BACKGROUND:With the increased number of patients with total hip arthroplasty, blood source became less gradual y. Simultaneously, the risk of a variety of serious diseases infected by blood transfusion troubled the patients. Thus, it is very important to find a method that can reduce blood transfusion and did not increase risk. There are reports addressing the application of tranexamic acid to reduce bleeding during total knee, total hip arthroplasty and spinal surgery.
OBJECTIVE:To explore the effects of injection with tranexamic acid through articular cavity and discontinuous clip pipe on blood loss, functional recovery and complication after total hip arthroplasty.
METHODA total of 99 patients, who received total hip arthroplasty because of femoral fracture or coxarthropathy from January 2011 to February 2014, were selected in this study. They were divided into tranexamic acid group (n=55) and control group (n=44). After skin suture, patients in the tranexamic acid group were injected with 2.0 g tranexamic acid dissolved in 20 mL physiological saline through articular cavity. After replacement, the drainage was opened after 2 hours of interval. From then on, the drainage was opened for 10 minutes every 4 hours. Patients in the control group received discontinuous clip pipe. Negative pressure drainage tube was pul ed out at 48 hours after replacement. Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit, preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time, 6-month postoperative hip Harris score and lower extremity deep vein thrombosis or pulmonary embolism were compared between the two groups.
RESULTS AND CONCLUSION:Significant differences in blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were visible after replacement in patients of both groups (P<0.05). Blood loss, the number of blood transfusion, blood transfusion volume, 24-hour postoperative hemoglobin and hematocrit were better in the tranexamic acid group than in the control group. No significant difference in preoperative, 3-hour postoperative fibrinogen, prothrombin time and activated partial thromboplastin time was detectable between the two groups (P>0.05). No significant difference in 6-month postoperative hip Harris score was found between the two groups (P>0.05). No lower extremity deep vein thrombosis was observed using Doppler ultrasonography at 3, 10 and 14 days after replacement in 99 patients. Lower extremity deep vein thrombosis or pulmonary embolism was not detected at 6 months after replacement. Above data indicated that injection with tranexamic acid through articular cavity and discontinuous clip pipe after total hip arthroplasty could obviously decrease postoperative blood loss and blood transfusion, and did not increase the risk of lower extremity deep vein thrombosis.

Objkctive To determine the potential ability of the area of each peak for the proton magnetic resonance spectroscopy(1 H-MRS) in the diagnosis of DNS(Delayed neuropsychological sequelae after carbon monoxide poisoning).Methods MRI and STEAM(stimulated-echo-acquisition mode)were performed in 38 DNS patients and 18 healthy volunteers.The area of the peak of each organic compound were obtained in each volume of interest.Results The data spectra abtained from patients shows NAA(881±76),Cho(2 352 ±86),β、γGlx(3 024 ± 187).Compared with the control group,theβ、γGlx ratio and Cho area increased,but the NAA ratio decreased.The area of NAA,Cho,β、γGlx between DNS and control group were compared,the results showed significant differences (P ＜0.05).In spectroscopy,the Lip evaluated peak in 0.9～1.40 ppm were detected.Conclusion 1H-MRS may do some contribution to the diagnosis of DNS.

Objective To study the association between the plasma homocysteine level and coronary artery disease(CAD), and the methylenetetrahydrofolate reductase (MTHFR) A1298C polymorphism, the methionine synthase (MS) A2756G polymorphism and their associations to the plasma homocysteine level and CAD in the elderly . Methods One hundred and twenty-nine elderly patients with CAD documented by coronary angiogram and 48 elderly patients with normal coronary angiographic results were included in this study. Plasma homocysteine level were measured by fluorescence polarization immunoassay (FPIA) method and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to analyse the MTHFR A1298C and MS A2756G genotypes. Results The plasma homocysteine level was significantly higher in CAD group than that in the control group〔(16.2?8.6) ?mol/L vs (12.7?5.0) ?mol/L,P0.05);the prevalence of MTHFR 1298CC homozygous in the CAD patients was significantly less than that in the control group (3.1% vs 14.6%, P

Objective To investigate the relationship between aquaporin-1, -2, -3, -4 mRNA (AQP1-4) and renal parenchyma thickness in congenital hydronephrotic kidney in children. Methods The expressions of aquaporin 1, -2, -3, and -4 mRNA in hydronephrotic kidney of 37 children (aged 60.3±48.8 months) were evaluated with congenital hydronephrosis and control kidney of 6 children (aged 62.7±17.1 months) by using semi-quantitative reverse transcriptase polymerase chain reaction technique. Hydronephrotic kidney parenchyma thickness was measured by B-Ultrasound preoperative-ly and verified at operation. The relations of aquaporin 1, -2, -3, and -4 mRNA to the hydronephrotic kidney parenchyma thickness were analyzed by correlation analysis. Results The aquaporin 1 ,-2,-3, and -4/beta-actin ratio in the hydronephrotic kidney and normal kidney were 0.39±0.22 vs 0.90± 0.10, 0.42±0.20 vs 0.92±0.09, 0.525±0.22 vs 0.98±0.12, 0.30±0.18 vs 0.74±0.21 respec-tively, and the differences were significant (P<0.01). Hydronephrotic kidney parenchyma thickness measured by D-Ultrasound was 5.01±2.38 mm, which was identical with those measured at opera-tion. Significant correlation was found between the levels of aquaporin 1,-2,-3, and -4 mRNA and hydronephrotic kidney parenchyma thickness (r=0.773, 0.772, 0.557, 0.625, respectively; P< 0.01). Conclusions Significant correlation exists between decreased expressions of aquaporin 1 ,-2, -3, and -4 mRNA and atrophic change of renal parenchyma. This result may provide evidence to ex-plain the mechanism why the thinner renal parenchyma thickness, the weaker renal concentration and dilution function.

