wood cloth disease”，and then included into type Ⅱ. The prescriptions （11 pieces) with six flavors as sweet ，sour and pungent ，and with prominent medicinal properties such as dull ，heavy and moistening effects could be used to treat “edema”，and then included into type Ⅲ. CONCLUSIONS ：Tibetan medicine P. granatum seeds is often used in combination with the isothermal medicines such as P. longum ，A. kravanh . P. granatum seeds are also commonly found in cool prescriptions ，revealing that Tibetan medicine pays attention to “Sanweihuo”while treating diseases ，which embodies the academic thought of Tibetan medicine that “there is cooling in temperature ，and there is temperature in cooling ”.
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Objective To investigate the clinical efficacy and related complications of bilateral minimally invasive transforminal lumbar interbody fusion via Quadrant channels for the treatment of single-level degenerative lumbar spondylolisthesis.Methods Sixty selective pa-tients with single-level mild and moderate degenerative lumbar spondylolisthesis who underwent bilateral MIS-TLIF via Quadrant channels from August 2015 to May 2017 were retrospectived investigated.Operative time,blood loss,X-Ray exposure time,postoperative drainage and related complications were recorded.Lumbar functional improvement was defined as an improvement in the JOA.The VAS was also employed at pre and postoperation(6 months),to evaluate low back and leg pain.Intervertebral fusion was assessed by Bridwell evaluation criteria and the clinical outcome was assessed by the MacNab scale at 6 months.In addition,related complications also were be analyzed.Results All patients underwent a successful MIS-TLIF surgery,of whom 58 patients were followed up for 6 months.The operation time was 170~290 minutes (mean:220.17 minutes),intraoperative blood loss was 100~260 mL(mean:168.62 mL),intraoperative radiation exposure was 15~36 times (mean:25.60 times) and postoperative drainage was 50~163 mL(mean:103.43 mL).Different significance between 6 months post-operative follow-up and pre-operation was exhibited (P<0.05) in VAS scores (t=34.97,P=0.000).At 6 months post-operative follow-up,there were significant differences(P<0.05) compared with pre-operation in JOA scores(t=36.91,P=0.000).At 6 months post-operative follow-up,21 cases of grade 1 and 37 cases of grade 2 fusion were present as determined by the Bridwell evaluation criteria(100% fusion).MacNab scale as-sessment classified 2 patients having excellent clinical outcome and 54 patients in good clinical outcome(96.55% of patients had good to excel-lent results).Amomg 60 cases,complications observed in 6 patients,direct injuries to nerve root in 1 case,dural tears occurred in 1 case,super-ficial wound infection in 1 case,pedicle screw was pulled out during the reduction of slip because of severe osteoporosis in 1 case and leg numb-ness and pain in 2 cases. Conclusion Bilateral MIS-TLIF via Quadrant channels with less complications is a safe and effective approach for the treatment of single segment degenerative lumbar spondylolisthesis,but potential complications should be prevented as well.