BACKGROUND:Topical tranexamic acid (TXA) administration has been described to be effective in decreasing blood loss in total hip arthroplasty (THA).Most of research focus on the postoperative total drainage,but the drainage at different time points after replacement is little reported.OBJECTIVE:To investigate the effect of topical TXA on the volume of drainage at different time points after THA.METHODS:Data of 79 cases of primary unilateral THA were analyzed retrospectively,and allotted to two groups.TXA group (n=38) was subjected to the reverse perfusion of 1.5 g of TXA (50 mL) by drainage tube after THA,and control group (n=41) was given 50 mL of normal saline in the same way.The postoperative drainage at 1,2 and 3 days,total postoperative drainage,and hemoglobin level at postoperative 3 days were collected and compared between two groups.RESULTS AND CONCLUSION:There was no significant difference in the baseline data between two groups (P ＞ 0.05).(1) The postoperative drainage at 1 day and total drainage in the TXA group was significantly lower than that in the control group,and the drainage showed no significant difference at postoperative 2 and 3 days between two groups (P ＞0.05).(2) The hemoglobin level was significantly increased in the TXA group compared with the control group at 3 days postoperatively (P ＜ 0.05).(3) To conclude,the topical TXA administration can reduce the postoperative drainage in primary unilateral THA,especially at the first day.

Objectives:To investigate in vitro tumor killing effect of recombinant human perforin C terminal truncated 125 amino acid polypeptide (rhPFP C) and N terminal truncated 118 amino acid polypeptide (rhPFP N, 22 139aa) using liver cancer cell line SMMC 7721 as target cells. Methods:Recombinant human PFP C and PFP N peptide were expressed by E.coli in fusion form with glutathione S transferase(GST), and were purified by affinity chromatography with glutathione agarose. Liver cancer cell line SMMC 7721 was treated with fusion proteins in different concentrations for 24 h before surviving cells were measured with microscopy and colorimetric MTT assay. Results:After treatment with rhPFP C or rhPFP N, SMMC 7721 cell membrane damaged, appeared lysis. In MTT assay, optical density values in test group were significantly lower than those in control group. At concentration of 2.5 ?g/ml, the killing activity of rhPFP C and rhPFP N were 33.38% and 5.90% respectively. Conclusions:Both rhPFP C and rhPFP N showed obvious killing effect on liver cancer cell line SMMC 7721.The activity of rhPFP C was great higher than that of rhPFP N.

Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Objective To explore the way to compile a global military medical literature collection and perspectives for its research.Methods The names of military medical research institutions and their trends of development were summa-rized via semantic analysis.The collection of retrieval words for military medical research institutions( then the collection) was constructed based on expert consultation.The names of military medical research institutions were collect-ed with manual screening after retrieval withthe collection.The literature collection of military medical research institu-tions was completed with coordinated retrieved of their papers and other publications.Results According to different needs of information analysis, the literature collection of military medical research institutions could be analyzed in terms of their size, types of development, and academic authority.Conclusion Based onthe collection, the military medical research institutions collected in this article included institutions that used to be neglected during the course of information tracking of military medicine.Three kinds of institutions should be paid more attention to.The institutions were the ones with a large number of papers and citations, the ones whose papers increased or decreased dramatically, as well as the ones whose research directions were the priority fields of Chinese PLA.

