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Objective:Using Meta analysis comprehensive evaluation of the curative effect of stem cells to treat lower limb ischemic diseases.Methods:Using a computer to retrieve published both at home and abroad literatures about stem cell therapy for lower limb ischemic diseases,after quality evaluation according to certain standard into literature,using RevMan 6.0 software is analyzed.Using the funnel figure,Begg's regression analysis for publication bias estimation between different studies.Results:Participants included 16 studies,including 629 cases of the object of study.Meta analysis results show that the stem cells before,during and after the treatment of lower limb ischemic diseases,TcPO2 statistically significant TcPO2 levels after treatment (WMD=9.27,95％ CI:9.27,4.53,P=0.000).Before and after treatment was statistically difference between ABI,ABI levels after treatment (WMD=0.13,95％ CI:0.13,0.19,P=0.000).Temperature measurement was statistically difference,temperature measuring levels after treatment(WMD=2.75,95％CI:2.75,1.92,P=0.000).Three Meta analysis exists heterogeneity and publication bias results show that the funnel chart is symmetrical,at the same time Begg's regression analysis results showed that no publication bias.Couclusion:Stem cells to treat lower limb ischemic diseases effectively,the forward security still need massive evidence-based medicine.
ABSTRACT
<p><b>OBJECTIVE</b>To summarize experiences of operative treatment for Essex-Lopresti injury, and analyze the effect of the compare repair of interosseous membrane of forearm(IOM)on the forearm function.</p><p><b>METHODS</b>Twenty-four patients of Essex-Lopresti injury were treated from January 2005 to December 2013, 16 patients(group A) with radius and/or ulna fractures were treated with open reduction and internal fixation of radius or ulna and repair of forearm bone membrane at the same time, and then treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. Another 8 patients without radius and or ulna fractures(group B) were treated with open reduction and internal fixation of head of radius, as well as lower ulnar joint fixation or repair of wrist triangle fiber complex. The wrist joint function was evaluated using Cooney wrist functional rating index, and the elbow joint function was evaluated using Mayo elbow-performance score 2 weeks and 2 years after operation.</p><p><b>RESULTS</b>According to Cooney wrist functional rating index, 4 patients in group A got a fair result and 12 poor, 2 patients in group B got a fair result and 6 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 5 patients in group B got a good result, 2 fair and 1 poor 2 years after operation. According to Mayo elbow-performance score, 2 patients in group A got a good result, fair and 6 poor, 1 patient in group B got a good result, 5 fair and 2 poor 2 weeks after operation; 8 patients in group A got a good result, 6 fair and 2 poor, 4 patients in group B got a good result, 3 fair and 1 poor. There were no statistically differences between two groups 2 weeks and 2 years after operation.</p><p><b>CONCLUSIONS</b>It is important to restore the length of radius and/or ulna and maintain the dynamic stabilization of elbow and wrist for treat Essex-Lopresti injury. The repair of IOM has no effect on the forearm function.</p>
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<p><b>OBJECTIVE</b>To investigate the clinical characteristics of Segond fracture and its operative method and opportunity.</p><p><b>METHODS</b>From June 2008 to December 2011, arthroscopic exploration was performed in 16 patients with Segond fracture. Six patients were explored at 1 week after injury ,their anterior cruciate ligament were broken completely combined with meniscus injury. Ten patients were explored at 8-10 weeks after injury, 4 patients with anterior and posterior cruciate ligament breakage completely, 4 patients with anterior cruciate ligament breakage completely,and 2 patients with anterior cruciate ligament breakage incompletely,among 10 cases, 8 cases of anterior cruciate ligament breakage completely combined with meniscus injury, 1 case of anterior cruciate ligament breakage incompletely without obviously meniscus injury, 1 case combined with fibular head fracture and lateral collateral ligament injury. All broken cruciate ligaments were rebuilt after arthroscopic exploration and meniscus injuries were sutured in 5 cases. Clinical effects were evaluated according to Lysholm-Gillquist scoring of knee joint function.</p><p><b>RESULTS</b>Six patients were operated at 1 week after injury,their knee joint swelled obviously at 3 days after operation,unloaded blood oozing by joint puncture,and out-of-bed activity with assistance at the I week after operation. Other 10 patients were operated at 8-10 weeks after injury,no knee joint obviously swelled,no blood oozing was found by joint puncture ,and out-of-bed activity with assistance at 3 days after operation. All patients were followed up from 12 to 50 months with an average of 24 months. Postoperative Lysholm-Gillquist scoring of all patients were higher than preoperative and recovered well.</p><p><b>CONCLUSION</b>Segond fractures often associated with anterior cruciate ligament breakage and meniscus injury,it is important that early detection for treatment. The best time of cruciate ligament rebuilding and meniscus repairing may be at 8-10 weeks after injury.</p>