Objective To assess the efficacy and safety of tranexamic acid (TXA) in decreasing operative blood loss and the need for transfusion during posterior spinal fusion for the treatment of idiopathic scoliosis in adolescents. Methods A retrospective comparative analysis of 93 consecutive adolescents undergoing posterior spinal fusion procedures was per?formed. Patients were divided into treatment group (TXA, n=43) and control group (n=50). Clinical indicators were compared in operation and after operation between two groups. Results There was significantly less operative blood loss (703±176) mL in TXA group than that of control group (1143±389) mL. And post operation flow was also lower in TXA group than that of control group [(145 ± 75)mL vs (278 ± 95) mL, P<0.001)]. Autologous blood recovery in patients was lower in TXA group than that of control group [(241.0±109.1) mL vs (372.7±123.0) mL, P<0.001). There were no major intraoperative complica?tions in two groups. There was no blood transfusion in TXA group, and there was 1 case with 400 mL blood transfusion in con?trol group. Conclusion TXA treatment can decrease blood loss and blood transfusion and not increase intraoperative and postoperative complications in surgery of posterior spinal fusion of adolescent idiopathic scoliosis.

Objective To verify the feasibility and application value of an improved method for determination of urinary iodine by As3+-Ce4+ catalytic spectrophotometry.Methods Adults urine samples were collected,iodine calibration curves of 0-300 μg/L and 300-1200 μg/L were prepared,and urinary iodine was determined by the improved As3+-Ce4+ catalytic spectrophotometric method.Lyophilized human urinary iodine ingredient standards were used to validate linearity and range,limit of detection,precision and accuracy of this improved detection method.Results The linear range of the calibration curve was 0-300 μg/L,the detection limit was 1.8 μg/L,and the range of correlation coefficient was-0.9995--0.9997.When measuring urinary iodine at 40-80,100-149,200-280 μg/L,the relative standard deviations were 1.5％,0.8％ and 0.5％.When measuring urinary iodine at 40-80,100-149,150-180 μg/L,the average recoveries were 97.8％,99.8％ and 96.6％.Two given values of urinary iodine of national standard samples were (73.0± 9.0) and (206.0± 10.0)μg/L,and the results determined by this method were (75.5 + 0.9) and (207.5 ± 1.9)μg/L,and the relative deviation was 3.4％ and 0.7％,respectively,the results determined were all within the given value range.The linear range of the calibration curve was 300-1200 μg/L,the detection limit was 305.2 μg/L,the range of the correlation coefficient was-0.9996--0.9999.When measuring urinary iodine at 300-400,500-600 and 1000-1200μg/L,the relative standard deviations were 0.6％,1.0％ and 0.7％.When measuring urinary iodine at 300-499,500-599 and 600-700 μg/L,the average recoveries were 99.7％,99.2％ and 100.4％.Two given values of urinary iodine of national standard samples were (558.3 ± 3.5) and (884.8 ± 4.7)μg/L,the results determined by this method were (556.0 + 17.0) and (883.0 ± 28.0)μg/L,and the relative deviation was 0.4％ and 0.2％,respectively,the results were all within the given value range.Conclusions This method extends the detection range of iodine concentration,and improves precision and accuracy.This method greatly reduces the amount of arsenic used therefore reduces environmental pollution,which is suitable for promotion.

Objective To investigate the mechanism of small-dose cisplatin in enhancing photodynamic therapy sensitivity and apoptosis in human cervical carcinoma cell lines.Methods The Hela and Siha cells were divided into four groups(blank control group,photodynamic therapy only,cisplatin only,photodynamic therapy and cisplatin).The effects on proliferation of Hela and Siha cells in the four groups were examined by MTT assay.The expression of P185c-erbB-2 in Hela and Siha cells affected was detected by immunocytochemistry.Results The degree of apoptosis caused by the joint application of cisplatin and photodynamic therapy was greater than that caused by cisplatin or photodynamic therapy alone.The expression of P185c-erbB-2 in cells declined correspondingly.However,the order of cisplatin and photodynamic therapy did not cause obvious differences in the effect.Conclusion The in vitro proliferation of Hela and Siha cells is restrained obviously by cisplatin combined with photodynamic therapy;the effect is greater than that of cisplatin or photodynamic therapy only.The mechanism of cispatin's enhancement of photodynamic therapy sensitivity may be related to inhibiting P185c-erbB-2 expression.

