Objective To evaluate the quality of clinical studies on dentistry from the Chinese Journals. Methods Clinical studies in Chinese Journal of Conservative Dentistry of 2002 were searched. The quality of the clinical studies on assessment of treatments’ efficacy was evaluated. Results Among 204 related studies from 12 issues, there were 93 (45.58%) restrospective intervention studies, 6 randomized controlled blinded trials (2.94%), 42 randomized trials without blindness (20.58%), 20 controlled trials without randomization (9.80%) and 25 clinical observational studies (12.25%). The statistical analysis showed that 20 studies were with inappropriate methods. Conclusions It is necessary to improve the design and statistical analysis of clinical studies on stomatology in China to produce high-quality research evidence.
Objective We aimed to describe the prevalence of metabolic syndrome, its epidemiological characteristics, and to analyse the relationship of waist-to-hip ratio (WHR) and body mass index (BMI) with metabolic syndrome (MS) among staff at Southeast University. Methods The data from the overall physical examination of 1979 staff were analyzed.Results The crude prevalence of MS were 21.7%,26.4% and 14.2% in the whole population, men and women respectively. The standardized rates were 14.7%,19.0% and 9.4%. The prevalence of MS in men was significantly higher than that in women(Plt;0.05). Both abdominal obesity and visceral obesity were positively correlated with the prevalence of MS(r=0.295, 0.248, P=0.000). Conclusion The prevalence of MS among staff of Southeast University has shown a significant increase in 2006. WHR and BMI are both correlated with the prevalence of MS.
Objective To sum up the experimental and clinical history as wellas latest development of repair of growth plate injury Methods Recent articles about repair of growth plate injury were extensively reviewed and major reparative methods were introduced, especially including tissue engineering research on growth plate.Results Repair of growth plate injury was a great difficulty inexperimental study and clinical treatment of pediatric orthopedics. Transplantation of free growth plate and cartilage were unfavorably used because of lack ofblood supplement. Although circulation problem was solved by transplantation ofvascularized growth plate, autografts of epiphyseal cartilage were involved in limitation of donor, and allografts of epiphyseal cartilage induced immunological reaction. Noncartilaginous tissue and material could only prevent formation of bony bridge in small defect of growth plate and lacked ability of regenerative repair. Transplantationof tissue engineered cartilage and chondrocytes might be a choice for repair ofgrowth plate injury Conclusion Owing to lack of safe and effective methods ofrepairing growth plate injury, research on chondrocyte and tissue engineered cartilage should be further done.
OBJECTIVE: To sum up the studying course and latter development of repair of injury of growth plate. METHODS: Recent original articles about repair of injury of growth plate were extensively reviewed, focused on the progresses in understanding repair of injury of growth plate and comparison of several major reparative methods. RESULTS: Repair of injury of growth plate is a great difficulty in experimental study and clinical treatment of pediatric orthopedics. Graft of free growth plate and cartilage were unfavorably used because of lack of blood supplement. Although graft of vascularized growth plate solved circulation problem, both two kinds of grafts were involved in limitation of donor and immunologic reaction. Non-cartilaginous tissue and material could only prevent formation of bony bridge in small defect of growth plate and lacked ability of regenerative repair. Transfer of tissue engineered cartilage might be the best choice for repair of injury of growth plate. CONCLUSION: Considering source of transplanted material, reparative effect and adverse reaction, repair of injury of growth plate with tissue engineered cartilage deserves further investigation.
OBJECTIVE To investigate possibility of cartilage cultured in centrifuge tube as graft materials. METHODS: Articular chondrocytes isolated from a 3-week-old rabbit formed cartilage after cultivation for 2 weeks. Articular cartilage of humeral head, growth plate of proximal tibia and meniscus were collected from a 6-week-old rabbit. The ultrastructure of chondrocytes and extracellular matrix in the three kinds of cartilages and cultured cartilage were observed by transmission electronic microscopy. RESULTS: Cartilage cultured in centrifuge tube possessed unique ultrastructure and was similar to articular cartilage and growth plate, but it was markedly different from meniscus. The four kinds of cartilages were characteristic of respectively different chondrocytes and extracellular matrix. Cultured cartilage showed typical apoptosis of chondrocytes and "dark chondrocytes" appeared in growth plate. Condrocyte apoptosis was not seen in articular cartilage and meniscus. CONCLUSION: Cartilage cultured in centrifuge tube has unique ultrastructure and may be used as graft materials for articular cartilage and growth plate.
Objective To evaluate the analgesic effect of intra-articular ropivacaine with lidocaine. Methods A double-blind randomized controlled trial was conducted. Ninety patients receiving selective knee arthroscopy were randomized into three groups of 30 patients. At the end of the operation, before the release of the tourniquet, an intra-articular injection was administered to each patient through arthroscope, in accordance with their random allocation: 0.9% normal saline (normal saline group); 100 mg ropivacaine (ropivacaine alone group) and 100 mg ropivacaine and 100 mg 2% lidocaine (ropivacaine with lidocaine group). Pain intensity was assessed after the operation using the 100-mm visual-analog scale (VAS), and the amount of supplemental analgesics used within the following 24 hours were recorded. Results The VAS scores of 2 hours postoperatively at rest, and 1, 2, 4, and 8 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine alone group (Plt;0.05). The VAS scores 0.5, 1 and 2 hours postoperatively at rest, and at the awaking moment, 0.5, 1, 4, 8, and 24 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine with lidocaine group (Plt;0.05). Conclusion Intra-articular ropivacaine can reduce a patient’s pain after operation. The combination of lidocaine with intra-articular ropivacaine can reduce the patient’s pain severity immediately after the operation and achieve an early analgesic effect.
