ABSTRACT
BACKGROUND:Tai Chi exercise can relieve the decreasing lung function and increase exercise tolerance in patients with chronic obstructive pulmonary disease, but some studies found that Tai Chi exercise did not achieve the desired improvement effect in patients. OBJECTIVE:To objectively evaluate the rehabilitation effects in lung function and exercise endurance of Tai Chi exercise on old patients with stable chronic obstructive pulmonary disease. METHODS:A computer-based online retrieval of PubMed, EMBASE, Web of Science, The Cochrane Library, CNKI, VIP and WanFang databases between January 1980 and July 2014 were searched. Randomized control ed trials of Tai Chi intervening in old patients with chronic obstructive pulmonary disease were col ected, including Tai Chi exercise intervention group and drug or physical education control group. RESULTS AND CONCLUSION:A total of 6 randomized control ed trials were included, with 406 patients. The results of Meta-analyses showed that, compared with the control group, Tai Chi exercise obviously improved the percentage of forced expiratory volume in one second/forced vital capacity (MD=4.62, 95%CI:0.73-8.51, P=0.02), the percentage of forced expiratory volume in one second to the prediction value (MD=4.95, 95%CI:0.33-9.57, P=0.04) and 6-minutes walking distance (MD=33.81, 95%CI:6.00-61.62, P=0.02) in patients with chronic obstructive pulmonary disease. Forced expiratory volume in one second showed no significant difference between Tai Chi exercise intervention group and control group (MD=0.02, 95%CI:-0.10, 0.14, P=0.76). Tai Chi exercise could improve the lung function and exercise endurance in old patients with stable chronic obstructive pulmonary disease, and has positive rehabilitation effects.
ABSTRACT
BACKGROUND:At present, it remains unclear whether delayed functional exercises after arthroscopic rotator cuff repairs could elevate the healing rate of tendon. The opportunity of functional exercises after rotator cuff repairs is stil controversial, and there is no relevant system evaluation. OBJECTIVE:To systematical y evaluate the differences in curative effects of early and delayed functional exercises after arthroscopic rotator cuff repairs. METHODS:We searched the Pubmed, EMBASE, Cochrane Central Register of Control ed Clinical Trials, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure, and Chongqing VIP Database. The key words were“arthroscopy, rotator cuff, rehabilitation”. The references of the included literatures were re-retrieved. The deadline of retrieval was August 15, 2012. The included literatures were randomized control ed trials on early and delayed functional exercises after arthroscopic rotator cuff repairs. Methodological quality evaluation, screening and heterogeneous test were conducted. REVMAN5.1 software was utilized to analyze the extracted data. RESULTS AND CONCLUSION:We included three randomized control ed trials, including 237 patients:119 in the early movement group and 118 in the delayed movement group. During fol ow-up at 1 year after operation, no significant differences in range of motion, pain degree, American Shoulder and Elbow Surgeons Scale, Simple Should Test scores and re-tear rate of rotator cuff were detected between the two groups. Results confirmed that compared with delayed functional exercises, early functional exercises after arthroscopic rotator cuff repair did not have advantages on the improvement of joint function and range of motion, but also did not negatively affect cuff healing. Postoperative rehabilitation can be modified to ensure patient’s compliance.
