Objective To investigate the effectiveness of joystick technique assisted closed reduction and cannulated screw fixation in the treatment of femoral neck fracture. Methods Seventy-four patients with fresh femoral neck fractures who met the selection criteria between April 2017 and December 2018 were selected and divided into observation group (36 cases with closed reduction assisted by joystick technique) and control group (38 cases with closed manual reduction). There was no significant difference in gender, age, fracture side, cause of injury, Garden classification, Pauwels classification, time from injury to operation, and complications (except for hypertension) between the two groups (P>0.05). The operation time, intraoperative infusion volume, complications, and femoral neck shortening were recorded and compared between the two groups. Garden reduction index was used to evaluate the effect of fracture reduction, and score of fracture reduction (SFR) was designed and was used to evaluate the subtle reduction effect of joystick technique. ResultsThe operation was successfully completed in both groups. There was no significant difference in operation time and intraoperative infusion volume between the two groups (P>0.05). All patients were followed up 17-38 months, with an average of 27.7 months. Two patients in the observation group received joint replacement due to failure of internal fixation during the follow-up, and the other patients had fracture healing. Within 1 week after operation, the Garden reduxtion index of the observation group was better than the control group; the SFR score of the observation group was also higher than that of the control group; the proportion of femoral neck shortening within 1 week after operation and at 1 year after operation in the observation group were lower than those in the control group. The differences of the above indexes between the two groups were significant (P<0.05). ConclusionThe joystick technique can improve the effectiveness of closed reduction of femoral neck fractures and reduce the incidence of femoral neck shortening. The designed SFR score can directly and objectively evaluate the reduction effect of femoral neck fracture.
Objectives To investigate the correlation between blood total cholesterol (TC) and prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) and to provide references for clinical treatment and prognosis assessment. Methods We included 232 ISSNHL patients with total deafness in Wenzhou Central Hospital from June 2015 to March 2017 using a prospective cohort design. Recording information including age, gender, hypertension, diabetes mellitus, vertigo, level of blood total cholesterol (TC), level of triglyceride (TG), level of low-density lipoprotein (LDL-C) and LDL/HDL ratio (LDL-C/HDL-C) were collected. Correlation between the prognosis of ISSNHL and blood total cholesterol were analyzed by univariable and multivariable logistic regression analysis. Results The clinical effective rate of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L was higher than that of patients with TC lower than 5.2 mmol/L (univariable: RR=6.49, 95%CI 3.16 to 13.30, P<0.001; multivariable-adjusted covariates: RR=6.15, 95%CI 2.66 to 14.3,P<0.001) with significant difference. No significant difference was found between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (univariable: RR=1.02, 95%CI 0.52 to 2.00,P=0.960; multivariable-adjusted covariates: RR=1.61, 95%CI 0.55 to 4.73, P=0.386). Gender-specific analysis showed for both male and female groups, the effective rates of patients with TC ranging from 5.2 mmol/L to 6.2 mmol/L were significantly higher than those of patients with TC lower than 5.2 mmol/L. There was no significant difference between patients with TC lower than 5.2 mmol/L and patients with TC higher than 6.2 mmol/L (P>0.05) in either male group or female group. Conclusion The current study suggests that patients with levels of TC ranging from 5.2 mmol/L to 6.2 mmol/L predicts the best prognosis.
ObjectiveTo systematically review the epidemiological characteristics and economic burden of traumatic spinal cord injury (SCI) in China.MethodsPubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect studies of the epidemiological characteristics and economic burden of SCI in China from January 1st, 1978 to August 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 32 studies were included. The results of meta-analysis showed that: the prevalence of SCI in China was 37 persons per million per year (95%CI 21 to 53), with the average age ranged from 34.7 to 54.4 years. Men had a higher risk of SCI than Women. Motor vehicle collisions (MVCs) and falls were the two main causes of SCI. The neurological injury levels were varied, ASIA grade A was the most common and grade E was the least.ConclusionCurrent evidence shows that there is a high prevalence of SCI in China with heavy social and medical burden. The main reason of SCI is motor vehicle collisions and falls. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
ObjectiveTo systematically review the prevalence of low back pain in adult population in China, so as to provide a reliable scientific basis for further scientific research and social decision-making of low back pain.MethodsPubMed, EMbase, VIP, WanFang Data and CNKI databases were electronically searched to collect the studies on prevalence of low back pain in adult population in China from inception to October 28, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, systematic review was performed.ResultsA total of 16 studies were included. The results showed that: significant heterogeneity had been observed among the different studies. The previous affected prevalence was 7.21% to 39.0%, annual prevalence was 20.88% to 29.88%, and time period prevalence was 6.11% to 28.5%. Six studies reported the different prevalence between genders, in which only one study found a little higher prevalence in male, and the other five found higher prevalence in females than males.ConclusionsCurrent evidence shows that there is significant heterogeneity in studies on prevalence of low back pain among adults in China, and all of them are data from a single province or region. It is suggested that a national prospective survey should be conducted to provide more accurate epidemiological data.