Objective The aim of the study was to evaluate the association of fasting plasma glucose (FPG) level over 5.3 mmol/L to the development of abnormal glucose metabolism and cardiovascular diseases (CVD).Methods This was a retrospective cohort study with 1 064 non-diabetic subjects(980 males;84 females) aged 60 or over, who carried out annual health check-up in Chinese PLA General Hospital from May, 1996 to May, 2015.Based on the average FPG level of 3 years before enrollment, the subjects were divided into four groups : ＜ 5.3 mmol/L, 5.3-＜ 5.6 mmol/L, 5.6-＜ 6.1 mmol/L and 6.1-＜ 7.0 mmol/L.Glucose metabolic changes, complications and mortality were follow-up until May, 2015.Results (1)The initial 3-year average FPG levels were (4.9 ±0.4) mmol/L in the total 1 064 subjects.Among them, 126 subjects developed diabetes mellitus (DM) and 144 subjects developed impaired glucose regulation (IGR) during the follow-up visits.The proportions of IGR and diabetes increased with the FPG levels (P ＜ 0.05).The risk for developing IGR was significantly higher in subjects with FPG≥5.3 mmol/L than in those with FPG ＜ 5.3 mmol/L (RR =3.08, 95％ CI 2.02-4.81, P ＜0.01).The risk for incident DM was markedly increased in subjects with FPG ≥ 5.6 mmol/L than in those with FPG ＜5.6 mmol/L (RR =6.73, 95％ CI 3.90-11.52, P ＜0.01);(2)The risk for CVD was eight folds higher in subjects with FPG ≥5.3 mmol/L than in subjects with FPG ＜ 5.3 mmol/L (RR =8.42,95％ CI 5.11-13.82, P ＜ 0.05);(3) Survival analysis showed that the risk of death was 1.47 times higher in subjects with FPG ≥ 5.3 mmol/L than in subjects with FPG ＜ 5.3 mmol/L after years of followed-up (RR=l.47, 95％CI 1.09-1.98, P=0.0127).Conclusion The risks for IGR, CVD and mortality are higher in the elderly with FPG ≥5.3 mmol/L, which highlights the importance for the disease prevention in elder people with FPG 5.3 mmol/L or more.

Objective To investigate the short-term efficacy of CT-guided radiofrequency ablation (RFA) for the treatment of advanced non-small cell lung cancer. Methods During the period from June 2010 to June 2013, a total of 100 patients with advanced non-small cell lung cancer were admitted to authors’ hospital. The patients were equally and randomly divided into the study group (n=50) and the control group (n=50). The patients of the control group received concurrent radiotherapy and chemotherapy treatment, while the patients of the study group received CT-guided RFA. The clinical effect, changes in CT values after the treatment, the improvement of physical condition and postoperative complications were recorded, and the results were compared between the two groups. Results The remission rate of the disease in the study group was 86.0%, which was much higher than that in the control group (52.0%), and the difference between the two groups was statistically significant (P<0.05). After the treatment, the CT value of the study group was (14.1±3.9) HU, which was significantly lower than that of the control group (29.8±4.7 HU, P<0.05). The physical improvement rate of the study group (66.0%) was significantly higher than that of the control group (44.0%), the difference between the two groups was statistically significant (P<0.05). The occurrence of postoperative complications, such as pulmonary infection, chest pain, fever, thoracic effusion and gastrointestinal reaction, in the study group was strikingly lower than that in the control group (P<0.05). Conclusion For the treatment of advanced non-small cell lung cancer, CT-guided radiofrequency ablation is safe and less-invasive, it can improve the clinical short-term effect as well as the quality of life. Therefore, this technique should be recommended in clinical practice.

Objective To investigate the effecacy of open reduction internal fixation in cases with rib fracture. Methods The pain scores,respiratory related clinical indicators change of 81 rib fractuure cases underwent open reduction internal fixation surgery were ob-served. A comparison was made between the surgical group and the non-surgical group of 37 cases on pain scores trend and hospital stay. Re-sults All operations were successfully completed and postoperative recovery was good. Postoperative pain scores and respiratory rate was sig-nificantly lower(P=0. 000),Oxygen saturation was significantly higher(P=0. 002),the proportion of expectoration difficult,dyspnea and ac-tivities inconvenience were significantly lower(P<0. 05). Pain scores of surgical group significantly decreased after surgery peak hours that was the fourth day hospitalized,but the overall decline of pain scores in non-surgical group was slow. The hospital stay between the surgical group and the non-surgical group was not significantly different(P=0. 084). Conclusion The efficacy of open reduction internal fixation is significant to rib fracture with exact surgery indications,and appropriate timing of surgery is the fourth day after admission.

