Objective To assess the impact of tranexamic acid on visible and hidden blood loss after the preliminary unilateral total hip arthtoplasty (THA).Methods The study involved 60 patients who received primary unilateral THA due to femoral neck fracture from March 2010 to September 2011.They were 18 males and 42 females,at 58 to 86 years of age (average 74.5 years).They were divided into Group A (n =20),not given tranexamic acid,Group B (n =20),given tranexamic acid in operation,Group C (n =20),given tranexamic acid at preoperative one hour according to stratified random method.Total red blood cell loss,visible red blood cell loss,and hidden red blood cell loss in each group were calculated.Results Visible red blood cell loss in Groups A,B,and C was (95.4 ± 17.7) ml,(45.5 ± 11.5) rnl,and (45.3 ± 8.4) ml respectively.Moreover,difference of visible red blood cell loss was significant between Groups A and B (P ＜ 0.05),but insignificant between Groups B and C (P ＞ 0.05).Hidden red blood cell loss in Groups A,B,and C was (322.4 ± 57.7) ml,(203.8 ±46.6) ml,and (137.6 ± 34.7) ml respectively,with significant difference between Groups A and B (P＜0.05) and between Groups B and C (P＜0.05).Conclusions Tranexamic acid reduces the visible and hidden blood loss in primary unilateral THA significantly.While tranexamic acid administered at preoperative one hour gains advantage of less hidden blood loss over the intraoperative administration.

'99 Rehabilitation Exercise Program after THA includes myodynamic exercise,range of motion,activity of daily living discipline.The patients begin to do this program as soon as they finish operation.And the whole time is two weeks.The program includes clinostatism and sitting position, standing position and walking exercise.The patients who have done this program can restore affected extremity function quickly, reduce postoperatives and shorten hospitalization dates.The program is feasible in clinic.

There is a huge gap in the quality of assistive technology (AT) service between China and the USA. In the USA, the certification of Assistive Technology Professional （ATP） has been used to supervise the development of AT service, while China is at the beginning of AT service. The current situation and the effects about the certification of ATP, how to get the ATP, the requirements someone must have were discussed in the paper.

The paper presented the methods and experiences of managing nursing posts in Beijing Friendship Hospital.As introduced in the paper,such measures as conversion of organizational structure,innovative nursing post setup,new training model,dynamic allocation of nursing manpower,and effective performance incentive mechanism,promoted better nursing quality and stabilized nursing team,achieving sustainable development of quality nursing service.

Child, Preschool ; Fibroma ; pathology ; Humans ; Male ; Oropharyngeal Neoplasms ; pathology

Objective To evaluate the efficacy of the soft-shell technique with domestic materials during the cataract phacoemulsification. Methods Eighty-two eyes of 76 patients with the mature cataract phacoemulsification were divided into 3 groups randomly, including 28 eyes using the soft-shell technique with sodium tvlose and sodium hyaluronate (the domestic group),and 28 eyes using DuoVisc (Viscoat+ProVisc) (the import group), and 26 eyes using sodium hyaluronate (the common group). Results The average naked vision was 0.50 ± 0.22,0.51 ± 0.27,0.27 ± 0.21 respectively on the first day after operation.There was no signiticant difference between the domestic group and the import group (P＞0.05 ), while the first two groups and the common group had significant difference (P ＜ 0.05). The average naked vision was 0.61 ± 0.17,0.63 ± 0.18,0.58 ± 0.18 respectively 7 days after operation. There was no statistical difference among the three groups (P ＞ 0.05 ). The rate of corneal endothelial cells 1 month after operation was 7.1% in the domestic group,7.0% in the import group and 15.9% in the common group. It was clear that the rate in the domestic group and the import group was much lower than that in the common group. Meanwhile, the difference existed statistically between the two groups and the common group (P ＜ 0.01 ). However, the difference between the domestic group and the import group had no statistical significance. Conclusion The soft-shell technique with domestic materials is as safe and effective as that with the import materials in protecting the corneal endothelial cells during the cataract surgery in patients with the mature cataract.

Objective To inquire clinical effects of hysteroscopic electroresection in the treatment of submucous hysteromyoma. Methods A retrospective analysis regarding curative effects of hysteroscopic electroresection in 72 cases of submucous hysteromyoma was carried out. Results The resected myoma was 1.5~7 cm in diameter, and the number of resected myoma was 1~3. The operation time was 10~90 min (mean, 30 min). The operation was accomplished on one session in all the 72 cases. No uterine perforation, bleeding and bowel injuries took place. Postoperative follow-up for 4~20 months in the 72 cases reported a satisfaction rate of 97 2% (70/72). Out of 6 patients who had pregnancy desire, 2 were pregnant with child and 1 of them had a delivery. Conclusions Hysteroscopic electroresection in the treatment of submucous hysteromyoma is safe and effective. It can markedly improve the menstruation and elevate the pregnancy rate.

