RESUMO
BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex polygenic disease and is one of the most common endocrinological and reproductive disorders. The purpose of this study was to evaluate the efficacy of acupuncture combined with herbal medicine among infertile females with polycystic ovary syndrome (PCOS). METHOD: A total of 86 women with PCOS, experiencing infertility, were recruited and randomly assigned to receive either manual acupuncture (MA) or sham acupuncture (SA) twice per week for three menstrual cycles. Both groups received herbal medication. The evaluations were conducted after three menstrual cycles and 24 weeks' follow-up. RESULTS: The trial was completed by 79 (91.86%) of the 86 randomly selected patients. During this study, the pregnancy rate in the MA group (46.34%) was significantly higher than the SA group (18.42%), with a P-value of 0.008. Moreover, the ovulation rate of the MA group (58.14%) was higher than that of the SA group (45.74%), with a P-value of 0.046. The improvement rate of PCOS score and testosterone level showed a statistical difference between the two groups (P-values were <0.05). There were no other differences between the two groups. Sex hormones level, including E2, T, P, LH, and LH/FSH were significantly lower after intervention in the MA group (P-values were <0.05) compared with baseline, while only the progesterone level was reduced in the SA group (P-value = 0.008). CONCLUSION: Manual acupuncture combined with herbal medicine may be clinically useful for infertile women with PCOS in improving pregnancy and ovulation rate. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1800014997.
RESUMO
OBJECTIVE: To retrospective analysis the complications after treatment of metacarpal and phalangeal fractures with internal fixation, and propose measures to prevent or reduce surgical complications. METHODS: From July 2007 to October 2009, 342 patients with metacarpal and phalangeal fractures were treated with internal fixation,including 203 males and 139 females with an average age of 30.4 years old ranging from 18 to 56 years. There were 217 right hands and 125 left hands, 38 cases of the first metacarpal fracture, 47 cases of the second metacarpal fracture, 52 cases of the third metacarpal fracture, 40 cases of the forth metacarpal fracture, 39 cases of the fifth metacarpal fracture, 43 cases of the proximal phalangeal fractures, 52 cases of the middle phalangeal fractures, and 48 case of the distal phalangeal fractures. The fractures were fixed with K-wires in 129 patients, mini plates in 153 cases, screws in 48 cases, wires in 12 cases. RESULTS: All 324 patients were followed up for 3 to 15 months (averaged 8.5 months) and complications occurred in 74 patients (22.84%). The main complication was unhealthy wound healing in 24 patients (7.4%), others was adhesion of tendon in 54 patients (16.67%), malunion in 34 patients (10.49%), nonunion in 13 patients (4.01%) and shortening of metacarpal and phalangeal in 21 patients (7.41%). CONCLUSION: The important reasons responsible for complications are iatrogenic factors such as unsuitable implant selection, unskillful surgical technique and improper post-operative functional rehabilitation.