ObjectiveThis meta-analysis aimed to compare the relative safety and efficacy of cannulated compression screw (CCS) and femoral neck system (FNS) in treating patients with femoral neck fractures and to provide evidence-based medical evidence for FNS in treating femoral neck fractures.MethodsPubMed, Embase, Cochrane, and China National Knowledge Infrastructure databases were searched to collect outcomes related to femoral neck fractures treated with FNS and CCS, including time to fracture healing, incidence of non-union, incidence of osteonecrosis of the femoral head, incidence of failure of internal fixation, rate of femoral neck shortening, Harris hip score, Barthel index, operative time, intraoperative blood loss, fluoroscopy frequency, and complications. A meta-analysis was performed using RevManv5.4 (The Cochrane Collaboration) and Stata v14.0 software.ResultsThis analysis included 21 studies involving 1,347 patients. The results showed that FNS was superior to CCS in terms of fracture healing time [mean difference (MD) = −0.75, 95% CI = (−1.04, −0.46), P < 0.05], incidence of bone non-union [odds ratio (OR) = 0.53, 95% CI = (0.29, 0.98), P = 0.04], incidence of osteonecrosis of the femoral head [OR = 0.49, 95% CI = (0.28, 0.86), P = 0.01], incidence of internal fixation failure [OR = 0.30, 95% CI = (0.18, 0.52), P < 0.05], rate of femoral neck shortening [OR = 0.38, 95% CI = (0.27, 0.54), P > 0.05], Harris hip score [MD = 3.31, 95% CI = (1.99, 4.63), P < 0.001], Barthel index [MD = 4.31, 95% CI = (3.02, 5.61), P < 0.05], intraoperative bleeding [MD = 14.72, 95% CI = (8.52, 20.92), P < 0.05], fluoroscopy frequency [OR = 0.53, 95% CI = (0.29, 0.98), P = 0.04], and complications [OR = 0.31, 95% CI = (0.22, 0.45), P < 0.05]. The difference between FNS and CCS in operative time was not statistically significant [MD = −2.41, 95% CI = (−6.88, 2.05), P = 0.29].ConclusionFNS treatment of femoral neck fracture can shorten the fracture healing time; reduce the incidence and translucent rate of bone non-union, osteonecrosis of the femoral head, and internal fixation failure; reduce intraoperative blood loss and postoperative complications; and improve hip joint function and activity. We are confident in the findings that FNS, an effective and safe procedure for internal fixation of femoral neck fractures, is superior to CCS.
Background: Sarcopenia caused by spinal cord injury seriously affects the muscle function, which impairs the locomotion function of patients. As an effective physiotherapeutic, functional electrical stimulation is benefit to the recovery of muscle function without exact mechanisms. So the objection of the study is to explore the biological regulatory factors related to functional electrical stimulation for muscle function recovery of patients with sarcopenia after spinal cord injury using bioinformatics methods.Methods: The related microarray datasets GSE142426 and GSE33886 were downloaded from the Gene Expression Omnibus database. We used the R software to merge the two datasets, correct the inter-batch differences and screen the differentially expressed genes. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway were analyzed by using the DAVID online tool. The STRING database was used to analyze the interaction of differentially encoded proteins. The key genes were selected to draw the ROC curves, and CYCS was used to perform gene set enrichment analysis.Results: A total of 114 differentially expressed genes were selected, including 44 up-regulated genes and 70 down-regulated genes, and four hub genes were identified including CYCS, SUCLG1, ATP5B and ATP5C1. ROC curve showed that CYCS was considered as the best indicator and GSEA analysis showed that up-regulation of CYCS was related to mitochondria and energy metabolism.Conclusion: The mechanism of function electrical stimulation on muscle function recovery of spinal cord injury patients with sarcopenia is mainly related to regulate mitochondrial energy metabolism and scavenge reactive oxygen species to mitigate the oxidative damage.
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