ABSTRACT
BACKGROUND:Locking compression plate and dynamic hip screw are the two major extramedul ary fixations for the femoral intertrochanteric fractures, however, the comparison of the clinical efficacy between two methods is stil controversial. OBJECTIVE:To systematical y evaluate the clinical efficacy of locking compression plate versus dynamic hip screw in the treatment of femoral intertrochanteric fractures, and provide a theoretical basis for clinical application. METHODS:Authors searched for control ed studies on locking compression plate and dynamic hip screw in the treatment of femoral intertrochanteric fractures in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP periodical database, Wanfang resource database, Chinese Biomedical Literature service systems published from January 1999 to April 2014. The inclusion and exclusion criteria were made, and the literature meeting the criteria was screened, and the methodological quality of the included studies was evaluated. Meta-analysis was carried out using the RevMan 5.2 software. RESULTS AND CONCLUSION:Ultimately 682 patients from 8 studies met the inclusion criteria, including 336 patients in the locking compression plate group and 346 patients in the dynamic hip screw group. Meta-analysis results showed that:there were no statistical y significant differences in operating time [MD=-12.07, 95%CI (-29.85, 5.71), P=0.18], peri-operative bleeding loss [MD=-15.01, 95%CI (-87.85, 57.83), P=0.69], post-operation drainage [MD=-13.62, 95%CI (-28.49, 1.26), P=0.07], ambulation time [MD=-0.14, 95%CI (-0.68, 0.41), P=0.63], length of hospitalization [MD=-0.74, 95%CI (-2.29, 0.82), P=0.35], bone union time [MD=-1.18, 95%CI (-2.78, 0.42), P=0.15] between locking compression plate and dynamic hip screw groups. The excellent and good rate of postoperative hip function reduction [OR=2.03, 95%CI (1.23, 3.36), P=0.006] was significantly higher in locking compression plate group than in the dynamic hip screw group. The incidence of coxa vara was lower in the locking compression plate group than in the dynamic hip screw group [OR=0.34, 95%CI (0.12, 0.96), P=0.04]. There were no significant differences in looseness, breakage, withdrawal of internal fixation [OR=1.20, 95%CI (0.59, 2.45), P=0.61] and the incidence of total complications [OR=0.55, 95%CI (0.24, 1.28), P=0.16] between locking compression plate and dynamic hip screw groups. However, the included studies have high possibility of selection bias and measurement bias, and wil affect proof strength of results. Therefore, more clinical randomized control ed studies with compact design are needed for verification.
ABSTRACT
BACKGROUND:At present, the anatomic reconstruction of coracoclavicular ligament is a trend for the treatment of acromioclavicular joint dislocation. Endobutton plate is a new and effective surgical method found in recent years. Although the recent curative effect is satisfactory, as a method of internal fixation, its rigid fixation does not conform to the requirements of the biomechanics. Furthermore, a randomized control ed clinical study and systematic evaluation are absent. OBJECTIVE:To systematical y evaluate clinical outcomes and safety between endobutton plate and the other surgical methods for treatment of acromioclavicular joint dislocation. METHODCochrane (2014-01), PubMed (1966-01/2014-03), Medline (1966-01/2014-03), EMbase (1984-01/2014-03), CNKI (1979-01/2014-03), VIP (1989-01/2014-03) and Wanfang (1989-01/2014-03) databases were searched by computer. Six Chinese journals about orthopedics were searched by hand. References of relevant literatures were searched. Randomized control ed trials that were related to different surgical methods for the treatment of acromioclavicular joint dislocation were col ected. In accordance with inclusion criteria, some literatures were included and their qualities were assessed strictly. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Col aboration. RESULTS AND CONCLUSION:Final y 7 published studies with randomized control ed trials met al the inclusion criteria. A total of 359 patients were included, containing 152 cases of endobutton plates fixation, 149 cases of clavicle hook plate fixation, and 58 cases of screw fixation. Except two researches addressed the comparison among three surgical ways, the remaining were about two ways. Meta-analysis showed that the excellent rate was better in endobutton plates fixation than in clavicle hook plate fixation (P=0.0002) and in screw fixation (P=0.009). Compared with other fixation methods, there were significant differences in shoulder joint pain (P=0.01), but no significant difference was detected in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection (P=0.44, P=0.10, P=0.37, P=0.21, P=0.96). Results indicated that, the efficiency of endobutton plates fixation for acromioclavicular joint dislocation was better than clavicle hook plate fixation and screw fixation, and caused less shoulder pain than clavicle hook plate fixation. There was no significant difference in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection among the three methods. Due to the limited number of cases in this study, the multicenter, large-sample and long-term clinical randomized control ed studies are needed to increase the strength of the evidence.
