Objective To examine the influence of inra-articular injection of tranexamic acid on blood loss after total knee replacement. Methods 50 patients with unilateral primary total knee replacement were enrolled and they were randomly divided into two groups:the stud-y group (n=25 cases),which were given intra-articular injection of tranexamic acid (1 000 mg) and drain clamping for 2 hour posteratively, and the control group ( n=25 cases) ,which were given physiologic saline. The blood loss,postoperative volume of drainage,hemoglobin lev-el,hematocrit,blood transfusion cases,D-dimer level and deep venous tromboemblic ( DVT) events were recorded. Results Postoperative volume of drainage,blood transfusion cases and D-dimer level were lower in the study group (P<0. 05). Hemoglobin level and hematocrit were higher in the study group (P<0. 05). No DVT ocurred in the two groups. Conclusion Intra-articular injection of tranexamic acid with 2 hours of drain-clamping is effective for reducing postoperative blood loss in total knee replacement, and there is noincrease of deep venous tromboemblic.

Objective To research and compare the effectiveness distinction between applying exclusive salcatonin and combining salcatonin and Xianling Gubao to treat osteoporotic pain patients.Methods 84 cases of osteoporotic pain patients in our hospital from Feb.2013 to Feb.2014 were selected and divided into two groups.Patients in treatment group were received combination of salcatonin and Xianling Gubao treatment.Patients in control group received salcatonin treatment only.To apply VAS judge the pain degree of patients.The clinical performance and results were observed and recorded.The degree of satisfaction of patients was surveyed through questionnaire.Results The VAS of patients in treatment group was (2.17 ±1.02), while it was (4.26 ±1.37)in control group.There were 15 cases of excellent,and 23 cases of efficacious in treatment group and the total effective rate was 90.48%.There were 10 cases of excellent,and 19 cases of efficacious in control group and the total effective rate was 60.95%.The degree of satisfaction of patients in treatment group was 95.24%,while it was 71.43% in control group.Conclusion Combining salcatonin and Xianling Gubao has better clinical effect than applying exclusive salcatonin in treatment of patients with osteoporotic pain.The combination of them could quicken the speed of recovery and increase the degree of satisfaction of patients.

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Objective To investigate the distribution and drug resistance change of Pseudomonas aeruginosa in the hospital of traditional Chinese medicine to provide a reference for the prevention and control of hospital infections.Methods Various submitted specimens from the inpatients in our hospital from Jan.2012 to Dec.2014 were performed the isolation and culture,bacterial identification and drug susceptibility analysis.Results In these 3 years,the detection rate of Pseudomonas aeruginosa positive strains was gradually increased year by year;the detection rate of sputum specimens was highest;which were mainly isolated from the patients in the respirtion department and cardiology department;the drug resistance rate of non-restricted,restricted and special antibacterial drugs showed an overall downward trend.Conclusion The sseudomonas aeruginosa isolated rate is increased year by year,the antimicrobial drugs classification management achieves initial results,and the overuse or unreasonable use of antibacterial drugs should be prevented.

BACKGROUND:Annulus puncture method is commonly reported in the establishment of intervertebral disc degeneration (IDD) models, but there is a lack of comparative studies concerning complete MRI, pathologyical and extracellular matrix changes. Thereafter, a further exploration is imperative. OBJECTIVE:To investigate the feasibility of establishing IDD models using annulus puncture. METHODS:Thirty New Zealand white rabbits were randomly divided into two groups (n=15 per group). In experimental group, through extraperitoneal approach, the L1-2, L2-3, and L3-4 intervertebral space were exposed, and then stabbed by 16-gauge hypodermic needles;while rabbits in sham operated group were only subjected to making and incision but not to puncture. Five rabbits in each group were randomly selected for MRI examination at 4, 8 and 16 weeks after modeling, and were sacrificed through air embolism to obtain the nucleus pulposus. Histological changes were observed by hematoxylin-eosin staining, and the level of proteoglycan was detected by Safranin O staining. RESULTS AND CONCLUSION:In the experimental group, T2-weighted signal in the disc was decreased in a time-dependent manner;an obvious reduction was found at 4 weeks after modeling, and reached the peak at 16 weeks. In contrast, the sham operated group showed no significant changes at each time point. Hematoxylin-eosin staining showed that in the experimental group, cartilage-like cells decreased, while fibroblast-like cells in the disc increased in number and proportion, and extracellular fibers were in disorder;all above changes became obvious at 4 weeks after surgery and the most obvious at 16 weeks, but there were no significant changes in the sham operated group. Safranin O staining revealed that the color of the tissues under puncture became lighter, and this variation became overt at 4 weeks after surgery and the most obvious at 16 weeks. In conclusion, annulus puncture is a reliable method to make IDD models.

