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Purpose
To compare the efficacy and safety of recombinant human bone morphogenetic protein (rhBMP) and iliac crest autograft in the fusion treatment of lumbar spondylolisthesis.Methods
The studies using randomized controlled trials to compare the rhBMP with iliac crest autograft in the treatment of lumbar spondylolisthesis were retrieved from Embase, Pubmed, ProQuest dissertations & theses (PQDT), China national knowledge infrastructure (CNKI), Chinese Biomedical Database, Wanfang Data, Cochrane Library (from March 1998 to March 2018). Postoperative fusion rate, clinical success rate, postoperative intervertebral height, complications, operation time, blood loss and duration of hospitalization were chosen as the outcome indicators. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.3 was used for data-analysis.Results
Eleven articles were included in the meta-analysis. The results showed that, comparing the efficacy of rhBMP with iliac crest autograft, statistical significance was found in the 24-month fusion rate post operation [95% CI (1.38, 24.70), p = 0.02] and operation time [95% CI (?14.22, ?2.08), p = 0.008]. There is not sufficient evidence for statistical differences in the remaining indicators.Conclusion
The current literature shows rhBMP is a safe and effective grafting material in the treatment of lumbar spondylolisthesis. Further evidence is dependent on the emergence of more randomized controlled trials with higher quality and larger sample sizes in the future. 相似文献Introduction
The aim of this study was to determine whether complications following mastectomy with immediate breast reconstruction (IBR) were associated with breast cancer recurrence.Methods
A retrospective review was performed of women diagnosed with stage I-III breast cancer who underwent mastectomy with IBR between 2005 and 2010. Patient demographics, tumor data, surgical wound complications, treatment details and timing were recorded and analyzed.Results
We identified 458 women with a median follow up time of 7.6 years. A total of 22% of patients experienced IBR complications. There was a delay in initiation of adjuvant therapy in patients who had a complication (52 vs 41 days, p?<?0.001). There was no significant difference in recurrences between groups with and without complications (p?=?0.65).Conclusions
In breast cancer patients who undergo mastectomy with IBR, wound complications delayed initiation of adjuvant systemic therapy, but were not associated with an increased risk of cancer recurrence. 相似文献Methods: Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%).
Results: The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively.
Conclusions: Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery. 相似文献