Objective To evaluate the effect of tranexamic acid (TXA ) in medical treatment of chronic subdural hematoma (CSDH) .Methods A total of 19 patients with CT-confirmed CSDH in our department from Mar 2014 to Aug 2015 received an in-travenous dose of 1g TXA in the first week ,and followed by a maintenance oral dose of 250 mg TXA three times a day for 1 - 5 months (2 .73 ± 1 .05) months .These patients received a follow-up period of 6 - 10 months .Hematoma volume and neurological functions were compared before and after treatment .Results The therapeutic outcome was divided into effectiveness and ineffec-tiveness .Thirteen cases (68 .4% ) were effective ;six cases (31 .6% ) were ineffective .Among them ,three patients (15 .8% ) whose neurological functions deteriorated underwent surgery ,one patient (5 .3% ) who did not show any improvement with initial one month of TXA underwent surgery ,one patient (5 .3% ) stopped the treatment due to the side-effect of drug ,one patient (5 .3% ) lost .Conclusion Results of this preliminary study show that the administration of TXA is effective and safe in treating CSDH .

Objective To investigate the effect of Galangin on migration and invasion in gliomas and explore the possible mechanism.Methods (1) After treating the glioma lines U87 and U251 with 0,10,20 and 40 μmol/L galangin for 24 h,CCK-8 was performed to detect the cell viability;wound healing assay and Transwell assay were used to detect the cell migration and invasion,respectively;protein expression of transforming growth factor (TGF) β was detected by Western blotting.(2) The second experiment was divided into control group,20 μmol/L galangin treatment group,TGFβ over-expression group and 20 μmol/L galangin+TGFβ over-expression group;the cells in the control group and 20 μmol/L galangin treatment group were transfected with empty-vector plasmids;cells in the TGFβ over-expression group and 20 μmol/L galangin+TGFβ over-expression group were transfected with TGFβ plasmids,and 24 h after the transfection,the cells in the 20 μmol/L galangin treatment group and 20 μ mol/L galangin+TGFβ over-expression group were added 20 μmol/L galangin;24 h after that,wound healing assay and Transwell assay were used to detect the cell migration and invasion,respectively;TGF β protein expression was detected by Western blotting.Results (1) As compared with cells from the 0,10 and 20 μmol/L galangin group,the cells from 40 μmol/L galangin group had significantly lower cell viability (P＜0.05).Cells from the 0,10 and 20 μmol/L galangin group had significantly decreased wound healing percentage,significantly decreased cell number reaching to the lower chamber,and statistically decreased TGFβ protein expression in sequence (P＜0.05).(2) U87 and U251 cells from the TGFβ over-expression group,control group,20 μmol/L galangin+TGFβ over-expression group and 20 μmoll/L galangin treatment group had successively decreased wound healing percentage,decreased cell number reaching to the lower chamber,and decreased TGFβ protein expression (U87 cells:1.63±0.21,1.00±0.00,0.78±0.05 and 0.43±0.08;U251 cells:1.98±0.20,1.00± 0.00,0.86±0.06 and 0.29±0.04),with significant differences (P＜0.05).Conclusion Galangin inhibits the glioma migration and invasion through TGFbβ down-regulation.

Objective : To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces. Methods: Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied. Results: Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital. Conclusion For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.