Objective To explore the awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. Methods From January to August 2012, using self-designed questionnaire, trained neurologists conducted the face to face investigation in 500 inpatients with a high risk of stroke, including those with a history of stroke in Department of Neurology in the Second Affiliated Hospital of Chongqing Medical University. Results A total of 467 valid questionnaires were recovered. Only 16.1% (75/467) patients were aware of thrombolytic therapy for acute stroke, of whom 50.7% (38/75) knew the time window of thrombolytic therapy. Awareness of thrombolytic therapy was higher in patients aged 56-70 years, with a higher level of education and income, and in those who knew at least 3 stroke warning signs and those with a history of stroke. While awareness of the time window of thrombolytic therapy was higher in those unmarried or widowed and with a history of stroke. Multiple logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, knowledge of stroke warning signs and a history of stroke; awareness of the time window was associated with marital status and a history of stroke (P<0.05). Conclusions Inpatients with a history of stroke and with a high risk of stroke in the Department of Neurology have poor awareness of thrombolytic therapy for acute ischemic stroke. It is necessary to improve the level of patients’ knowledge about thrombolytic therapy for acute stroke by health education.
Objective To identify the chief factors influencing the hospitalization expenses in fracture patients with health insurance so as to provide information for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods A total of 113 fracture patients with medical insurance in a hospital of a certain city from September 2006 to April 2007 were included and statistical analysis was performed by using multinomial linear regression analysis. Results The major factors influencing the hospitalization expenses in fracture patients with health insurance included the proportion of material fees and drug fees, length of stay, performance of operations and blood transfusion and etc. Conclusion Lowering the proportion of material fees and drug fees reasonably, reducing the length of hospital stay and avoiding operations and blood transfusion were the key to the control of hospitalization expenses for fracture. It is imperative to speed up and deepen the reform in medical insurance system, formulate scientific diagnostic and treatment routines and clinical pathways as well as expense standards, and try out the payment on certain single disease such as fracture.
ObjectiveTo review the research progress of in vivo bioreactor (IVB) for bone tissue engineering in order to provide reference for its future research direction.MethodsThe literature related to IVB used in bone tissue engineering in recent years was reviewed, and the principles of IVB construction, tissue types, sites, and methods of IVB construction, as well as the advantages of IVB used in bone tissue engineering were summarized.ResultsIVB takes advantage of the body’s ability to regenerate itself, using the body as a bioreactor to regenerate new tissues or organs at injured sites or at ectopic sites that can support the regeneration of new tissues. IVB can be constructed by tissue flap (subcutaneous pocket, muscle flap/pocket, fascia flap, periosteum flap, omentum flap/abdominal cavity) and axial vascular pedicle (axial vascular bundle, arteriovenous loop) alone or jointly. IVB is used to prefabricate vascularized tissue engineered bone that matched the shape and size of the defect. The prefabricated vascularized tissue engineered bone can be used as bone graft, pedicled bone flap, or free bone flap to repair bone defect. IVB solves the problem of insufficient vascularization in traditional bone tissue engineering to a certain extent.ConclusionIVB is a promising method for vascularized tissue engineered bone prefabrication and subsequent bone defect reconstruction, with unique advantages in the repair of large complex bone defects. However, the complexity of IVB construction and surgical complications hinder the clinical application of IVB. Researchers should aim to develop a simple, safe, and efficient IVB.
Objective To investigate the effect of rivaroxaban on the risk of bleeding after total knee arthroplasty (TKA). Methods A total of 119 cases undergoing primary TKA because of knee osteoarthritis between June 2009 and May 2011, were randomly divided into the rivaroxaban group (59 cases) and the control group (60 cases). There was no significant difference in gender, age, height, weight, side, disease duration, and grade of osteoarthritis between 2 groups (P gt; 0.05). Thepreoperative preparation and operative procedure of 2 groups were concordant. At 1-14 days after TKA, rivaroxaban 10 mg/d were taken orally in the rivaroxaban group, and placebo were given in the control group. The blood routine examination was performed before operation and at 2 days postoperatively; the total blood loss and hemoglobin (HGB) decrease were calculated according to the formula; the blood loss, postoperative wound drainage, and wound exudate after extubation were recorded to calculate the dominant amount of blood loss; and the bleeding events were recorded within 35 days postoperatively. Results The total blood loss and HGB decrease were (1 198.34 ± 222.06) mL and (33.29 ± 4.99) g/L in the rivaroxaban group and were (1 124.43 ± 261.01) mL and (31.57 ± 6.17) g/L in the control group, showing no significant difference (P gt; 0.05); the postoperative dominant blood loss in the rivaroxaban group [(456.22 ± 133.12) mL] was significantly higher than that in the control group [(354.53 ± 96.71) mL] (t=4.773, P=0.000). The bleeding events occurred in 3 cases (5.1%) of the rivaroxaban group and in 1 case (1.7%) of the control group, showing no significant difference (χ2=1.070, P=0.301). Conclusion Rivaroxaban has some effects on the risk of bleeding after TKA. In general, rivaroxaban is safe.