Pan-genome analysis highlights the role of structural variation in the evolution and environmental adaptation of Asian honeybees.

The Asian honeybee, Apis cerana, is an ecologically and economically important pollinator. Mapping its genetic variation is key to understanding population-level health, histories and potential capacities to respond to environmental changes. However, most efforts to date were focused on single nucleotide polymorphisms (SNPs) based on a single reference genome, thereby ignoring larger scale genomic variation. We employed long-read sequencing technologies to generate a chromosome-scale reference genome for the ancestral group of A. cerana. Integrating this with 525 resequencing data sets, we constructed the first pan-genome of A. cerana, encompassing almost the entire gene content. We found that 31.32% of genes in the pan-genome were variably present across populations, providing a broad gene pool for environmental adaptation. We identified and characterized structural variations (SVs) and found that they were not closely linked with SNP distributions; however, the formation of SVs was closely associated with transposable elements. Furthermore, phylogenetic analysis using SVs revealed a novel A. cerana ecological group not recoverable from the SNP data. Performing environmental association analysis identified a total of 44 SVs likely to be associated with environmental adaptation. Verification and analysis of one of these, a 330 bp deletion in the Atpalpha gene, indicated that this SV may promote the cold adaptation of A. cerana by altering gene expression. Taken together, our study demonstrates the feasibility and utility of applying pan-genome approaches to map and explore genetic feature variations of honeybee populations, and in particular to examine the role of SVs in the evolution and environmental adaptation of A. cerana.

The role of electrocochleography and the caloric test in predicting short-term recurrence of benign paroxysmal positional vertigo.

Objective: The study aimed to assess the value of physiological tests for evaluating inner ear function in predicting the short-term recurrence of benign paroxysmal positional vertigo (BPPV). Materials and methods: The clinical information of all idiopathic BPPV patients who were treated in our clinic between February 2021 and December 2022 were reviewed. All patients included in the study had completed audiology examinations including pure tone audiometry, electrocochleography (EcochG), auditory brainstem response, and vestibular function examination such as the vestibular caloric test. The relationships between the results of the above tests and short-term recurrent BPPV were analyzed. Results: A total of 96 patients with unilateral idiopathic BPPV were included for analysis. The numbers of non-recurrent patients and recurrent patients were 57 (59.4%) and 39 (40.6%), respectively. Only the results of EcochG and the caloric test showed significant differences between non-recurrent and recurrent patients (both P < 0.05). The results of these two tests were also found to be independently predictive of short-term recurrence (both P < 0.05). The non-recurrence rate for patients with normal results in both tests reached up to 78.3%, which was significantly higher than that for patients with abnormal results in both tests, 28.6% (P < 0.05). Conclusion: Endolymphatic hydrops and canal paresis were independent risk factors for short-term recurrent BPPV. Additional treatments should be considered to reduce the recurrence rate, including dehydration treatment and vestibular rehabilitation.

[Compliance and withdraw reason of sublingual immunotherapy in 245 patients with allergic rhinitis].

Objective:To investigate the compliance of patients with allergic rhinitis（AR） receiving sublingual immunotherapy and its influencing factors. Methods:The clinical data of 291 AR patients who received sublingual immunotherapy for dust mites at the First Hospital of Peking University from January 2016 to January 2018 were retrospectively analyzed, and their outpatient or telephone follow-up was conducted. For patients whose treatment time was less than 2 years, the time and reason for the loss were recorded, and the factors affecting their compliance were discussed from the aspects of gender, age, and education. Results:Among the 291 patients, 245 cases（84.2%） were successfully followed up, and 193 cases（78.8%） fell off midway（treatment time<2 years）. The overall compliance rate was 21.22%（52/245）. The compliance rate of children is higher than that of adults（χ²=21.306, P<0.05）, and gender and education level have no significant effect on the compliance rate. The time period for the largest number of shedding was 6-<12 months after treatment（68 cases, 27.8%）. The main cause of shedding was symptom relief, which was considered cured（16.7%）. Secondly, within 3 months after treatment, a total of 61 patients（24.9%） fell off, of which 34 cases（13.9%） fell off because of troublesome medication, often missed medication, and simply stopped taking the drug. Statistics on the overall reasons for shedding in 193 patients, the top three shedding reasons were: cured after symptom relief（59 cases, 30.6%）, troublesome medication, discontinuation after missed dose（44 cases, 22.8%）, slow onset or ineffectiveness（26 cases, 13.5%）. Conclusion:The overall compliance of sublingual immunotherapy in patients with allergic rhinitis is poor, and the compliance of children is better than that of adults. Clinicians should focus on the reasons for patients to fall off at various times, strengthen patient education, enhance patient confidence in treatment, and improve the compliance of patients.