ABSTRACT
BACKGROUND:Currently, the treatment of proximal humeral fractures mainly contains joint preservation (conservative treatment, open reduction and internal fixation) and arthroplasty, but how to choose the treatment is stil controversial. OBJECTIVE:To evaluate and compare the clinical outcomes of joint preservation versus arthroplasty in the treatment of displaced 3-or 4-part humeral fractures in randomized control ed trials using meta-analysis. METHODS:Medline (January 1966 to December 2013), PubMed (January 1980 to December 2013), Embase (January 1990 to December 2013), Science (January 1990 to December 2013), Springer (January 1990 to December 2013), China National Knowledge Infrastructure (1994 to 2013), and Wanfang database (1982 to 2013) were searched for randomized control ed trials addressing joint preservation and arthroplasty for 3-or 4-part proximal humeral fractures. Articles meeting the inclusion criteria were included. The related data were extracted and loaded onto Comprehensive Meta-Analysis Software for meta-analysis. RESULTS AND CONCLUSION:Seven articles with 320 patients (165 patients undergoing joint preservation and 155 patients receiving arthroplasty) were accepted in this mete-analysis and al of them were high-quality English researches by modified Jadad Scale. Meta-analysis results displayed that the random-effects mean Constant score across al types was 55.9 (95%CI:50.7-61.1;P<0.001). Constant score was higher in the joint preservation group than in the arthroplasty group (P<0.01). The study displayed significant heterogeneity (I2 0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized control ed trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3-or 4-part proximal humeral fractures.=88%, Q statistic=107.6, Q=13;P<0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized controlled trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3- or 4-part proximal humeral fractures.
ABSTRACT
Objective] To evaluate the acupuncture treatment of type 2 diabetes peripheral neuropathy clinical curative effect and safety. [Methods] Com-puter retrieval of the CENTRAL, Cochrane, Web Of Science, CBM, CNKI, VIP database, find al about acupuncture and moxibustion treatment of type 2 diabetic gastroparesis of randomized control ed trial(RCT), build library retrieval time until March 19, 2014.At the same time ShouJian into literature references.According to inclusion and exclusion criteria, independently by two researchers after RCT extraction and filtering, data quality evaluation, using Revman5.2 Meta analysis software, use the GRADE system for quality evaluation of evidence. [Results] Seven studies involving 364 patients were includ-ed.Meta analysis showed:(1) effective rate:the acupuncture compared with drugs, the results between the two groups were statistical y significant (RR=3.35, 95% CI=(2.05, 5.48)], suggesting that acupuncture treatment can improve efficiency for the treatment of type 2 diabetes peripheral neuropathy. (2) MNCV:the median nerve, and results showed that the statistical significance was found between the two groups[MD=2.29, 95%CI=(0.61, 3.98)].Includ-ing philalways nervous, the result showed that between the two groups had statistical significance[MD=2.16, 95% CI=(0.16, 4.16)].(3)SNCV:includ-ing median nerve, the results showed that the statistical significance was found between the two groups[MD=1.79, 95% CI=(0.57, 3.02)].Including phi-lalways nervous, the result showed that the two groups had statistical significance[MD=3.59, 95%CI=(2.28, 4.91)].Based on GRADE system ,al the evidence was at low level and weak recommendation. [Conclusion] Acupuncture-moxibustion for the type 2 diabetes peripheral neuropathy is better than the conven-tional medicine treatment.Limited by the guality of the inclusive literalures, it needs more high quality, large sample of RCT further argument.
ABSTRACT
[Objective]To explore new directions for traditional Chinese medicine(TCM) scientific research. [Method]Reviewing RWS overseas in recent years, with a randomized control ed trial(RCT) contrast, this study summarized the RWS features and discussed the limitations and advantages of RCT and RWS when carrying out the TCM scientific research.[Result] RWS is different from RCT in research purpose, brings into exclusion criteria, sample size, intervention and evaluation index, evaluation time, data col ection, management and statistical analysis method, etc. [Conclusion] Compared with RCT, RWS more fits the basic characteristics of TCM cal ed holistic concept and syndrome differentiation, is advantageous to the preservation of TCM, indicat-ing the new direction for TCM scientific research.