Objective To summarize clinical experience of one-station therapy for infected seriouslyischemic diabetic foot.Methods The clinical data of 15 patients (15 diseased limbs in total) with infected seriously-ischemic diabetic foot,who were admitted to authors' hospital during the period from June 2015 to April 2016 to receive treatment,were retrospectively analyzed.For all patients,one-station sequential therapy was carried out,which included endovascular revascularization (EVR) to open occluded vessel,surgical debridement and closed negative pressure wound drainage and antiseptic moisturizing wound dressing.The healing rate of infected wound and the limb salvage rate were evaluated.Results The 15 patients included 10 males and 5 females,with a median age of 77 years old.Lower extremity angiography showed that multiple segmental lesions of lower limb were detected in 13 patients and simple leg lesions in 2 patients.According to TASC Ⅱ update classification,leg artery disease of grade D was observed in 13 patients and artery disease of grade C in 2 patients.After EVR therapy,at least one branch of leg arteries was reopened in 14 limbs.Intact arterial arch of pedal-plantar loop (PPL) was seen in 6 patients,semi-arterial arch in 7 patients,and absent of arterial arch in 2 patients.After surgical debridement,the wound was washed by using negative pressure wound therapy (NPWT) device as well as serf-made washing equipment.The time to control wound infection was (7.85±2.84) days.After discharge,the patients were followed up every 3-4 days,at the same time wound dressing exchange with antibacterial moisturizing sulfadiazine silver lipid hydrogel was conducted.Wound healing was achieved in 12 patients,and the mean healing time was (3.70±0.87) months.The wound failed to heal in 3 patients,among them below knee amputation had to be performed in 2 patients (13.3％,both patients showed absent of arterial arch of PPL),and the remaining one patient died of cardiovascular event.Statistically significant difference in PPL pathological changes existed between wound healing group and wound un-healing group (P=0.006 7).Conclusion The treatment of infected seriouslyischemic diabetic foot is rather complicated.Being one-station therapy,the sequential managements,which include EVR,NPWT device together with washing equipment and use of antibacterial moisturizing wound dressing,can effectively increase the blood supply to the affected limb,shorten the time to control infection and lower amputation rate.Therefore,one-station therapy should be regarded as the preferred method for infected seriously-ischemic diabetic foot.

Objective To investigate the safety and effectiveness of left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter. Methods Left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter was performed following coronary angiography in 86 patients.The success rate of the procedure, the result of LIMA angiography, the time to LIMA, the volume of contrast, the incidence of complications and bypass vessels in patients who received coronary artery bypass grafting (CABG) were recorded and analysed. Results The success rate was 97.6%(84/86), and the result of LIMA angiography was satisfied; the time to LIMA was (6.5 ± 2.8) min, and the volume of contrast was (17.6 ± 11.1) ml;the incident of complications was 4.7%(4/86);56 patients received CABG. LIMA was harvested in all cases and left radial artery in 53 cases. Conclusions LIMA angiography via right transradial approach with 5F universal coronary angiography catheter is safe and effective, and it has significant sense to patients who will receive CABG.

Debridement is an indispensable step in repairing of burn wounds. Hydrosurgery system is an advanced instrument for debridement. Compared with the conventional debridement instruments, the hand-piece of hydrosurgery system is more facile and easy to be controlled, which is helpful for the debridement of wounds with irregular shape and uneven surface; besides, hydrosurgery system combines necrotic tissue resection and wound perfusion simultaneously, and its debridement process is highly tissue-selective, which is helpful to improve the wound-bed and to create favorable conditions for skin grafting and wound healing. Hydrosurgery system has been used in burn wounds debridement for more than 10 years. It is widely used abroad and has been introduced to China in recent years. Due to the complexity of burn wounds, there are also many different opinions about the clinical use of hydrosurgery system for different wounds, including debridement efficiency, effect, cost and the amount of bleeding. In this paper, we systematically summarized the effect of hydrosurgery system on the debridement of burn wounds, so as to provide reference for clinicians.

BACKGROUND: Mechanical ventilation is a double-edged sword to acute respiratory distress syndrome (ARDS) including lung injury, and systemic inflammatory response high tidal volumes are thought to increase mortality. The objective of this study is to evaluate the effects of dynamic ventilatory factors on ventilator induced lung injury in a dog model of ARDS induced by hydrochloric acid instillation under volume controlled ventilation and to investigate the relationship between the dynamic factors and ventilator-induced lung injuries (VILI) and to explore its potential mechanisms. METHODS: Thirty-six healthy dogs were randomly divided into a control group and an experimental group. Subjects in the experimental group were then further divided into four groups by different inspiratory stages of flow. Two mL of alveolar fluid was aspirated for detection of IL-8 and TNF-α. Lung tissue specimens were also extracted for total RNA, IL-8 by western blot and observed under an electronic microscope. RESULTS: IL-8 protein expression was significantly higher in group B than in groups A and D. Although the IL-8 protein expression was decreased in group C compared with group B, the difference was not statistically significant. The TNF-α ray degree of group B was significantly higher than that in the other groups (P<0.01), especially in group C (P>0.05). The alveolar volume of subjects in group B was significantly smaller, and cavity infiltration and cell autolysis were marked with a significant thicker alveolar septa, disorder of interval structures, and blurring of collagenous and elastic fiber structures. A large number of necrotic debris tissue was observed in group B. CONCLUSION: Mechanical ventilation with a large tidal volume, a high inspiratory flow and a high ventilation frequency can cause significant damage to lung tissue structure. It can significantly increase the expression of TNF-α and IL-8 as well as their mRNA expression. Furthermore, the results of our study showed that small tidal ventilation significantly reduces the release of pro-inflammatory media. This finding suggests that greater deterioration in lung injury during ARDS is associated with high inspiratory flow and high ventilation rate.