Objective To investigate the efficacy and safety of tranexamic acid in perioperative blood loss in old patients with multi-level lumbar spinal stenosis.Methods From January 2009 to September 2010,a total of 68 consecutive patients with multi-level lumbar spinal stenosis ( ≥65 years old) underwent posterior decompression,internal fixation and bone graft fusion who were randomly divided into group A and group B with 34 patients in each.The patients in group A received tranexamic acid and the patients in group B received an equal volume of normal saline.The amounts of intraoperative blood loss,postoperative wound drainage,blood transfusion,the number of the patients needing blood transfusion and hemoglobin,fibrinogen,prothrombin time and so on were examined preoperatively and 24 hours postoperatively.All the patients were observed for the clinical symptoms of deep vein thrombosis.Results The amounts of intraoperative blood loss,postoperative wound drainage,blood transfusion and the number of the patients needing blood transfusion in group A were significantly decreased than those in group B[ (641.1 ± 128.4) ml vs.(780.1 ± 107.3) ml,(228.80 ± 52.07) ml vs.(345.50 ±42.16) ml,(1.02 + 1.56) U vs.(2.89 ± 1.76) U,16 cases vs.28 cases ],there were significant differences between two groups (P ＜ 0.05 ).As for the value of postoperative hemoglobin concentration in group A [ ( 104.00 ± 4.87) g/L ] was significantly higher than that in group B [ (92.20 + 5.47 ) g/L ] (P ＜ 0.05 ).There were no significant differences in the levels of fibrinogen,prothrombin time,and activated partial thromboplastin time between two groups (P ＞ 0.05).No deep vein thrombosis was found 7 days postoperatively.Conclusion Tranexamic acid can be effectively used in spine surgery in old patients with multi-level lumbar spinal stenosis without increasing the risk of venous thrombosis.

Objective To evaluate the clinical effect of postural reduction and bracing on thoracolumbar fractures without neurological deficit.Methods21 patients with thoracolumbar fractures(T11～L2

【Objective】 To explore the correlation between serum vitamin D level and male semen parameters and serum sex hormones. 【Methods】 A total of 56 men who received assisted reproductive treatment in our hospital during Oct.2020 and Oct.2021 were included in the infertility group, and 56 male patients with previous reproductive histories who were treated due to other diseases during the same period were enrolled as the control group. The sperm motility and concentration were assessed using a computer assisted semen analysis system (CASA). The normal sperm morphology rate was evaluated with sperm morphological staining. Sperm DNA fragmentation index (DFI) was detected with chromatin diffusion method to evaluate sperm chromatin integrity. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T) and 25-hydroxyvitamin D [25(OH)D] were detected with ELISA. The correlation between serum 25(OH)D level and semen parameters and sex hormones was analyzed. 【Results】 Serum 25(OH)D level was significantly higher in the control group than in the infertile group (P=0.002). It was positively correlated with semen parameters, including sperm motility (r=0.483, P<0.001), sperm count (r=0.216, P=0.019), and testosterone level (r=0.210, P=0.025). There was no significant correlation between serum 25(OH)D concentration and sperm morphology, LH and FSH levels. 【Conclusion】 Serum 25(OH)D is significantly correlated with and affects total sperm count, sperm motilityand serum testosterone, thus playing a role in male reproduction. The specific mechanism needs further study.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.