Meta-analysis of the clinical efficacy of the Gamma3 nail vs Gamma3U-blade system in the treatment of intertrochanteric fractures

BACKGROUND The traditional Gamma3 nail is a mainstream treatment for femoral intertrochanteric fractures.Literature reports that the Gamma3U-blade system can increase the stability of the Gamma3 nail and reduce complication incidence.However,comparative studies between the Gamma3U-blade and Gamma3 systems are limited;hence,this meta-analysis was performed to explore the clinical efficacy of these two surgical methods.AIM To investigate the clinical efficacy of Gamma3 and Gamma3 U-blade for intertrochanteric fractures.METHODS A computerized search for Chinese and English literature published from 2010 to 2022 was conducted in PubMed,Cochrane,CNKI,Wanfang,and VIP databases.The search keywords were gamma 3,gamma 3 U blade,and intertrochanteric fracture.Additionally,literature tracking was performed on the references of published literature.The data were analyzed using Revman 5.3 software.Two individuals checked the inputs for accuracy.Continuous variables were described using mean difference and standard deviation,and outcome effect sizes were expressed using ratio OR and 95%confidence interval(CI).High heterogeneity was considered at(P<0.05,I2>50%),moderate heterogeneity at I2 from 25%to 50%,and low heterogeneity at(P≥0.05,I2<50%).RESULTS Following a comprehensive literature search,review,and analysis,six articles were selected for inclusion in this study.This selection comprised five articles in English and one in Chinese,with publication years spanning from 2016 to 2022.The study with the largest sample size,conducted by Seungbae in 2021,included a total of 304 cases.Statistical analysis:A total of 1063 patients were included in this meta-analysis.The main outcome indicators were:Surgical time:The Gamma3U blade system had a longer surgical time compared to Gamma3 nails(P=0.006,I2=76%).Tip-apex distance:No statistical significance or heterogeneity was observed(P=0.65,I2=0%).Harris Hip score:No statistical significance was found,and low heterogeneity was detected(P=0.26,I2=22%).Union time:No statistical significance was found,and high heterogeneity was detected(P=0.05,I2=75%).CONCLUSION Our study indicated that the Gamma3 system reduces operative time compared to the Gamma3 U-blade system in treating intertrochanteric fractures.Both surgical methods proved to be safe and effective for this patient group.These findings may offer valuable insights and guidance for future surgical protocols in hip fracture patients.

Impact of twice-a-day transcranial direct current stimulation intervention on cognitive function and motor cortex plasticity in patients with Alzheimer's disease

Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer's disease(AD),and some studies suggest a close relationship between cognition and plasticity.However,the clinical benefits of transcranial direct current stimulation(tDCS)in patients still need to be evaluated.Aims This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity.Methods 124 patients with AD were randomly assigned to active tDCS(n=63)or sham tDCS(n=61).The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks(5 days per week,2 days off).The Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive(ADAS-Cog)were used for cognition evaluation at baseline,week 2 and week 6.The cortical plasticity was represented by motor-evoked potential(MEP)measured with an electromyogram.Results The results showed thatmultiplecourses of active tDcS can improve the cognitive functions of patients with AD,especially in the memory domain(word recall,recall of test instructions and word recognition).In addition,the damaged MEP level was enhanced following active treatment.In the active tDCS group,the improvements in ADAS-Cog total and subitem(word recall and word recognition)scores were negatively correlated with the enhancement of MEP.Conclusions Our research indicates for the first time that twice-a-day tDS may improve the cognitive function of patients with AD.This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity,which warrants mechanistic investigations of the relationship between cognition and plasticity in the future.

The Factors Affecting the Efficacy of α-interferon in the Treatment of(CHB)

Objective:To analyze the factors affecting the efficacy ofα-interferon in the treatment of chronic hepatitis B(CHB).Methods:A total of 100 patients with CHB treated in our hospital from June 2018 to June 2019 were selected.All patients were treated withα-interferon to evaluate the efficacy,and the factors affecting the effect ofα-interferon on CHB were analyzed.Results:After treatment,54 patients fully responded and 46 patients did not;the levels of white blood cells,HBV DNA,and HBsAg in the complete response group were lower than those in the incompletely response group,and the differences were statistically significant(P<0.05);Multivariate logistic regression analysis found that serum HBV DNA and HBsAg were independent factors affecting the efficacy ofα-interferon in the treatment of CHB(OR>1,P<0.05).Conclusion:Serum HBV DNA and HBsAg are risk factors that affect the efficacy ofα-interferon in the treatment of CHB.Monitoring the changes of serum HBV DNA and HBsAg levels has important clinical significance for predicting the efficacy.