Objective To observe the mRNA and protein expression of SOCS-1 and SOCS-3 in the peripheral blood mononuclear cells(PBMCs) in patients with systemic inflammatory response syndrome(SIRS) and explore its clinical significance.Methods Peripheral blood of 20 patients with SIRS and 16 healthy people wag collected and the PBMCs were isolated by centrifugafion and Ficoll-Hypaque sedimentation.The mRNA of SOCS-1 and SOCS-3 was determined by reverse transcription-polymerase chain reaction(RT-PCR).And the protein content of SOCS-1 and SOCS-3 was determined by Western Blotting.Results The SOCS-1 mRNA expression in the PBMCs of SIRS group (0.642±0.112) was significant higher than that of control group(0.458±0.044)(P<0.05).There was no significant difference between the PBMCs,SOCS-1 content of control group(0.488±0.019) and SIRS group (0.471±0.041).The SOCS-3 mRNA expression in the PBMCs of SIRS group(0.989±0.324) was higher than that control group(0.459±0.046)(P<0.05).There was no significant difference between the PBMCs'SOCS-3 content of control group(0.400±0.025) and SIRS group(0.426±0.015).Conclusions The mRNA expression of SOCS-1 and SOCS-3 in the PBMCs were higher in SIRS patients.The SOCS-1 and SOCS-3 may participate in the development of SIRS.

Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.

Objective To evaluate diagnostic value of mitral regurgitation jet volume(MRvol) in the quantification of mitral regurgitation severity by general imaging three-dimensional quantification (GI3DQ) using the guideline recommended 2D integrative method as a reference.Methods Ninety-three patients with MR were divided into central MR group(n =41) and eccentric MR group(n =52).The American Society of Echocardiography (ASE)-recommended 2D integrative method was used as a reference for MR grading and MRvol was directly measured by GI3DQ method.Results In central MR,as assessed by receiver operating characteristic (ROC) analysis,the area under the curve(AUC)was 0.87(P <0.0001), and MRvol by GI3DQ at a cutoff value of 16.2 ml yielded 96.2% of sensitivity and 63.6% of specificity to differentiate mild from moderate MR;the AUC was 0.98(P < 0.0001),and a cutoff value of 47.8 ml yielded 98.6% of sensitivity and 96.2% of specificity to differentiate moderate from severe MR. In eccentric MR,the AUC was 0.76(P =0.086),and MRvol at a cutoff value of 14.8 ml yielded 90.9% of sensitivity and 60.0% of specificity to differentiate mild from moderate MR;the AUC was 0.84(P <0.0001) and a cutoff value of 40.7 ml yielded 80.0% of sensitivity and 79.7% of specificity to differentiate moderate from severe MR.Conclusions MRvol measured directly by GI3DQ could more exactly evaluate MR severity,and have better sensitivity and specificity to differentiate moderate from severe MR in central MR.

Objective To investigate the clinical effect of clivo-axial angle(CAA)in the posterior approach for patients with unstable upper cervical spine.Methods Twenty-one patients with unstable upper cervical spine treated with posterior approach surgery from October 2014 to March 2016 were included in this study,and the patients were divided into the decompression group(11 cases)and the non-decompression group (10 cases)according to whether the intraoperative decompression was included.The clivo-axial angle(CAA) were measured by mobile three-dimensional before and after the surgery in order to estimate the reduction of spinal cord compression effect after the posterior cervical surgery combined with the reduction,fixation and bone graft fusion,then to guide the restoration.CT was used to measure the CAA and MR was used to measure the cervico-medullary angle(CMA)before operation and 3 months after operation.Japanese Orthopedic Association (JOA)scores was used to evaluate the neurological function 6 months after operation.Results All patients were followed up for 6-12 months.CMA((156.3±3.6°)vs.(155.9±2.7°))and CAA((154.3±5.1°)vs. (151.3±4.7°))of the decompression group and the non-decompression group at 3 months after surgery were improved significantly compared with those collected before the surgery(CMA:(131.5 ± 0.6°)vs.(131.1 ±0.5°);CAA:(133.2 ± 1.7°)vs.(132.4 ± 1.2°)),the differences were statistically significant(CMA: t=-21.81,P=0.00 vs.t=-28.54,P=0.00;CAA: t=-12.44,P=0.00 vs.t=-11.68,P=0.00).After operation,CAA((152.3 ± 1.3)vs.(132.6 ± 1.5))was significantly improved,compared with that before reduction((131.1±1.9)vs.(132.4±1.5°))(t=-30.09,P=0.00 vs.t=-35.93,P=0.00).JOA scores of the two groups at 6 months after operation((9.8±1.3)points vs.(10.3±1.7)points)were significantly lower than those before the surgery((7.1 ± 0.7)points vs.(7.6 ± 1.1)points),the differences were statistically significant(t=6.01,P=0.00 vs.t=4.36,P=0.00).No complications such as fixed failure,infection,spinal cord injury and vertebral artery injury were found in all patients.Conclusion For patients with upper cervical spine instability,the usage of intraoperative three-dimensional C arm scanning in CAA measurement to determine the effect of spinal cord compression can guide the reduction,simple and feasible,the clinical effect is satisfactory.