AlM:To investigate the efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects. METHODS: ln this retrospective case analysis, 28 patients ( 28 eyes ) with persistent corneal epithelial defects after anterior segment surgery from January 2011 to June 2013 in our hospital were reviewed. After regular treatment for at least 2wk, the persistent corneal epithelial defects were treated with highly hydrophilic soft contact lenses, until the corneal epithelial healing. Continued to wear the same lens no more than 3wk, or in need of replacement the new one. All cases were followed up for 6mo. Key indicators of corneal epithelial healling, corneal fluorescein staining and ocular symptoms improvement were observed.RESULTS: Twenty-one eyes were cured (75. 00%), markedly effective in 5 eyes (17. 86%) , effective in 2 eyes (7. 14%), no invalid cases, the total efficiency of 100. 00%. Ocular symptoms of 25 cases (89. 29%) relieved within 2d, the rest 3 cases (10. 71%) relieved within 1wk. The corneal epithelial of 6 cases ( 21. 43%) repaired in 3wk, 13 cases (46. 43%) in 6wk, 7 cases (25. 00%) in 9wk, 2 cases ( 7. 14%) over 12wk. There were no signs of secondary infection. And no evidence of recurrence in 6mo.CONCLUSlON: Highly hydrophilic soft contact lenses could repair persistent corneal epithelial defects after anterior segment surgery significantly, while quickly and effectively relieve a variety of ocular irritation.

Objective To discuss the relationship between monocyte CD36 expression and carotid intima-media thickness (cIMT) in rheumatoid arthritis (RA) patients.Methods A total of 207 RA patients were divided into arteriosclerosis group and non-arteriosclerosis groups in accordance with the results of ultrasound in carotid artery,and semi-quantity score was used for cIMT in patients with RA.Risk factors of cIMT in RA patients were analyzed by Spearman correlation and Logistic regression analysis.Results C reactive protein (CRP),triglyceride (TG),tumor necrosis factor (TNF),interleukin-6 (IL-6) and monocyte CD36 expression were found to be statistically different between the two groups (P ＜0.05).Monocyte CD36 fluorescence intensity was negatively correlated with TNF,IL-6,CRP and cIMT in patients with RA (r=-0.344,P＜0.01;r=-0.646,P＜0.01;r=-0.160,P=0.021;r=-0.687,P＜0.01).Logistic analysis showed that monocyte CD36 was associated with the formation of artery atheromatous plaque in patients with RA [OR=1.580,95％CI (1.057,2.36l),P＜0.01].Receiver operating characteristic curve (ROC) curve analysis showed that monocyte CD36 fluorescence intensity was useful when the value with the area under curve was 0.926,the sensitivity and specificity was 83.7％ and 82.5％ respectively.Conclusion Monocyte CD36 fluorescence intensity is correlated with artery atheromatous plaque in patients with RA,monocyte CD36 fluorescence intensity may be a marker to estimate cIMT in RA patients.

P2X receptors are ligand gated ion channels, extracellular ATP is their natural extracellular ligand. When any of the subtypes of P2X receptors and extracellular ATP are combined, P2X channel opens, allowing cations (calcium, sodium, potassium, etc. ) pass through. Enteric nervous system is composed of the gut myenteric plexus and submucosal plexus, in both of which P2X receptors exist, mediating different effects under physiological and pathological conditions. In this paper, the enteric nervous system,P2X receptor distribution and related functions are reviewed in order to further explore the P2X receptor in the diagnosis and treatment of intestinal diseases.

OBJECTIVE:To observe clinical efficacy and ADR of blue and red light phototherapy combined with TCM exter-nal treatment in the treatment of ecthyma. METHODS:64 ecthyma patients were randomly divided into experimental group and control group by number with 32 cases in each group. Both groups were provided with intravenous drip of Erigeron injection and Shenxiong glucose injection to improve limb microcirculation. The experimental group was also provided with blue and red light phototherapy (blue light 20 min+ red light 20 min) combined with TCM external treatment once a day;while control group was provided with only TCM external treatment once a day. After 1 month treatment,clinical efficacy and healing time of 2 groups were observed and compared,and ADR monitoring was conducted. RESULTS:The cure rate of experimental group was 78.13%, and the total effective rate was 96.88%,which were higher than those of control group(40.63% and 81.25%),there was statisti-cally significant difference (P<0.05). The average healing time of experimental group was (18.75 ± 5.97) d,and that of control group was(27.12 ± 6.67)d;there was statistically significant difference between 2 groups (P<0.05). No ADR was found in 2 groups during treatment. CONCLUSIONS:Blue and red light phototherapy combined with TCM external treatment in the treatment of ecthyma has the remarkable curative effect and good safety,and shorten the healing time.