Objective To explore the effect Tiaoli-Qixue decoction on bleeding and coagulation during perioperative period of total hip arthroplasty (THA).Methods A total of 180 THA patients who met the inclusion criteria were randomly divided into three groups with 60 cases in each group.All patients underwent routine anti-infection treatment after unilateral THA through lateral hip approach.The patients took the Tiaoli-Qixue decoction 3 days before THA in the treatment group.The patients in the Xuesaitong control group received intravenous Xuesaitong on the day of operation and rivaroxaban tablets were administered orally on the day of operation in the westem medicine control group.The continuous medication was administered until 7 days after operation in three groups.The amount of hemorrhage and drainage after operation were recorded and the total amount of dominant hemorrhage was calculated.The Degao M4 semi-automatic hemagglutination instrument was used to detect plasma D-dimer level and observe thrombosis.Harris scale was used before and after operation to calculate the excellent and good rates of Harris score.Results The total amount of dominant hemorrhage (376.67 ± 61.44 ml vs.400.08 ± 61.16 ml,413.33 ± 53.76 ml,F=5.963),intraoperative hemorrhage (165.50 ± 15.67 ml vs.174.75 ± 14.68 ml,175.42 ± 11.13 ml,F=9.452) and postoperative drainage (211.17 ± 58.12 ml vs.225.33 ± 56.93 ml,237.92 ± 54.28 ml,F=3.370) in the treatment group of traditional Chinese medicine were significanlty less than those in the Xuesaitong control group and the Western medicine control group (P＜0.01 or P＜0.05).On the 7th day after operation,there were 6 cases of thrombosis in the treatment group of traditional Chinese medicine,4 cases in the Xuesaitong control group and 4 cases in the Western medicine control group.There was no significant difference between the three groups (x2=0.667,P=0.881).Six months after operation,the excellent and good rate of that the treatment group of traditional Chinese medicine was 45.0％ (27/60),which of the the Xuesaitong control group was 11.7％ (7/60),and which of the the Western medicine control group was 13.3％ (8/60).There was significant difference among the three groups.Conclusions The Tiaoli-Qixue decoction bleeding and coagulation can reduce the amount of dominant bleeding during perioperative period in patients with THA,and effectively prevent and treat deep venous thrombosis of lower limbs after THA.

Objective Based on the medical records and follow-up records of hospitalized patients who received anti-tuberculosis therapy in the Third People' s Hospital of Zhenjiang in Jiangsu province from 2006 to 2012,we investigated the incidence and outcome of anti-tuberculosis drug induced hepatotoxicity (ATDH) and provided evidence for the prevention of ATDH.Methods According to tuberculosis patients' medical information and liver function test records,ATDH patients were diagnosed according to the criteria of International Consensus Meeting and American Thoracic Society respectively,then the related factors and outcomes were analyzed.Results A total of 1 967 hospitalized tuberculosis patients were reviewed retrospectively,in which 1 403 (71.3％) were men,1 790 (91.0％) were pulmonary tuberculosis patients,1 528 (77.8％) were patients receiving initiative treatment,979 (49.8％) were sputum smear-positive patients,and 1 297 (65.9％) had other complicated diseases.According to the criterion of International Consensus Meeting,the incidence of ATDH was 16.5％,the median time of onset was 25 days.According to the criterion of American Thoracic Society,the incidence of ATDH was 8.3％,the median time of onset was 23 days.The incidence of ATDH was significantly higher in males and HRZE therapy group (P＜0.05).Under the two liver criteria,69.5％ and 70.1％ of the patients changed primary therapy respectively after ATDH occurred.89.8％ and 88.4％ patients' liver function returned to normal range after changing or stopping therapy.Conclusion According to two liver injury criteria,the incidences of ATDH were 16.5％ and 8.3％ in hospitalized tuberculosis patients respectively,and ATDH mainly occurred in the furst month of anti-tuberculosis treatment.The monitoring of liver function should be strengthened in males and HRZE therapy group to reduce the incidence of ATDH.

OBJECTIVE To reevaluate systematic reviews/meta-analysis of efficacy and safety of tolvaptan for hyponatremia. METHODS Retrieved from CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and the Cochrane Library database， systematic reviews/meta-analysis about tolvaptan for the treatment of hyponatremia were included from the inception to June 15， 2022. After screening literature and extracting data， the PRISMA statement， AMSTAR 2 scale and GRADE method were used to evaluate the reporting quality， methodological quality and evidence quality of the included literature， respectively. RESULTS A total of 6 articles were included， of which 1 was systematic review and 5 were meta-analysis， including 56 outcome indicators. All of the 6 studies had PRISMA scores ranging from 15.0 to 20.5， and the quality of them was moderate. Results of the AMSTAR 2 scale showed that the methodological quality of 5 literatures were very low， and the quality of 1 literature was low. The quality of GRADE evidence showed that there were 6 moderate-quality indicators， 13 low-quality indicators， 35 very low-quality indicators， and 2 indicators that could not be assessed due to missing data. The main factors causing degradation were limitations， inconsistency， imprecision and publication bias. In terms of efficacy， tolvaptan could effectively increase the level of serum sodium， increase urine volume， reduce body weight， reduce abdominal circumference， relieve edema， and reduce alaninetransaminase level. In terms of safety， the incidence of total adverse drug reaction induced by tolvaptan was controversial； it may increase the risk of dry mouth， thirst， frequent urination or excessive correction of serum sodium. CONCLUSIONS Tolvaptan has great efficacy in the treatment of hyponatremia， but serum sodium overcorrection should be avoided in terms of safety. Relevant systematic reviews/meta-analysis have shortcomings of low reporting quality， methodological quality and evidence quality， which may reduce the reliability of the results， so the results should be treated with caution.