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Background

Non-traumatic osteonecrosis of the femoral head (ONFH) is a refractory osteonecrosis disease caused by an abnormal blood supply to bone tissue. However, therapeutic hip preservation strategies are diverse, and the therapeutic outcomes are not ideal.

Objective

A network meta-analysis was performed to assess the effect of hip preservation treatments on non-traumatic ONFH.

Methods

We searched public electronic databases through May 15, 2017 using the following keywords: “femoral head necrosis osteonecrosis”; “femoral head osteonecrosis”; “osteonecrosis of femoral head”; “avascular necrosis of femoral head”; “necrosis of femoral”; and “random*”. The primary outcome in the present analysis was the treatment failure rate. Secondary outcomes included the Harris hip and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.

Results

We included 21 articles assessing a total of 1415 hips in our analysis. In the network meta-analysis, the treatments were ranked by the surface under the cumulative ranking curve (SUCRA). Core decompression (CD) plus cytotherapy was most likely to reduce the treatment failure rate (SUCRA score = 18.9%), followed by alendronate treatment (SUCRA score = 17.8%), cocktail treatments (SUCRA score = 15.6%), extracorporeal shock wave therapy (ESWT) plus alendronate (SUCRA score = 15.4%), and avascular biomaterials plus cytotherapy (SUCRA score = 13.8%) in a frequentist framework; similar results were obtained in a Bayesian framework. For the secondary outcomes, ESWT was most likely to improve the Harris hip score (SUCRA score = 33.7%), followed by ESWT plus alendronate (SUCRA score = 33.1%) and cocktail (SUCRA score = 19.6%) treatments in a frequentist framework. A traditional analysis showed that the effect of CD plus cytotherapy was significantly better than the effect of CD alone in improving the WOMAC score (SMD, ?6.01; 95% CI, ?7.81 to ?4.22; p < 0.001).

Conclusion

CD plus cytotherapy is a relatively superior treatment for reducing treatment failure rates in early and intermediate ONFH patients, and ESWT is the most effective treatment for improving Harris hip scores.  相似文献   
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目的了解护理人为差错的特点及其与不良事件的关系,为减少护理不良事件、保证患者安全提供依据。方法从某三级甲等医院的护士不良事件上报系统收集护理不良事件,根据SRK模型进行人为差错分类。结果共收集护理不良事件806起,其中护理人为差错占74.32%,非人为差错占25.68%;在护理人为差错中,规则型错误所占比例最高(58.43%),其次为技能型疏忽和技能型遗忘(分别为22.37%和11.69%),知识型错误和规则型疏忽占比较少(分别为7.18%和0.33%);不同类型护理人为差错导致的不良事件严重程度比较,差异有统计学意义(P<0.01);知识型错误、规则型错误导致的不良事件严重程度显著高于技能型遗忘和技能型疏忽(均P<0.01)。结论护理人为差错是导致护理不良事件的主要因素,知识型及规则型人为差错引起的护理不良事件后果较严重,需要从组织层面和个人层面防范护理人为差错的发生。  相似文献   
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李潇  柳航  周琳  杨奕  葛卫红 《现代药物与临床》2023,46(10):2270-2276
菲类化合物是石斛属植物的特征成分之一,可分为简单菲、二氢菲、双菲及菲醌(酮)等菲衍生物4种类型。综述了金钗石斛、铁皮石斛、束花石斛、细茎石斛、流苏石斛、密花石斛、鼓槌石斛、曲轴石斛、石斛兰和绒毛石斛10种石斛属植物中毛兰菲、鼓槌菲、杓兰素等20个菲类活性成分,并介绍其抗肝纤维化、抗肿瘤、抗炎、抗氧化、降血糖等药理活性,希望为该属植物的新药研发和临床应用提供参考。  相似文献   
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Allergic rhinitis is thought to be an allergic disease associated with immunoglobulin (Ig)E-mediated immune response, characterized by increased T helper type 2 (Th2) cytokine production, elevated eosinophil levels in the nasal mucosa and induced nasal secretions. MicroRNA (miRNA) microarray data revealed that the expression level of miR-466a-3p was significantly decreased. Notably, GATA binding protein (GATA-3) was identified as one of its target genes through miRNA target prediction web tools. The expression levels of miR-466a-3p were altered by mimics and lentivirus both in vivo and in vitro, similar to those of GATA-3. Furthermore, the symptoms and histology of allergic rhinitis as well as the levels of serum IgE and interleukin (IL)-4 were examined in different groups of mice. Interestingly, the results for lentiviral miR-466a-3p-treated allergic rhinitis mice were relatively similar to normal mice, compared to allergic rhinitis mice without treatment. Also, miR-466a-3p negatively regulated GATA-3 expression in allergic rhinitis mice, indicating the participant of Th2-cell responses in allergic rhinitis. Taken together, our findings highlight a new perspective on the role of miR-466a-3p in allergic rhinitis. In addition, this study provides a theoretical framework and experimental reference for future research targeting microRNAs as therapeutic targets and diagnostic biomarkers of allergic rhinitis.  相似文献   
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