Objective To study the effect of tranexamic acid on the blood loss in vein and joint of patients with total knee arthroplasty. Methods 90 patients diagnosed with primary osteoarthritis from January 2012 to December 2013 were selected as subject.They were scheduled for the first-time unilateral total knee arthroplasty.All patients were divided into three groups randomly.Experimental group one was tranexamic acid intravenously,Experiment group two was given tranexamic acid with knee local injection,and Experimental group three was given nothing.Hemoglobin and total blood loss were detected and compared in 48 hours after operation in three groups;subcutaneous ecchymosis situation within 7 days were recorded and compared.Results Hemoglobin levels of Experiment group one and Experiment group two in 20 hours and 48 hours after operation were more than those of Experiment group three significantly (P<0.05 );hemoglobin levels in three groups in 20 hours and 48 hours after operation were all less than before operation (P<0.05 ),and hemoglobin in 20 hours after operation were all less than those of 48 hours.Total blood loss,blood transfusion cases and subcutaneous ecchymosis in Experiment group one and Experiment group two were all less than those in Experiment group three (P<0.05 ), but there was no statistically significant difference of those datas between Experiment group one and Experiment group two.Conclusion Tranexamic acid could reduce blood loss in knee replacement surgery and reduce the suffering and economic burden of patients.

Ameloblastoma ; pathology ; Bone Neoplasms ; classification ; genetics ; pathology ; Chondromatosis ; pathology ; Chondrosarcoma ; classification ; pathology ; Enchondromatosis ; pathology ; Humans ; Osteosarcoma ; classification ; pathology ; Sarcoma, Ewing ; pathology ; Societies, Medical ; United States ; World Health Organization

Objective To investigate the role of real-time visualization during flexible cystoscopy in alleviating pain in male patients. Methods A total of 110 male patients under going diagnostic and monitoring flexile cystoscopy were randomized into 2 equal groups. Group A included 55 patients who were allowed to view the procedure on a video monitor; Group B included 55 patients who were not allowed to. All procedures were finished by a single urologist. Patients in both groups were given explanation before cystoscopy, and those in Group A were also given explanation when they were watching the video monitor. The patients'pain feeling was recorded on an VAS (visual analogpain scale) ranging from 0 to 10 after flexible cystoscopy. The pulse and respiratory rate were also recorded. Results The patients in Group A had a significantly lower VAS score than those in Group B (1.29±1.20 vs 3.36±2.46, P<0.001). The postprocedure pulse rate and respiratory rate were not significantly different between the two groups. Conclusion To be allowed to watch the flexible cystoscopy procedure on a video monitor with simultaneous explanation can alleviate pain in male patients.

Objective To discuss the method to increase the success rate of stomach tube insertion for patients with indwelling nasotracheal tube in order to shorten the time of insertion operation and reduce the discomfort of patients.Methods Seventy patients with nasotracheal tube were randomly divided into the observation group(38 cases)and the control group(32 cases).When the operator for the observation group inserted stomach tube to 18～22 centimeters deep,the nurse pumped the gas out from the tracheal catheter aerocyst.After the stomach tube reached stomach the tracheal catheter aerocyst was aerified again.The control group did not release the gas from tracheal catheter aerocyst when inserting the stomach tube.The first intubation success rate and time needed for intubation were compared between the two groups.Results The first intubation success rate of the observation group was higher than that of the control group(P＜0.05).While the time needed for intubation was shorter than that of the control group(P＜0.01).Conclusions Method used by the observation group not only increased the first intubation success rate,but also shortened time needed for intubation.This method can alleviated pain of patients and worth applying widely in clinic.

This paper reported 13 cases of delayed traumatic chest wall abscess from January 2012 to January 2015.All the patients were associated with type 2 diabetes.After local puncture for confirmative diagnosis, a chest wall abscess dissection was carried out as soon as possible.At each site of upper and lower pole, an indwelling drainage tube was placed for irrigation and negative pressure suction.Sensitive antibiotics were selected based on susceptibility test results.The drainage tubes were removed 7-14 days after surgery.There were 8 cases of primary healing of incision and 5 cases of secondary healing of incision.All the patients were cured.Follow-ups for 6-36 months (average, 17 months) showed no recurrence.

OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

Trimethylamine-N-oxide (TMAO),metabolites of the intestinal microflora,is a newly discovered risk factor for cardiovascular disease.The intestinal flora converted choline and L-carnitine into trimethylamine in the food.Trimethylamine is oxidized to TMAO in liver enzymes.Lowering TMA can stimulate macrophages to reverse cholesterol transport and inhibit atherogenesis.TMAO poietin-monooxygenase 3 (FMO3) is a tool for cholesterol metabolism and reverse cholesterol transpor,lowering FMO3 can slow the gallbladder's secretion of bile,delay intestinal absorption of cholesterol,and limit the synthesis of oxidized cholesterol and cholesterol esters.TMAO in the blood can up regulate scavenger receptors in macrophages,and promote accumulation of cholesterol and formation of foam cells in macrophages,thereby promoting vascular plaque formation and promote the inflammatory response by MAPK and nuclear factor kappa B pathway.TMAO concentrates on affecting cholesterol metabolism,increasing insulin resistance,promoting platelet aggregation,increasing thrombosis,promoting vascular inflammatory response and directly leading to the formation of atherosclerotic plaques.Lowering TMAO levels can potentially prevent or treat atherosclerotic related diseases and reduce the incidence of cardiovascular and cerebrovascular diseases.The intestinal flora of the TMA/FMO3/TMAO pathway is the major pathway regulating lipid metabolism and inflammation.

OBJECTIVE:To observe analgesic effect and safety of ketorolac tromethamine combined with butorphanol tartrate in the treatment of acute pain after fracture surgery. METHODS:76 acute pain patients after fracture surgery were selected and ran-domly divided into control group and observation group,with 38 cases in each group. Control group was given Ketorolac trometh-amine injection 30 mg,ivgtt,and then 2 ml/h,0.5 mg/kg,ivgtt;observation group was additionally given butorphanol tartrate 10 mg,ivgtt,on the basis of control group. Pain degree was evaluated with VAS before and 10 min,1,2,4 and 6 h after treatment, and the occurrence of ADR was observed in 2 groups. RESULTS:10 min,1,2,4 and 6 h after treatment,VAS score of 2 groups were significantly lower than before,with statistical significance(P<0.05);6 h after treatment,VAS score of observation group was significantly higher than that of control group,with statistical significance (P<0.05);there was no statistical significance in VAS score between 2 groups 10 min,1,2 and 4 h after treatment (P>0.05). The incidence of ADR in observation group (5.26%)was significantly lower than in control group(21.05%),with statistical significance(P<0.05). CONCLUSIONS:Com-pared with ketorolac tromethamine alone,ketorolac tromethamine combined with butorphanol tartrate shows shorter analgesia dura-tion,similar therapeutic efficacy,and lower incidence of ADR.

Objective To investigate the feasibility of the gene therapy on angiogenesis after myocardial infarction in rats.Methods Thirty-six male SD rats,after the ligation of left anterior descending coronary artery,were divided into 2 groups as experimental and control one.Expressions of VEGF were measured by RT-PCR and Immunohistochemistry(IHC).Angiogenesis and capillary density were evaluated by HE stain,and qualitative and quantitative analysis were carried out.The adverse effects were tested after injection of pVEGF165-PLGA nanoparticle.Results Compared with control groups,ischemic myocardial cells persistently and stably expressed VEGF in experimental group;Vascular endothelial cells actively proliferated,and the effect of angiogenesis was significant;48 hours later,nanoparticles were observed in myocardial cells.Conclusion Injection of with pVEGF165-PLGA nanoparticle,it can stimulate effective host-derived angiogenesis,which results in the prevention of impaired cardiac muscle after myocardial infarction.It may be an effect way to treat MI.

ObjectiveTo explore the relationships of driving coping styles with driving behaviors and road accidents of drivers.MethodsThree hundreds and thirty-seven drivers were randomly surveyed by Driving Coping Questionnaire ( DCQ),Driver Behavior Questionnaire (DBQ).Results ( 1 ) Except avoidance coping style,confrontive coping and emotion-focused coping were correlated positively with the three driving behaviors ( r =0.18 ～ 0.56,P ＜ 0.01 ),and positive appraisal coping had negatively correlations with them (( r =-0.34 ～-0.41,P＜0.01 ).(2)Positive appraisal coping,confrontive coping and emotion-focused coping could predict 33.5％ of error behaviors and 23.5％ of slip behaviors.And confrontive coping and positive appraisal coping could predict 40.2％ of speeding and violation behaviors.(3) Compared with safety drivers,accident drivers had significantly differences in confrontive coping in mild and moderate crashes( t=-2.75,2.80,P＜ 0.01 ).ConclusionDriving coping styles are the important factors influencing drivers' behaviors and road safety.