ObjectiveUsing SYRCLE tool (the SYstematic Review Centre for Laboratory animal Experimentation) to evaluate the risk of bias of animal studies in stroke field published in Chinese journals, identify problems of these studies in design, implementation and measurement, in order to provide references for improving the quality of animal studies in China. MethodsWe searched databases including CBM, VIP, CNKI and WanFang Data from inception to December 31st, 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included animal studies using SYRCLE tool developed by the National Centre for the Replacement, Refinement and Reduction of Animals in Research. ResultsA total of 582 studies were included. The assessment results showed that the number of reported items with "Low Risk" in SYRCLE, which have 22 items, reported in >50% of the 4 items and in <30% the 16 items in articles of animals experiments. More than 99% of the studies fulfilled the 3 items and more than 17% of the articles to meet the 10 items while less than 1% of the documents met the 17 items. The quality of studies increased excepted the period of 2010 to 2014. The methodological quality of animal experiments presented a trend of increasing and no significant differences were found in CSCD indexed or not. ConclusionThe methodological quality of animal experiments of stroke is poor in China in terms of the selection bias, implementation bias, measurement bias, withdraw bias and reporting bias.
ObjectiveTo evaluate the clinical therapeutic effect of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder superior labrum anterior posterior (SLAP) lesions with Meta-analysis. MethodsThe databases such as PubMed, EMbase, the Cochrane Library (Issue 3, 2014), CBM, VIP and CJFD (from the establishment time of databases to December 2014) were searched to collect all randomized controlled trials (RCT) on the clinical effectiveness of biceps tendon tenotomy and fixation versus biceps tendon repair for shoulder SLAP lesions. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 5.0 software. ResultsThree RCT were included. Among the total 137 patients involved, Meta-analysis showed that, compared with the biceps tendon repair group, the biceps tenotomy group had superior amount in the UCLA score [WMD=3.43, 95%CI (2.29, 4.56), P<0.000 01], the shoulder pain [WMD=1.18, 95%CI (0.30, 2.05), P=0.009], function [WMD=0.96, 95%CI (0.51, 1.41), P<0.000 1] and satisfaction [WMD=1.16, 95%CI (0.31, 2.01), P=0.007] with significant differences. But there were no significant differences between the two groups in the shoulder flextion [WMD=0.10, 95%CI (-0.87, 1.06), P=0.84] and strength [WMD=0.13, 95%CI (-0.09, 0.35), P=0.25]. ConclusionBased on the current studies, the biceps tenotomy and fixation is superior to the biceps tendon repair in treating shoulder SLAP lesions. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCT are required to further evaluate the effects.
ObjectiveTo investigate the correlation of synovial fluid uric acid, the serum and synovial fluid interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α with knee osteoarthritis (KOA). MethodsThe clinical data of 130 patients with KOA treated between January and December 2013 and 30 patients with gouty arthritis (GA) treated at the same period were collected. The clinical symptoms, Western Ontario and McMaster Universities Osteoarthritis Index score, the serum and synovial fluid IL-1β, IL-6, and TNF-α, uric acid levels, radiographic joint stenosis score, and bone hyperplasia score of the patients were compared using t-test analysis and Spearman correlation analysis. ResultsIn the KOA group, the synovial fluid uric acid and joint stenosis score (r=0.31, P=0.037), bone hyperplasia score (r=0.38, P=0.027) were positively correlated; serum and synovial fluid uric acid gradient and hypnalgia were positively correlated (r=0.34, P=0.031); the synovial fluid IL-6 and joint stenosis score (r=0.33, P=0.029), bone hyperplasia score (r=0.37, P=0.032) were positively correlated; the synovial fluid IL-1β and joint stenosis score (r=0.39, P=0.023), bone hyperplasia score (r=0.34, P=0.034) were positively correlated; and the synovial fluid uric acid and IL-1β (r=0.26, P=0.003), IL-6 (r=0.21, P=0.016) were positively correlated. ConclusionSynovial uric acid, IL-1β and IL-6 play a role in the inflammatory progress of knee osteoarthritis.
ObjectiveTo investigate the surgical outcome of combined posterior and anterior approaches for the resection of thoracolumbar spinal canal huge dumbbell-shaped tumor. MethodsBetween January 2009 and March 2015, 12 patients with thoracolumbar spinal canal huge dumbbell-shaped tumor were treated by posterior approach and anterolateral approach through diaphragmatic crura and thoracoabdominal incision for complete resection. There were 9 males and 3 females, with an average age of 45 years (range, 30-65 years). The disease duration was 8-64 weeks (mean, 12.7 weeks). The tumor was located at T12, L1 in 6 cases, at L1, 2 in 5 cases, and at L2, 3 in 1 case. The tumor size ranged from 4.3 cm×4.0 cm×3.5 cm to 7.5 cm×6.3 cm×6.0 cm. According to tumor outside the spinal involvement scope and site and based on the typing of Eden, 5 cases were rated as type b, 2 cases as type d, 4 cases as type e, and 1 case as type f in the transverse direction; two segments were involved in 8 cases, and more than two segments in 4 cases. The degree of tumor excision, tumor recurrence, and the spine stability were observed during follow-up. The verbal rating scale (VRS) was used to evaluate pain improvement. ResultsThe average surgical time was 170 minutes (range, 150- 230 minutes); the average intraoperative blood loss was 350 mL (range, 270-600 mL). All incisions healed by first intention, and no thoracic cavity infection and other operation related complication occurred. Of 12 cases, 10 were histologically confirmed as schwannoma, and 2 as neurofibroma. The patients were followed up 6 months to 6 years (mean, 31 months). Neurological symptoms were significantly improved in all patients, without lower back soreness. The thoracolumbar X-ray film and MRI showed no tumor residue. No tumor recurrence, internal fixator loosening, scoliosis, and other complications were observed during follow-up. VRS at last follow-up was significantly improved to grade 0 (10 cases) or grade I (2 cases ) from preoperative grade I (2 cases), grade II (8 cases), and grade III (2 cases) (Z= —3.217, P=0.001). ConclusionCombined posterior approach and anterolateral approach through diaphragmatic crura and thoracoabdominal incision for complete resection of thoracolumbar spinal canal huge dumbbell-shaped tumor is feasible and safe, and can protect the stability of thoracolumbar spine and paraspinal muscle function. It can obtain satisfactory clinical result to use this method for treating the complex type of thoracolumbar spinal canal dumbbell-shaped tumor.