1.Treatment scheme selection strategy and progress of elderly femoral neck fracture of Garden type II
Baitong LI ; Tianyi ZHOU ; Zhen LIU ; Jian SHANG
Chinese Journal of Tissue Engineering Research 2017;21(3):445-449
BACKGROUND: There are various treatment methods for femoral neck fracture in the elderly, and they have advantages and disadvantages, especially for the elderly type of stable femoral neck fractures Garden type II of treatment options. OBJECTIVE: To summarize the current main clinical methods of senile femoral neck fractures of Garden type II, compare the advantages and disadvantages of internal fixation and joint replacement, and provide the best treatment for orthopedic surgeons. METHODS: We retrieved PubMed database. Key words were elderly femoral neck fracture, Garden type II, selection strategy and progress. Combining with the clinical cases encountered in the comparative analysis, the relevant discussion was analyzed. RESULTS AND CONCLUSION: Although the risk of surgery and the pain of non-surgical patients in early stage, the effects are not ideal. Internal fixation of Garden type II femoral neck fracture and joint replacement in elderly patients is controversial. For the elderly and Garden type II femoral neck fractures, the rate of revision after cannulated screw fixation was significantly higher than that of hip replacement. Both cement-type and biological-type implant prosthesis can improve hip function largely, and reduce non-surgical complications, and finally get a satisfactory clinical effect. The clinician should make the best treatment plan according to the patient’s age, bone condition, fracture type and physical condition.
3.A biomechanical study of patellar tension plating system for patellar fractures
Tianyi ZHOU ; Shixin GUO ; Baitong LI ; Xinguang HAN ; Jian SHANG
Chinese Journal of Orthopaedic Trauma 2018;20(1):62-67
Objective To investigate biomechanical properties of the patella tension plating system in order to provide a theoretical basis for its clinical application. Methods Thirty-six models of artificial patella were randomly divided into 3 groups ( n=12 ) . After transverse patellar fractures were created in the models, the 3 groups were subjected to fixation respectively with Kirschner wire tension band ( tension band group ) , patellar concentrator ( concentrator group ) and patellar tension plate ( tension plate group ) . Next, 6 specimens from each group were placed on a mechanical testing machine to measure the fracture displacements after 100 cycles of simulated knee flexion and extension movements. Tensile strength tests were performed on the remaining 6 specimens in each group to measure the maximum load at fixation failure. Results The fracture displacement in the tension plate group ( 0. 40 ± 0. 26 mm ) was significantly smaller than those in the tension band group ( 2. 58 ± 0. 72 mm ) and in the concentrator group ( 1. 25 ± 0. 74 mm ) ( P < 0. 05 );the maximum load at fixation failure in the tension plate group ( 1 , 709 ± 206 N ) was significantly greater than those in the tension band group ( 581 ± 122 N ) and in the concentrator group ( 1, 003 ± 211 N ) ( P <0. 05 ) . Conclusion As a new treatment for patellar fractures, the patellar tension plating system can perform better in biomechanical properties than Kirschner wire tension band and patellar concentrator.
4.Study on a Core Outcome Set(COS)of Myasthenia Gravis in Clinical Trials of Chinese Medicine
Xinchen JI ; Baitong WANG ; Peng XU ; Dongmei ZHANG ; Qiaoying LI ; Tianying CHANG ; Zhiguo LÜ ; Jian WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(6):2180-2187
Objective To standardize the selection of clinical research outcome indicators,which can objectively evaluate the clinical efficacy or effect of traditional Chinese medicine in the treatment of myasthenia gravis.This study aims to standardize the construction of the core outcome set of clinical research of traditional Chinese medicine in the treatment of myasthenia gravis.Methods We followed the core outcome set development specification(COS-STAD)to carry out research,established a research working group,which set up a Delphi-method advisory group.Two graduate students of working group conducted a document research and meetings of patients to establishe an outcome set item pool of myasthenia gravis in clinical trials of Chinese medicine under the instruction of other members.With the questionnaire based on the content of item pool,we then carried out Delphi-method expert consultations and a consensus meeting.Results The core outcome set of clinical research on myasthenia gravis treated with traditional Chinese medicine included five outcome domains:endpoint outcome,myasthenia gravis symptom evaluation,medication evaluation,quality of life evaluation and safety outcome;Nine outcome measures:recurrence rate,incidence of hormone complications,incidence of crisis,QMGS scale(MGFA quantitative myasthenia gravis score),daily activity scale of MG patients(ADL),analysis of immunosuppressant dosage,analysis of glucocorticoid dosage,analysis of cholinesterase inhibitor dosage,and incidence of adverse events.Conclusion The five outcome domains and nine outcome measures included in the core outcome set can be used as outcome options for the efficacy evaluation of myasthenia gravis clinical research.