BACKGROUND:With the increased number of patients with total hip arthroplasty, blood source became less gradual y. Simultaneously, the risk of a variety of serious diseases infected by blood transfusion troubled the patients. Thus, it is very important to find a method that can reduce blood transfusion and did not increase risk. There are reports addressing the application of tranexamic acid to reduce bleeding during total knee, total hip arthroplasty and spinal surgery.
OBJECTIVE:To explore the effects of injection with tranexamic acid through articular cavity and discontinuous clip pipe on blood loss, functional recovery and complication after total hip arthroplasty.
METHODA total of 99 patients, who received total hip arthroplasty because of femoral fracture or coxarthropathy from January 2011 to February 2014, were selected in this study. They were divided into tranexamic acid group (n=55) and control group (n=44). After skin suture, patients in the tranexamic acid group were injected with 2.0 g tranexamic acid dissolved in 20 mL physiological saline through articular cavity. After replacement, the drainage was opened after 2 hours of interval. From then on, the drainage was opened for 10 minutes every 4 hours. Patients in the control group received discontinuous clip pipe. Negative pressure drainage tube was pul ed out at 48 hours after replacement. Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit, preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time, 6-month postoperative hip Harris score and lower extremity deep vein thrombosis or pulmonary embolism were compared between the two groups.
RESULTS AND CONCLUSION:Significant differences in blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were visible after replacement in patients of both groups (P<0.05). Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were better in the tranexamic acid group than in the control group. No significant difference in preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time was detectable between the two groups (P>0.05). No significant difference in 6-month postoperative hip Harris score was found between the two groups (P>0.05). No lower extremity deep vein thrombosis was observed using Doppler ultrasonography at 3, 10 and 14 days after replacement in 99 patients. Lower extremity deep vein thrombosis or pulmonary embolism was not detected at 6 months after replacement. Above data indicated that injection with tranexamic acid through articular cavity and discontinuous clip pipe after total hip arthroplasty could obviously decrease postoperative blood loss and blood transfusion, and did not increase the risk of lower extremity deep vein thrombosis.

AlM: To understand the prognostic factors of myopic rhegmatogenous retinal detachment ( RRD) surgery, and provide guidance for clinical treatment.
METHODS: This retrospective study included 288 myopic RRD eyes ( excluding trauma, aphakia, congenital diseases, tractional and exudative retinal detachment ) from April 2007 to April 2014 in our department. The surgical anatomic reduction situation was statistically recorded, the effects of hole's size, retinal detachment duration on sight restoration and surgery success rate were analyzed
RESULTS:The statistical results showed that 245 eyes (85. 1%) healed after their first operation, about 95. 1%cases finally healed after their second or third operation. The degree of myopia and aging factor influenced the RRD operation:the higher degree and the older age were, the lower success rates were (P<0. 05). Through surgery, postoperative visual acuity was significantly better than the preoperative ones ( P<0. 01 ). A higher degree of myopia RRD led to poor visual acuity ( P < 0. 01 ). Postoperative visual acuity of 152 eyes ( 52. 9%) were improved, of which 106 eyes' visual acuity was 0. 05 or more.
CONCLUSlON:Surgery is an effective means of treating myopic RRD. The older patients have lower success rates. A higher degree of myopia led lower reset rate after retinal detachment surgery and poor postoperative visual acuity. When treat myopic RRD, we should pay attention to the recovery of visual function.

