ObjectiveTo systematically review the effectiveness of double-bundle versus single-bundle for arthroscopic transtibial reconstruction of posterior cruciate ligament (PCL). MethodsWe searched PubMed, The Cochrane Library, EMbase, VIP and WanFang Data to collect randomized controlled trials (RCTs) of PCL reconstruction treated with double-bundle versus single-bundle arthroscopic transtibial technique. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies, and then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 4 RCTs involving 186 patients were included. The results of meta-analysis showed that double-bundle was superior to single-bundle in Lysholm score (MD=2.17, 95%CI 0.29 to 4.05, P=0.02), Tegner score (MD=0.62, 95%CI 0.09 to 1.16, P=0.02), IKDC objective score (A:RR=1.57, 95%CI 1.09 to 2.26, P=0.02; A+B:RR=1.15, 95%CI 1.01 to 1.32, P=0.04). However, there was no significant difference in the KT-1000 posterior between both groups (MD=-0.65, 95%CI -3.29 to 1.99, P=0.63). ConclusionThe current evidence shows that the double bundle arthroscopic transtibial is superior to the single bundle PCL reconstruction. Due to the limited quality and quantity of the included studies, more high quality studies with large sample-size are needed to validate the conclusion.
ObjectiveTo systematically review the efficacy of at the fracture level (AFL) versus cross the fracture level (CFL) short-segment pedicle screw fixation for thoracolumbar fractures. MethodsWe electronically search PubMed, The Cochrane Library (Issue 8, 2015), EMbase, CBM, CNKI, VIP and WanFang data to collect randomized controlled trials (RCTs) of AFL versus CFL short segment pedicle screw fixation for thoracolumbar fractures from inception to Aug. 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 11 RCTs involving 730 patients were included. The results of meta-analysis indicated that: compared with the CFL group, the AFL group had more blood loss (MD=9.8, 95%CI 7.40 to 12.20), less implant failure rate (RR=0.19, 95%CI 0.07 to 0.48), lower long term postoperative VAS score of thoracolumbar pain (MD=-1.20, 95%CI -1.85 to -0.56), higher correction in short term postoperative kyphotic Cobb angle (MD=3.56, 95%CI 2.25 to 4.87), smaller value in long term postoperative kyphotic Cobb angle and its loss of correction (MD=-3.95, 95%CI -7.78 to -0.12; MD=-4.65, 95%CI -6.91 to -2.40), smaller degree of anterior vertebral height compression in short and long term postoperative (MD=-3.51, 95%CI -5.23 to -1.80; MD=-8.28, 95%CI -12.22 to -4.33), better result in long term postoperative anterior vertebral height and its loss of correction (MD=8.00, 95%CI 3.85 to 12.15; MD=-6.06, 95%CI -7.68 to -4.44). There were no significant differences between two groups regarding operation time, infectious complications and short term postoperative kyphotic Cobb angle (MD=0.11, 95%CI -5.36 to 5.57; RR=0.55, 95%CI 0.11 to 2.85; MD=-0.66, 95%CI -2.19 to 0.87). ConclusionCurrent evidence shows that AFL short-segment pedicle screw fixation for thoracolumbar fractures is superior to CFL fixation. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the effects of autograft versus allograft tendon for posterior cruciate ligament single-bundle reconstruction. MethodsDatabases including PubMed, The Cochrane Library (Issue 3, 2015), EMbase, CBM, CNKI, VIP and WanFang Data were searched from inception to August 2015, to collect randomized controlled trials, clinical controlled trials and cohort studies of autograft tendon versus allograft tendon for posterior cruciate ligament single-bundle reconstruction. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 7 cohort studies involving 376 patients who had undergone the arthroscopic transtibial single-bundle PCL reconstruction were included. The results of meta-analysis indicated that no significant differences were found between the autograft group and the allograft group in Lysholm score (MD=-0.54, 95%CI -2.36 to 1.27, P=0.56), Tegner score (MD=-0.04, 95%CI -0.88 to 0.80, P=0.93), IKDC objective score (OR=1.31, 95%CI 0.68 to 2.53, P=0.41) and posterior translation side-to-side difference (SMD=-0.15, 95%CI -0.37 to 0.07, P=0.18). However, patients in the allograft group had a longer duration of fever when compared with the autograft group patients (MD=-3.55, 95%CI-5.61 to -1.49, P=0.0007). ConclusionCurrent evidence shows that autograft tendon and allograft tendon tibial have similar effects in PCL single-bundle reconstruction, though there is a longer duration of fever in patients with allograft. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigate the causes of chronic cough in Chongqing City and assess the efficacy of specific therapy. Methods A total of 233 consecutively non-selected referred patients ( 136 females) whose cough duration more than eight weeks were studied. Their age[ median ( range) ] was 44. 5( 15-78) yrs and cough duration was 2. 6 ( 0. 2-30) yrs. They were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association and American College of Chest Physicians. The etiological diagnosis was made according to clinical manifestations, lab examinations, and response to specific therapy. The effects was assessed four weeks after the drug withdraw. Results The cause of chronic cough was confirmed in 216 patients ( 92. 7% ) . Seventeen patients( 7. 3% ) had not been definitely diagnosed. Cough due to a single cause was found in 163 patients ( 75. 45% ) , and due to multiple causes in 53 patients ( 24. 53% ) . The causes included upper airway cough syndrome ( UACS) in 127 patients( 44. 4% ) , cough variant asthma ( CVA) in 73 patients( 25. 5% ) , gastro-esophageal reflux cough ( GERC) in 26 patients( 9. 1%) , postinfectious cough and angiotensin converting enzyme ( ACE) inhibitor-induced cough in 6 patients( 2. 1% ) , atopic cough in 5 patients( 1. 7% ) , chronic bronchitis in 3 patients ( 1. 0% ) , respectively. After specific therapy based on diagnosis, cough cured in 59 patients ( 25. 3% ) , and alleviated in 114 patients ( 49. 3% ) , no response in 40 patients( 17. 1% ) . Conclusion The causes of chronic cough in different areas maybe variant. UACS, CVA and GREC are the main causes of chronic cough in Chongqing City. Specific therapy is effective in majority of patients with chronic cough.