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BACKGROUND@#Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA.@*METHODS@#This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events.@*RESULTS@#Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain.@*CONCLUSIONS@#This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
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Humans , Female , Middle Aged , Aged , Osteoarthritis, Knee/drug therapy , Flurbiprofen/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Pain/drug therapy , Treatment Outcome , Double-Blind MethodABSTRACT
Objective To investigate the effects of fresh lumbar osteoporotic vertebral compression fracture (OVCF) on spinopelvic sagittal parameters and distribution of Roussouly types.Methods One hundred and eight patients with one-level fresh lumbar OVCF and 110 patients with simple osteoporosis (OP) were diagnosed and treated at Department of Orthopedic Surgery,Shougang Hospital from January 2016 to August 2017.The basic clinical data of all the patients were documented and their lumber spines were classified by Roussouly types.The 2 groups were compared in terms of spinopelvic sagittal parameters such as pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),and lumbar lordosis (LL) and Roussouly types.The correlation between Roussouly types and fracture segments was observed in OVCF group.Results There was no significant different in PI between OVCF and OP groups (50.35° ± 11.00° versus 51.96° ± 11.73°) (P ＞ 0.05).PT in OVCF group (18.79°± 9.51°) was significantly larger than that (16.19°± 9.03°) in OP group while SS (31.56° ± 7.88°) and LL (40.22°± 12.29°) in the former significantly smaller than those in the latter (35.77° ± 8.82° and 47.89° ± 13.20°,respectively) (P ＜ 0.05).Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OVCF group were 35,40,28 and 5 cases,respectively,with types Ⅰ and Ⅱ accounting for 69.5％;Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OP group were 17,30,49 and 14 cases,respectively,with type Ⅲ being predominant (44.5％).There was a significant difference between the 2 groups in distribution of Roussouly types (P ＜03.05).In OVCF group,fractures of L1 and L2 vertebrae accounted for 82.4％.There was a significant correlation between fracture segments and lumbar Roussouly types (P =0.034).Conclusions Patients with fresh lumbar OVCF tend to have a forward gravity and sagittal disequilibrium,leading to posterior pelvic rotation,increased PT,decreased SS,and downward shift of the apex of the lumbar curve.Their Roussouly classification is mainly type Ⅰ or type Ⅱ.
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Objective By comparing clinical efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with conventional low viscosity bone cement for osteoporotic vertebral compression fractures,to explore the clinical value of treatment of osteoporotic vertebral compression fractures with high viscosity bone cement.Methods In this prospective study,100 patients with one-level OVCF and older than 70 years were diagnosed and treated in our hospital from June 2014 to December 2015,which were randomly divided into 2 groups (50 patients in each),applied unilateral percutaneous vertebroplasty with high viscosity bone cement and bilateral percutaneous kyphoplasty with conventional low viscosity bone cement,respectively.Collected data of basic clinical informations (including age,gender,body mass index,etc.),preoperative and postoperative visual analog scales (VAS),Oswestry disability questionnaire (ODI),operative time,intraoperative X-ray times,the amount of bone cement injection,leakage of bone cement,anterior vertebral height and kyphosis (Cobb angle) of preoperative and postoperative,and statistical analysis.Results There were significant improvement of both VAS and ODI scores of the postoperative 1 day,3 months and 12 months compared with preoperative,but there was no significant difference between two groups;The operative time,intraoperative fluoroscopy times,bone cement injection amount and intraoperative bone cement leakage of high viscosity bone cement PVP group were significantly less than those of low viscosity bone cement PKP group (P＜0.05);the anterior vertebral height and kyphosis improved,and there was a significant difference between preoperative and postoperative of low viscosity bone cement PKP group (P＜0.05).Conclusion The efficacies of unilateral PVP with high viscosity bone cement and bilateral PKP with conventional low viscosity bone cement for osteoporotic vertebral compression fractures are the same,which can relieve pain and improve function of life significantly.However,the high viscosity bone cement PVP is simpler surgical procedure,with shorter operative time,less intraoperative radiation,less bone cement leakage rate.The domestic bone cement injection device can significantly reduce the cost of surgery,it worth to be widely used for clinical application.
