OBJECTIVETo evaluate the clinical efficacy of manipulative reduction combined with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF) using meta-analysis method, in order to provide a reference for clinical treatment.

METHODSA systematic computer-based search (from January 1987 to April 2014) from CNKI, Wanfang database, Web of Science and PubMed were performed for the collection of controlled clinical researches on manipulative reduction combined with PVP or PKP in treating OVCF. The quality of selected researches was evaluated. Meta-analysis was adopted to evaluate visual analog scale, Cobb angle, anterior height ratio of the injured vertebra.

RESULTSA total of 7 researches of 410 patients were included in the present analysis, there were 5 RCTs and 2 non-RCTs and all come from China. Manipulative reduction combined with PVP could got better improvement in Cobb angle (WMD=-7.35; 95%CI: -12.15, -2.54) and anterior height ratio of the injured vertebra (P<0.01) than simple PVP, but no significant difference was found in improvement of visual analog scale (WMD=-0.01; 95%CI: -0.45, 0.42). There were no significant differences in the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra between manipulative reduction combined with PKP and simple PKP (P>0.05).

CONCLUSIONCompared with simple PVP, manipulative reduction combined with PVP may result in more clinical efficacy on the improvement of Cobb angle and anterior ratio of the injured vertebra. And compared with simple PKP, manipulative reduction combined with PKP has no obvious advantages on the improvement of visual analog scale, Cobb angle, anterior height ratio of the injured vertebra. However, the number and quality of the literatures, may resulted in the effect of mistrust, so more large sample and high-quality RCTs are needed in future.

Combined Modality Therapy ; Fractures, Compression ; therapy ; Humans ; Manipulation, Spinal ; methods ; Minimally Invasive Surgical Procedures ; methods ; Osteoporotic Fractures ; therapy ; Spinal Fractures ; therapy

Schistosomiasis is a kind of zoonosis with serious hazard,which is popular in many countries and regions in the world. One of the efforts for schistosomiasis prevent and control is developing new drugs and vaccines,and knowing the tran?scription regulation mechanism and the function of transcription factors will help us find the targets of new drugs and vaccines as soon as possible. This article reviews the progress of Schistosoma transcription factors and research methods.

Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P < 0.05). There was no statistically significant difference between the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, (P > 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.

OBJECTIVETo evaluate incidence of postoperative delirium after hip surgery in elderly patients by meta-analysis.

METHODSFrom January 1, 2014 to December 31, 2013, clinical literatures about postoperative delirium after hip surgery in elderly patients,were searched from the Pubmed. Literature extract table were formed according to inclusion and exclusion criteria. Stata-12.0 was applied for Meta-analysis. P was used to test heterogeneity of study, random-effect model was performed when I2 > 50%. Subgroup analysis was used according to stage of age, assessment scale of delirium and statistical area of literature. Begg test was used to test publication bias.

RESULTSTwenty-one literatures were included. Incidence of postoperative delirium after hip surgery in elderly patients by weighted and combination was 17% [95% CI (16%, 18%)]. Incidence of postoperative delirium after optional hip surgery was decreased more than emergency operation in included 5 literatures [OR = 0.32, 95% CI (0.22, 0.45)]. Incidence of postoperative delirium in patients less than 80 years old was 21% [95% CI (19%, 23%)], while 21% [95% CI (19%, 24%)] in patients more than 80 years old. Incidence of postoperative delirium in CAM evaluation scale was 23% [95% CI (21%, 26%)], while 19% [95% CI (17%, 21%)] in other evaluation scales. Incidence of postoperative delirium in Asian area was 17% [95% CI (15%, 20%)], while 23% [95% CI (21%, 25%)] in European and American area. There was no publication bias tested by Begg test (P < 0.05).

CONCLUSIONIncidence of postoperative delirium after hip surgery in elderly patients increases higher, especially in emergency operation. A standardizing research method is benefit for evaluate incidence of postoperative delirium after hip surgery in elderly patients, decreasing heterogeneity and publication bias.

