Objective To investigate the effect of intravenous injection of tranexamic acid on reducing bleeding effect in invasive total hip replacement.Methods In our hospital from April 2015 to April 2016, 50 cases of total hip joint replacement patients as the object of study, patients were randomly divided into observation group and control group, 25 cases in each group.The control group were injected with 0.9% NaCl injection;observation group received intra-articular injection of tranexamic acid after suture, the transfusion volume of blood, complications, hemoglobin concentration, and rate of blood transfusion were compared between the two groups.Results The rate of blood transfusion in the control group was 52.0%, significantly higher than that of the observation group (24.0%), and the difference was statistically significant (χ2 =4.16, P<0.05).The drainage (260.1 ±78.6) mL and transfusion volume (230.8 ±60.1) mL in observation group were better than control group (370.04 ±56.2)mL and (380.2 ±40.6)mL,with statistical significance (P <0.05).The hemoglobin concentration in observation group was lower than control group(P <0.05).There were 2 cases of hematoma, 5 cases of paining in observation group and 3 cases of hematoma, 6 cases of paining in control group, with no statistical significance (χ2 =0.368, P>0.05).Conclusion Tranexamic acid is the main method for prevention of postoperative bleeding, but could not reduce postoperative complications.

In this paper, the classification of the upper limb rehabilitation robot was discussed and the research progress was overviewed.Finally, the prospects of upper limb rehabilitation robot were put forward.

BACKGROUND:Colagen materials have good biocompatibility and biodegradability, but also had some problems such as low mechanical strength, poor resistance to degradation exposed in the process of clinical application. Numerous studies have reported that proper crosslinking could improve the disadvantage of colagen materials, regulate porous network structure, sweling and degradation of colagen materials. OBJECTIVE: To optimize carbodimide crosslinking process of colagen sponge and determine the best process conditions. METHODS:Colagen sponge was cross-linked by carbodimide for the preparation of loose and porous colagen sponge. Meanwhile, we optimized the conditions of cross-linking, in which the selected concentration of carbodimide was 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100 mmol/L, linking time was 2, 4, 6, 8, 12, 16, 20, 24 hours, and linking temperature was 5, 10, 15, 20, 25, 30, 35℃. We evaluated the best process conditions of colagen sponge through the aperture, porosity, water absorption, and degradation rate. RESULTS AND CONCLUSION:The optimal conditions were carbodimide concentration 50 mmol/L, crosslinking temperature 20℃,crosslinking time 6 hours. At this point, the average pore diameter of colagen sponge was 105 μm, the porosity was 79.45%, water absorption was 287.14%, and the degradation rate was 15.04% (2 days). The crosslinking of colagen sponge significantly improved its water absorption and degradation resistance.

The present paper is to study the center line of the plantar pressure of normal young people, and to find the relation between center line of the plantar pressure and gait stability and balance. The paper gives the testing principle and calculating methods for geometric center of plantar pressure distribution and the center of pressure due to the techniques of footprint frame. The calculating formulas in both x direction and y direction are also deduced in the paper. In the experiments carried out in our laboratory, the gait parameters of 131 young subjects walking as usual speed were acquired, and 14 young subjects of the total were specially analyzed. We then provided reference data for the walking gait database of young people, including time parameters, space parameters and plantar pressure parameters. We also obtained the line of geometry center and pressure center under the foot. We found that the differences existed in normal people's geometric center line and the pressure center line. The center of pressure trajectory revealed foot movement stability. The length and lateral changes of the center line of the plantar pressure could be applied to analysis of the plantar pressure of all kinds of people. The results in this paper are useful in clinical foot disease diagnosis and evaluation of surgical effect.
Foot ; physiology ; Gait ; Humans ; Pressure ; Reference Values ; Walking

