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BACKGROUND: Traditional fluoroscopy-guided pedicle screw fixation is not highly accurate and can lead to serious surgical complications. To reduce surgical complications and improve the success rate of surgery, robotic assistive technology emerges as the times require. OBJECTIVE: To compare the difference of robot-assisted and fluoroscopy-guided pedicle screw placement using meta-analysis. METHODS: The study included clinical controlled trials on robot-assisted and fluoroscopy-guided pedicle screw placement published in and outside China from December 2008 to December 2018. The retrieval was performed in the online databases include Embase, PubMed, Central, CNKI, CQVIP, Wanfang, and CBM. Keywords used for search were robot assisted, fluoroscopy guided, conventional, freehand, pedicle screw in English and Chinese. After the data were extracted, statistical software Review Manager 5.3 was used for data-analysis. RESULTS AND CONCLUSION: (1) Based on the above search strategy, 1 615 studies were retrieved, and 13 were included. (2) Statistical analysis found that placement accuracy in the robot-assisted group was better than that of the fluoroscopy group [95%CI(1.55, 4.06), P=0.000 2]. Radiation intensity in the fluoroscopy group was lower than that in the robot-assisted group [95%CI(0.42, 0.82), P < 0.001], and the difference was statistically significant. (3) However, the incidence of complications [95%CI(0.23, 4.65), P=0.96] and revised surgery [95%CI(0.03, 3.17), P=0.33] were not statistically significant between the robot-assisted group and the fluoroscopy group. Intraoperative fluoroscopy time was similar between the two groups [95%CI(-38.55, 78.26), P=0.51]. Postoperative back pain [95%CI(-0.58, 0.38), P=0.68], leg pain score [95%CI(-0.20, 0.19), P=0.94] and operation time [95%CI(-6.33, 53.02), P=0.12] were also similar between the two groups, and the differences were not statistically significant. (4) Compared with fluoroscopy, robot-assisted technique has higher pedicle screw placement accuracy, especially under percutaneous conditions. Inevitably, the intraoperative radiation intensity is also more than conventional fluoroscopy.
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OBJECTIVE:To evaluate the improvement and rectification effects about prescription checking and intervention skills of pharmacists. METHODS:By retrospective investigation,2417 outpatient prescriptions and 1698 outpatient prescriptions were respectively selected from some one hospital during Oct.-Dec. 2015 (before improvement and rectification) and Jan.-Mar. 2016 (after improvement and rectification). According to standards,guidelines and references as Prescription Administrative Poli-cy,Prescription Review Management Standard(trial)and drug instructions,irrational drug use and prescription checking and inter-vention skills of pharmacists were compared before and after the implementation of rectification measures as optimizing hospital in-formation system,improving comprehensive skills of pharmacists,strengthening pharmacists'concept,establishing feedback mech-anism. RESULTS:After the implementation of rectification measures,unsuitable indications,clinical diagnosis inconsistent with medication,antibiotics use without indications,unsuitable usage and dosage,unsuitable drug combination and irrational drug use were all decreased,but repeated drug use was increased,without statistical significance (P>0.05). The number of non-standard prescriptions and unsuitable prescriptions checked by pharmacists were decreased,without statistical significance(P>0.05). The in-cidence of checking missing,excessive checking and checking error were all increased from 2.40%,0.99%,3.39% before im-provement and rectification to 0.47%,0.29%,0.77%,with statistical significance(P<0.05). CONCLUSIONS:The improvement and rectification measures of the hospital can improve comprehensive prescription checking and intervention skills of pharmacists. Ir-rational drug use should be further standardized.
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Objective To study the impacts of alcohol dependence on the anticonvulsant effect of diazepam. Meth?ods Kunming mice (n=36) were divided into 3 groups (n=12 in each group), Alcohol Dependence Group(A group), Diaze?pam Group(D group)and Normal Saline Group(N group). A group received an intraperitoneal injection with a 0.2 mL dose of 0.8%alcohol in NS (normal saline) , while both D and N group received an injection with a 0.2 mL dose of NS without alco?hol , twice a day. Mice’s autonomic activities were monitored every day. After 7 days, the electroconvulsive experiment was performed. Both A and D group were given a weight-based dose of 0.05 mL/10 g of 0.05%diazepam via intraperitoneal injec? tion, while N group was given a 0.05 mL/10 g dose of NS. Before administration and after 15, 30, 60 min of administration, the convulsion threshold of each group was measured. Results The count of autonomic activity of mice in A group was less than that of mice in D and N group during the 2nd day to 6th day(P0.05). The convulsion threshold of mice in A group was higher than that of mice in D and N group before administration(P0.05). After 15 min of administration, the convulsion threshold of mice in D group was high?er than that of mice in A and N group(P0.05). Conclusion Alcohol dependence has anticon?vulsant effect. Alcohol dependence weakens the anticonvulsant effect of diazepam.