Objective To study the impact of sodium arsenite(NaAsO2) exposure on melanoma cells A375 (hereinafter referred to as the A375) and G361 (hereinafter referred to as the G361) pigment production and tyrosinase (TYR) activity and the differences of pigment metabolism capacity between the cell lines.Methods A375 and G361 cells were exposed to sodium arsenite at concentrations of 0.0(control),0.1 and 1.0 μmol/L for 72hours.Cell viability was measured by Alamar Blue assay.Melanin levels and TYR activity were measured at the same time.Results After exposure for 72 hours,the cells of 0.1 μmol/L dose groups of both of the two cell lines [A375:(103.32 + 1.26)％; G361:(104.10 + 1.76)％] showed a slightincrease of proliferation without significant differences compared with those of the control[A375:(100.00 ± 1.08)％; G361:(100.00 + 1.79)％,all P ＜ 0.05] ;while cell viability of the 1.0 μmol/L dose group of both of the two cell lines[A375:(75.32 ± 1.59)％; G361:(78.26 ± 2.10)％] were significantly lower than those of the control (all P ＜ 0.05).Melanin levels of G361 cell line [(7.19 ± 0.35),(7.34 ± 0.83),(8.19 ± 0.86)pg/cell] were significantly higher than that of A375[(4.35 ± 0.72),(4.54 ± 0.01),(4.60 + 0.59)pg/cell,all P ＜ 0.05] in all the three groups.TYR activity of G361 cell line [(54.13 ± 1.21),(54.56 ± 0.21),(56.25 ± 0.85)Bq] were also markedly higher than that of A375 cell[(42.00 ±0.21),(42.90 ± 0.54),(42.91 ± 0.01)Bq,all P ＜ 0.05] in all the three groups.The melanin levels and TYR activities of both of the two cells lines showed an increase tendency along with increased doses of arsenic exposure,but without significant differences when compared with those of the three groups (all P ＞ 0.05).Conclusions Arsenic related pigment disorder may be associated with increased melanin levels and TYR activities induced by arsenic exposure; individual difference of pigment metabolism may be associated with different basal melanin levels and TYR activity between different individuals.

Objective To establish the diagnosis criterion and management protocol for nonalcoholic steatohepatitis(NASH).Methods The data of 75 patients with NASH including 10 chronic hepatitis,10 simple fatty,15 alcoholic liver disease,10 healthy conerol and 40 tpye 2 diabetic patient without viral hepatitis were investigated.Results Among 75 NASH patients,the mean age was 36.8 years,and male were 66(88%);their body mass index(BMI)≥25 were 58 (77.3%).Serum ALT and insulin concentration were elevated in all patients with NASH;60 cases were with hypertriceridemia (80%),30 with normal oral glucose tolerate test (OGTT) (40%),fatty liver was detected in 67 patients (90%)by ultrasonography.The BMI were different between NASH and healthy controls,P

Objective To investigate the current status analysis the risk factors of medical adhesive related skin injury(MARSI) in neonates in NICU, in order to provide guidance in prevention and nursing of the skin injury. Methods Convenience sampling five NICU in Shenyang, prospective investigate the incidence of MARSI of neonates during the NICU stay, and analysis the incidence , injury type distribution and risk factors. Results The incidence of MARSI in neonates in NICU was 12.8%(53/413);the major injury type of MARSI was epidermal stripping(47.2%,25/53)and skin tear(35.8%,19/53) in mechanical injury;Logistic analysis showed that the independent risk factors of MARSI were the use of stomach tube, dehydrate skin and blue light therapy (χ2=5.953, 9.806 and 7.568, P<0.05). Conclusions MARSI is frequency interrupted in neonates during the NICU stay, correct selection of medical adhesive products, application of suitable paste and remove skills are helpful to reduce the incidence of MARSI in neonates during the NICU stay.

To prepare monoclonal antibodies for blocking acute hemorrhagic conjunctivitis (AHC)viruses,BALB/C mice were immunized with Hela cells.The spleen of immunemouse was re-moved,and spleen cells were fused with SP2/0 cells.The antibodies against cell receptors wereselected by cell protection assay.Four cell strains secreted McAbs designated R7.R8.R16 andR24 were screened to be able to block cellular receptors and inhibit the infection of Ev70 as wellas CA24v on Hela cell.These results demonstrate that the receptors for Ev70 and CA24v are si-miliar.Indirect immunofluorescence test with the four McAbs showed definite fluorescence onliving Hela cells,which the intensity was concordance with the mean intensity resulted fromflowcytometer.Positive reaction on fixed Hela cells were only observed with R7 and R8.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Neuromyelitis Optica ; therapy