Objective: To evaluate the expression of cytokeratin (CK)7, CK8/18, CK19 and p40 in esophageal squamous cell carcinoma (ESCC) and its significances. Methods: One hundred and ninety cases of surgically resected ESCCs and 154 normal esophageal tissues as control were collected at the First Affiliated Hospital of Zhengzhou University in 2012.Of the 190 ESCC cases including 116 male and 74 female, aged 28-82 (60.3±8.6) years, 88 cases <60 years old and 102 cases ≥60 years old. Tissue sections were immunostained for CK7, CK8/18, CK19 and p40, and the expression was evaluated and correlated with the clinicopathologic findings and outcome. Results: CK19 and p40 were expressed in 190 cases of ESCCs; with 147 cases (77.4%) and 151 cases (79.5%) showing high p40 and CK19 expression, respectively; while 43 cases (22.6%) and 39 cases (20.5%) showed low p40 and CK19 expression, respectively. The low expression groups showed more lymph node metastases and higher pTNM stages compared to the high expression groups. The high CK19 expression group showed better prognosis than the low expression group (P<0.01); p40 expression was not correlated with prognosis(P>0.05). In contrast, CK7 and CK8/18 expression was only seen in 29 cases (15.3%) and 59 cases (31.1%) of ESCCs, respectively, and their expression correlated significantly with the degree of tumor differentiation and lymph node metastasis (P<0.05). The prognosis in the CK7 negative group was better than that in the CK7 positive group. Similar results were found in CK8/18 expression. Multivariate analysis revealed that pTNM stages, low CK19 expression and CK8/18 expression were independent prognostic factors. Conclusions Low p40 expression and the expression of CK7 and CK8/18 cannot exclude poorly-differentiated ESCCs.CK7 and CK8/18 expression and low CK19 and p40 expression in the ESCCs are associated with lymph node metastasis and poor prognosis. Decreased expression of CK19 and positive expression of CK8/18 in ESCCs are independent prognostic markers.

Objective To investigate the short-term efficacy of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid in treatment of recurrent aphthous ulcer (RAU).Methods Eighty patients clinically diagnosed with RAU were chosen and randomly divided into two groups.Test group 1 (40 cases) and Test group 2 (40 cases) were treated with compound gargle solution chlorhexidine giuconatie and kangfuxin liquid respectively until ulcer has been healed completely to evaluate the difference of two groups in clinical efficacy.Return visit and follow-up visit were conducted 7 days and 30 days after the initial treatment,respectively.Results The analgesic onset time of Test group 1 [(6.24 ± 1.09) min] was shorter than that of Test group 2 [(8.62 ± 1.04) min],with statistically significant difference (P ＜ 0.01).The analgesic maintenance time of Test group 1 [(29.47 ± 3.45) min] was longer than that of Test group 2 [(21.61 ±2.18) min],with statistically significant difference (all P ＜ 0.01).The duration of ulcer of Test groups 1 and 2 was (5.97-± 0.87)days and (4.76 ± 1.14)days,with statistically significant difference (P ＜0.01).Conclusions Compound gargle solution chlorhexidine giuconatie and kangfuxin liquid both have a certain level of clinical efficacy for RAU,with the former featuring shorter analgesic onset time and longer duration and the latter advantageous in promoting RAU healing short-term usage of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid cannot prolong RAU dormancy.

Objective:To explore the regulatory role and mechanism of tribbles pseudokinase 3 (TRB3) on hepatocarcinoma (HCC) cells proliferation, apoptosis and migration.Methods:Immunohistochemistry and Western blot were used to detect TRB3 expression in cancerous and adjacent cancerous liver tissues of HCC patients. TRB3 expression was detected in vitro in HepG2 and Huh7 hepatocarcinoma cell lines. Simultaneously, CCK8 and EdU were used to detect cell proliferation after TRB3 targeted inhibition with small interfering RNA. CCK8 and EdU were used to detect cell proliferation. Flow cytometry assay was used to detect apoptosis. Transwell assay was used to evaluate migration ability. Simultaneously, Western blot was used to detect changes in apoptosis, migration-related proteins and AKT phosphorylation activity. The mean comparison between the two groups was performed by t-test, and the comparison between multiple groups was performed by one-way analysis of variance.Results:Western blot showed that the expression of TRB3 was significantly up-regulated in HCC tissues. Compared with normal liver tissues adjacent to cancer, the relative expression levels were 0.78 ± 0.12 and 0.29 ± 0.09, respectively, P < 0.01, and the difference was statistically significant. After interfering siRNA inhibited TRB3, CCK8 and EdU tests showed that the proliferation activity of HepG2 and Huh7 cells were significantly weakened ( P < 0.05). Flow cytometry results showed that the apoptotic proportions of HepG2 and Huh7 cells was significantly increased ( P < 0.01). Western blot also showed that the expression of apoptosis regulatory proteins BAX and BIM were significantly increased ( P < 0.01). Transwell assay results showed that the migration ability of HepG2 and Huh7 cells was decreased ( P < 0.05), and the expression of migration regulatory proteins MMP4 and MMP9 was also significantly down-regulated. Western blot results showed that the AKT phosphorylation level was significantly increased. Conclusion:TRB3 regulates hepatocarcinoma cells proliferation, apoptosis and migration by inhibiting the AKT phosphorylation activity. Therefore, TRB3 may be a potential target site for the liver cancer treatment.

