Objective To examine the influence of inra-articular injection of tranexamic acid on blood loss after total knee replacement. Methods 50 patients with unilateral primary total knee replacement were enrolled and they were randomly divided into two groups:the stud-y group (n=25 cases),which were given intra-articular injection of tranexamic acid (1 000 mg) and drain clamping for 2 hour posteratively, and the control group ( n=25 cases) ,which were given physiologic saline. The blood loss,postoperative volume of drainage,hemoglobin lev-el,hematocrit,blood transfusion cases,D-dimer level and deep venous tromboemblic ( DVT) events were recorded. Results Postoperative volume of drainage,blood transfusion cases and D-dimer level were lower in the study group (P<0. 05). Hemoglobin level and hematocrit were higher in the study group (P<0. 05). No DVT ocurred in the two groups. Conclusion Intra-articular injection of tranexamic acid with 2 hours of drain-clamping is effective for reducing postoperative blood loss in total knee replacement, and there is noincrease of deep venous tromboemblic.

Objective To investigate the distribution and drug resistance change of Pseudomonas aeruginosa in the hospital of traditional Chinese medicine to provide a reference for the prevention and control of hospital infections.Methods Various submitted specimens from the inpatients in our hospital from Jan.2012 to Dec.2014 were performed the isolation and culture,bacterial identification and drug susceptibility analysis.Results In these 3 years,the detection rate of Pseudomonas aeruginosa positive strains was gradually increased year by year;the detection rate of sputum specimens was highest;which were mainly isolated from the patients in the respirtion department and cardiology department;the drug resistance rate of non-restricted,restricted and special antibacterial drugs showed an overall downward trend.Conclusion The sseudomonas aeruginosa isolated rate is increased year by year,the antimicrobial drugs classification management achieves initial results,and the overuse or unreasonable use of antibacterial drugs should be prevented.

BACKGROUND:Annulus puncture method is commonly reported in the establishment of intervertebral disc degeneration (IDD) models, but there is a lack of comparative studies concerning complete MRI, pathologyical and extracellular matrix changes. Thereafter, a further exploration is imperative. OBJECTIVE:To investigate the feasibility of establishing IDD models using annulus puncture. METHODS:Thirty New Zealand white rabbits were randomly divided into two groups (n=15 per group). In experimental group, through extraperitoneal approach, the L1-2, L2-3, and L3-4 intervertebral space were exposed, and then stabbed by 16-gauge hypodermic needles;while rabbits in sham operated group were only subjected to making and incision but not to puncture. Five rabbits in each group were randomly selected for MRI examination at 4, 8 and 16 weeks after modeling, and were sacrificed through air embolism to obtain the nucleus pulposus. Histological changes were observed by hematoxylin-eosin staining, and the level of proteoglycan was detected by Safranin O staining. RESULTS AND CONCLUSION:In the experimental group, T2-weighted signal in the disc was decreased in a time-dependent manner;an obvious reduction was found at 4 weeks after modeling, and reached the peak at 16 weeks. In contrast, the sham operated group showed no significant changes at each time point. Hematoxylin-eosin staining showed that in the experimental group, cartilage-like cells decreased, while fibroblast-like cells in the disc increased in number and proportion, and extracellular fibers were in disorder;all above changes became obvious at 4 weeks after surgery and the most obvious at 16 weeks, but there were no significant changes in the sham operated group. Safranin O staining revealed that the color of the tissues under puncture became lighter, and this variation became overt at 4 weeks after surgery and the most obvious at 16 weeks. In conclusion, annulus puncture is a reliable method to make IDD models.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

Objective To research and compare the effectiveness distinction between applying exclusive salcatonin and combining salcatonin and Xianling Gubao to treat osteoporotic pain patients.Methods 84 cases of osteoporotic pain patients in our hospital from Feb.2013 to Feb.2014 were selected and divided into two groups.Patients in treatment group were received combination of salcatonin and Xianling Gubao treatment.Patients in control group received salcatonin treatment only.To apply VAS judge the pain degree of patients.The clinical performance and results were observed and recorded.The degree of satisfaction of patients was surveyed through questionnaire.Results The VAS of patients in treatment group was (2.17 ±1.02), while it was (4.26 ±1.37)in control group.There were 15 cases of excellent,and 23 cases of efficacious in treatment group and the total effective rate was 90.48%.There were 10 cases of excellent,and 19 cases of efficacious in control group and the total effective rate was 60.95%.The degree of satisfaction of patients in treatment group was 95.24%,while it was 71.43% in control group.Conclusion Combining salcatonin and Xianling Gubao has better clinical effect than applying exclusive salcatonin in treatment of patients with osteoporotic pain.The combination of them could quicken the speed of recovery and increase the degree of satisfaction of patients.

