Medicine
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Meta Analysis Comparative Study
Bilateral total knee arthroplasty: Simultaneous or staged? A systematic review and meta-analysis.
Total knee arthroplasty (TKA) is one of the most successful orthopedic surgeries performed in recent decades. However, controversies still exist between conducting simultaneous or staged bilateral TKA. The objective of this study is to conduct a systematic review assessing the clinical outcome associated with simultaneous bilateral and staged bilateral total knee arthroplasty (BTKA). ⋯ Since there are risks and benefits to both procedures, these potential complications must be interpreted in light of each individual patient's needs and concerns. Further research must be conducted, in the form of a randomized clinical trial, to evaluate the outcomes mentioned in this review.
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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urogenital disease. Moxibustion is a complementary treatment option for CP/CPPS. This systematic review will assess the efficacy and safety of moxibustion as a sole or add-on therapy for CP/CPPS. ⋯ CRD42019121338.
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Randomized Controlled Trial
Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?: A prospective randomized comparative study.
Lumbar decompressive surgery is a standard surgical technique for lumbar spinal stenosis. Many new surgical techniques have been introduced, ranging from open surgery to minimally invasive procedures. Minimally invasive surgical techniques are preferred because patients experience less postoperative pain and shorter hospital stays. However, the success rate of minimally invasive techniques have been controversial. The object of this study was to assess the feasibility of spinal decompression using biportal technique/endoscopic surgery compared with microscopic surgery. ⋯ Lumbar decompressive surgery using biportal technique/endoscopy showed favorable clinical outcomes, less pain and a shorter hospital stay compared to microscopic surgery in patients with lumbar spinal stenosis.
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Posthepatectomy liver failure (PHLF) is the main cause of perioperative death, and liver cirrhosis is one of the most important risk factors for PHLF. Spleen stiffness (SS) is a novel ultrasonic indicator for liver cirrhosis and portal hypertension, however, it is not clear that whether it has a significant influence on PHLF. Future remnant liver volume (FRLV) is a significant factor for liver regeneration after hepatectomy, spleen volume (SV) could also predict the degree of liver cirrhosis, and recent literatures reported that SV to FRLV ratio (SV/FRLV) could predict small for size syndrome (SFSS) in liver transplantation, however, the relationship between SV/FRLV and PHLF in patients receiving hepatectomy is not known. ⋯ Univariate analysis found several variables significantly related to PHLF, they were as follows: tumor diameter (P = .01), cirrhosis (P = .001), neutrophil to lymphocyte ratio (NLR) (P = .018), LS (P = .001), SS (P = .001), SV/FRLV (P < .001), operation duration (P = .003), transfusion (P = .009), hepatic inflow occlusion (HIO) (P = .001). Finally, SV/FRLV (P < .001, hazard ratio (HR) = 26.356, 95% confidence interval (CI) 1.627-425.21), SS (P = .009, HR = 1.077, 95%CI 1.017-1.141), and HIO time (P = .002, HR = 1.043, 95%CI 1.014-1.072) were determined as the independent risk factors of PHLF by multivariate analysis. SS and SV/FRLV help to predict the development of PHLF in patients with hepatocellular carcinoma.
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There is a dearth of accurate information about the associations between risk factors and type 2 diabetes in mainland China. We conducted a systematic review and meta-analysis to explore the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in adults at least 18 years old in mainland China. We searched English and Chinese databases from January 1st, 1997 to December 31st, 2017 for relevant observational studies. ⋯ For regional stratification, the magnitudes of ORs for hypertension, dyslipidemia, and hypercholesterolemia in northern areas were larger than that in southern areas, while opposite situation occurred for a family history. Except for the factor a family history, provincial results for the other nine risk factors differed from the overall results and among provinces. Effect differences existed for modifiable and non-modifiable risk factors in secular trends and regional distribution, which is of potential public health importance for type 2 diabetes prevention.