Aged ; Delirium ; epidemiology ; Hip Fractures ; surgery ; Humans ; Incidence ; Postoperative Complications ; epidemiology ; Publication Bias

Objective To investigate the effect of local injection of Botulinum toxin type A(BTXA) on spasticity and function of the affected upper limb in stroke patients.Methods A total of 32 stroke patients were re- cruited and randomly divided into two groups:a BTXA group and a control group.All the patients had spasticity of upper limb muscles,which scored grade 2 to 3 with the Modified Ashworth Scale(MAS) ,and decreased elbow joint range of motion.The 16 patients in the BTXA group received BTXA injection in the biceps brachii muscles and flexor muscles of forearm on 10～15 points,while those in the control group did not.All the patients in both groups were treated with rehabilitation training techniques.The MAS,Fugl-Meyer upper limb function assessment and Barthel In- dex were employed to evaluate the changes of muscle tone,upper limb function and activity of living (ADL)perform- ance of the patients before injection and at 1st,2nd,6th 12th weeks after injection.Results The therapeutic effect between the BTXA group anti control group was significantly different in terms of biceps muscle tone,the scores of Fugl-Meyer upper limb function assessment and Barthel Index.Compared with preinjection,muscle tone was de- creased significantly and ADL performance was improved after injection in BTXA group.The effects of BTXA lasted more than 12 weeks.Conclusion Intramuscular muhipoint injection of BTXA was useful in reducing muscle spas- ticity,and was helpful for increasing motor ability of the affected upper limb and ADL performance of the stroke pa- tients.

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.
Animals ; China ; Medicine, Chinese Traditional ; standards ; Pharmaceutical Preparations ; analysis ; standards ; Quality Control

The clinical analgesic effect of electro-acupuncture (EA) stimulation (EAS) on breakthrough pain induced by remifentanil in patients undergoing radical thoracic esophagectomy, and the mechanisms were assessed. Sixty patients (ASAIII) scheduled for elective radical esophagectomy were randomized into three groups: group A (control) receiving a general anesthesia only; group B (sham) given EA needles at PC4 (Ximen) and PC6 (Neiguan) but no stimulation; and group C (EAS) electrically given EAS of the ipsilateral PC4 and PC6 throughout the surgery. The EAS consisting of a disperse-dense wave with a low frequency of 2 Hz and a high frequency of 20 Hz, was performed 30 min prior to induction of general anesthesia and continued through the surgery. At the emergence, sufentanil infusion was given for postoperative analgesia with loading dose of 7.5 μg, followed by a continuous infusion of 2.25 μg/h. The patient self-administration of sufentanil was 0.75 μg with a lockout of 15 min as needed. Additional breakthrough pain was treated with dezocine (5 mg) intravenously at the patient's request. Blood samples were collected before (T1), 2 h (T2), 24 h (T3), and 48 h (T4) after operation to measure the plasma β-EP, PGE2, and 5-HT. The operative time, the total dose of sufentanil and the dose of self-administration, and the rescue doses of dezocine were recorded. Visual Analogue Scale (VAS) scores at 2, 12, 24 and 48 h postoperatively and the incidence of apnea and severe hypotension were recorded. The results showed that the gender, age, weight, operative time and remifentanil consumption were comparable among 3 groups. Patients in EAS group had the lowest VAS scores postoperatively among the three groups (P<0.05). The total dose of sufentanil was 115±6.0 μg in EAS group, significantly lower than that in control (134.3±5.9 μg) and sham (133.5±7.0 μg) groups. Similarly, the rescue dose of dezocine was the least in EAS group (P<0.05) among the three groups. Plasma β-EP levels in EAS group at T3 (176.90±45.73) and T4 (162.96±35.00 pg/mL) were significantly higher than those in control (132.33±36.75 and 128.79±41.24 pg/mL) and sham (136.56±45.80 and 129.85±36.14 pg/mL) groups, P<0.05 for all. EAS could decrease the release of PGE2. Plasma PGE2 levels in EAS group at T2 and T3 (41±5 and 40±5 pg/mL respectively) were significantly lower than those in control (64±5 and 62±7 pg/mL) and sham (66±6 and 62±6 pg/mL) groups. Plasma 5-HT levels in EAS group at T2 (133.66±40.85) and T3 (154.66±52.49 ng/mL) were significantly lower than those in control (168.33±56.94 and 225.28±82.03) and sham (164.54±47.53 and 217.74±76.45 ng/mL) groups. For intra-group comparison, plasma 5-HT and PGE2 levels in control and sham groups at T2 and T3, and β-EP in EAS group at T3 and T4 were significantly higher than those at T1 (P<0.05); PGE2 and 5-HT levels in EAS group showed no significant difference among the different time points (P>0.05). No apnea or severe hypotension was observed in any group. It was concluded that intraoperative ipsilateral EAS at PC4 and PC6 provides effective postoperative analgesia for patients undergoing radical esophagectomy with remifentanil anesthesia and significantly decrease requirement for parental narcotics. The underlying mechanism may be related to stimulation of the release of endogenous β-EP and inhibition of inflammatory mediators (5-HT and PGE2).