Objective:To understand the current situation of children's fluorosis in the coal-burning-borne endemic fluorosis areas (abbreviated as coal-burning fluorosis) in Suojia Miao, Yi and Hui Township (Suojia Township for short) in Liuzhi Tequ, Guizhou Province, and to provide scientific basis for formulating prevention and control strategies and measures.Methods:In 2019, the cluster sampling method was adopted to select children aged 8-12 years old from 6 primary schools in Suojia Township, Liuzhi Tequ, Guizhou Province to conduct a questionnaire survey to collect basic information, and perform dental fluorosis examination and indexing in accordance with the "Diagnosis of Dental Fluorosis" standards. Immediate urine samples were collected from children in April and October, and urinary fluoride content was determined by ion selective electrode method.Results:A total of 1 381 children aged 8-12 years old were investigated, aged (9.84 ± 1.38) years old, including 679 boys and 702 girls. A total of 625 children with dental fluorosis were detected, and the detection rate was 45.26%; the dental fluorosis index was 1.00, and the prevalence intensity was moderate; the main score of dental fluorosis was extremely mild, accounting for 37.00% (511/1 381). The detection rates of dental fluorosis in children aged 8 to 12 years old were 35.10% (106/302), 35.83% (115/321), 47.96% (129/269), 55.23% (153/277), and 57.55% (122/212), respectively; the difference between different ages was statistically significant (χ 2 = 48.949, P < 0.01), and the detection rate of dental fluorosis in children increased with age(χ 2trend = 45.254, P < 0.01).The detection rates of dental fluorosis in boys and girls were 43.59% (296/679) and 46.87% (329/702), respectively, and there was no significant difference between different genders (χ 2 = 1.492, P > 0.05). In April and October, 123 and 107 urine samples of children aged 8-12 years old were tested. The geometric mean of urinary fluoride was 1.55 and 0.47 mg/L, respectively. The urinary fluoride level in April was higher than the normal range (< 1.40 mg/L). Conclusions:Suojia Township in Liuzhi Tequ of Guizhou Province is still a fluorosis area, and there is a big difference in urinary fluorine level in different months, which indicates that the residents in this area may have intermittent high fluorine intake, and prevention and control of endemic fluorosis should be further strengthened.

Objective: To understand the homosexual behavior and related factors among married MSM in Mianyang city. Methods: Between January and October in 2017, a snowball sampling method was adopted to carry out cross-sectional survey through questionnaires plus HIV testing among those MSM in Mianyang city. Logistic regression model was used to analyze homosexual behaviors and related factors among married MSM under study. Statistical analysis was used by EpiData 3.1 and SPSS 19.0 software. Results: A total of 234 MSM participated in this survey. The overall rate of homosexual behavior in these married MSM appeared as 94.9% (222/234). Rate of having anal sex behavior was 94.4% (221/234) in the past 6 months, with rate of condom use as 57.9% (128/221). HIV positive rate was 8.1% (18/222). As for the motives for homosexual behavior after marriage, 87.8% (195/222) were driven by feelings of love, 12.2% (27/222) due to 'releasing pressure’. Proportion of male sex partners would include occasional sex partners (62.2%, 138/222), stable male sex partners (26.1%, 58/222) and stable boyfriends (11.7%, 26/222). Factors from logistic regression analysis showed that homosexual behaviors were related to the factors including education level of senior high school or above vs. education level of junior middle school or below (OR=3.65, 95%CI: 1.33-9.98); local residency over one year vs. the ones having local residency less than one year (OR=23.28, 95%CI:1.67-324.89); having 10 or more friends in the MSM community vs. having below 10 friends in MSM community (OR=4.15, 95%CI: 1.28-13.43); without sex pleasure with spouse vs. having sex pleasure with spouse (OR=3.25, 95%CI: 1.22-8.62); having 2 or more anal sex partners in the past 6 months vs. having less than 2 anal sex partners in the past 6 months (OR=0.28,95%CI: 0.09-0.81). Conclusions The rate of homosexual behavior and HIV positive rate were high among MSM in Mianyang city. Homosexual behaviors after marriage were influenced by multiple factors among MSM. The motives of homosexual behavior after marriage were driven by feelings of love, the related factors were education level of senior high school or above, local residency over one year, having 10 or more friends in the MSM community and without sex pleasure with spouse. As for the motives of these behaviors was caused by releasing pressure, the related factors was having more than 2 anal sex partners.