Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The ...Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.展开更多
目的:观察背部推拿手法对亚急性衰老并免疫功能低下家兔血清免疫细胞与免疫球蛋白的影响。方法:将36只家兔按随机数字表法分为空白组、模型组、药物组、推拿组4组,采用腹腔注射环磷酰胺方法造模,观察各组家兔干预前后体质量差值、血清...目的:观察背部推拿手法对亚急性衰老并免疫功能低下家兔血清免疫细胞与免疫球蛋白的影响。方法:将36只家兔按随机数字表法分为空白组、模型组、药物组、推拿组4组,采用腹腔注射环磷酰胺方法造模,观察各组家兔干预前后体质量差值、血清免疫细胞分化簇3(cluster of differentiation,CD3^+)、辅助性T细胞(cluster of differentiation 4,CD4^+)、细胞毒性T细胞(cluster of differentiation 8,CD8^+)、自然杀伤细胞(atural killer cell, NK)含量、外周血免疫球蛋白M(Immunoglobulin M,IgM)、免疫球蛋白G(Immunoglobulin G,IgG)含量的变化。结果:与空白组比较,模型组家兔体质量差值小,呈显著性差异;与模型组比较,推拿组和药物组家兔体质量差值大,呈显著性差异;与空白组比较,模型组家兔血清免疫细胞CD8^+、NK含量增加,CD3^+、CD4^+含量降低,呈显著性差异;与模型组比较,推拿组和药物组血清免疫细胞CD3^+、CD4^+、NK含量增加,CD8^+含量降低,呈显著性差异,与空白组比较,模型组家兔外周血IgM、IgG含量降低,呈显著性差异;与模型组比较,推拿组和药物组外周血IgM、IgG含量增加,呈显著性差异。结论:采用腹腔注射环磷酰胺方法能够制造免疫抑制动物模型,背部推拿手法能够改善和调节机体免疫功能,其作用机制可能是通过调节机体的细胞免疫和体液免疫功能来实现的。展开更多
基金2022 Key Specialty Construction Project of Traditional Chinese Medicine:Traditional Chinese Orthopedics and Traumatology Department (No.962042)2020 Regional Traditional Chinese Medicine (Orthopedics and Traumatology)Diagnosis and Treatment Center (Jin Wei Zhong[2020]No.5)。
文摘Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.
文摘目的:观察背部推拿手法对亚急性衰老并免疫功能低下家兔血清免疫细胞与免疫球蛋白的影响。方法:将36只家兔按随机数字表法分为空白组、模型组、药物组、推拿组4组,采用腹腔注射环磷酰胺方法造模,观察各组家兔干预前后体质量差值、血清免疫细胞分化簇3(cluster of differentiation,CD3^+)、辅助性T细胞(cluster of differentiation 4,CD4^+)、细胞毒性T细胞(cluster of differentiation 8,CD8^+)、自然杀伤细胞(atural killer cell, NK)含量、外周血免疫球蛋白M(Immunoglobulin M,IgM)、免疫球蛋白G(Immunoglobulin G,IgG)含量的变化。结果:与空白组比较,模型组家兔体质量差值小,呈显著性差异;与模型组比较,推拿组和药物组家兔体质量差值大,呈显著性差异;与空白组比较,模型组家兔血清免疫细胞CD8^+、NK含量增加,CD3^+、CD4^+含量降低,呈显著性差异;与模型组比较,推拿组和药物组血清免疫细胞CD3^+、CD4^+、NK含量增加,CD8^+含量降低,呈显著性差异,与空白组比较,模型组家兔外周血IgM、IgG含量降低,呈显著性差异;与模型组比较,推拿组和药物组外周血IgM、IgG含量增加,呈显著性差异。结论:采用腹腔注射环磷酰胺方法能够制造免疫抑制动物模型,背部推拿手法能够改善和调节机体免疫功能,其作用机制可能是通过调节机体的细胞免疫和体液免疫功能来实现的。
