ObjectiveTo evaluate the effect of surgical and traditional treatments for multiple rib fractures through systematic review and meta-analysis.MethodsCNKI, Wanfang, VIP, PubMed, OVID, EMbase, The Cochrane Library, Thieme and Springer Link database for information from inception to July 2019 were screened by computer. Randomized controlled trials (RCTs) of surgical and conventional methods for the treatment of multiple rib fractures were screened, assessed and extracted. RevMan 5.3 software was used for meta-analysis.ResultsTwelve studies were included, including 1 039 patients. There were 512 patients in the operation group and 527 patients in the traditional treatment group. The results of meta-analysis showed that there was a significant difference between the two groups in the incidence of pneumonia (RR=0.41, 99%CI 0.29 to 0.58, P<0.000 01), incidence of atelectasis (RR=0.24, 99%CI 0.06 to 0.94, P=0.007), duration of mechanical ventilation (SMD=–2.64, 99%CI –4.38 to –0.91, P<0.000 1), duration of intensive care unit stay (SMD=–1.33, 99%CI –2.26 to –0.40, P=0.000 2), duration of hospital stay (SMD=–2.25, 99%CI –3.30 to –1.19, P<0.000 01)and incidence of chest wall deformity (RR=0.08, 99%CI 0.04 to 0.17, P<0.000 01). There was no significant difference between the two groups in the hospital mortality (RR=0.75, 99%CI 0.23 to 2.46, P=0.53), incidence of tracheostomy (RR= 0.69, 99%CI 0.39 to 1.21, P=0.09), ventilator support rate (RR=0.65, 99%CI 0.41 to 1.05, P=0.02) and chest drainage time (SMD=–2.58, 99%CI –6.41 to 1.25, P=0.08).ConclusionSurgical treatment of multiple rib fractures can reduce pulmonary complications, shorten hospital stay, and reduce the incidence of chest wall deformity, which is conducive to rapid recovery and improves quality of life.
Objective To understand the new characteristics of clinical symptoms of patients with mild COVID-19 during the prevalence of SARS-CoV-2 Omicron, and provide basis for better prevention and treatment of COVID-19.Methods A cross-sectional retrospective study was conducted with WeChat questionnaire among medical staff with COVID-19 recently, who come from the Third Affiliated Hospital of Chongqing Medical University and The Second Affiliated Hospital of Army Medical University.Results A total of 630 valid questionnaires was received. 99.2% of infected people had been vaccinated against COVID-19. 2.4% of infected persons developed pneumonia and 2.1% were hospitalized. The most common symptoms after infection were coughing (89.7%), fever (83.0%), fatigue (84.1%), headache and dizziness (75.7%), muscle soreness (72.7%), sore throat (62.1%), nasal congestion and runny nose (60.6%), expectoration (71.6%), anorexia (58.0%) and taste loss (40.2%). The incidence of gastrointestinal symptoms and cardiovascular symptoms was relatively low (17.8% and 31.0% respectively). The severity of self-reported symptoms of most infected persons was moderate or severe. The proportion of serious symptoms reported was coughing (23.8%), sore throat (27.0%), headache and dizziness (17.9%). The severity of symptoms reported by young group (<35 years old) was significantly higher than that of older group (>35 years old). Fever was the highest at 38 to 39 ℃ (52.4%). 77.0% of fever sustained for 1 to 3 days. At the time of investigation, the viral detection turned negative in 60.6% of infected people, and the time of turning negative was mostly 7 to 10 days. More than half of the infected persons still had different symptoms, among which cough (43.7%) and fatigue (23.8%) were the most common.Conclusions Most subjects with mild COVID-19 infection have obvious upper respiratory tract and systemic symptoms, the most prominent is the high incidence of cough, which has become a new feature of omicron infection. And most of the infected people have moderate to severe symptoms, and the younger ones have more severer symptoms.