Laryngopharyngeal reflux as a potential cause of Eustachian tube dysfunction in patients with otitis media with effusion.

Objective: To explore the association between laryngopharyngeal reflux disease (LPRD)-related symptoms and the Eustachian tube (ET) function in adult patients with otitis media with effusion (OME). Materials and methods: A total of 105 adult patients with OME were retrospectively studied. All these patients had undergone tubomanometry (TMM) test for the affected ears before treatments. The LPRD-related symptoms were all assessed by the Reflux Symptom Index (RSI) scale. Results: Among the 105 included patients, the numbers of subjects with only one and both two ears affected were 65 (57.1%) and 40 (42.9%), respectively. Therefore, a total of 145 affected ears were studied. For these affected ears, a linear regression analysis that included sex, age, BMI, smoking history, drinking history, RSI value, and the condition of the contralateral ear suggested that only RSI value was significantly associated with TMM value (P < 0.001), with the correlation coefficient of -0.112. Among the 9 symptoms in RSI scale, affected ears with the following symptoms (vs. affected ears without) showed significantly lower TMM values: excess throat mucus or postnasal drip, difficulty swallowing food, liquids, or pills, and sensations of something stuck in your throat or a lump in your throat (all P < 0.05). Conclusion: LPRD may disrupt ET function in adult OME patients. A higher RSI score is independently predictive for a bad ET patency in such patients and is indicative for an additional anti-reflux therapy.

Changes in cytomegalovirus load in the breast milk of very/extremely premature infants and the effect of pasteurization and freeze-thawing on reducing viral load.

Objective: This study aimed to clarify the change in Cytomegalovirus (CMV) loads in breast milk (BM) of very/extremely premature infants (VPI/EPI) with birth weight < 1,500 g after birth, and to compare the effectiveness of pasteurization and freeze-thawing methods in reducing the CMV load of BM. Methods: Breast milk samples were collected and tested every 2 weeks by fluorescence quantitative polymerase chain reaction (FQ-PCR). We determined CMV load in BM before and after pasteurizing, and freeze-thawing. Results: Cytomegalovirus DNA can already be detected in colostrum. The viral load gradually increased in the first 4 weeks, peaked in the 4th to 6th weeks, and gradually decreased thereafter. The viral load gradually returned to the initial level approximately 10-12 weeks postpartum. During the peak period of the CMV load in BM, the viral load was higher in the EPI than the VPI (P < 0.05). The average CMV load (logarithmic [LG]) in the pasteurization group was significantly lower than that in the raw BM group. The average CMV load in the freeze-thawed BM group was significantly lower than that in the raw BM group. The mean CMV load in the pasteurized BM group was lower than that in the freeze-thawed BM group, but the difference was not statistically significant. The CMV-DNA clearance rate in pasteurized was higher than in freeze-thawed (P < 0.05). Conclusion: The CMV detoxification rate in BM is high and the peak load period is mainly between 4 and 6 weeks. The CMV load values detected are higher than the threshold values (7 × 103 copy number/mL) of CMV infection that are reported in the literature as a concern. Both the freeze-thaw and pasteurization techniques can effectively reduce the CMV load.

Modified Endoscopic Dacryocystorhinostomy: A Clubhead-Shaped Nasal Mucoperiosteal Flap Technique.

A modified endoscopic dacryocystorhinostomy technique using a clubhead-shaped nasal flap combined with a posteriorly hinged lacrimal flap was designed for tension-free anastomosis with the surrounding mucoperiosteum. This technique showed satisfactory outcomes that facilitated the maintenance of the rhinostomy in eight cases with nasolacrimal duct obstruction. Laryngoscope, 132:2314-2318, 2022.

Genus-Wide Characterization of Bumblebee Genomes Provides Insights into Their Evolution and Variation in Ecological and Behavioral Traits.

