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Li Q.,Shandong University | Wang C.,Shandong University of Traditional Chinese Medicine | Huo Y.,Shandong University | Jia Z.,The 306th Hospital of Peoples Liberation Army | Wang X.,Shandong University
Journal of Orthopaedic Surgery and Research | Year: 2016

Background: A number of meta-analyses have been carried out to evaluate the effects of minimally invasive surgery (MIS) versus open surgery (OS) for acute Achilles tendon rupture. However, discordant findings were seen in these meta-analyses. The present study, performing a systematic review of overlapping meta-analyses regarding MIS versus OS of acute Achilles tendon rupture, aimed to assist decision-makers interpret and choose among conflicting meta-analyses, as well as to offer treatment recommendations based on current best evidence. Methods: The literature search was performed to identify systematic reviews comparing MIS with OS for Achilles tendon rupture. Meta-analyses only comprising randomized controlled trials (RCTs) were included. Two authors individually evaluated the quality of meta-analysis and extracted data. The Jadad decision algorithm was conducted to ascertain which meta-analysis offered the best evidence. Results: A total of four meta-analyses was included. All these meta-analyses comprised RCTs or quasi-RCTs and were determined as Level-II evidence. The scores of the Assessment of Multiple Systematic Reviews (AMSTAR) ranged from 7 to 10 (median 9.5). The Jadad algorithm indicated that the best meta-analysis should be chosen according to the search strategies and application of selection. A high-quality meta-analysis with more RCTs was chosen, which suggested that there was no statistically significant difference between MIS and OS regarding rerupture rate, tissue adhesion, sural nerve injury, deep infection, and deep vein thrombosis. However, MIS could decrease superficial infection rate, and had a better patient satisfaction for good to excellent outcomes in comparison to OS. Conclusions: Based on the best available evidence, MIS may be superior to OS for treating acute Achilles tendon rupture. However, due to some limitations, this should be cautiously interpreted, and further high-quality studies are needed. © 2016 The Author(s).

Dong F.,The Second Peoples Hospital of Liaocheng | Fan M.,The Second Peoples Hospital of Liaocheng | Jia Z.,The 306th Hospital of Peoples Liberation Army
Journal of Orthopaedic Surgery and Research | Year: 2016

Background: With more than 50,000 orthopaedic surgeons, China is having an increasing impact on fracture surgery research. However, the most influential Chinese articles on fracture surgery have not been determined. This study aimed to characterise the most-cited articles on fracture surgery by Chinese authors to provide insight into the fracture research in China. Methods: The Web of Science was used to search for citations of fracture surgery articles that originated in China. The 50 most-cited articles were identified. The title, number of citations, year of publication, journal, article type, level of evidence, city, institution, and authors were recorded and evaluated. Results: The 50 top-cited papers were published between 1984 and 2012. The most prolific decade began in the year 2000. These articles received 28 to 209 citations (mean 52), were written in English, and published in 12 journals. Injury was the most popular journal, with the largest number of articles (11) on the top 50 list. The region with the largest number of published articles was Hong Kong (20), followed by Kaohsiung (8), Shanghai (8), and Taipei (7). Most were clinical studies (39), while the remaining studies were basic science articles (11). The hip was the most common topic in the clinical studies. The most popular level of evidence was IV. Conclusions: This list of the top 50 publications identifies the most influential Chinese fracture surgery articles for the global community. This study presents insight into the historical contributions of Chinese researchers and the fracture surgery trends in China. © 2016 The Author(s).

