rhBMP in lumber fusion for lumbar spondylolisthesis: A systematic review and meta-analysis / 中华创伤杂志(英文版)

PURPOSE@#To compare the efficacy and safety of recombinant human bone morphogenetic protein (rhBMP) and iliac crest autograft in the fusion treatment of lumbar spondylolisthesis.@*METHODS@#The studies using randomized controlled trials to compare the rhBMP with iliac crest autograft in the treatment of lumbar spondylolisthesis were retrieved from Embase, Pubmed, ProQuest dissertations & theses (PQDT), China national knowledge infrastructure (CNKI), Chinese Biomedical Database, Wanfang Data, Cochrane Library (from March 1998 to March 2018). Postoperative fusion rate, clinical success rate, postoperative intervertebral height, complications, operation time, blood loss and duration of hospitalization were chosen as the outcome indicators. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.3 was used for data-analysis.@*RESULTS@#Eleven articles were included in the meta-analysis. The results showed that, comparing the efficacy of rhBMP with iliac crest autograft, statistical significance was found in the 24-month fusion rate post operation [95% CI (1.38, 24.70), p = 0.02] and operation time [95% CI (-14.22, -2.08), p = 0.008]. There is not sufficient evidence for statistical differences in the remaining indicators.@*CONCLUSION@#The current literature shows rhBMP is a safe and effective grafting material in the treatment of lumbar spondylolisthesis. Further evidence is dependent on the emergence of more randomized controlled trials with higher quality and larger sample sizes in the future.

Meta-analysis of clinical effects between non-metallic materials and metallic materials by internal fixation for patellar fracture / 中国骨伤

<p><b>OBJECTIVE</b>To systematically evaluate clinical effects of metal and non-metallic materials in internal fixation for patellar fracture.</p><p><b>METHODS</b>The reports concerning about controlled trial of metallic and non-metallic materials for patellar fracture from create database to June 2018 were searched from PubMed, EMBASE, Web of science, CNKI and Wanfang data. Information was screened and taken out according to inclusion and exclusion criteria by 2 researchers, and risk of bias in non-andomised studies of interventions (ROBINS-I) was used to evaluate literature quality. Rate of reoperation, excellent and good rate of clinical rehabilitation, incidence of postoperative complications were compared with Revman 5.3 software for Meta-analysis.</p><p><b>RESULTS</b>Totally 9 retrospective cohort studies including 493 patients were selected. There was no significant difference in reoperation rate of internal fixation failure between metallic implants and non-metallic implants[OR=0.52, 95% CI (0.25, 1.08) =0.08]. The excellent and good rate of postoperative clinical rehabilitation in patients receiving non-metallic implants were higher than those in receiving metallic implants[OR=3.34, 95% CI (1.67, 6.71), =0.000 7]; incidence of total complications was also lower than that of metallic implants[OR=0.21, 95% CI (0.07, 0.60), =0.003]. There was no significant difference in the incidence of non-metallic related complications after removing Kirschner wire needle and complications of skin irritation [OR=1.08, 95% CI(0.45, 2.56), =0.86].</p><p><b>CONCLUSIONS</b>Non-metallic plants could provide the same success rate of internal fixation as metal plants, could improve the excellent and good rate of postoperative rehabilitation by reducing incidence of complications associated with metallic plants. In further, more evidence-level research is needed to confirm in the future.</p>

Relationship between subfoveal choroidal thickness and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To investigate the relationship between the subfoveal choroidal thickness ( SFCT) and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects.METHODS:Seventy-eight type 2 diabetic patients (156 eyes) from ophthalmology and endocrinology ward of our hospital were enrolled in this study, including 39 females and 39 males, with a mean age of (59. 8±6. 2)years. According to early treatment diabetic retinopathy study ( ETDRS) grading method, all samples were divided into diabetic retinopathy ( DR ) group, mild or moderate nonproliferative diabetic retinopathy group, severe nonproliferative diabetic retinopathy ( NPDR) group and proliferative diabetic retinopathy ( PDR ) group. The SFCT and choroidal hemodynamic index were measured by enhanced depth imaging optical coherence tomography ( EDl-OCT ) and Color Doppler lmaging. Recording glycosylated hemoglobin content of all samples. Using multivariate linear regression to analyse the relationship between the SFCT and both choroidal hemodynamic index and glycosylated hemoglobin.RESULTS: The end diastolic velocity ( EDV ) was significant higher and the SFCT was significant thinner in no diabetic retinopathy ( NDR) group than other groups. There was no significant difference of peak systolic velocity ( PSV ) between four groups. The resistance index ( Rl) was significant higher in severe NPDR group than NDR group and mild or moderate group, the Rl in PDR group was hihgest than other group with statistically significance. The SFCT was correlated positively ( b =0. 540,P<0. 001) with the glycosylated hemoglobin. No significant correlation was found between the SFCT and the choroidal hemodynamic index (DR,P=0. 341;PSV,P=0. 770;EDV,P=0. 131;Rl,P=0. 084).CONCLUSlON: Our results suggest that there is no significant correlations between the SFCT and the choroidal hemodynamic index; glycosylated hemoglobin is one of the factors that affect the SFCT in diabetic patients.