Objective To investigate the effect of rivaroxaban on prevention from deep venous thrombosis after hip replacement surgery .Methods 80 patients with lower limb parallel arthroplasty were randomly divided into observation group and control group from January 2014 to January 2015.40 cases in each group.Control group was given aspirin treatment, observation group was given rivaroxaban treatment, indicators changes were followed up and recorded.Results PT, APTT values of observation group one week after treatment were (35.79 ±2.16),(15.84 ±2.11) s, which were better than control group (45.64 ±2.12),(18.72 ±2.02) s (P<0.05).TT, D-dimer of observation group(13.48 ±2.10)s,(2.34 ±0.33)g/L after a week were better,than control group (16.38 ±1.79)s, (1.42 ±0.21)g/L (P<0.05) respectively.Conclusion Effect of rivaroxaban in prevent deep venous thrombosis after hip replacement surgery is exact without obvious adverses reaction, it is worthy of further research and application.

Humans ; Jugular Veins ; Neoplastic Cells, Circulating ; Thyroid Neoplasms ; complications

OBJECTIVE To investigate the effect of berberine on differentiation of rat bone marrow mesenchymal stem cells (MSCs) to adipocytes and its mechanism. METHODS Rat MSCs were isolated and cultured, adipocytic differentiation was induced with adipogenesis-inducing medium (AIM). Cells were assigned into 6 groups:normal control, AIM group, AIM+berberine 0.1, 0.3, 1 and 3 μmol·L-1 groups, respectively. Morphology characteristics of mesenchymal stem cells were observed under an inverted microscope and adipocyte levels were analyzed by oil O staining. Alkaline phosphatase (ALP) activity was detected using p-nitrophenyl phosphate as a substrate. The cell survival was determined by MTT assay. Expressions of peroxisome proliferator activated receptor γ (PPARγ), fatty acid binding protein (aP2) and CCAAT enhancer-binding protein α (C/EBPα) mRNA were detected by semiquantitative RT-PCR. RESULTS Compared with normal control group, MSCs adipogenic differentiation, PPARγ, aP2 and C/EBPα mRNA expression significantly increased in AIM group (P<0.01), ALP activity in AIM group significantly decreased (P<0.01). Compared with AIM group, berberine inhibited MSCs adipogenic differentiation (P<0.01) and berberine 0.1, 0.3, 1 and 3 μmol·L-1 increased ALP activity by 26%, 54%, 81% and 122%, respectively. Berberine 3 μmol·L-1 significantly downregulated PPARγ expression (0.91±0.10 vs 1.34±0.06) (P<0.01), aP2 (1.05±0.10 vs 1.53±0.09) (P<0.01) and C/EBPα mRNA (1.24±0.06 vs 1.54±0.09) (P<0.01). Berberine had no effect on proliferation of MSCs. CONCLUSION Berberine inhibits differentiation of MSCs into adipocytes, which might be closely related to the downregulation of PPARγ, aP2 and C/EBPα mRNA.

Tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)is the third member of the tumor necrosis factor(TNF)superfamily.It has received much concern because of its selective killing effect on tumor cells and virus infected cells.However,the subsequent studies have suggested that TRAIL also induces normal cells,such as the death of neurons and oligodendrocytes.TRAIL is associated with a variety of central nervous system diseases including primary brain tumor,multipie sclerosis and ischemic stroke.

Tumor necrosis factor-like weak inducer of apoptosis(TWEAK)is a new member of the tumor necrosis factor family.After TWEAK binding to its receptor Fn14.it induces extensive biological activities.TWEAK-Fn14 pathway participates in pathophysiological mechanisms of cell apoptosis,regulation of the blood-brain barrier permeability and inflammation in central nervous system,and it is closely correlated with the diseases such as ischernic stroke.multiple sclerosis and gliocytoma.

Thrombolysis can effectively treat ischemic stroke, but it has the risk of resulting in hemorrhagic transformation. A number of studies have suggested that hemorrhagic transforma-tion is closely correlated with matrix metalloproteinase mediated disruption of blood-brain barrier and the increase of vasopermeability. The increase plasma matrix metalloproteinase(MMP) -9 can be used as an independent predictor of hemorrhagic transformation. Using MMP inhibitors during the early cerebral ischemia may reduce the incidence and severity of hemor-rhagic transformation, however, it needs to be further validated.

Objective To investigate the pathogen distribution and risk factors of pulmonary infection after acute cervical spinal cord injury (ACSCI) in an attempt to offer reference for early antiinfection therapy.Methods The study comprised 223 cases who were admitted from October 2011 to October 2014.There were 149 males and 74 females,at (43.3 ± 13.5) years of age.Species of pathogens identified were gram-positive,gram-negative and mixed.Effects of age,gender,injury types and tracheotomy on pathogen distribution were analyzed.Results Gram-negative infection was found in 114 cases (51.1％),with tracheotomy accounting for 7.0％ of the cases and death accounting for 1.8％ of the cases,and the main causative pathogens were Klebsiella pneumonia,Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii.Gram-positive infection was found in 41 cases (18.4％),with tracheotomy accounting for 12.2％ of the cases and death accounting for 7.3％ of the cases,and the main causative pathogens were Staphylococcus aureus and Streptococcus pneumonia.Mixed infection was found in 68 cases (30.5％),with tracheotomy accounting for 22.1％ of the cases and death accounting for 13.2％ of the cases.Gender had no significant correlation with pathogen distribution.For the cases of complete spinal cord injury and tracheotomy,the ratio of mixed infection increased significantly (P ＜ 0.05).For the cases younger than 30 years,the pathogens were mainly gram-positive bacteria (P ＜ 0.05).Conclusions Main pathogens of pulmonary infection after ACSCI are gram-negative bacteria.The cases younger than 30 years are associated with higher risk of grampositive infection,while the cases with complete injury or tracheotomy are associated with higher risk of mixed infection.