Mei X.,Tianjin Hospital | Zhu X.,Tianjin Hospital | Zhu X.,Tianjin Medical University | Zhang T.,Tianjin Hospital | And 2 more authors.
International Journal of Surgery | Year: 2016

Objective: Hand and wrist research has recently shown obvious progress. The quantity and quality of publications from different nations, however, have not been analyzed. In our study, we aimed to assess the characteristics of worldwide productivity in hand and wrist literature using highly cited subspecialty journals. Methods: Literature search using the Web of Science database was conducted to identify hand and wrist articles in four highly cited subspecialty journals from 2005 to 2014. The number of articles, impact factors and citations were analyzed to evaluate the contributions of different countries. Publication activity was adjusted for the countries by population size. Results: A total of 4268 publications were identified. The number of articles showed a significant increase of 2.10-fold between 2005 and 2014 (p = 0.0001). North America, West Europe, and East Asia were the most prolific areas. The majority of publications (92.03%) were from high-income countries, 7.97% from middle-income countries, and no publications from lower-income countries. The United States published the most articles (53.89%), followed by United Kingdom (6.51%), Japan (6.14%), Canada (3.70%), and China (3.37%). Articles originating from the United States showed the greatest number of total 5-year impact factors (5y-IF) (4059.56) and total citations (17,998). When normalized to population size, United States ranked the first (7.16), followed by Sweden (6.53), and Netherlands (5.72). However, Netherlands (1.893) had the highest mean 5y-IF, followed by Germany (1.884) and Australia (1.883). Sweden had the highest average citations per article (11.38), followed by Germany (9.63), and Australia (9.08). Conclusions: The number of publications of hand and wrist research shows a significant increase during the past 10 years. The United States is the most productive country in hand and wrist literature. However, some European countries and Australia may have higher quality of articles according to mean 5y-IF and mean citations per article. © 2016 IJS Publishing Group Limited.

Li J.,Shenyang Northern Hospital | Li Y.,Shenyang Northern Hospital | Wang X.Z.,Shenyang Northern Hospital | Yang S.G.,Jinan Military 88th Hospital | And 9 more authors.
Chinese Medical Journal | Year: 2014

Background The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml·min-1·1.73 m-2)) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD). Methods The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis. Results The AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤0.92 (n=1 006); 0.92 1.16 (n=992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow=1.1%, AGEFmid=2.3% and AGEFhigh=5.8%, P <0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio=4.96, 95% CI: 2.32-10.58, P <0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P <0.001). Conclusion The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/ peripheral arterial angiography.

Zou D.W.,The 306th Hospital of Peoples Liberation Army
Zhonghua wai ke za zhi [Chinese journal of surgery] | Year: 2010

To prospectively evaluate the clinical effects of posterior paramedian approach in nerve root decompression and reducing muscle damage in low back surgeries. Study group included 30 cases treated from January 2007 to May 2008, DDD 8 cases, spondylolisthesis 6 cases, LDH 11 cases, Low back surgery failure re-operation 5 cases. Based on the comprehensive understanding of modern spine anatomy, we abandoned laminectomy in our procedure, applied a mid-waist skin incision, dissect to the paraspinal muscles where you could easily reach the facets by separating between the multifidus and longissimus, enlarge the canal by performing resection along ligamentum flavum and the inner broader of the articular process, remove enough tissue till you could expose the traversing root and the disc space, this method could achieve a limited but precise and effective decompression with not taking out all of the articular process. Once the anatomy mark of the pedicle is located (usually would be at the central area of the incision), pedicle screws placement would be precise and easy without struggling with muscle traction. The following procedures would be Spondylolisthesis reduction, discectomy and interbody fusion. Post-op patients of study group all showed significant improvement of pain symptoms, VAS reduced from 7.14 + or - 1.8, pre-op to 1.39 + or - 0.72 post-op, narrowed disc space regained height, spondylolisthesis reached anatomic reduction, no complications such as pedicle screw misplacement and nerve root damage were found, the lumbar spine regained it's physiological lordosis structure. Significant difference is discovered (P < 0.001) in statistic study concerning the rate of intractable low back pain between pre-op and post-op. Applying low back surgery through posterior para-median approach could directly reach the inferior/superior facets and the "soft" structures of the spinal canal, expose the exact decompression region and anatomy mark of the pedicle in the central surgical field without strong retraction on the para-spinal muscles. This approach has the advantage of lowering the surgical difficulty of implantation, reducing the risk of nerve damage and is also a minimum invasive procedure. In many cases, laminectomy is unnecessary, leaving the lamina intact could preserve the physiological anatomy of the spine.

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