ObjectiveTo systematically review the efficacy of transdermal fentanyl versus oral morphine for moderate/severe cancer pain. MethodsDatabases such as The Cochrane Library (Issue 1, 2014), PubMed, Web of Science, CNKI, VIP, CBM and WanFang Data were searched for randomized controlled trials (RCTs) on the efficacy of transdermal fentanyl versus oral morphine for moderate/severe cancer pain up to January 2014. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1.0 software. ResultsA total of 35 RCTs involved 3 406 patients were included. The results of meta-analysis showed that, there was no significant difference in effectiveness between transdermal fentanyl and oral morphine for moderate/severe cancer pain (OR=1.00, 95%CI 0.80 to 1.27, P=0.99). Compared with oral morphine, transdermal fentanyl was better in lowering the incidences of constipation, nausea and vomiting, lethargy and urinary retention; but transdermal fentanyl increased the incidences of skin rashes and itch (P < 0.05). ConclusionTransdermal fentanyl is as effective as oral morphine in the treatment of moderate/severe cancer pain, and transdermal fentanyl causes less side effects. Due to poor quality of the included studies, the above conclusion should be verified by further conducting more high quality RCTs.
In this paper, we propose an image-based key frame gating method to reduce motion artifacts in intravascular ultrasound (IVUS) longitudinal cuts. The artifacts are mainly caused by the periodic relative displacement between blood vessels and the IVUS catheter due to cardiac motion. The method is achieved in four steps as following. Firstly, we convert IVUS image sequences to polar coordinates to cut down the amount of calculation. Secondly, we extracted a one-dimensional signal cluster reflecting cardiac motion by spectral analysis and filtering techniques. Thirdly, we designed a Butterworth band-pass filter for filtering the one-dimensional signal clusters. Fourthly, we retrieved the extremes of the filtered signal clusters to seek key frames to compose key-frames gated sequences. Experimental results showed that our algorithm was fast and the average frame processing time was 17ms. Observing the longitudinal viewpictures, we found that comparing to the original ones, the gated sequences had similar trend, less saw tooth shape, and good continuity. We selected 12 groups of clinical IVUS sequences[images (876±65 frames), coronary segments length (14.61±1.08 mm)] to calculate vessel volume, lumen volume, mean plaque burden of the original and gated sequences. Statistical results showed that, on one hand, both vessel volume and lumen volume measured of the gated sequences were significantly smaller than those of the original ones, and there was no significant difference on mean plaque burden between original and gated sequences, which met the need of the clinical diagnosis and treatment. On the other hand, variances of vessel area and lumen area of the gated sequences were significantly smaller than those of the original sequences, indicating that the gated sequences would be more stable than the original ones.
ObjectiveTo evaluate the effectiveness of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of medial knee osteoarthritis with varus. MethodsBetween December 2013 and June 2015, 61 patients with medial knee osteoarthritis with varus were treated by arthroscopic debridment in 32 cases (group A) and by proximal fibular osteotomy combined with arthroscopic debridement in 29 cases (group B). No significant difference was found in gender, age, side, disease duration, OA stage, visual analogue scale (VAS) score, and knee society score (KSS) between 2 groups (P > 0.05). The clinical outcome was evaluated by VAS score and KSS score at 1 week, 3 months, and 12 months after operation. ResultsThe patients in 2 groups were followed up 12 months. All incisions healed by first intention. There was no significant difference in complication incidence between groups A and B (0 vs. 3.4%; χ2=0.723, P=0.432). The VAS scores were significantly decreased at 1 week, 3 months, and 12 months after operation when compared with preoperative score in 2 groups (P < 0.05). The VAS score of group A was significantly lower than that of group B at 1 week after operation (P < 0.05), but the VAS score of group A was significantly higher than that of group B at 3 months, and 12 months after operation (P < 0.05). The knee function was obviously improved in 2 groups, and the KSS scores at 1 week, 3 months and 12 months after operation were significantly better than preoperative score (P < 0.05). The KSS score of group A was significantly lower than that of group B at 3 months, and 12 months after operation (P < 0.05). ConclusionProximal fibular osteotomy combined with arthroscopic debridement can treat knee malalignment and disease in knee, it is an effective and safe method to treat the medial knee osteoarthritis with varus.