Objective To analyze the effect of mesporous calcium silicate (m-CS)/calcium sulfate cement (CSC),m-CSC for short,in bone defect repair.Methods Setting time and compressive strength of the m-CSC (15 m-CSC as group Ⅰ and 30 m-CSC as group Ⅱ) were tested.CSC was used as the control.Cement samples were immersed in Tris-HCl solution,andin vitro degradation of the m-CSC was measured.Cell morphology and cell proliferation as well as differentiation on the samples were assessed.The cements were implanted into the traumatic femoral defects in rabbits,and the in vivo degradability and osteogenesis of the cements were investigated by histological evaluation after implantation for 4,8 and 12 weeks.Results Addition of m-CS into CSC prolonged the setting time (7.8 min in group Ⅰ and 10.5 min in group Ⅱ),obviously longer than 3.7 min in control group and did not have obvious effect on compressive strength of the cements.Weight loss of m-CSC solution was obviously lower (61.8 wt％ in group Ⅰ and50.3 wt％ in group Ⅱ),compared to70.4 wt％ in control group,pH value in group Ⅱ decreased from 7.40 to 7.26,while decreased from 7.40 to 6.86 in control group,m-CSC could promote cell proliferation and differentiation compared to CSC.At postoperative 12 weeks,histological sections showed massive new bony tissue (55.2％) in group Ⅱ,obviously higher than 25.6％ in control group.Conclusion m-CSC exhibits good biocompatibility,degradability and osteogenesis,and can promote bone regeneration in bone defect repair.

ObjectiveTo investigate the effectiveness and toxicity of CyberKnife in the treatment of lung metastases.MethodsTreatment details and outcomes were reviewed for 93 targets of 48 histologically verified patients treated by CyberKnife at the CyberKnife Center of Tianjin between September 2006 and June 2010.The median tumor volume was 6.0(0.2 - 135.2) cm3,the median biological equivalent dose was 140.8(53 - 180) cGy (α/β =10),the median fraction was 3(1-7) times and the median isodose line was 81％ (71％-91％ ).ResultsThe rate of follow-up is 96％.33 cases were followed up for more than 2years.The effective rate was 90.3％.Two targets of 2 patients locally progressed.The 1-and 2-year local control rates,overall survival (OS) rates and progression-free survival (PFS) rates were 98％ and 98％,83％ and 63％,and 64％ and 37％,respectively.Univariate analyses showed that age older than 60 versus ≤60 years tended to be predictor for PFS ( x2 =3.45,P =0.063 ) ;The PFS of patients who had single lesion was better than patients with multiple lesions ( x2 =4.49,P =0.034 ) ; patients with disease-free interval longer than 18 months had better OS ( x2 =6.50,P =0.011 ).Five patients were reported to experience treatment-related grade 1 radiation pulmonary injury,and one each for subcutaneous fibrosis with pigmentation,grade 2 and grade 3 adverse event.ConclusionsFor patients with lung metastatic lesion,CyberKnife is an effective option with high local control rate and little acute reaction.The long-term outcome and toxicity need further study.

Objective To analyze the factors influencing the incidence of refracture after surgery for femoral shaft fracture in children and put forward their countermeasures.Methods A retrospective study was conducted in the children who had been treated at Department I of Pediatric Orthopaedics,Zhengzhou Orthopaedic Hospital from September 2013 to May 2017 for primary femoral shaft fracture or refracture after surgery for femoral shaft fracture.Their clinic data were collected concerning age,gender,height,weight,primary fracture,treatment protocol,time for removal of fixation,time and site of refracture,and violence for refracture.The likely factors associated with refracture were identified by comparing the gender ratios,age distributions and primary fractures between the children with primary fracture and those with refracture,and by comparing the proportions of overweight and obese ones between the children with refracture and their normal counterparts.Results A total of 278 children,with a male to female ratio of 2.43∶ 1,were treated for primary femoral shaft fracture while 22 children,with a male to female ratio of 0.83∶ 1,for refracture contemporarily.In the children with primary fracture and those with refracture,respectively,there were 172 (61.9％) cases and 2 cases (9％) aged from 0 to 4 years,85 cases (30.6％) and 10 cases (45.5％) aged from 5 to 9 years,21 cases (7.5％)and 10 cases (45.5％) aged from 10 to 14 years.There were significant differences between the 2 groups in gender ratio and proportions of age (P ＜ 0.05).Compared to the normal children of the same age,the proportions of overweight and obese ones were significantly higher in those with refracture (P ＜ 0.05).There were no significant differences between the children with refracture and those with primary fracture in the site or type of primary fractures (P ＞ 0.05).Conclusions Refracture after surgery for femoral shaft fracture in children may be closely associated with their gender,age and overweight.Care should be taken to avoid refracture in children with high risks.