Bumblebees are a diverse group of globally important pollinators in natural ecosystems and for agricultural food production. With both eusocial and solitary life-cycle phases, and some social parasite species, they are especially interesting models to understand social evolution, behavior, and ecology. Reports of many species in decline point to pathogen transmission, habitat loss, pesticide usage, and global climate change, as interconnected causes. These threats to bumblebee diversity make our reliance on a handful of well-studied species for agricultural pollination particularly precarious. To broadly sample bumblebee genomic and phenotypic diversity, we de novo sequenced and assembled the genomes of 17 species, representing all 15 subgenera, producing the first genus-wide quantification of genetic and genomic variation potentially underlying key ecological and behavioral traits. The species phylogeny resolves subgenera relationships, whereas incomplete lineage sorting likely drives high levels of gene tree discordance. Five chromosome-level assemblies show a stable 18-chromosome karyotype, with major rearrangements creating 25 chromosomes in social parasites. Differential transposable element activity drives changes in genome sizes, with putative domestications of repetitive sequences influencing gene coding and regulatory potential. Dynamically evolving gene families and signatures of positive selection point to genus-wide variation in processes linked to foraging, diet and metabolism, immunity and detoxification, as well as adaptations for life at high altitudes. Our study reveals how bumblebee genes and genomes have evolved across the Bombus phylogeny and identifies variations potentially linked to key ecological and behavioral traits of these important pollinators.

[Clinical Characteristics and Bone Marrow Histopathology Features in Essential Thrombocythaemia Patients with Different Gene Mutation in China].

OBJECTIVE: To investigate the clinical characteristics, laboratorial and bone marrow pathological features of primary thrombocytopenia (ET) patients with different mutations of CALR, JAK2 and MPL genes. METHODS: The chinical data of 120 cases of ET in Jiangsu provincial people's hospital/ The First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2017 were collected and analyzed, including 76 cases with JAK2 gene mutation, 40 cases with CALR gene mutation, 2 cases with MPL gene mutations, 2 cases without gene mutation. RESULTS: Among the ET patients, compared with the JAK2 gene mutation, CALR gene mutation showed statistically significant deareament of white blood cells and hemoglobin (P=0.001, P=0.01) and the male platelets in CALR group showed significant increament (P=0.04). Fourthermore, the average number of megakaryocytes and its cluster numbers in each hight power field of vision showed statistically significant decreament in CALR group as compared with JAK2 group (P=0.001, P=0.001), and thrombotic events in CALR group were signicantly lower than those in JAK2 group (7.5% vs 18.4%) (P=0.03). CONCLUSION: Mutations of CALR, JAK2 have different clinical characteristics and blood pathological changes of Chinese ET patients, and their clinical significance is worth to explore.

Parotidectomy by an endoscopic-assisted postauricular-groove approach.

BACKGROUND: To investigate the feasibility of an endoscopic-assisted postauricular-groove approach parotidectomy and to evaluate the advantages and limitations of such an approach. METHODS: A total of 72 patients with parotid gland tumors underwent a parotidectomy procedure between January 2014 and January 2016. Of the aforementioned patients, 15 were treated by a postauricular-groove approach (group I), whereas the remaining 57 were treated by the Blair "S" incision (group II). RESULTS: Difference in visual analogue scale score for aesthetic outcome (0 vs 3) and median intraoperative blood loss (30 vs 50 mL) was statistically significant. Operation time and transient facial nerve paralysis were comparable. No recurrence of tumors was found in either group. CONCLUSION: The endoscopic-assisted postauricular-groove approach for limited parotid tumor resection offers several advantages over the conventional "S" incision parotidectomy. In addition, it is arguably safer and results in a superior aesthetic outcome.

[Tumors originated from the inferior nasal turbinates: clinical features in 34 patients].