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BACKGROUND:The conservative treatment of humeral fracture is difficult to achieve a good reduction. Minimaly invasive percutaneous plate fixation has been widely used, and has good repair results, but the specific mechanism of action is not clear. OBJECTIVE:To compare the repair effect of different fixation methods on proximal humerus fractures. METHODS: From August 2011 to October 2014, we selected 96 patients with proximal humerus fractures from the Shougang Hospital of Peking University. These patients were equaly divided into two groups according to the principle of random draw. Patients in the control group were treated with open reduction and conventional surgery fixation. Patients in the treatment group received minimaly invasive percutaneous plate fixation. Operation time, intraoperative blood loss, incision length and postoperative hospital stay were recorded in both groups. At 8 weeks after treatment, patients received radiography to identify the reduction. Range of motion of the shoulder joint was scored. Within 8 weeks after treatment, the occurrence of complications was observed and compared in both groups. RESULTS AND CONCLUSION:Intraoperative blood loss, incision length and postoperative hospital stay were significantly less in the treatment group than in the control group (P 0.05). At 8 weeks after treatment, the excelent and good rate of reduction was significantly higher in the treatment group than in the control group (98%, 81%,P < 0.05). Flexion, abduction, external rotation and internal rotation scores were significantly higher in the treatment group than in the control group (P < 0.05). Bone compartment syndrome, vascular injury, infection and bleeding were significantly lower in the treatment group than in the control group (P < 0.05). These findings confirm that compared with open reduction and internal fixation, minimaly invasive percutaneous plate fixation of proximal humerus fractures has less impact on the body, can promote reduction of the fracture, has few complications, and contributes to the recovery of shoulder function.
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Objective To investigatethe constituents of enteroviruse which can cause hand‐foot‐and‐mouth disease(HFMD) ,and prevent against the development of new prevailing strains and provide basis for prevention and control of HFMD in Luoyang city . Methods Reverse‐transcription polymerase chain reaction (RT‐PCR) was used to identify the type of RNA of stool specimen of HFMD cases in Luoyang ,to distinguish the subtype of strain ,9 enterovirus‐positive specimens which coxcackie virusA16(CA16)‐and enterovirus71(EV71)‐negative were selected randomly for 5′UTR sequencing .strain‐specific primers were used to detect posi‐tive samples in 75 CA16‐ and EV71‐negative but other enterovirus‐positive specimens by using real time RT‐PCR .Composition characteristics of CA6 were further analyzed .Results Primary screening was conducted with the results of 5′UTR sequencing of 9 commonent erovirus‐positive specimens and there were 5 CA6‐positive ,which were prevailing strains;there were 20 CA6‐positive of 75 commonenterovirus‐positive specimens ,the proportion of CA6‐positive in enterovirus‐positive specimens was 29 .76% (25/84) . Thirteen samples were collected from male and 12 from female ,2 cases resulted in severe symptoms ,5 from city and 20 from coun‐try .Conclusion The composition of commonent erovirus which results in HFMD was complex and the proportion of CA6 was higher ,which should be pay more attention .
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Objective To retrospectively report 30 cases of distal femoral fractures treated with retrograde intramedullary interlocking naill( GSH nail). Methods From February 1999 to December 2002, 30 cases of distal femoral fractures were treated with GSH nails.According to AO/ASIF classification system, there were 11 cases of type A1, 7 A2, 3 A3, 5 C1, 3 C2 ,and 1 C3 .The follow up period ranged from 6 to 54 months. Results The average time for bone healing was 16 weeks. According to Neer s knee rating scale, there were 21 excellent cases and 5 good; the excellent and good rate was 86.6% . Conclusion It's a good method to treat type A& C (AO/ASIF) distal femoral fractures with GSH nail.