ABSTRACT
BACKGROUND:Intramedul ary nails and locking plates are widely used for two-part proximal humerus fracture. Which is better for two types of implants in patients remains controversial. OBJECTIVE:To determine the clinical outcome of intramedul ary nails versus locking plates for two-part proximal humerus fracture according to Cochrane Meta analysis. METHODS:We searched PubMed, SCI, Embase, the Cochranel Library and CBMdisc, VIP information, Wanfang Database, and CNKI for randomized control ed trials and quasi-randomized control ed trials on intramedul ary nails and locking plates for two-part proximal humerus fracture. RevMan 5.2 software was used to analyze operation time, intraoperative blood loss, fracture healing time, postoperative complications (heterotopic ossification, pain, screw penetration, necrosis of humeral head), and Constant Score. RESULTS AND CONCLUSION:Six articles of clinical control ed trials were included with 259 patients. 131 patients received intramedul ary nails, and 128 patients received locking plates. Meta-analysis displayed that no significant difference in fracture healing time, heterotopic ossification, pain, necrosis of humeral head and Constant Score was detected between intramedul ary nails and locking plates for two-part proximal humerus fracture. Operation time, intraoperative blood loss, and screw penetration were significantly less in the fixation with intramedul ary nails than that in locking plates (P<0.05). These findings suggested that compared with locking plates, intramedul ary nails method for two-part proximal humerus fractures could reduce screw penetration.
ABSTRACT
BACKGROUND:Some control studies attempt to answer the advantages and disadvantages of high-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults, but have arrived at different conclusions. OBJECTIVE:To explore the therapeutic efficacy of high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults by Meta analysis. METHODS:PubMed, Embase, Cochranel Library, CBMdisc, VIP and WanFang Databases were searched by computer, and relevant Chinese and English orthopedic journals were retrieved by hand. Controled trials related to high-dose methylprednisolone sodium succinate therapy of acute spinal cord injury in adults were included. The methodology quality of included trials was criticaly assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION:Nine clinical controled trials were included. Meta-analysis results showed that compared with the conventional therapy, the neurological recovery rate after 24 hours of administration, pneumonia incidence and gastrointestinal reactions increased significantly after high-dose methylprednisolone sodium succinate therapy. However, there were no statistical differences in the rate of urinary tract infection, nonunion rate and stress ulcer incidence between these two therapies. These findings indicate that the high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults has better outcomes in neurological function recovery, but can lead to higher incidence of lung infection and gastrointestinal reactions. Therefore, lung infection and gastrointestinal reactions should be avoided as much as possible during the course of treatment.
ABSTRACT
BACKGROUND:Intramedul ary nail and traditional steel plate fixation have been widely used in the treatment of distal tibial (extra-articular) fractures, but these two kinds of methods have shortcomings. Some control studies attempt to answer the advantages and disadvantages of the issue on the treatment of extra-articular distal tibial fractures with intramedul ary nail and steel plate fixation, but the conclusions are different. OBJECTIVE:To determine the efficiency and safety of intramedul ary nail and plate fixation in the treatment of extra-articular distal tibial fractures by Meta analysis. METHODS:PubMed, Embase, Cochrane Library, CBMdisc, Weipu information database and Wanfang were searched by computer, and relevant Chinese and English orthopedic journals were hand-searched. Control ed trials related to intramedul ary nail and plate fixation in the treatment of extra-articular distal tibial fracture were included. The quality of trials was critical y assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION:Four articles were included. Meta analysis showed that compared with the plate fixation, the malunion rate of the intramedul ary nail for extra-articular distal tibial fractures increased. There was no statistical difference in the rate of nonunion rate, delayed fracture healing, and infection rate after operation. These indicate that intramedul ary nail and plate fixation both have good effects on fracture healing.
ABSTRACT
Objective To evaluate the effect of gastroesophageal reflux disease(GERD)on exacerbations of chronic obstructive pulmonary disease(COPD).Methods All of 74 patients with COPD accomplishing the reflux diagnostic questionnaire(RDQ)were.divided into GERD group(n=38)and non-GERD group(n=36)according the scores of RDQ.The clinical data including the frequency of exacerbations of COPD were compared between the two groups.Results The frequency of exacerbations of COPD was significantly higher in GERD group compared with that in non-GERD group[(2.68±0.77)times/year vs (1.38±0.49)times/year,t=8.74,P＜0.05].The mean FEV;percentage was similar in the two groups [(39.82 4-10.95)%vs(37.11±12.24)%,t=1.00,P＞0.05].The score of RDQ was probably as a factor of predicting the frequency of exacerbations of COPD(R2a=o.39,t=6.98,P＜0.05).Conclusion The presence of GERD appears to be associated with increased exacerbations of COPD.
ABSTRACT
0.05).The total treatment costs were(1084.43?247.38)yuan for the treatment group and(1211.23?275.95)yuan for the controlled group,which had significant difference(P0.05).The total costs were(1270.45?218.12)yuan for the treatment group and(1407.51?51.01)yuan for the controlled group(P
ABSTRACT
OBJECTIVE:To evaluate the cost-effectiveness of 3 therapeutic regimes in the treatment of functional dyspepsia. METHODS:125 cases were randomly divided into 3 groups,group A was treated with domperidone,group B was treated with domperidone plus doxepin hydrochloride,and group C was treated with domperidone plus famotidine,the curative effects of the 3 group were observed after oral administration and the cost-effectiveness analysis was conducted as well. RESULTS:The costs for group A,B and C were 792.56 yuan,800.12 yuan and 803.76 yuan,respectively;The effective rates were 51.17%,82.50%and 71.43%,respectively;The cost-effectiveness ratio were 15.49,9.70 and 11.25,respectively;The incremental cost-effectiveness ratios of group B and C vs. group A were 0.24 and 0.55,respectively. CONCLUSION:Regime B was superior among the other two therapeutic regimes.