Objective To compare the clinical outcomes and safety of synchronous vs staged bilateral total hip arthroplasty (THA).Methods Fifty-eight cases (116 hip joints) undergone bilateral THA from January 2008 to January 2010 were reviewed retrospectively.Follow-up period was postoperative 2 years,including synchronous bilateral THA in 29 cases (synchronous group) and staged bilateral THA in 29 cases (staged group).The two patient groups were compared in aspects of total operation time,total amount of blood loss,total amount of blood transfusion,duration and cost of hospitalization,postoperative discrepancy in bilateral leg length,preoperative and postoperative function score and perioperative complications.Results During the follow-up,no complications of incision infection,deep vein thrombosis and prothesis dislocation or loosening were noted.And postoperative delirium symptoms occurred only in four cases (three in synchronous group and one in staged group).There were no statistical differences between synchronous group and staged group in aspects of total operating time [(117.9 ± 23.8) minutes vs (124.1 ± 18.8) minutes],total amount of blood loss [338.1 ml (180-720 ml) vs 303.9 ml (200-600 rnl)],total amount of blood transfusion [227.6 ml (0-800 ml) vs 189.7 ml (0-400 ml)],postoperative function score.However,differences of the following data were considered statistical significance between synchronous group and staged group:expense of hospitalization [9.5 ten thousand yuan (7.0-11.3 ten thousand yuan) vs 10.5 ten thousand yuan (8.8-11.0 ten thousand yuan)],length of hospitalization [(12.1 ±3.2) days vs (20.1 ±3.5) days],postoperative discrepancy in bilateral leg length [(0.11 ± 0.22) cm vs (0.42 ± 0.44) cm].Conclusions Synchronous bilateral THA is safe and feasible as far as the patients' physical condition is allowed,perioperative management is rational and physicians have mature surgical techniques.Moreover,it gains advantage over staged bilateral THA considering cost of hospitalization,length of hospitalization and postoperative discrepancy in bilateral leg.

BACKGROUNDCorrect diagnosis is very important to patients with suspected lung cancer. According to the higher ¹⁸F-FDG intake of tumor tissues much more than normal tissues, this study evaluates the clinical value of ¹⁸F-FDG dual-head coincidence SPECT/CT in diagnosis of lung cancer.

METHODSSixty-one patients with lung mass underwent ¹⁸F-FDG dual-head coincidence SPECT/CT imaging and thoracic CT imaging before operation. These imageological results were compared with histological examination of lung mass.

RESULTSThe sensitivity, specificity and accuracy of ¹⁸F-FDG-SPECT/CT in differentiating malignant and benign lesions were 82%, 87%, 84%, respectively. Compared with thoracic CT imaging, diagnostic rate of mediastinal lymphatic metastasis was significantly higher by ¹⁸F-FDG-SPECT/CT (52% vs 81%, P < 0.05) .

CONCLUSIONSCombined functional-anatomical image of ¹⁸F-FDG-SPECT/CT has potential to improve staging and localizing procedures of lung cancer. It is an excellent modality in diagnosis and differential diagnosis of lung cancer.

Objective To observe the anatomy of the perforator flap of the posterolateral midforearm. Methods Lateral condyle of the humems wag taken as the observation mark on 30 specimens of adult upper limb perfused with red latex.The surgical magnifier Wag used to obse~e the origin,branches and distribution of the perforating branches of the posterolateral midforearm as well as alanagtomosis between perforating branches and peripheral vessels.Mimic operation WaS performed on the two sides of the fresh specimen.Results The perforating branches of the posterolateral midforearm originated from the radial musculoculancous branches of the posterior interosseous artery,the intermuscular branches of the radial artery and the direct periosteal branch of the radial artery had relatively stable location of piercing the deep fascia.Then,the perforating branches of the posterolateral midforearm pagsed through the deep fascia to the subcutaneous part among the spatium intermusculare of extensor digitorum and extensor carpi radialis brevis,supinator and abductor pollicis longus(within 12.5-15.8 cm below the lateral condyle of the humerus).Large number of small blood Vessels were also separated and closely aligned with the musculoculancous branches vascular,perineural and neural stem vascular chain of lateral branches of posterior antebrachial cutaneous nerve.Then,the vascular plexus was formed along the spatium intermusculare and lateral branches of posterior antebrachial cutaneous nerve longitudinal axis between extensor digitorum and extensor carpi radialis brevis. Conclusion The axial pattern flaps or cross-regional blood supply skin flap pedicled with the perforating branches of the posterolateral midforearm Can be formed to repair the soft tissue defect of tlle forearm and wrist.