Objective To explore the effects of tilted seat surface on front protraction of upper limb and postural adjustment while sitting in children with spastic cerebral palsy. Methods From 2010 to 2014, 15 children with spastic cerebral palsy (patients group) and 15 healthy children (control group) were recruited. They were asked to reach forward sitting on the tilted seat surface with different degrees (-15°, 0°, 15° ) to test the reaction time and movement time. The contraction times of rectus abdominis and back extensors were recorded and ana-lyzed. Results The reaction time and movement time were shorter, and the contraction rates of rectus abdominis and back extensors were lower in the degree with-15° than with 0° and 15° (P<0.001). There was no difference in reaction time between two groups (P>0.05), and the movement time was longer in the patients group than in the control group (P<0.001). The contraction rates were higher in the patients group than in the control group. Conclusion Anterior tilted seat surface may improve the front protraction function of upper limb and the postural adjustment in children with cerebral palsy.

Objective To investigate expression levels of epithelial mucin 1 (MUC1) and epitbelial mucin15(MUC15) in elderly patients with papillary thyroid carcinoma and assess the role of MUC1 and MUC15 in the pathogenesis of thyroid papillary carcinoma.Methods Protein expression of MUC1 and MUC15 was detected by immunohistochemistry in 10 samples from normal thyroid tissue adjacent to thyroid adenoma,57 samples from papillary thyroid carcinoma (PTC),and 14 samples from PTC in neck lymph node metastasis.Results Expression rates of MUC1 in normal thyroid tissues,thyroid papillary carcinoma,and lymph node metastatic carcinoma were 40.0％,75.4％,64.3,respectively,and the rates for MUC15 were 0,73.7％,71.4％,respectively.The positive expression rate of MUC1 was higher in PTC tissues than in normal thyroid tissues (x2 =5.10,P=0.02) and,compared with normal thyroid tissues,the positive expression rate of MUC15 increased in PTC tissues and lymph node metastatic carcinoma (x2 =12.25 and 19.75,both P＜0.05)MUC15 protein expression was higher in micro-PTC (less than or equal to 1 cm in diameter) than in carcinoma larger than 1 cm in diameter (90.9％ vs.62.9,x2 =5.48,P=0.02).MUC15 expression was higher in PTC without lymph node metastasis than in PTC with lymph node metastasis (83.8％vs.55.0％,x2 =5.55,P=0.02).MUC1 expression was positively correlated with MUC15 expression in thyroid papillary carcinoma (r=0.35,P=0.01).Conclusions MUC1 and MUC15 may have synergistic effects in the initiation and progression of PTC.MUC15 may play a role in regulating tumorigenesis of thyroid papillary carcinoma in early stages and can potentially serve as a supplementary marker in the screening of micro-thyroid papillary carcinoma.

PURPOSE: The objective was to determine the characteristics and prognostic factors of 86 Chinese patients with trisomy 8 aberrations and compare the prognostic value of International Prognostic System (IPSS) and Revised IPSS (IPSS-R) in this cohort. MATERIALS AND METHODS: A total of 86 cases diagnosed with primary myelodysplastic syndromes (MDS) with isolated tr8 or with tr8 and other additional cytogenetic aberrations diagnosed and treated at the Union Hospital, Tongji Medical College of Huazhong University of Science and Technology between July 2002 and March 2013 were reviewed. RESULTS: The median survival of the entire group was 23.0 months, and acute myeloid leukemia (AML) developed in 43% (37/86) patients within the follow up time. The univariate analysis revealed that overall survival (OS) was correlated with age, thrombocytopenia, absolute neutrophil count, marrow blasts, cytogenetic status and red blood cell transfusion at diagnosis, and the multivariate analysis revealed that age, marrow blasts, cytogenetic status and transfusion dependence were independent parameters for the OS. The cytogenetic complexity and marrow blasts had the strongest impact on the AML transformation by multivariate analysis. Comparing the two prognostic systems, both two systems could successfully discriminate risk groups for survival. IPSS-R was more refined than IPSS for predicting OS, but had no advantage in predicting the risk of AML development. CONCLUSION: This study confirmed the influence of clinical factors on the prognosis of 86 Chinese MDS patients with trisomy 8. In addition, IPSS-R can further refine prognostic discrimination in the IPSS risk categories.
Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group/*genetics ; Chromosome Aberrations ; Chromosomes, Human, Pair 8 ; Disease Progression ; Female ; Humans ; Leukemia, Myeloid, Acute/*genetics ; Male ; Middle Aged ; Multivariate Analysis ; Myelodysplastic Syndromes/*ethnology/*genetics ; Prognosis ; Retrospective Studies ; *Trisomy