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OBJECTIVE:To explore the clinical effect and safety of Zoledronic acid injection combined with percutaneous ver-tebroplasty for osteoporotic vertebral compression fracture(OVCF). METHODS:A total of 130 OVCF patients selected from our hospital during Jan. 2014-Dec. 2015 were divided into observation group and control group according to random number table,with 65 cases in each group. Control group was given bone cement by percutaneous vertebroplasty. Observation group was additionally given Zoledronic acid injection 5 mg,ivgtt,once a year(dripping time ≥15 min),on the basis of control group. Both groups were given calcium and vitamin D orally after surgery. VAS scores,Oswestry disability index(ODI)and ADL scores were ob-served in 2 groups 1 week and 6 months after treatment. Bone density of lumbar vertebra L1-L4 and femoral neck were detected in 2 groups after one year of treatment. RESULTS:Before treatment,there was no statistical significance in VAS scores,ODI or ADL scores,bone density of lumbar vertebra LI-L4 and femoral neck between 2 groups(P>0.05). VAS scores and ODI of 2 groups were decreased significantly,while ADL scores were increased significantly 1 week and 6 months after treatment;obser-vation group were significantly better than control group,with statistical significance(P<0.05). One year after treatment,bone density of lumbar vertebra L1-L4 and femoral neck in observation group were significantly higher than control group,with statis-tical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups as fever,dizziness, bone and joint pain,muscle soft tissue pain and new fracture(P>0.05). CONCLUSIONS:Zoledronic acid combined with per-cutaneous vertebroplasty in the treatment of OVCF can significantly relieve pain,improve dysfunction and enhance bone density with good safety.
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OBJECTIVE:To compare the clinical efficacy and safety of rivaroxaban and low molecular weight heparin calcium (LMWHA)in the prevention of deep venous thrombosis(DVT)after total hip arthroplasty(THA). METHODS:A total of 100 THA patients selected from orthopedics department of our hospital as research objects were divided into control group and observa-tion group according to random number table,with 50 cases in each group. Control group was treated with LMWHA injection 0.4 mL subcutaneously,qd;observation group was given Rivaroxaban tablet 10 mg orally,qd. Both groups received treatment on the first day after surgery,for consecutive 14 d. Coagulation indexes(PT,APTT,Fib,TT,D-D),VAS score,the incidence of DVT and PE were observed in 2 groups. The postoperative bleeding volume and ADR as hematoma and gastrointestinal bleeding were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in coagulation indexes or VAS scores between 2 groups(P>0.05). After treatment,PT,APTT,TT and D-D levels,VAS scores of 2 groups were decreased sig-nificantly,while Fib levels were increased significantly;VAS score of observation group was significantly lower than that of con-trol group,with statistical significance(P0.05). The incidence of DVT and PE in observation group were 8.00% and 7.50% ,which were significantly lower than 12.00% and 4.00% of control group,with no statistical significance(P>0.05). The postoperative bleeding volume of observation group was(298.31±52.18)mL,which was significantly lower than(327.40±54.20)mL of control group,with statistical signifi-cance(P0.05). CONCLUSIONS:Rivaroxaban and LMWHA can significantly improve coagulation state,prevent the generation of DVT after THA. While rivaroxaban is better in shortening pain time without increasing the risk of ADR.
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OBJECTIVE:To explore the clinical effect and safety of Zoledronic acid injection combined with percutaneous ver-tebroplasty for osteoporotic vertebral compression fracture(OVCF). METHODS:A total of 130 OVCF patients selected from our hospital during Jan. 2014-Dec. 2015 were divided into observation group and control group according to random number table,with 65 cases in each group. Control group was given bone cement by percutaneous vertebroplasty. Observation group was additionally given Zoledronic acid injection 5 mg,ivgtt,once a year(dripping time ≥15 min),on the basis of control group. Both groups were given calcium and vitamin D orally after surgery. VAS scores,Oswestry disability index(ODI)and ADL scores were ob-served in 2 groups 1 week and 6 months after treatment. Bone density of lumbar vertebra L1-L4 and femoral neck were detected in 2 groups after one year of treatment. RESULTS:Before treatment,there was no statistical significance in VAS scores,ODI or ADL scores,bone density of lumbar vertebra LI-L4 and femoral neck between 2 groups(P>0.05). VAS scores and ODI of 2 groups were decreased significantly,while ADL scores were increased significantly 1 week and 6 months after treatment;obser-vation group were significantly better than control group,with statistical significance(P<0.05). One year after treatment,bone density of lumbar vertebra L1-L4 and femoral neck in observation group were significantly higher than control group,with statis-tical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups as fever,dizziness, bone and joint pain,muscle soft tissue pain and new fracture(P>0.05). CONCLUSIONS:Zoledronic acid combined with per-cutaneous vertebroplasty in the treatment of OVCF can significantly relieve pain,improve dysfunction and enhance bone density with good safety.
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BACKGROUND:Membrane guided bone regeneration technology has become an important method in repairing bone defects. With the deepening of the research, related concept and the mechanism of membrane guided bone regeneration have been gradual y confirmed, but there are stil some unresolved issues. OBJECTIVE: To review the classification of membrane tubes, performance, disadvantages and advantages in membrane guided bone regeneration, as wel as some unresolved issues in application and research. METHODS:The first author searched PubMed and CNKI databases to retrieve articles about the discovery of membrane guided bone regeneration and the concepts, classification of membrane tubes, performance, disadvantages and advantages during bone defect treatment, which were published from 1963 to 2013. The key words were“guided bone regeneration, guided tissue regeneration, bone defect treatment”in English and Chinese, respectively. RESULTS AND CONCLUSION:Membrane guided bone regeneration technique is a most promising treatment for bone defects, but for the treatment of long tubular bone defects, it is stil in the experimental stage. Currently, there is no membrane tube for long-segment bone defects. According to the material sources, the membrane tubes can be divided into:non-biological material, such as polytetrafluoroethylene, polylactic acid, silica gel, titanium film;biological materials, such as col agen membrane, chitin membrane, polyhydroxybutyrate. The membrane tubes can also be classified into nondegradable materials and biodegradable materials. Biodegradable materials have good histocompatibility and no cytotoxicity, which can degrade in a certain period after implantation;part of the membrane can also al ow free exchange of tissue fluid and nutritional substances. But there are stil some shortcomings that the degradation time is difficult to control and the volume is difficultly maintained under the membrane tube. New bone formation in non-biodegradable materials is complete. In the process of osteogenesis, the membrane tube cannot be absorbed and has to be removed secondarily, though it has good histocompatibility and better therapeutic outcomes. In the future, we should further improve membrane performance, so that the membrane tube can play a dual role, fixation and guided bone regeneration;a series of animal studies should be conducted to study the effect of stress on the membrane tube and osseointegration within the membrane tube, to master the law of osseointegration of membrane tubes, thereby providing evidence for repair of long tubular bone defects.