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Objective To systematically evaluate the efficacy of small-needle-knife therapy combined with manipulation in treating frozen shoulder. Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI, CBM, VIP, Wanfang Data, Embase, Cochrane Library and Pubmed database were searched. Retrieval time was from the establisment of the database to February 2017. Two researchers screened literature, extract materials independently. The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. Results 12 articles were included in a systematic review, a total of 1118 cases of patients. Meta-analysis showed that, compared with small-needle-knife therapy alone, small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate [OR=5.07, 95%CI(3.07, 8.37), P<0.000 01] and cure rate [OR=2.89, 95%CI(2.21, 3.78), P<0.000 01], enhance motor function score [MD=63.98, 95%CI(38.61, 89.35), P<0.000 01], with statistical significance. Conclusion Small-needle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder. However, the quality of included research is relatively low, so large-sample, multi-center and high-quality randomized controlled trials are required for verification.
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BACKGROUND: Dermal hypoesthesia surrounding the incision usually occurs after total knee arthroplasty (TKA), which severely affects the patients' life quality. But the relevant studies are still immature, and its prevention methods and prognosis remain controversial.OBJECTIVE: To review the research and progress of dermal hypoesthesia following TKA.METHODS: A computer-based online research of CJFD, WanFang, VIP and Medline databases was performed for the literature addressing the dermal hypoesthesia surrounding the incision after TKA published from December 2001 to December 2016. The keywords were "total knee arthroplasty, incision, numbness, abnormal sensation" in English and Chinese, respectively. Finally, 36 eligible articles were selected for result analysis after excluding the repetitive ones.RESULTS AND CONCLUSION: (1) Dermal hypoesthesia surrounding the incision following TKA is commonly seen, but the related researches are few. Most of researches concentration on protecting against cutaneous nerve injury by modifying surgical approach, nerve conduit, neural nutrients and surgical repair, but all possess certain shortcomings, so there is a lack ideal prevention scheme. (2) The repairing methods for peripheral nerve injury, including biomolecular, cell and catheter therapies, have been applied in the repair of cutaneous nerve injury following TKA, but still on initial stage,and its effectiveness and safety need to be confirmed in depth. (3) Therefore, whether dermal hypoesthesia surrounding the incision following TKA needs treatment or not, and how to treat is an urgent problem for joint surgeon.
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BACKGROUND: Traditional total hip arthroplasty can easily lead to the postoperative complications such as prosthetic loosening and subsidence. The unique design concept of collum femoris preserving (CFP) prosthesis, effectively solves the above problems.OBJECTIVE: To summarize the research progress of CFP prosthesis in total hip arthroplasty.METHODS: A computer-based online retrieval in CNKI, CBM, VIP, WanFang, PubMed, Embase, The Cochrane Library,Web of Science databases from1990 to 2017 was performed with the keywords of "collum femoris preserving, CFP, total hip arthroplasty, TKA" in English and Chinese, respectively. The development history of CFP, design concept, surgical indications and contraindications, complications, surgical considerations as well as clinical effectiveness were analyzed and summarized.RESULTS AND CONCLUSION: A total of 41 articles were included. The stress distribution of CFU prosthesis is similar with the physical condition of proximal femur. The preserved normal eccentricity has good resistance to rotation, thus effectively avoiding prosthetic loosening and subsidence resulting from osteoporotic proximal femur, and still keeps more bone reserve for future revision surgery. Most of studies only prove that the CFP prosthesis has a certain curative efficacy, but the differences between traditional and CFP prosthesis remain unclear. A large number of high-quality evidence-based medicine and clinical researches are needed to support the clinical application of CFP prosthesis, thus providing data reference for orthopedic surgeons.
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BACKGROUND: Periprosthetic infection after total knee arthroplasty (TKA) has become the most serious complication. However, there is still a lack of clinical study on the distribution of pathogenic bacteria. Therefore, understanding the distribution characteristics of the main pathogenic bacteria is critical for preventing and treating OBJECTIVE: To analyze the bacteriological characteristics in the patients with periprosthetic joint infection following TKA, so as to provide reference for early prevention and treatment. METHODS: CNKI, VIP, WanFang and PubMed databases were retrieved for the literature concerning periprosthetic infection following TKA published before 2016. The incidence of periprosthetic joint infection after TKA was statistically analyzed. RESULTS AND CONCLUSION: (1) 103 articles were included, involving 1 399 patients. (2) The main pathogenic bacteria were Staphylococcus aureus,coagulase negative Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli, Streptococcus and Enterococcus.There is no significant difference in the distribution of bacteria at home and abroad. Treatment strategies are divided into conservative and surgical treatments. (3) The key for successfully preventing and treating periprosthetic infection after TKA lies in the multiple disciplinary team collaboration, understanding the distribution of bacteria, early diagnosis and active preventive measurements, as well as rational treatment strategies.
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<p><b>OBJECTIVE</b>To evaluate the association of gr/gr deletion in the AZFc region of Y chromosome with idiopathic male infertility using Meta-analysis.</p><p><b>METHODS</b>All relevant case-control studies addressing the relationship between gr/gr deletion and idiopathic male infertility were identified from PubMed, VIP and CNKI (from January 2003 to August 2010). Statistical analyses were performed with the RevMan4. 2 software.</p><p><b>RESULTS</b>Twenty eligible articles were selected in this study, including 5 246 cases of idiopathic infertility and 4 380 controls. The integrated data from the 20 studies revealed a significantly higher frequency of gr/gr deletion in the patients than in the controls, with an odds ratio (OR) of 1.63 (95% CI: 1.23 -2.44) (P = 0.002). However, when the Meta-analysis was limited to 16 studies with stricter case and control selection criteria, the overall OR increased to 1.84 (95% CI: 1.47 - 2.29) (P < 0.000 01). Thirteen studies showed that oligozoospermia patients had a significantly higher frequency of gr/gr deletion than controls (OR = 2.12, 95% CI: 1.61 - 2.80) (P < 0.000 01). Eight studies showed a significant association between the gr/gr deletion subtype without DAZ1/DAZ2 gene copies and spermatogenic impairment (OR = 1.83, 95% CI: 1.31 - 2.55) (P = 0.000 4), but no statistically significant differences were found in the frequency distribution of the gr/gr deletion subtype missing DAZ3/DAZ4 gene copies between the patients and controls (OR = 1.43, 95% CI: 0.97 -2.11) (P = 0.07).</p><p><b>CONCLUSION</b>The present data suggest that gr/gr deletion may be one of the risk factors of male infertility.</p>