OBJECTIVE: The purpose of this study was to analyzed the histopathologic spectrum and clinical features of the tumors originated from the inferior nasal turbinates. METHOD: Clinical data of 34 patients with tumours of the inferior nasal turbinates, treated from Jan. 1998 to Dec. 2012, were retrospectively reviewed. Of the 34 patients, 18 male and 16 female, aged from 25 years to 76 years (mean: 45.6yr). RESULT: (1) Pathology : Of the 34 patients, 23 (67.6%) were benign and 11 (32.4%) were malignant. Hemangiomas were the most frequent benign tumour accounting for 18/23 (78.3%) in benign tumour and for 52.9% in all the tumors originated from inferior nasal turbinates. Other benign tumours included inverted papilloma, squamous papillomas and extrapleural solitary neurofibroma tumor. The most common malignant tumour was non-Hodgkin's lymphoma accounting for 6/11 (54.5%) in malignant tumour and for 17.6% in all the tumors. Other malignant tumour included squamous cell carcinoma, melanoma and undifferentiated carcinoma. (2) Distribution: Most tumors (31/34) arose from unilateral turbinates. Hemangiomas is the commonest tumor originated from anterior part of the turbinate in 14 cases of 18 (77.8%). NHL and melanoma involved through turbinates. 3. Symtoms: Nasal obstruction was the most common symtom (25/34, 73.5%). Epistaxis and bloody nasal discharge were the chief complaint in hemangiomas. CONCLUSION: 1. The most common benign and malignant tumors of the inferior turbinate were hemangioma and NHL. The majority of the hemangiomas (14/18) arose from the anterior part of the inferior turbinate. NHL or melanoma often presented progressive, unilateral or bilateral diffuse enlargement of the inferior turbinate with poor vascular contractile reactivity to the ephedrine.

[Surgical treatment for advanced carcinoma of hypopharynx and laryngeal function preservation].

OBJECTIVE: To evaluate the treatment outcome advanced hypopharyngeal carcinoma by surgery with laryngeal function preservation. METHODS: Twenty cases with squamous cell carcinoma of the hypopharynx who were treated by the function preserved surgery between January 2000 and March 2012 were reviewed. Of the patients 19 were males and 1 female, and their median age was 62.0 years. Eight cases were only applied with total or subtotal hypopharyngectomy, and others received total or subtotal hypopharyngectomy with partial-laryngectomy. Postoperative functional training was performed. Radiotherapy was used in all cases from 2 to 4 weeks after surgery. RESULTS: Speech intelligibility remained in all 20 patients and 80.0% of the patients were extracted the trachea tube in the average 60 days. CONCLUSIONS: Laryngeal functions of larynx can be preserved in advanced hypopharyngeal carcinoma by total or subtotal hypopharyngectomy alone or plus partial laryngectomy with functional reconstruction, and the patients can maintain their rational speech and swallowing functions.

[Management and classification of first branchial cleft anomalies].

OBJECTIVE: We aimed to identify the different courses of first branchial cleft anomalies and to discuss the management and classification of these anomalies. METHOD: Twenty-four patients with first branchial cleft anomalies were reviewed. The courses of first branchial cleft anomalies and their corresponding managements were analyzed. Each case was classified according to Olsen's criteria and Works criteria. RESULT: According to Olsen's criteria, 3 types of first branchial cleft anomalies are identified: cysts (n = 4), sinuses (n = 13), and fistulas (n = 7). The internal opening was in the external auditory meatus in 16 cases. Two fistulas were parallel to the external auditory canal and the Eustachian tube, with the internal openings on the Eustachian tube. Fourteen cases had close relations to the parotid gland and dissection of the facial nerve had to be done in the operation. Temporary weakness of the mandibular branch of facial nerve occurred in 2 cases. Salivary fistula of the parotid gland occurred in one patient, which was managed by pressure dressing for two weeks. Canal stenosis occurred in one patient, who underwent canalplasty after three months. The presence of squamous epithelium was reported in all cases, adnexal skin structures in 6 cases, and cartilage in 14 cases. The specimens of the fistula which extended to the nasopharynx were reported as tracts lined with squamous epithelium (the external part) and ciliated columnar epithelium (the internal part). According to Work's criteria, 9 cases were classified as Type I lesions, 13 cases were classified as Type II lesions, and two special cases could not be classified. The average follow-up was 83 months (ranging from 12 to 152 months). No recurrence was found. CONCLUSION: First branchial cleft anomalies have high variability in the courses. If a patient is suspected to have first branchial anomalies, the external auditory canal must be examined for the internal opening. CT should be done to understand the extension of the lesion. For cases without internal openings in the external auditory canal, CT fistulography should be done to demonstrate the courses, followed by corresponding treatment. Two special cases might be classified as a new type of lesions.

[Cervical necrotizing fasciitis caused by Klebsiella pneumoniae: three cases report and review of literature].

