ObjectiveTo explore the practice of the evidence-based treatment strategy for cervical spinal cord injury. MethodsOne patient with cervical spinal cord injury was admitted to our hospital on January 3, 2013. We obtained medical evidences by searching databases and regulated the best treatment after evaluating the patient's comprehensive conditions. And then, the whole treatment strategy was fully implemented. Finally, the consequent results were evaluated. ResultsThe evidence-based medicine showed that the therapeutic targets were to save the residual function, prevent complications, and promote the recovery of neural function. Based on the real-time conditions of patient, we developed and practiced the evidence-based comprehensive rehabilitation programs, including absolute rest in bed, high-dose steroids, neurotrophic drugs, Chinese medicine rehabilitation and prevention of complications. After a follow-up of half a year, the patient obtained a good curative effect. The patient was saved from paralyzing. Moreover, the patient restored the capacity of standing, walking and a certain level of self-care ability. ConclusionFor the cervical spinal cord injury, treatment decision based on evidence-based medicine is more scientific, and it can ensure maximum benefit for the patients. Therefore, it is worthy of popularizing.
ObjectiveTo evaluate the efficacy and safety of bisphosphonates in preventing and treating glucocorticoid induced osteoporosis. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) related bisphosphonates for the prevention and treatment of glucocorticoid induced osteoporosis from inception to January 2016. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 20 RCTs were included, which involved 2 330 patients. The results of meta-analysis showed that, compared with the placebo group, the bisphosphonates group could significantly increase the bone mineral density (BMD) at lumbar and femoral neck (MD=3.70, 95%CI 2.65 to 4.75, P<0.000 01; MD=2.18, 95%CI 1.30 to 3.06, P<0.000 01), but the bisphosphonates group could not decrease the incidence rates of vertebral fracture or non-vertebral fracture (OR=0.66, 95%CI 0.38 to 1.16, P=0.15; OR=0.73, 95%CI 0.42 to 1.28, P=0.28). There were no significant differences in the incidence rates of total adverse reactions and total severe adverse reactions between the two groups (OR=0.89, 95%CI 0.62 to 1.28, P=0.53; OR=0.93, 95%CI 0.62 to 1.39, P=0.72). ConclusionCurrent evidence shows that, compared with placebo, bisphosphonates canld effectively prevent and treat the decrease of bone mineral density of glucocorticoid induced osteoporosis, not decrease the incidence of fracture, but not increase the incidence of adverse reactions.