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Objective: To analyze the effects of neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance through comparing clinical indicators of the two operation modes and to provide a reference for selection of proper minimally invasive surgery. Methods: One hundred and twenty-six patients with hypertensive cerebral hemorrhage who received diagnosis and treatment in our hospital between December 2015 and December 2017 were selected and grouped into an observation group (n=63) and a control group (n=63) using random number table. Patients in the observation group were treated by neuroendoscopic surgery, while patients in the control group were treated by small bone window craniotomy. The surgical condition, clinical effect and prognosis of the two groups were analyzed and compared. Results: Patients in the observation group completed surgery in a shorter time and bled less during operation compared to the control group, and the hematoma clearance rate of the observation group was obviously higher than that of the control group; the differences had statistical significance (P<0.05). The nerve deficiency scale (NDS) scores of the two groups at the postoperative 3rd month were lower than those before surgery (P<0.05), and the activity of daily life (ADL) score at the postoperative 3rd month was higher than that before surgery (P<0.05). The observation group had lower NDS score and higher ADL score compared to the control group, and the differences had statistical significance (P<0.05). The incidence of complications of the observation group was lower than that of the control group after surgery, and the rate of favourable prognosis of the observation group was higher than that of the control group at the postoperative 3rd month (P<0.05). Conclusion: Neuroendoscopic surgery is more effective and safe, causes less bleeding and has better prognosis and nerve function recovery compared to small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage. How to cite this:Gui C, Gao Y, Hu D, Yang X. Neuroendoscopic minimally invasive surgery and small bone window craniotomy hematoma clearance in the treatment of hypertensive cerebral hemorrhage. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.463 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Aim: The purpose of this study was to conduct a meta-analysis to systematically compare the clinical outcomes between knee barbed sutures (KBS) and knee traditional sutures (KTS) for wound closure in total knee arthroplasty (TKA). Method: This study retrieved potential academic articles comparing the clinical outcomes between KBS and KTS in TKA from the MEDLINE database, the PubMed database, the EMBASE database and the Cochrane Library. The reference articles for the identified studies were carefully reviewed to ensure that all available documents were represented in the study. Results: A total of 14 articles (eight randomized controlled trials [RCTs], six non-RCTs) were involved in our study. The overall participants of barbed Sutures group were 1255, whereas it was 1247 in the traditional sutures. Our meta-analysis showed that KBS is preferable for wound closure of TKA as its shorter lower total cost (weighted mean difference [WMD] = -276.281, 95% CI = -480.281 to -72.280; p = 0.008) and wound closure time (WMD = -4.895,95% CI = -6.105 to -3.685; p < 0.001). However, there was no difference in any complications (p = 0.572), wound complications (p = 0.550), superficial infection (p = 0.918), deep infection (p = 0.654), wound dehiscence (p = 0.649), suture abscess (p = 0.939), arthrofibrosis (p = 0.970), needle sticks (p = 0.158), suture breakage (p = 0.371) and knee society scores (KSS; p = 0.073). Conclusion: The use of KBS in TKA is associated with significantly shortened wound closure times and total closure cost without increased risk of intraoperative needle sticks and suture breakage and postoperative incision complications. Given the relevant possible biases in our study, adequately powered and more RCTs with long-term follow-up are needed to compare the efficacy and safety between KBS and KTS.

Objectives The purpose of this study was to conduct a meta-analysis to systematically compare the safety and efficacy of carotid endarterectomy and carotid artery stenting in contralateral carotid occlusion patients who needed reperfusion. Methods This study retrieved potential academic articles comparing results between carotid endarterectomy and carotid artery stenting for patients with contralateral carotid occlusion from the MEDLINE database, the PubMed database the EMBASE database, and the Cochrane Library from January 1990 to May 2018. The reference articles for the identified studies were carefully reviewed to ensure that all available documents were represented in the study. Results Four retrospective cohort study involving 6252 patients with contralateral carotid occlusion were included in our meta-analysis. During 30-day follow-up, there is significant difference in post-procedure mortality (odds ratio (OR) = 0.476, 95% confidence interval (CI) (0.306–0.740), P = 0.001); no significant differences are not found in post-procedure stroke (risk difference (RD) = 0.002, 95%CI (–0.007 to 0.011); P = 0.631), myocardial infarction (RD = 0.003, 95%CI (–0.002 to 0.008); P = 0.301), and transient cerebral ischemia (RD = 1.059, 95%CI (–0.188 to 5.964); P = 0.948). Conclusions Carotid endarterectomy was associated with a lower incidence of mortality compared to carotid artery stenting for patients with contralateral carotid occlusion. Regarding stroke, myocardial infarction, and transient ischemic attack, there was no significant difference between the two groups. More randomized controlled trials and prospective cohorts are necessary to help further clarify the ideal approach for these patients.