The Infuence of Neuman Theory Based Stress Management on the Level of Benefit Finding in Postoperative Breast Cancer Patients

Objective:To explore the influence of stress management program based on Neuman theory on the 1eve1 of beneft finding in postoperative breast cancer patients.Methods:Using convenient sampling method,60 postoperative breast cancer patients in the tumor ward of a hospital were selected and randomly assigned into observation group(n=30)and control group(n=30).The control group adopts the couventional postoperative psychological mursing program,and the observation group adopts the stress management program based on Neuman theory for psychological nursing.The differences in benefit finding,life quality,and medical coping strategies between the two groups before and after nursing were compared.Results:After the implementation of the two nursing programs,the 1level of benefit finding,life quality,and medical coping strategies of patients in the observation group were higher than those in the control group(t1=3.996,t2=4.662,t3=4.113,P<0.05);there was a statistically significant difference in the level of benefit finding,life quality,and medical coping strategies of patients before and after the implementation of the two nursing programs(P<0.05).Conclusions:The stress management strategy based on Neuman theory can improve patients'state of psychological stress coping,play a positive role in guiding the psychology of patients after breast cancer surgery,and can be used as a reference for the psychological nursing program of postoperative patients.

Practice and Effect Evaluation of Drug Reorganization in Patients with Chronic Obstructive Pulmonary Disease

Objective:To explore the feasibility of drug reorganization in clinical practice through the drug reorganization service of clinical pharmacists for patients with chronic obstructive pulmonary disease(COPD)in respiratory and critical care department,and to evaluate the effect of the service in multiple dimensions.Methods:a total of 100 patients with COPD admitted from January to July 2021 were randomly divided into two groups with 50 patients in each group.One group was treated with drug reforming intervention and the other group was not treated with intervention.Statistics and data analysis were carried out from three aspects:patient compliance,satisfaction and medication deviation.Results:(1)compliance:48h after admission,there was no significant difference between the two groups(P>0.05);According to the data statistics on the day of discharge and after one month,the compliance of the two groups was statistically significant(P<0.05),which was higher in the reorganization group.(2)Satisfaction:There was no significant difference between the two groups after admission.However,after drug reforming intervention by pharmaceutical staff,the results of reforming group were better and statistically significant(P<0.05).(3)Medication deviation:There were 50 deviations in the reorganization group,of which drug omission accounted for 52%,which was the main factor.After communicating with clinicians,the clinicians5 acceptance rate of the reorganization scheme reached 94.12%.Conclusion:The implementation of drug reorganization service can effectively prevent the medication deviation of COPD patients,save the cost of patients,improve the satisfaction and compliance,and ensure the medication safety of patients.

Clinical Study of Gefitinib for Non-Small Cell Lung Cancer

Objective:To evaluate the clinical efficacy of gefitinib in non-small cell lung cancer.Methods:A total of 45 patients with non-small cell lung cancer who received treatment in Taizhou Second People's Hospital from January 2018 to January 2020 were selected as the subjects in this study,in which all of them were treated with gefitinib.Its efficacy and safety were evaluated.Results:The objective response rate was 53.33% and the disease control rate was 84.44%.After treatment,the levels of tumor markers were measured again,of which the levels of CA125 and CEA were significantly lower than before(P<0.05).After treatment,the patients'CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+) were significantly lower than those before treatment,and CD_(8)^(+) was significantly higher(P<0.05).Conclusion:Gefitinib,which is a targeted therapy for non-small cell lung cancer,can reduce the level of serum tumor markers and improve the immune function.The curative effect is good,but more emphasis should be on the adverse reactions caused by a single drug use.