OBJECTIVE: To analyze the clinical manifestations of three cases of cervical necrotizing fasciitis caused by klebsiella pneumoniae and to analyze the published articles concerning the relationship between invasive klebsiella syndrome and necrotizing fasciitis in Chinese Mainland. METHOD: We have retrospectively analyzed three cases of cervical necrotizing fasciitis caused by klebsiella pneumoniae treated in our department between 2003 and 2012. We also reviewed the Chinese-language scientific literature included in the WanFang data by searching with the following key words: necrotizing fasciitis, klebsiella pneumoniae and liver abscess. RESULT: These patients recovered uneventfully without obvious complications or disseminated infection foci. Sporadic cases of invasive klebsiella syndrome were reported without necrotizing fasciitis involvement in Chinese Mainland. CONCLUSION: Cervical necrotizing fasciitis caused by klebsiella pneumoniae may give rise to disseminated infection but there has been no such case report in Chinese Mainland.

[Extrapleural solitary fibrous tumor in nose: 2 cases report and review of literature].

OBJECTIVE: To analyze the clinical characteristics, imaging features, pathological findings, treatment and prognosis of the extrapleural solitary fibrous tumor (EPSFT) in nose, and then to improve the quality of diagnosis and treatment of EPSFT. METHOD: Clinical data of two patients with EPSFT were collected in recent 2 years. All the information, including clinical symptoms, imaging characteristics, blood routine, serum biochemical, treatment options, pathological immunohistochemical findings, and following-up results were reported and analyzed, and the clinical features of EPSFT in the nose were summarized with review of the literature. RESULT: (1) The main clinical characteristics were nasal obstructive and epistaxis. (2)There were no imaging differences essentially between EPSFT and other tumors in nasal cavity. In terms of enhancement CT scanning, the image manifestations of EPSET were similar to that of hemangioma to a certain degree in nasal cavity. (3) Routine blood and serum biochemical test were normal in the patients with EPSFT in the nose. (4)Confirmed diagnosis mainly depended on pathological and immunohistochemical findings. (5) These two patients underwent surgical treatment, and the tumors were en bloc resected, and were in full recovery. Follow-up time is 2 years in one case and the other one is 1 year. No recurrence or metastasis were found in these two patients. CONCLUSION: DSA and vascular embolism is recommended before surgical treatment in some patients. En bloc resection is the preferred treatment option with definite curative effect for the patients with EPSFT in nose, and the prognosis is favorable.

[Selective neck dissection and the management of the hypopharyngeal cancer].

OBJECTIVE: To determine the most appropriate form of selective neck dissection(SND) in the hypopharyngeal cancer with cervical lymph node metastasis. METHOD: We have retrospectively analyzed the distribution and prevalence of cervical metastasis in 26 patients with hypopharyngeal squamous cell carcinoma from January 1998 to December 2008. All the patients underwent SND as part of the primary treatment. There were 34 elective SNDs and 17 therapeutic SNDs from 11 node-negative hypopharyngeal cancers and others node-positive. RESULT: Occult metastasis was found in 6 patients (55%) with cervical metastasis confined to level II and III. Clinical node-positive necks were all pathologically identified with 6.7%, 66.7%, 86.7%, 46.7%, and 20.0% of the prevalence of metastasis to level I, II, III, IV and V respectively. The regional recurrences were found in 4 patients during the follow-up, which were all from cN+ patients. No patient experienced level I recurrence. CONCLUSION: The results of this study suggest that SND (I-III) may be feasible for the treatment of cN0 hypopharyngeal cancer, which needs a larger sample to verify. Meanwhile, from our data, it has a satisfactory result to perform SND (II-V) with adjuvant radiotherapy for the cN+ patients.

[Bacteriological analysis of persistent rhinosinusitis after endoscopic sinus surgery].

OBJECTIVE: To investigate the bacterial characteristics of persistent rhinosinusitis after functional endoscopic sinus surgery (FESS). METHOD: Twenty patients with nasal septum deviation, 30 patients with chronic rhinosinusitis (CRS) and 20 patients with persistent rhinosinusitis, were selected to take discharges from middle meatus during the operation. Bacteria culture and drug susceptibility of the discharges were compared between three groups. RESULT: There were 13, 15 and 15 isolates detected in nasal septum deviation group, CRS group and persistent rhinosinusitis group. There was no significant difference among the three groups at the detection rate of Gram-positive bacteria. But there was significant difference between the persistent rhinosinusitis group and the other two groups at the detection rate of Gram-negative bacteria. The detection rate of antibiotic-resistant bacteria were significantly higher in persistent rhinosinusitis group than in CRS group. CONCLUSION: Aerobic bacteria can live in nasal cavity. Bacteria infection is one of the etiological factors of persistent rhinosinusitis after FESS. Gram-negative bacteria and antibiotic resistant bacteria are increased in patients with persistent rhinosinusitis. To treat the persistent rhinosinusitis after surgery, the antibiotics should be reasonably used according to the bacteria culture and the drug susceptibility.

