ObjectiveTo evaluate whether atrial fibrillation could predict poor outcomes in stroke patients receiving thrombolysis by meta-analysis. MethodsWe searched MEDLINE, the Cochrane Library and EMbase databases for cohort studies concerning the effect of atrial ribrillation on prognosis of stroke patients receiving thrombolysis up to March 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of nine retrospective cohort studies involving 6 313 patients were included. The results of meta-analysis showed that:atrial fibrillation could increase the risk of symptomatic intracerebral hemorrhage (OR=1.51, 95%CI 1.15 to 1.99, P=0.003) and mortality (OR=1.90, 95%CI 1.29 to 2.80, P=0.001) of ischemic stroke patients receiving thrombolysis; the early improvement rate (OR=0.74, 95%CI 0.60 to 0.90, P=0.002) and later improvement rate (OR=0.50, 95%CI 0.39 to 0.64, P<0.000 01) of the atrial fibrillation group were lower than that of the non-atrial fibrillation group. ConclusionAtrial fibrillation could be a risk factor of poor outcome in ischemic stroke patients receiving thrombolysis. Due to the limitation of quantity and quality of the included studies, large-scale, multi-central and high quality clinical studies are needed.
ObjectiveTo investigate the hemostasis effect of compression dressing therapy after total hip arthroplasty (THA). MethodThirty-four patients undergoing unilateral THA between December 2014 and March 2015 were randomly divided into observation group (compression dressing group, n=17) and control group (ordinary dressing group, n=17) . There was no significant difference in gender, age, height, weight, lesion hips, pathogeny, disease duration, and preoperative hemoglobin between 2 groups (P>0.05) . The total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, the hidden blood loss, the total blood transfusion volume, the number of patients receiving blood transfusion, and the related complications were compared between 2 groups. ResultsNo significant difference was found in operation time and hospitalization time between 2 groups (t=0.337, P=0.738; t=0.140, P=0.889) . The incisions healed by first intention in all patients. Six cases had incision subcutaneous hematoma in the control group, no incision subcutaneous hematoma occurred in the observation group (χ2=7.286, P=0.018) . No postoperative complications of wound superficial infection and venous thrombosis occurred in 2 groups. After operation, blood transfusion was given in 1 case of observation group and 7 cases of control group, showing significant difference (χ2=5.885, P=0.039) , and the total blood transfusion volume was 600 mL and 3 200 mL, respectively. There was no significant difference in preoperative blood volume and intraoperative blood loss between 2 groups (P>0.05) , but the total blood loss theoretical value, the postoperative drainage volume, the visible blood loss, and the hidden blood loss in observation group were significantly less than those in control group (P<0.05) . ConclusionsThe compression dressing should be performed after THA because it can effectively reduce postoperative blood loss and the incidence of wound hematoma.
ObjectiveTo investigate the current situation of randomized controlled trials (RCTs) of thrombin like enzyme research and the ability to provide a reliable basis for the clinical practice. MethodsRCTs identified from four Chinese databases up to the year 2012 were assessed according to international standard, including SinoMed (1978-2012), CNKI (1979-2012), Wanfang Data (1986-2012), and VIP (1989-2012). ResultsA total of 2358 articles were searched and 53 RCTs were identified. The results showed that the quality of these articles was not high enough to meet the needs of clinical practice in China. ConclusionIn China, current quantity and quality of RCTs of thrombin like enzyme can not meet the need of clinical practice. In order to improve the prevention and treatment of hemorrhagic diseases, and surgical bleeding, especially for patients lacking clotting factor, more high-quality RCTs are required.
ObjectiveTo investigate the effectivness of the clinging lesser trochanter osteotomy with the Wagner cone in total hip arthroplasty (THA) for Crowe type ⅠV developmental dysplasia of the hip (DDH) in adult. MethodsBetween November 2009 and September 2012, 7 female patients (9 hips) with Crowe type ⅠV DDH were treated by THA procedures of clinging lesser trochanter osteotomy with Wagner cone, aged 24-62 years (mean, 42 years). All patients experienced severe pain and claudication. The left hip was involved in 2 cases, the right hip in 3 cases, and bilateral hips in 2 cases. The Harris score of involved hip was 50.00±7.04. The both limps were discrepancy with an average length difference of 3.4 cm (range, 3-4 cm). The results of Trendelenburg sign were positive. X-ray films showed high complete dislocation of the involved hips. ResultsThe incisions healed by first intention. There was no complication such as infection, dislocation, prosthesis loosening, neurovascular injury. The average follow-up was 36.4 months (range, 25-48 months). Pain and claudication were improved and all patients could restore to work. The Harris score was improved to 83.42±6.47, showing significant difference when compared with preoperative score (t=8.90, P=0.00). The results of Trendelenburg sign were negative. X-ray films showed that all patients got a bony union at osteotomy site of greater trochanter at 3-6 months after operation. And the interface between prosthesis and bone was stable. There was no prosthesis loosening or sinking during the follow-up. ConclusionClinging lesser trochanter osteotomy with Wagner cone could be an option to shorten the femur in THA for patients with Crowe type ⅠV DDH. It is effective in decreasing the risk of neurovascular injury.