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Objective: To compare the effectiveness of exercise therapy with surgery for lumbar spinal stenosis
Methods: Five English databases PubMed, the Cochrane Library, Web of science, OVID and PEDro database were searched for randomized controlled trials comparing surgical procedures with exercise therapy for lumbar spinal stenosis. Information on patients, study design, inclusion criteria, intervention and followup, outcomes, treatment details and adverse events were extracted. Meta-analysis was performed using Review Manager Version 5.3
Results: Two randomized controlled trials and one mixed design trial with a total of 897 patients were included. The pooled results showed a significant difference between exercise and surgery in Oswestry Disability Index at two years [MD= 3.85, 95%CI: 0.48 to 7.22; P=0.03], but no significant difference at six months [MD= 2.18, 95%CI: -2.80 to 7.17; P=0.39] and one year [MD= 4.26, 95%CI: -1.79 to 10.32; P=0.17]. In terms of physical function of 36 Items Short Form Health Survey, there were no significant differences between exercise and surgery at six months [MD= -2.23, 95% CI: -7.46 to 2.99; P=0.40], one year [MD= -2.17, 95% CI: -7.44 to 3.10; P=0.42] and two years [MD= -0.67, 95% CI: -6.16 to 4.82; P=0.81]
Conclusion: In brief, the current evidence demonstrated a trend that exercise therapy had a similar effect for lumbar spinal stenosis compared with decompressive laminectomies. However, for the small sample size and low methodology quality of the included trials, some rigorously designed and large-scaled RCTs need to be performed to confirm the conclusion
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Objective To investigate the clinical characteristics and the pathogens of recurrent urinary tract infection (RUTI) after renal transplantation.Methods The data of adult recipients with UTI from November 2011 to December 2016 were retrospectively analyzed.The recipients were divided into single UTI (SUTI) group and RUTI group.The clinical characteristics and pathogens were analyzed,and the independent risk factors of RUTI were analyzed using logistic regressionmodel.Results Fifty-three cases were selected,including 29 cases of SUTI and 24 cases of RUTI.The positive rate of blood culture (55％ vs.25％,P =0.042) and the concentration of FK506 in the peri-infection period (11.0 + 3.4 ng/mL vs.8.6 + 3.2 ng/mL,P =0.024) in the RUTI group were significantly higher than that those in the SUTI group at the first UTI.The increased concentration of FK506 in the peri-infection period at the first UTI was an independent risk factor for RUTI (β:0.282,95％ CI:1.026-1.713,P＜0.05).There were 86 infection events in 53 patients,and pathogenic microorganisms were cultured in blood culture and urine culture for 86 times.The positive frequency of culture in the RUTI group was higher than that in the SUTI group,but not significantly.The most common pathogenic microorganisms included Escherichia coli (17 times),pseudomonas aeruginosa (16 times),and Enterococcus (16 times).Conclusion Reduction of the FK506 concentration during the peri-infection period at the first UTI is the key to prevent RUTI after renal transplantation.The empirical antibiotics for RUTI should be sensitive for Escherichia coli (ESBL +)and pseudomonas aeruginosa.
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BACKGROUND/AIMS: Several studies have demonstrated that serum interferon-γ-inducible-protein-10 (IP-10) levels at baseline and single nucleotide polymorphisms (SNPs) near the IL28B gene were associated with viral response and treatment outcomes. Our purpose was to assess the combination of pretreatment IP-10 levels with IL28B SNPs as predictors of treatment response to pegylated interferon α-2a plus ribavirin in patients infected with genotype 1 hepatitis C virus in China. METHODS: Seventy-two patients with chronic hepatitis C without fibrosis/cirrhosis were enrolled in the study. The virologic parameters and baseline serum IP-10 levels were determined. IL-28B genotypes were determined by sequencing. RESULTS: In this cohort, serum baseline IP-10 levels lower than 426.7 pg/mL could predict rapid virological response/sustained virological response (SVR). Patients carrying favorable IL28B SNP genotypes had higher SVRs than did those carrying unfavorable variants (IL28B rs12979860, p=0.002; IL28B rs8099917, p=0.020). Combining both baseline IP-10 and IL28B SNPs could improve the prediction of SVR in favorable allele carriers of IL28B, rs12979860 CC and rs8099917 TT. Serum baseline IP-10 levels and IL28B genotypes were independent predictors of SVR. CONCLUSIONS: Our study shows that the combination of baseline serum IP-10 levels and the determination of IL28B SNPs increase the predictability of SVR rates in this cohort.