[Clinical study on acupotomy of occipitalia on the treatment of cervicogenic headache].

OBJECTIVE: To observe the effects of acupotomy on cervicogenic headache and explore the function of cutaneous nerve entrapment in the mechanism of cervicogenic headache. METHODS: From October 2008 to June 2009, 82 patients with cervicogenic headache were treated with acupotomy. There were 23 males and 59 females, ranging in age from 17 to 73 years (averaged 41.57 years). The course of disease ranged from 0.5 to 50 years,with an average of 10.4 years. The location of treatment was occipitalia, both of left and right side: altogether were 8 points, including tenderness point of postmastoid; the mid-point between mastoid and C2 spinous process; the internal 1/3 attachment between occipital protuberance and mastoid process; the posterior midline of C2 spinous process open to 1.5-2 cm. The chief complaint of all patients was headache. PPI assessment rating was observed. RESULTS: The total effective rate at 1 month after treatment was 81.70% (67/82). Recurrence of headache within 3 months after treatment was obvious. However, 17.07% (14/82) patients did not reoccur at 6 months after treatment. CONCLUSION: 17.07% patients with cervicogenic headache recovered by acupotomy, so it shows cutaneous nerve entrapment plays an important role in the mechanism of cervicogenic headache. For the patients whose headache recurred at 3 months after treatment, increasing the treatment time and therapeutic range is suggested.

[A comparative study of complications in transoral CO2 and Nd:YAG laser surgery for glottic carcinoma].

OBJECTIVE: To compare the complications in transoral CO2 and Nd:YAG laser surgery for the treatment of laryngeal carcinoma. METHODS: Retrospective analysis of 83 cases of glottic laryngeal carcinoma treated with laser surgery from January 1, 1999 to December 31, 2008 was carried out. Thirty-two cases were treated with the CO2 laser, including Tis (2 cases), T1N0M0 (21 cases), T2N0M0 (8 cases), and T3N0M0 (1 case). Fifty-one cases were treated with the Nd:YAG laser, including Tis (3 cases), T1N0M0 (36 cases), T1N2M0 (3 cases), and T2N0M0 (9 cases). RESULTS: Four complications (12.5%) occurred in the CO2 laser group. There was 1 local infection (3.1%), 1 numbness of the tongue (3.1%), 1 odontoseisis (3.1%), and 1 subcutaneous emphysema (3.1%). Twenty-seven complications (52.9%) occurred in 19 patients in the Nd:YAG laser group. There were postoperative bleeding 2 (3.9%), dyspnea 5 (9.8%), local infection 7 (13.7%), aspiration pneumonia 4 (7.8%), numbness of the tongue 2(3.9%), pharyngeal cutaneous fistula 1 (2.0%), vocal cord fixation 4 (7.8%), and laryngostenosis 2 (3.9%). CONCLUSION: More complications were observed in the patients with Nd:YAG laser surgery when compared to the patients with CO2 laser surgery.

[Comparative observation of efficacy on lumbar disc herniation treated with acupotomology and operation].

OBJECTIVE: To compare the efficacy difference between acupotomology and operation in the treatment of lumbar disc herniation (LDH). METHODS: One hundred and eighty-four cases were randomized into an acupotomology group (109 cases) and an operation group (75 cases). In acupotomology group, acupotomology was applied to relevant local soft tissues in LDH and the reactive points in the distribution of superior gluteal nerves, at the outlet of sciatic nerve and in the nerve innervate area of the lower extremities separately. In operation group, the small-windowed discectomy through small incision was adopted. The clinical efficacies were assessed between two groups. RESULTS: In acupotomology group, the clinical cured rate was 82.6% (90/109) and the effective rate was 96.3% (105/109). In operation group, they were 86.7% (65/75) and 97.3% (73/75) respectively. There were no significant differences in statistics between two groups (both P > 0.05). CONCLUSION: Acupotomology is definitely effective in the treatment of lumbar disc herniation and its efficacy is similar to that of operation.