OBJECTIVETo investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty.

METHODSFrom October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula.

RESULTSThe mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups.

CONCLUSIONRivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

Arthroplasty, Replacement, Hip ; adverse effects ; Case-Control Studies ; Female ; Hemorrhage ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Postoperative Complications ; prevention & control ; Risk ; Rivaroxaban ; Thiophenes ; pharmacology ; Time Factors

Allogeneic hematopoietic stem cell transplantation and donor lymphocyte infusion for multiple myeloma (MM) can induce graft-versus-myeloma immunity and long-term survival,but limited efficacy and associated toxicities have prevented its widespread application.Cellular immunotherapies and vaccines are explored to induce more specific,reliable,and potent antimyeloma immune responses with less treatmentrelated risk.Advances in molecular biology,basic and applied immunology,have led to several promising approaches such as genetically engineered T cells with chimeric antigen receptors and T-cell receptors targeting myeloma-specific epitopes,vaccine primed ex vivo expanded autologous T cells,expanded marrowinfiltrating lymphocytes,and plasma cell/dendritic cell fusion vaccines.The combination of these emerging therapies to immunomodulatory drugs and inhibitors of programmed death-1 T-cell regulatory pathways could improve the outcome for MM patients.This article reviews the latest progress of cellular and vaccine immunotherapy for MM at the 58th American Society of Hematology (ASH) Annual Meeting,and discusses how these therapies might integrate and synergize with existing treatment paradigms.

Objective　To investigate the significance of TGF-β1, TGFRl and TGFR2 in the pathogenesis and prognosis in patients with myelofibrosis. Methods　The expression of TGF-β1 and its receptors (TGFR1 and TGFR2 ) in bone marrow tissues and the level of TGF-β1 in the blood of 23 patients with myelofibrosis were detected by SABC immunocytochemistry and ELISA repectively. Results　Expression of TGF-β1 and TGFR 1 was significantly higher in primary and secondary myelofibrosis patients than that of the control. No significant difference of TGFR2 expression was found between the groups of myelofibrosis and the control (P>0.05). The level of TGF-β1 in the blood of the patients with myelofibrosis was significantly higher than that of the control (P<0.01) and more obvious in secondary cases while TGF-β1 decreased nearly to the normal level when patients were in clinical remission. Conclusion　TGF-β1 and it's receptors may be involved in the pathogenesis of myelofibrosis and might be of importance for the prognosis of the patients with myelofibrosis.

Objective To study curative effect of edaravone on acute severe brain injury through the observation of neuron-specific enolase( that is:NSE) changes.Methods 60 severe brain injury patients were randomly assigned into the treatment group (n=30 ) and the control group (n=30).Besides the routine treatment,edaravone was used in the treatment group for 7 days.The control group received the same treatment except edaravone.NSE were measured in the two groups before the treatment and at 1st,3rd,5th,7th day after the treatment.GCS was evaluated at 21 days.Results Compared the NSE before treatment and after three days,they had significant difference(P＜0.05,also between the two groups and the GCS after 21 days.they had no significant adverse drug reactions during the two groups of patients with medication.Conclusion Edaravone for patients with severe brain injury has a better treatment effect,medication safety,fewer adverse reactions from the mechanism of NSE at acute phase.

Objecfive To study the influence of edaravone therapy on semm levels of neuronspecific enolase (NSE)in the patients of severe brain trauma and assess the therapic effect of edaravone.Method Sixty patients of severe brain trauma were randomly assigned into the treatment group(n=30)and the control group(n=30).Besides the routine treatment in both groups.edaravone Was only used in the treatment group.NSE levels were measured in the two groups before treatment and at 1st,3rd,5th,7th day after treatment.Results NSE levels before treatment in treatment group and control group were(48.73±30.46)μg/L and (40.86±22.05)μg/L,respectively,there Was no statistical significance between two groups.NSE levels after treatment at 3rd,5th,7th day in the two groups were(34.16±15.08),(29.86±12.61),(29.93±14.77)μg/L and (27.42±10.07),(22.33±8.93),(21.17±9.67)μg/L,respectively,there were statistical significances between two groups and in the same group (P＜ 0.05 or ＜ 0.01 ). With the time of therapy extended,NSE levels declined progressively. There were no significant adverse drug reactions during the treatment period. Conclusions The influence of edaravone therapy on serum levels of NSE in the patients of severe brain trauma is significant,edaravone for patients with severe brain trauma has a better curative effect ,medication safety,and fewer adverse drug reactions during acute phase.

Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .

Objective To investigate the effect of extracorporeal shock wave therapy (ESWT) on early and mid-term knee osteoarthritis (KOA). Methods 70 patients were randomly assigned to ESWT group (n=34) or control group (n=36). The ESWT group was given shock wave on unilateral knee, while the control group accepted shock wave with the energy density of 0. They were evaluated with Visual Analog Scale (VAS) on movement, Lequesne Index and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before and 12 weeks after the intervention. Results The scores of VAS, Lequesne Index and WOMAC Osteoarthritis Index improved more in the ESWT group than in the control group after intervention (P<0.01). Conclusion ESWT is effective on KOA as a non-surgical treatment.

Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.

OBJECTIVETo explore the feasibility of membrane protein-based two-dimensional electrophoresis (2-DE) in the investigations of chondrocyte-related diseases and its complementarity with total protein-based 2-DE.

METHODSKnee cartilage samples were obtained to isolate the chondrocytes with type II collagenase/hyaluronidase digestion. The membrane proteins and total proteins were extracted and loaded separately onto PH3.0-10.0 non-linear gel strip for 2-DE analysis. The qualities of membrane protein-based 2-DE gels were evaluated, and the difference between the distribution profiles of the membrane protein spots and that of the total protein were observed and their complementarities were evaluated.

RESULTSMembrane protein-based 2-DE generated high-quality gel images, and on each gel 412.3±13.5 protein spots were identified. These spots were distributed in the region of isoelectric point pH 5.0-9.0. In the gel images generated by the total proteins, 564.3±5.9 protein spots were identified in each image, and the spots were distributed in the region of isoelectric point pH 3.0-7.0.

CONCLUSIONMembrane protein-based 2-DE of the chondrocytes can generate high-quality gel images, and the isoelectric distribution of the protein spots is complementary to that of total protein, which provides valuable information for chondrocyte-related diseases.

Adult ; Chondrocytes ; chemistry ; Electrophoresis, Gel, Two-Dimensional ; methods ; Female ; Humans ; Isoelectric Point ; Male ; Membrane Proteins ; isolation & purification ; Middle Aged

OBJECTIVETo investigate whole blood viscosity changes at different time points in rats model with lumbar vertebrae semidislocation, study Shi's theroy of qi and blood and "Gucuofeng and Jinchucao" [symbols: see text], also reveal pathological physiology characteristics of spinal disorder.

METHODSThirty-six SPF male rats weighted 350 to 450 g were randomly divided into rotatory fixation group (RF group), simple fixation group (SF group) and Sham group (Sham group), 12 rats in each group. Exterior vertebrae implanted through L4-L6 segments of lumbar vertebrae in RF and SF group were connected fixed device. In RF group, L5 spinous process were rotated to right, and caused L5 spinous process was non collinear with L4 and L6; in SF group, external fixed device were simple connected without rotation. At 1, 4, 8 and 12 weeks after fixation, whole blood viscosity changes were tested.

RESULTSAt 4 and 8 weeks after fixation, high (150/s), medium (60/s) and lower (10/s) shear rate in RF and SF group were higher than that of Sham group (P<0.05). At 1 and 12 weeks, there was no sigificant differences among three groups in whole blood viscosity (P>0.05).

CONCLUSION"Gucuofeng and Jinchucao" [symbols: see text] vertebrae could raise whole blood viscosity, increase degree of bloos stasis and induce or aggravate spinal disorder in further.

Animals ; Blood Viscosity ; Disease Models, Animal ; Joint Dislocations ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Rats ; Rats, Sprague-Dawley ; Time Factors