The morbidity of deep vein thrombosis (DVT) after total hip replacement,total knee replacement or hip fractures surgery is high,and there is no effect way to prevent.Rivaroxaban is an oral,direct factor Xa inhibitor.The prevention effect of rivaroxaban to DVT after orthopedic surgery is stronger than enoxaparin.The view summarizes the mechanism,pharmacokinetics,interaction of drugs and the antithrombotic effect after orthopedic surgery.

Objective To investigate the myelination of rat brain at different developmental stages.Methods Luxol fast blue staining,immunohistochemistry and Western blotting were applied to determine the distribution and alternation of myelin sheath in the brains of SD rats at different developmental stages.Results Negative LFB and MBP staining were shown at the stages of embryonicage 18 d(E18),postnatal age 0 d(P0) and P2.At P7,the corpus callosum was weakly stained by LFB.The positive stain of LFB and MBP occurred in P15 on the corpus callosum.With the development going on,the stain turned out stronger,especially in P30,which was similar with that in P90 and P720.The results of Western blot analysis showed the expression of MBP in rat brain was gradually increased with the development of rat brain.Conclusion The myelination starts before P15 in rat brain and becomes mature in P30.The optimal observation time of myelin is 30 d born after.

Objective To assess the efficacy of triple therapy including proton pump inhibitor (PPI), levofloxacin and amoxicillin for the first-line treatment of H. pylori infection, and the relation between H. pylori eradication and CYP2C19 genetic polymorphism. Methods Two hundred and five H. pylori-positive patients were divided into group E_(20) (esomeprazole 20 mg twice daily), group E_(40)(esomeprazote 40 mg twice daily),group R (rabeprazole 10 mg twice daily) and group L (lansoprazole 30 mg twice daily). Besides PPI, all patients were received levofloxacin 500 mg daily and amoxicillin 1000 mg twice daily for 1 week. The CYP2C19 genotypes were detected in 161 patients. The eradication of H. pylori were analyzed by intention-to-treat (ITT) and per protocol (PP) methods.ResultsThe H. pylori eradication was 86.70% in group E_(20), 88.5% in group E_(40),73.5% in group R and 78.1% in group L. Whereas the H. pylori eradication was 90% in patients with PM genotype,81.5% in patients with HetEM genotype and 82.1% in patients with HomEM genotype. The H.pylori eradication was 83.4% and 79.00% by per protocol (PP) and intention-to-treat (ITT) analyses,respectively. There was no significant difference in H. pylori eradication among four groups (P>0.05), and no relation was found between H. pylori eradication and genotypes (P>0.05). Conclusions PPI based triple therapy was effective in eradication of H. pylori, which is not influenced by CYP2C19 genotypes.

Background:Gastroesophageal reflux disease(GERD)is a common digestive disorder,but its underlying causes are still unclear.Patients with GERD often experience anxiety,depression,and ineffective esophageal motility.However,there have been limited studies on the relationship between anxiety/depression and esophageal motility.Aims:To investigate the mental state of patients with different subtypes of GERD and explore its correlation with esophageal motility.Methods:From September 2018 to June 2022,a total of 96 outpatients presenting typical acid reflux and heartburn symptoms with a GerdQ score≥10 were enrolled at Jincheng People's Hospital.They were divided into two groups based on gastroscopy findings:non-erosive reflux disease(NERD)group(77 cases)and reflux esophagitis(RE)group(19 cases).General data,clinical symptoms,anxiety/depression scores,and high-resolution esophageal manometry results were compared between the two groups using t-test,chi-square test,and Spearman correlation analysis.Results:There was a statistically significant difference between the NERD group and RE group(P<0.05),with more females in the NERD group.The self-rating anxiety scale(SAS)scores were significantly higher in the NERD group[44.00(29.00-58.00)]compared to the RE group[23.00(20.00-29.38)],indicating a greater presence of anxiety in the NERD group than in the RE group;this difference was statistically significant(P<0.01).However,there was no significant difference in self-rating depression scale(SDS),Hamilton anxiety scale(HAMA),or Hamilton depression scale(HAMD)scores between the two groups.Furthermore,a negative correlation was observed between distal contractile integral(DCI)values and SAS scores among GERD patients(P<0.05).Additionally,a small negative correlation existed between DCI values and SDS,HAMA,and HAMD(P>0.05).Conclusions:The NERD group exhibits a more pronounced anxiety state compared to the RE group.Furthermore,there exists a negative correlation between the anxiety state of GERD patients and DCI,suggesting that anxiety may influence esophageal motility involvement in the pathogenesis of GERD.

OBJECTIVETo explore the clinical significance of high-sensitivity C-reactive protein (hsCRP) in the development of chronic hepatitis B (CHB).

METHODSA total of 182 patients with untreated CHB and 50 healthy individuals (controls) participated in the study. Correlation analysis was performed to determine the association of serum hs-CRP with the age,sex,medical history,serum hepatitis B virus (HBV) DNA, liver function parameters,liver stiffness measure (LSM) and hepatic fibrosis; in addition, correlation analysis was carried out for the associations of degree of liver damage with grade of hepatic fibrosis, LSM and the serum levels of hs-CRP.

RESULTSCHB patients showed significantly higher serum hs-CRP levels than healthy controls (2.38 ± 2.79 vs.0.78 ± 1.07; t =2.495, P < 0.05). Serum hs-CRP levels were significantly correlated with HBV DNA (r = 0.159), liver function parameters (total bilirubin, r = 0.271; alanine aminotransferase, r = 0.298; aspartate aminotransferase, r = 0.389), and LSM, r = 0.562) (all P < 0.05). The correlations with liver function (r = 0.340), LSM (r = 0.292) and hepatic fibrosis grade were positive (r = 0.434) (all P < 0.01).

CONCLUSIONSerum hs-CRP levels in CHB patients can reflect degree of liver damage and of liver fibrosis.

Alanine Transaminase ; Aspartate Aminotransferases ; C-Reactive Protein ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
COVID-19 ; Humans ; Medicine, Chinese Traditional ; Research ; SARS-CoV-2 ; Treatment Outcome