Objective:To design a new type of intelligent power-assisted hip disarticulation prosthesis and to use experiments to verify its kinematic performance.Methods:The main body of the prosthesis was designed using a double parallel four-link configuration based on a remote motion center mechanism. A series elastic actuator was used to provide external power for the prosthesis, and an antagonistic torsion spring structure was used to achieve bidirectional energy storage assistance in hip flexion and extension. A control system based on impedance control was established. By setting up an auxiliary force field to compensate for the difference between the actual angle of the prosthesis and the target angle, the prosthesis assist function was realized. Finally, the traditional hip disarticulation prosthesis was used as a comparison to test the overall performance of the new intelligent power-assisted hip disarticulation prosthesis worn by normal people.Results:For the new smart-assisted hip-disarticulation prosthesis, the goodness-of-fit of its hip joint angle curve to that of a normal person was 86%, which was 14% higher than that of the traditional hip-disarticulation prosthesis (72%). The goodness-of-fit of the healthy-side angle of the new smart-assisted hip disarticulation prosthesis to the normal human was 94%, which was the same as that of the traditional hip disarticulation prosthesis.Conclusions:A new type of intelligent power-assisted hip disarticulation prosthesis is designed to realize the function of prosthesis-assisted movement.

Objective : To explore the etiology, clinical manifestations, diagnosis and treatment of verruciform xanthoma (VX) in adolescents to provide a reference for clinical diagnosis and treatment. Methods : The clinical data of a case of a palatal mass in a juvenile were analyzed, and the related literature was reviewed. Results: The palatal mass was proven to be VX by histopathological examination. Surgical resection was performed, and the prognosis was good. A review of the literature shows that VX is a rare benign mucosal skin lesion of an unknown etiology, with an incidence of approximately 0.025%-0.094%; VX is mostly found in middle-aged people, with no significant difference by sex. The clinical manifestations are similar to those of a variety of diseases, such as squamous papilloma, verruca vulgaris, fibroma, warty carcinoma and squamous cell carcinoma, which are not easy to distinguish and require histopathological diagnosis. The treatment of choice is surgical excision, with a low recurrence rate. Conclusion In the clinical experience of solitary mucosal masses in juveniles, it is necessary to send biopsy for pathological examination and avoid overtreatment.

Objective To explore the occurrence and related factors of diarrhea in the early stage of enternal nutrition in critically ill patients, therefore providing guidance for the optimization of enteral nutrition. Methods A prospective cross-sectional study was conducted in 29 ICUs of 28 general hospitals of Zhejiang Province between June 1 and October 1, 2016. Patients who were admitted to ICU required for enteral nutrition were included and continuously observed for over 7 days or till discharged from ICU. The patient's general characteristics, severity of disease, enteral nutrition, diarrhea-related and prognostic indicators were recorded. Multivariable logistic regression was performed to analysis risk factors associated with diarrhea and in-hospital mortality. Results A total of 533 critically ill patientswere enrolled in this study. The overall incidence of diarrhea was 30.8％ (n = 164). Diarrhea occurred most frequently on the three days after EN, with a median duration of 2 (1, 3) days. The daily incidence of diarrhea were significantly different between groups (all P< 0.05), which were gradually reduced on day 7. Multivariable logistic regression analysis showed that prokinetic drugs (OR=1.82; 95％ CI: 1.24-2.65), APACHE II score (OR=1.04; 95％ CI: 1.02-1.07), post-pylorus enteral feeding (OR=1.90; 95％ CI:1.11-3.36) were independent risk factors for diarrhea, while interruption of EN (OR=3.74; 95％ CI: 1.85-7.54), APACHE II score (OR=1.07; 95％ CI: 1.04-1.11), vasoactive agent (OR=2.31; 95％ CI: 1.42-3.77), and timing (>48 h) (OR=2.00; 95％ CI: 1.08-3.70) were independent risk factors for in-hospital mortality. Conclusions Our study showed that APACHE II score, the use of prokinetic drugs, and post-pylorus enteral feeding were risk factors for diarrhea. Patients suffering diarrhea experienced increased ICU length of stay, increased the time of mechanical ventilation and in-hospital mortality compared with patients without diarrhea. Interruption of EN induced by diarrhea significantly increased the risk of in-hospital mortality.