Objective To investigate the effect of sodium fluoride(NaF) on proliferation, differentiation and the mRNA expression of osteoprotegerin (OPG) and receptor activator of nuclear factor κβ ligand (RAN KL) of mouse osteoblasts. Methods Osteoblasts were isolated from calvarias of Kunming mice born in 1 - 2 d and cultured. Various concentrations of NaF(0, 10-8, 10-7, 10-6, 10-5, 10-4, 10-3mol/L) were added to the culture medium, the proliferation and activity of alkaline phosphatase(ALP) was determined after 72 h or 120 h. The expression of OPG mRNA and RANKL mRNA was analyzed by semi-quantification RT-PCR. Difference among groups was analyzed by One-Way AN0VA. Difference between two groups was analyzed by LSD-t test. Results There was significant difference in cell proliferation among groups after 72 h(F = 13.806, P < 0.05). Compared with control group(0.434 ± 0.010) , the proliferation was significantly induced in 10-7 - 10-4 mol/L groups treated osteoblasts (0.448 ± 0.010, 0.453 ± 0.013, 0.454 ± 0.016, 0.449 ± 0.018, all P< 0.05), and was significantly suppressed in 10-3 mol/L group(0.401 ± 0.009, P < 0.05). There was statistic difference in the activity of ALP among groups(F = 9.021, P < 0.05). Compared with control group (1.677 ± 0.682), the activity of ALP significantly increased in 10-7 - 10-5 mol/L groups[ (2.447 ± 0.756) × 106, (2603 ± 0.183) × 106, (2.687 ± 0.886) × 106 U/L, P < 0.05 or P < 0.01 ] and significantly decreased in 10-4 mol/L group[ (1.479 ± 0.366) × 106 U/L, P < 0.05 ]. There was significant difference in the expression of OPG mRNA among groups(F = 11.299, P< 0.05). Compared with control group (1.000 ± 0.000), the expression of OPG mRNA was significantly increased in 10-7 - 10-4 mol/L groups( 1.058 ± 0.027, 1.053 ± 0.026, 1.088 ± 0.055, 1.069 ± 0.008, P < 0.05 or P < 0.01) , while significantly decreased in 10-3 mol/L group (0.941 ± 0.029, P< 0.05). There was no difference in RANKL mRNA expression among groups (F= 1.311, P> 0.05). The ratio of RANKL/OPG decreased with increasing doses of fluoride and increased in 10-4, 10-3 mol/L groups, but there was no difference between groups(F = 1.376, P> 0.05). Conclusions A biphasic pattern of proliferation and differentiation has been induced in mouse osteoblasts, which manifests stimulation effect in low doses and suppression in higher doses. Low doses of sodium fluoride suppress differentiation and maturation of osteoblasts by increasing expression of OPG mRNA, while high doses of sodium fluoride enhance differentiation and maturation of osteoblasts by decreasing expression of OPG mRNA.

Objective:To compare the clinical effects of restrictive blood transfusion combined with hyperbaric oxygen preconditioning (HBOPC) and restrictive blood transfusion in the treatment of hip,knee arthroplasty (THA,THA).Methods:40 patients in the period of epidural anesthesia,femoral nerve hysteresis hip and knee arthroplasty were selected and randomly divided into two groups:restrictive transfusion group (maintain 80 g/L≤ Hb ＜100 g/L,n=20) and restrictive blood transfusion combined with HBOPC (HBOPC+maintain 80 g/L =Hb ＜100 g/L,n=20).The red blood cell transfusion,red blood cell transfusion rate,perioperative Hb,blood oxygen saturation (SO2),the incidence of hypotension during operation,hospitalization time and postoperative cerebral infarction,acute pulmonary embolism,pneumonia,myocardial infarction,wound infection rate and 90 days mortality rate were compared between two groups.Results:Compared with the restrictive transfusion group,the postoperative Hb,blood oxygen saturation (SO2) of restrictive blood transfusion combined with HBOPC group were significantly increased(P ＜ 0.05);the red blood cell transfusion,red blood cell transfusion rate,incidence of pneumonia,wound infection rate were significantly decreased (P＜0.05).Conclusion:Restrictive blood transfusion combined with hyperbaric oxygen preconditioning could improve the anoxic state of the hip,knee arthroplasty patients,which could effectively reduce red blood cell transfusion,reduce postoperative complications,has good clinical curative effect.