ABSTRACT
Objective To compare and analyze the accuracy and safety of robot-assisted and conventional freehand open approach in pedicle screw fixation using meta-analysis.Methods PubMed,Embase,Cochrane,China Biology Medicine,Wanfang and CNKI databases were searched by computer retrieval to identify the relevant literatures published before December1,2016.The qualified literatures were selected according to the preestablished the inclusion criteria and exclusion criteria,and processed for data extraction and quality evaluation.The RevMan 5.3 software was used for the meta-analysis.The relative risk (RR) and 95％ confidence interval (CI) were adopted to represent the effect differences in the dichotomous variable data.The effect difference of continuous variable data was represented by mean difference (MD) or standardized mean difference (SMD).When P＜0.05 and 95％ CI does not contain the value of 1,the difference was considered statistically significant.Results A total of 266 patients were enrolled,including 138 cases of robot-assisted group and 128 cases of conventional freehand open group,in which 1 200 screws were implanted,including 608 screws by robot-assisted system and 592 screws by conventional freehand open approach.The Gertzbein-Robbins grading criteria (grade A to C) were used.The results showed that there was no significant difference in the accuracy of pedicle screw fixation between the robotic-assisted and conventional freehand open approach according to the grading criteria,i.e.grades A (RR =1.07,95％CI:0.82,1.39,I2=46％,P=0.62),grades B (RR=l.56,95％CI:0.86,2.82,I2=0％,P=0.14) and grades C (RR=0.91,95％CI:0.32,2.55,I2=0％,P=0.85).For the two groups,the difference was no statistically significance in the complication rate (RR=0.33,95％CI:0.05,2.17,I2=0％,P=0.25),and in the revision rate (RR=0.53,95％CI:0.10,2.90,I2=0％,P=0.47).The difference was statistically significance in the overall surgical time (MD=20.90,95％CI:5.54,36.26,I2=15％,P=0.008),and in the exposure time (MD=-1.19,95％CI:-1.63,-0.75,I2=15％,P＜0.000 01).The difference was no statistically significance in the distance between screws and facet joint surfaces (SMD=-1.15,95％CI:0.79,1.51,I2=16％,P＜0.000 01).Conclusions Compared with the conventional freehand open approach,the current evidence cannot confirm that the robot-assisted system has significant advantages in the surgical accuracy of pedicle screw fixation and complication rate.The spinal surgical robot-assisted system,as a new technology,has considerable potential for further development and application in spinal surgery.
ABSTRACT
Objective To compare and analyze the accuracy and safety of robot-assisted and conventional freehand open approach in pedicle screw fixation using meta-analysis.Methods PubMed,Embase,Cochrane,China Biology Medicine,Wanfang and CNKI databases were searched by computer retrieval to identify the relevant literatures published before December1,2016.The qualified literatures were selected according to the preestablished the inclusion criteria and exclusion criteria,and processed for data extraction and quality evaluation.The RevMan 5.3 software was used for the meta-analysis.The relative risk (RR) and 95％ confidence interval (CI) were adopted to represent the effect differences in the dichotomous variable data.The effect difference of continuous variable data was represented by mean difference (MD) or standardized mean difference (SMD).When P＜0.05 and 95％ CI does not contain the value of 1,the difference was considered statistically significant.Results A total of 266 patients were enrolled,including 138 cases of robot-assisted group and 128 cases of conventional freehand open group,in which 1 200 screws were implanted,including 608 screws by robot-assisted system and 592 screws by conventional freehand open approach.The Gertzbein-Robbins grading criteria (grade A to C) were used.The results showed that there was no significant difference in the accuracy of pedicle screw fixation between the robotic-assisted and conventional freehand open approach according to the grading criteria,i.e.grades A (RR =1.07,95％CI:0.82,1.39,I2=46％,P=0.62),grades B (RR=l.56,95％CI:0.86,2.82,I2=0％,P=0.14) and grades C (RR=0.91,95％CI:0.32,2.55,I2=0％,P=0.85).For the two groups,the difference was no statistically significance in the complication rate (RR=0.33,95％CI:0.05,2.17,I2=0％,P=0.25),and in the revision rate (RR=0.53,95％CI:0.10,2.90,I2=0％,P=0.47).The difference was statistically significance in the overall surgical time (MD=20.90,95％CI:5.54,36.26,I2=15％,P=0.008),and in the exposure time (MD=-1.19,95％CI:-1.63,-0.75,I2=15％,P＜0.000 01).The difference was no statistically significance in the distance between screws and facet joint surfaces (SMD=-1.15,95％CI:0.79,1.51,I2=16％,P＜0.000 01).Conclusions Compared with the conventional freehand open approach,the current evidence cannot confirm that the robot-assisted system has significant advantages in the surgical accuracy of pedicle screw fixation and complication rate.The spinal surgical robot-assisted system,as a new technology,has considerable potential for further development and application in spinal surgery.
ABSTRACT
Objective To study the variable number tandem repeats(VNTR)polymorphism in intron 4 of the endothelial nitric oxide synthase(eNos)gene and its relationship with plasma NO in patents with PAH of COPD.Methods The VNTR polymorphism in intron 4of the eNos genes of PAH COPD and healthy control were detected by PCR.The plasma level of NO3-/NO2-was measured by spectrophotometer,which was used as an index of NO synthesis.Data were analyzed according to the different genotype and allelic gene frequency.Results The COPD PAH group significant higher frequency of VNTR 4a allele and 4a/4b allele and 4a/4b+4a/4a genotype than those of the control(P=0.027,P
ABSTRACT
This thesis gave the theorical origins of syndrome differentiation of CHD based on damp-pathogen by LU Zhi-zheng.Six factors includ invading by damp-pathogen,internal impairment by seven emotions,improper diet and imbalance between work and rest,different constitutions,Zang-Fu organs uncoordination,incorrect treatment,etc.are the chief factors result in damp-pathogen.The relationship between damp-pathogen and phlegm,damp-pathogen and blood stasis is analysed.Four pathogenesis that cause CHD by damp-pathogen are summarized.
ABSTRACT
Objective To investigate melanocyte membrane antigen associated with vitiligo,for further purification and cloning.Methods Sera from patients with vitiligo were screened by using a live cell enzyme-linked immunoabsorbent assay,98strongly positive sera were obtrained.Melanocyte antigens were immunoblotted after splitting of cultured normal human melanocytes.Thirty strong positive vitiligo sera were detected.Results There were positive bands in all screened sera as shown by immunoblotting.Whereas,positive band was seen in only one normal human sera.The antibody bound many antigens with different molecular weights(150kd,90kd,75kd,50kd,40~45kd).Positive rates for individual antigens were70%,60%,83%,16%and23%,respectively.Conclusions Antibody directed to melanocyte membrane antigens of melanocytes are present in the sera of patients with vitiligo.The molecular weights of the antigens are mainly150kd,90kd and75kd,the antigens with small molecules discovered previously maybe the degradation products of big molecules.
ABSTRACT
Human papillomavirus-related diseases are worldwide,what more,they may progress into benign or malignant tumors.On the other hand,through antinomy analytical method,scientists have modified E6 and E7 dialectically and make them the core of the HPV therapeutic vaccine, which can speedup the clean out of the virus.