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Objective To discuss the relationship between monocyte CD36 expression and carotid intima-media thickness (cIMT) in rheumatoid arthritis (RA) patients.Methods A total of 207 RA patients were divided into arteriosclerosis group and non-arteriosclerosis groups in accordance with the results of ultrasound in carotid artery,and semi-quantity score was used for cIMT in patients with RA.Risk factors of cIMT in RA patients were analyzed by Spearman correlation and Logistic regression analysis.Results C reactive protein (CRP),triglyceride (TG),tumor necrosis factor (TNF),interleukin-6 (IL-6) and monocyte CD36 expression were found to be statistically different between the two groups (P ＜0.05).Monocyte CD36 fluorescence intensity was negatively correlated with TNF,IL-6,CRP and cIMT in patients with RA (r=-0.344,P＜0.01;r=-0.646,P＜0.01;r=-0.160,P=0.021;r=-0.687,P＜0.01).Logistic analysis showed that monocyte CD36 was associated with the formation of artery atheromatous plaque in patients with RA [OR=1.580,95％CI (1.057,2.36l),P＜0.01].Receiver operating characteristic curve (ROC) curve analysis showed that monocyte CD36 fluorescence intensity was useful when the value with the area under curve was 0.926,the sensitivity and specificity was 83.7％ and 82.5％ respectively.Conclusion Monocyte CD36 fluorescence intensity is correlated with artery atheromatous plaque in patients with RA,monocyte CD36 fluorescence intensity may be a marker to estimate cIMT in RA patients.

Objective: To develop an HPLC-ELSD method for the determination of amygdalin, aucubin, harpagide, peimisine, peimine and peiminine in Keling capsules simultaneously.Methods: An Ultimate XB C 18 (250 mm× 4.6 mm , 5 μm) chromatographic column was adopted with an ELSD (the drift tube temperature was 105℃, the flow rate of nitrogen was 2.0 L·min-1).The mobile phase was acetonitrile-methanol (1∶1) and 0.4% acetic acid solution with gradient elution at a flow rate of 0.7 ml·min-1 , and the column temperature was set at 35 ℃.Results: Amygdalin, aucubin, harpagide, peimisine, peimine and peiminine was linear within the range of 13.56-271.20 μg·ml-1 (r=0.999 2), 8.48-169.60 μg·ml-1 (r=0.999 9), 4.89-97.80 μg·ml-1 (r=0.999 7), 2.66-53.20 μg·ml-1 (r=0.999 4), 1.82-36.40 μg·ml-1 (r=0.999 8) and 2.04-40.80 μg·ml-1 (r=0.999 6), respectively.The average recovery and the corresponding RSD were 97.90% (1.20%), 99.21% (1.62%), 97.68% (0.75%), 98.36% (1.38%), 99.70% (0.79%) and 97.95% (1.56%)(n =6), respectively.Conclusion: The method is simple and specific, and the results are accurate and repeatable.The method is helpful to the quality control of Keling capsules.

OBJECTIVE:To observe clinical efficacy and ADR of blue and red light phototherapy combined with TCM exter-nal treatment in the treatment of ecthyma. METHODS:64 ecthyma patients were randomly divided into experimental group and control group by number with 32 cases in each group. Both groups were provided with intravenous drip of Erigeron injection and Shenxiong glucose injection to improve limb microcirculation. The experimental group was also provided with blue and red light phototherapy (blue light 20 min+ red light 20 min) combined with TCM external treatment once a day;while control group was provided with only TCM external treatment once a day. After 1 month treatment,clinical efficacy and healing time of 2 groups were observed and compared,and ADR monitoring was conducted. RESULTS:The cure rate of experimental group was 78.13%, and the total effective rate was 96.88%,which were higher than those of control group(40.63% and 81.25%),there was statisti-cally significant difference (P<0.05). The average healing time of experimental group was (18.75 ± 5.97) d,and that of control group was(27.12 ± 6.67)d;there was statistically significant difference between 2 groups (P<0.05). No ADR was found in 2 groups during treatment. CONCLUSIONS:Blue and red light phototherapy combined with TCM external treatment in the treatment of ecthyma has the remarkable curative effect and good safety,and shorten the healing time.

Objective To explore the unified assessment methods based on present situation of after-department examination during the internship in the department of obstetrics and gynecology.Methods The present situation of after-department examination in the department of obstetrics and gynecology in 36 comprehensive hospitals of Chongqing Three Gorges Medical College were investigated through interviews and research papers including 12 grade A hospital of the first class hospital (33.33％),19 grade A hospital of the second class(52.78％) and 5 grade B hospital of the second class(13.89％).Totally 137 students of clinical major in 4 grade A hospital of the second class were enrolled and were divided into study group(n=72) and control group(n=65).hems of theoretical examination and skill examination as well as the evaluation standard were established combining with the syllabus of the licensed assistant doctors and the talent training scheme requirements.Students in study group were trained according to the practice syllabus,skill examination requirement and evaluation require-ment while those in control group had no cmresponding requirement.After-department examination was organized by school at the end of internship.The full score of theoretical examination and skill examination score was 50 respectively.Smvey results of after-depamnent examination were analyzed by Fisher's Exact Test and the results of after-depamnent examination were analyzed by t test.Results The hospitals having the after-department examination accounted for 80.56％(29/36).The hospitals having the after-depamnent examination according to the practice syllabus requirements accounted for only 20.69％(6/29).After the intervention,theoretical examination scores of study group and control group were 40.31 ± 3.47 and 35.78 ± 4.92,respectively,with statistically significant differences(t=6.26,P=0.000).The skills assessment scores of study group and control group were 40.42 ± 3.02 and 34.05 ± 5.18,respectively,with statistically significant differences(t=8.90,P=0.000).Conclusions The after-department examination in hospital is in a state of randomness,so unified assessment methods are necessary.