RESUMO
BACKGROUND: At present, there are many ways to treat acromioclavicular joint dislocation, mainly based on clavicular hook plate, but the anatomical reconstruction of the trapezoid ligament and conoid ligament of the acromioclavicular ligament is the most important trend in the treatment of acromioclavicular joint dislocation. Endobutton plate has been widely promoted in recent years. A large number of randomized controlled trials and retrospective study showed that it has better efficacy and lower incidence of complications compared with the clavicular hook plate. OBJECTIVE: To evaluate the excellent and good rate and the short-term incidence of complication between Endobutton plate and clavicular hook plate in the treatment of acromioclavicular joint dislocation. METHODS: The Cochrane Library (1966-06/2017-05), PubMed (1966-06/2017-05), MEDLINE (1966-02/2017-05), EMbase (1984-01/2017-05), CNKI (1979-01/2017-05), VIP (1989-01/2017-05), and Wanfang (1982-01/2017-05) databases were searched by computer. Simultaneously, six major Chinese orthopedic journals were retrieved by hand, and the references included in the related articles were consulted. Randomized controlled trials addressing Endobutton plates and clavicular hook plates for the treatment of acromioclavicular joint dislocation were collected. The literatures were screened for inclusion criteria, and their qualities were evaluated. Meta-analysis was performed using RevMan 5.3 software. RESULTS AND CONCLUSION: (1) A total of 13 randomized controlled trials containing 800 patients were included in the study. 394 patients were treated with Endobutton plate and 406 patients with clavicular hook plate as controls. Among which, only one study was compared in three different ways; the rest were compared between Endobutton plate and clavicular hook plate. (2) Meta-analysis showed that the excellent and good rate of Endobutton plate was superior to that of clavicular hook plate in the treatment of acromioclavicular joint dislocation (P < 0.000 01). Compared with clavicular hook plate, the incidence of incision infection, acromioclavicular joint pain, limited activity and redislocation were lower in Endobutton plate (P=0.02, < 0.001, < 0.00001, 0.03). (3) These findings suggested that the effect of Endobutton plate was better than that of clavicular hook plate in the treatment of acromioclavicular joint dislocation. The incidences of incision infection, acromioclavicular joint pain, limited mobility, and redislocation were lower in Endobutton plate than in the clavicular hook plate. Although the article included many randomized controlled trials, the qualities of these articles are limited. We still need to design more strictly large-sample randomized controlled trials to increase the credibility of the evidence.
RESUMO
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of Shenfu Injection (SFI), as a adjuvant therapy, in treating patients of ischemic cardiomyopathy with heart insufficiency (ICP-HI).</p><p><b>METHODS</b>One hundred patients of ICP-HF were equally randomized into two groups, the SFI group and the control group. All received the conventional treatment, but to patients in the SFI group SFI was given additionally via intravenous injection, 60 mL once a day, 10 days each month, the treatment course was 6 months. Changes of cardial functional grading, 6-min walking distance, echocardiographic indices, plasma N terminal pro-brain natriuretic peptide (pro-BNP) level were observed before and after treatment, and the occurrence of major adverse cardiovascular events (MACE) and mortality in patients were observed as well.</p><p><b>RESULTS</b>As compared with the conventional treatment alone, additional application of SFI showed a more significant efficacy in improving NYHA functional grade and 6-min walking distance, reducing the diameters of left ventricular at end diastole and systole, increasing left ventricular ejection fraction, and decreasing plasma N terminal pro-BNP level (P <0.05). The occurrence of MACE and the mortality in the SFI group were significantly lower than those in the control group respectively (P <0.05).</p><p><b>CONCLUSIONS</b>Based on the conventional treatment, the adjuvant therapy of SFI could improve the cardiac function, improve the quality of life, ameliorate ventricular reconstruction, and decrease the occurrence of cardiovascular events in patients of ICP-HI.</p>