Objective To investigate the clinical value of 3D printing technique in the treatment of adult displaced clavicle fracture.Methods The clinical data of forty adult patients with displaced clavicle fracture treated in Yan' an University Affiliated Hospital from January 2016 to December 2016 were retrospectively collected.According to different surgical methods,the patients were divided into group A and group B,with 20 cases in each group.The group A received the CT scan of the uninjured lateral clavicle before operation to obtain the original data.The mimics 17.0 software was used to perform 3D reconstruction and to generate the affected side mirror model.The 3D printer was introduced to print the affected mirror model.According to the model of preoperative planning,minimally invasive surgery was performed under model guidance.The group B(20 cases)was underwent minimally invasive surgery via conventional C arm fluoroscopy.The operation time,blood loss,fluoroscopy times and postoperative hospital stay in the two groups were recorded.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up were recorded.Results All patients received postoperative follow-up for nearly 6 months.The operation time of the two groups were(35.8±11.6)min and(50.1+15.5)min(t=3.303,P=0.002),the intraoperative blood loss were(38.4±9.3)ml and(60.3±10.2)ml(t=7.095,P=0.000), respectively,the fluoroscopy times of the two groups were(5.2±1.6)times and(9.7±2.1)times(t=7.622,P=0.000)respectively,the postoperative hospitalization stay were(6.7±0.5)d and(7±0.6)d(t=1.717,P=0.093),the differences were statistically different.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up in both two groups were improved significantly than those in preoperative(P<0.05),while there were no significant differences in the two scores between the two groups(P>0.05).Conclusion 3D printing technique assisting minimally invasive surgery for displaced clavicle fractures in adults has the advantages of shorter operation time,less intraoperative blood loss and less fluoroscopy.The clinical follow-up Results are satisfactory.

Objective To introduce the application of 3D printing individualized plastic guide plate in the treatment of pelvic and acetabular fracture and to evaluate its application value.Methods From June 2016 to April 2017,the clinical data of eleven adult patients with pelvic and acetabular fracture was analyzed retrospectively.The pelvic CT scan was performed before operation to obtain the original data.Three-dimensional reconstruction performed by mimics 17.0 software with the data and the fracture reduction performed on the software.3D printing individualized plastic guide plate was designed and made to guide the pre-implantation plate bending and shaping.The pre implantation plate bending was completed according to the plastic guide.Postoperative Matta imaging score was used to evaluate fracture reduction,while the function of the hip joint was assessed by the Harris scores.Results All the operations were successfully completed.There were no adverse complications during or after the operation.Anatomical reduction was performed in 10 cases and functional reduction in 1 case.The excellent and good rate of Matta scores was 90.9%,excellent in 7 cases,good in 3 cases,fair in 1 case and no poor case.The excellent rate of Harris scores was 81.8%,excellent in 6 cases, good in 3 cases,fair in 2 cases and no poor case.Conclusion In the treatment of pelvic and acetabular fracture,the application of 3D printing individualized plastic guide plate may not only make mode simple and feasible and save time and materials,but also simplify the operation,reduce the difficulty of operation and hold satisfactory clinical effect.