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Patient-specific instrumentation (PSI) has recently been introduced to improve the alignment following total knee arthroplasty (TKA). However, controversy remains between PSI and conventional instrumentation. The aim of this study is to compare the accuracy of PSI with conventional instruments for total knee arthroplasty (TKA). A systematic literature search was performed in databases including PubMed, the Cochrane Library, EMBASE, and Web of Science. All of the available randomized, controlled trials (RCTs) or non-randomized, controlled trials (nRCTs) comparing PSI with conventional instruments for TKA were identified. A statistical analysis was performed of this meta-analysis. Eighteen studies with 2417 patients were included in the authors' final analysis. The results of the meta-analysis demonstrated that there were no statistical differences in outliers of the mechanical axis (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.61-1.11), the femoral component in the coronal (RR, 0.56; 95% CI, 0.32-1.05) and sagittal (RR, 0.83; 95% CI, 0.60-1.14) plane, the tibial component in the coronal (RR, 0.84; 95% CI, 0.52-1.35) and sagittal (RR, 1.04; 95% CI, 0.69-1.55) plane, and the femoral component rotation (RR, 1.02; 95% CI, 0.57, 1.83) between the 2 groups. In addition, subgroup analysis showed that the study design and imaging used for preoperative scanning did not affect the outcome of the alignment, but a different PSI system might. The authors' meta-analysis indicated that the accuracy of PSI was not superior to conventional instruments for patients undergoing TKA. Future RCTs should focus on functional outcomes and component survivorship with mid- to long-term follow-up.

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The combination of two scion-one rootstock was used for two apple cultivars, 'Pink Lady' and 'Qinguan', budded on the same, one-year-old Malus hupehensis (Pamp.) Rehd. to reduce the impact of root and pot size and in order to understand the growth, water-use efficiency (WUE), and chlorophyll fluorescence characteristics. The two-scion grafted trees were planted in plastic pots under two water regimes, i.e. 70% field capacity (FC) and 55% FC. Results indicated that different scions were affected differently by drought stress. 'Pink Lady' had higher net photosynthetic rate (P N ), stomatal conductance (g s ), and transpiration rate (E) compared with 'Qinguan' under both water treatments. However, 'Qinguan' had lower minimal fluorescence (F 0 ), higher maximum fluorescence (F m ), and higher maximum photochemical efficiency of photosystem II (F v /F m ) than 'Pink Lady' at 55% FC. Moreover, 'Qinguan' had larger shoot dry mass (ShDM) and higher intrinsic WUE I than 'Pink Lady' under both water status. Gas-exchange and growth parameters, except for P N and scion diameter, were significantly affected by the cultivar and water treatment. At 70% FC, ShDM was significantly correlated with WUE I . Moreover, WUE I was negatively linearly correlated with g s at either 70 or 55% FC. These results might indicate that 'Pink Lady' was more sensitive to drought than 'Qinguan'. 'Qinguan' apple was able to improve WUE more than 'Pink Lady' under both well-watered and drought conditions. The growth parameters and photosynthetic capacity of two different scions showed that the combination of double scion-one rootstock might eliminate the influences of the rootstock and pot size.

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(2015) Nacetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis, Renal Failure, 37:10,[297][298][299][300][301][302][303] 2 ¼ 5% for the group of diabetes). Conclusion: Our results suggest that NAC decreases the incidence of contrast-induced nephropathy among patients with pre-existing renal insufficiency. The benefit was not existed in patients with diabetes.

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