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BACKGROUND:Open reduction pedicle screw fixation for thoracolumbar fracture could obtain satisfactory effects, and has been extensively used. However, it has potential risk during and after repair. Minimaly invasive percutaneous pedicle screw technique minimizes the trauma and complications of soft tissue. It remains poorly understood which is better minimaly invasive percutaneous or conventional open pedicle screw fixation for the repair of thoracolumbar fracture. OBJECTIVE:To perform quality evaluation and meta-analysis on curative effect and postoperative complications of minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures. METHODS:A detailed search of several electronic databases, including Cochrane Library, PubMed, WanFang, CNKI, VIP and CBM, was undertaken. Simultaneously,Chinese Journal of Orthopaedics, Chinese Journal of Orthopaedic Trauma, and Chinese Journal of Trauma were checked by hand to identify controled trials regarding minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures published from inception to 2015, and the references of the included studies were checked. According to inclusion and exclusion criteria, references were screened, data were extracted and quality was evaluated by four investigators independently. Meta-analysis was conducted using RevMan 5.2 software. The quality of references of the included controled trials was assessed with CONSORT statement and some surgery clinical evaluation indexes. RESULTS AND CONCLUSION: We included 28 studies, including 25 randomized controled trials/quasi-randomized controled trials and 3 retrospective comparative studies, with 1 285 patients. Meta-analysis results demonstrated that compared with the conventional open pedicle screw, minimaly invasive percutaneous pedicle screw fixation could significantly reduce operation time, blood loss, hospital stays, postoperative complication rate and height loss (P 0.05). These results indicate that minimaly invasive percutaneous pedicle screw fixation for thoracolumbar fracture was safe and reliable, had smal trauma, less blood loss, rapid recovery, short hospital stay, and less postoperative complications. Nevertheless, methods and results of most studies are not detailed enough. We suggested reporting randomized controled trials according to related standards in order to improve the report quality and authenticity of randomized controled trials.
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Objective To explore the accuracy rate of CO2 injection method and conventional magnetic resonance imaging (MRI) in the staging diagnosis for stage Ⅰ carcinoma of endometrium.Methods Preoperative staging diagnosis for stage Ⅰ carcinoma of endometrium was done,and the method of injecting CO2 gas into the uterine lumen by catheter was applied for pelvic MRI scan in 38 cases of stage Ⅰ carcinoma of endometrium.The pathological staging result was treated as the gold standard to compare the accuracy rate of CO2 injection method with conventional scan method (43 cases).Results For conventional MRI scan group,the accuracy rate of staging diagnosis in stage Ⅰ carcinoma of endometrium was 81.3 ％ (35/43),including stage Ⅰ A 75.0 ％(6/8),stage Ⅰ B 83.9 ％(26/31),stage Ⅰ c 75.0 ％(3/4).For CO2 injection group,the accuracy rate was 89.4 ％(34/38),including stage Ⅰ A 85.7 ％(6/7),stage Ⅰ B 88.9 ％(16/18),stage Ⅰ c 84.6 ％ (12/13).There was a statistical difference between the accuracy rates of two methods (x2=7.81,P ＜ 0.05).Conclusion Compared with conventional scan method,the CO2 injection method with better simplicity,safety and application value,could be more accurate to determine the location of endometrial cancer and the degree of myometrial infiltration.
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Objective To evaluate a serf-designed diagnostic protoeol which can early detect a femoral neck fracture for patients with a femoral shaft fracture. Methods From September 2005 to June 2007, a self-developed protocol was used to detect an ipsilateral femoral neck fracture for all the patients with femoral shaft fracture who had sought treatment in our department. This protocol consisted of anteroposterior plain radiography of internal rotator, intraoperative fluoroscopy of the hip, a fine (2 mm) cut computed to-mographic scan through the femoral neck, postoperative anteroposterior and lateral plain radiography of the hip in the operating room prior to awakening the patient, at the time of follow-up anteroposterior and lateral plain radiography of the hip in the presence of hip pain. The diagnostic effects of the protocol were compared with those of conventional diagnosis used for all the patients with femoral shaft fracture who had sought treatment in our department from September 2003 to August 2005. A chi-square analysis comparing the protocol group (September 2005 to June 2007) and the non-protocol group (September 2003 to August 2005) was used to assess the early and delayed diagnosis rates for an associated ipsilateral femoral neck fracture. Results The earlydiagnosis rate of an associated femoral neck fracture by the protocol was 93.8%, markedly higher than that by conventional method (46.2%), with statistically significant difference (χ2 = 4.069, P =0.044). Conclu-sion In presence of a femoral shaft fracture. this protocol consisting of plain radiography of intemal rotator, intraoperative fluoroscopy of the hip, fine cut computed tomographic scan of the femoral neck, postoperative plain radiography of the hip, and follow-up plain radiography of the hip in the presence of hip pain, may sig-nificantly improve the diagnostic rate of an associated femoral neck fracture.
Résumé
0.05).After treatment,blood serum E2 level in group M was (74.18?22.32) pmol?L-1,whereas that in group D was (24.96?3.94)pmol?L-1,there was significant difference(P0.05).Conclusion Clinical symptoms of patients with recurrent endometriosis in two groups are improved.Serum E2 level in group M remains in the follicular phase,but group D declines to postmenopausal range.Mifepristone does not result in lack of estrogen,ovulation recovers rapidly after treatment in group M compared with group D.Mifepristone and danazol have not obvious impact on blood serum cortisol.