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 explore the unified assessment methods based on present situation of after-department examination during the internship in the department of obstetrics and gynecology.Methods The present situation of after-department examination in the department of obstetrics and gynecology in 36 comprehensive hospitals of Chongqing Three Gorges Medical College were investigated through interviews and research papers including 12 grade A hospital of the first class hospital (33.33％),19 grade A hospital of the second class(52.78％) and 5 grade B hospital of the second class(13.89％).Totally 137 students of clinical major in 4 grade A hospital of the second class were enrolled and were divided into study group(n=72) and control group(n=65).hems of theoretical examination and skill examination as well as the evaluation standard were established combining with the syllabus of the licensed assistant doctors and the talent training scheme requirements.Students in study group were trained according to the practice syllabus,skill examination requirement and evaluation require-ment while those in control group had no cmresponding requirement.After-department examination was organized by school at the end of internship.The full score of theoretical examination and skill examination score was 50 respectively.Smvey results of after-depamnent examination were analyzed by Fisher's Exact Test and the results of after-depamnent examination were analyzed by t test.Results The hospitals having the after-department examination accounted for 80.56％(29/36).The hospitals having the after-depamnent examination according to the practice syllabus requirements accounted for only 20.69％(6/29).After the intervention,theoretical examination scores of study group and control group were 40.31 ± 3.47 and 35.78 ± 4.92,respectively,with statistically significant differences(t=6.26,P=0.000).The skills assessment scores of study group and control group were 40.42 ± 3.02 and 34.05 ± 5.18,respectively,with statistically significant differences(t=8.90,P=0.000).Conclusions The after-department examination in hospital is in a state of randomness,so unified assessment methods are necessary.

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.

OBJECTIVETo explore the effect of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] on bone regeneration rabbit mandible during distraction osteogenesis (DO).

METHODS40 Japanese white rabbit (weight 2.0-2.5 kg) were randomly divided into control group and groups. The experimental groups were divided inito 12.5, 25 and 50 µg/kg group according to the dosage of rhPTH (1-34) in each group. Each group involved 10 rabbits, and unilateral DO models were established at the right mandible of the rabbits. From the first day of distraction to the day of execution, the rabbits in the experimental groups were injected subcutaneously rhPTH (1-34) of the corresponding dose respectively, and the rabbits in the control group were injected subcutaneously 2% heat inactivated rabbit serum 1 ml respectively.. Five rabbits in each group were executed respectively at 1 week and 3 weeks after completion of distraction, and the specimens of DO were harvested. The gross observation, X-ray examination, and histological study were performed.

RESULTSGross appearance: At the first week of consolidation, the dense and opaque white tissue was seen in the distraction gap of the 50 µg/kg group, and the white translucent tissue was seen in the distraction gaps of the rest groups. At the third week of consolidation, the greyish white tissue was seen in the distraction gap of the control group, while the cartilage-like tissue was seen in the buccal side of the distraction gap of the 12.5 µg/kg group, the color of new-formed tissues was close to that of normal bone tissue in the lingual side. The buccal tissue at the edge of the distraction gap of the 25 µg/kg group fitted together with the primary bone tissue in its two sides. It was difficult to distinguish the boundaries between the distraction gap and the bone tissues in its two sides in the 50 µg/kg group. X-ray findings: At the first week of consolidation, a sparse opaque image was seen in the distraction gap of the 50 µg/kg group, and a low-density image was seen in the distraction gap of the rest groups. At the third week of consolidation, a sparse bone image was seen in the control group, and the edge of the bone was not continuous. With the increase of the dose in the experimental groups, the image of the distraction gap became more and more opaque, and the image of the distraction gap in the 50 µg/kg group was close to that of the normal bone tissue. HISTOLOGICAL FINDINGS: At the first week of consolidation, few osteoblasts were present at the edge of the distraction gap of the control group. A large number of bone cells and bone trabecular were present in the distraction gap of the 12.5 µg/kg group, the network of the bone trabecula was present in the 25 µg/kg group, and a few new bones were found in the 50 µg/kg group. At the third week of consolidation, the network of the trabecular bone was present in the distraction gap of the control group, while the network of the bone trabecula was present in the 12.5 µg/kg group, a lot of bone-like tissues in the 25 µg/kg group, and near-mature bone in the 50 µg/kg group.

CONCLUSIONSrhPTH(1-34) can promote the formation of new bone in the distracted gap during mandibular DO in rabbits.

Animals ; Bone Density ; Bone Regeneration ; drug effects ; physiology ; Humans ; Mandible ; drug effects ; surgery ; Osteogenesis, Distraction ; methods ; Parathyroid Hormone ; pharmacology ; Rabbits ; Random Allocation ; Recombinant Proteins ; pharmacology

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 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.

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.

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 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.