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.

Objective To investigate the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease (COPD).Methods 88 cases of COPD patients from October 2014 to October 2016 in our hospital were selected and randomly divided into two groups of the control group observation group with 44 cases in each group.The control group was treated with conventional treatment, the observation group was treated with fluticasone propionate plus noninvasive positive pressure ventilation, and then the curative effect of the two groups was compared.Results The total effective rate of observation group was 100% higher than that of the control group 70.5%, the difference was statistically significant (P<0.05), after treatment, the observation group of FVC (2.50 +0.32) L, FEV1 (1.36 +0.20) L, FEV1%(51.23+4.32), PaO2(10.51+2.10) kPa, PaCO2(5.15 +1.19) kPa, compared with the control group, the difference was statistically significant (P<0.05), the observation group recurrence rate 4.5% was lower than the control group 13.6%, the difference was statistically significant (P <0.05).Conclusion COPD patients with fluticasone propionate combined noninvasive positive pressure ventilation, can effectively improve lung function, reduce disease recurrence rate, a significant effect.

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.

OBJECTIVE To analyze pathogenic bacterium distribution and antibiotic resistance of our hospital,and provide scientific basis for clinical rational using of antibiotics.METHODS The patients′ clean catch(midstream)(urine) was collected from Jan 2004 to Dec 2005 and cultivated.Antibiotic sensitivity test and adopted by Kirby-Bauer method.RESULTS The pathogenic bacteria mainly consisted of Gram-negatives,among which Escherichia coli was the most frequent,the others in turn were Pseudomonas aeruginosa,Enterobacter cloacae and(Proteus) mirabilis;Enterococcus were the most common among Gram-positives;fungal infection obviously(increased).The bacteria showed different antibiotic resistance rate and multi-drug resistance.CONCLUSIONS It′s very important for making the clinical use of antibiotic more reasonable and controlling drug resistant strains(transmission).

Objective To improve the quality standard for Yangxue Anshen Pills. Method TLC was used to identify caulis spatholobi and herba ecliptae, and HPLC to determine the content of emodin. Results The TLC spots of caulis spatholobi and herba ecliptae were clear. The linear range of emodin was 0.009 92～ 0.124 0 ?g. The average recovery rate was 96.2%, and RSD was 1.1%. Conclusion The methods are simple and accurate, with good reproducity.

Objective:To observe the effects of acupuncture at the follicular phase on ovarian blood supply and pregnancy outcomes in patients who received in vitro fertilization/intracytoplasmic sperm injection-embry transfer (IVF/ICSI-ET) of assisted reproductive technology (ART).Methods:A total of 169 IVF/ICSI-ET female recipients from the Reproductive Center of Xiehe Hospital,Tongji Medical College,Huazhong University of Science & Technology were randomized into an observation group (57 cases),a placebo group (54 cases) and a control group (58 cases).The observation group received acupuncture during the follicular phase,meanwhile the placebo group received placebo-acupuncture,and the control group did not receive acupuncture.The hemodynamic index,biochemical pregnancy rate and clinical pregnancy rate of each group were observed,respectively.Results:As to the ovarian arterial hemodynamic index,the pulsatility index (PI),resistance index (RI),and the systolic-to-diastolic peak velocity ratio (S/D) of the observation group were (0.819±0.131),(0.552±0.055) and (2.306±0.512),respectively,obviously lower than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),but there were no statistically significant differences between the placebo group and the control group (all P＞0.05).As to the biochemical pregnancy rate and clinical pregnancy rate,the biochemical pregnancy rate in the observation group was 64.9％ and the clinical pregnancy rate was 52.6％,which were significantly higher than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),while there were no significant differences between the placebo group and the control group (both P＞0.05).Conclusion:Acupuncture treatment during the follicular phase can improve ovarian blood supply and pregnancy rate in those receiving IVF/ICSI-ET.

Objective To integrative the effect of ulinastatin on postoperative cognitive function in elderly gastric cancer surger-y.Methods Two hundred elderly patients with gastric cancer surgery were randomly divided into observed group (100 cases)and control group (100 cases).Patients in observed group received the intravenous drip of ulinastatin before and after the surgery,while others only received the intravenous drip of physiological saline before and after the surgery.Results The urine output of observed group was (441.7±78.5)mL,which was significantly lower than that in control group as the result was (613.2±81.2)mL(P <0.05).After the treatment,the score of MMSE,visual regeneration and association learning in both observed group and control group were significantly lower than that before the treatment(P <0.05).The scores of MMSE,visual regeneration and association learning in observed group were 24.4±1.5,9.7±1.7 and 12.4±1.8,which were significantly higher than that in control group as the scores were 21.1±1.0,8.7±1.5 and 11.3±1.7 (P <0.05).The level of S100βin serum of observed group at the end of sur-gery,1 day and 3 day after the surgery were (0.099±0.024)μg/L,(0.074±0.026)μg/L and (0.061±0.022)μg/L,which were significantly lower than that in control group as the results were (0.138±0.042)μg/L,(0.110±0.034)μg/L and (0.075±0.031)μg/L (P < 0.05).Conclusion Ulinastatin can not only improve the postoperative cognitive dysfunction in elderly patients with postoperative,but can also reduce the level of S100βin serum.It provides brain protection for patients.

BACKGROUND:Dihydroartmisinin can promote apoptosis of glioma cels GL261, but its effect on glioma stem cels is stil unknown. OBJECTIVE:To investigate the preliminary mechanism that dihydroartemisinin inhibits migration and invasion of glioma stem cels. METHODS: Glioma stem cels were isolated from mouse malignant glioma cel lines GL261. Immunofluorescence analysis was conducted to identify the characteristics of glioma stem cels. Migration and invasion abilities of glioma stem cels were analyzed by Transwel assay. The mRNA expressions of Tol-like receptor 2, matrix metaloproteinase-2 and matrix metaloproteinase-9 were examined by real-time fluorescence quantitative PCR. RESULTS AND CONCLUSION:The characteristics of glioma stem cels were identified by CD133 and Nestin staining. The migration and invasion of glioma stem cels were attenuated by dihydroartemisinin dose-dependently. Moreover, the mRNA expression of Tol-like receptor 2, matrix metaloproteinase-2 and matrix metaloproteinase-9 was also decreased by dihydroartemisinin in a dose dependent manner. These results suggest that dihydroartemisinin inhibits the migration and invasion of glioma stem cels probably through attenuation of Tol-like receptor signaling pathway.

Objective To compare the efficacy of three kinds of neurolytic celiac plexus block (NCPB) in the patients with upper abdominal cancer pain.Methods Sixty-seven patients of both sexes,with upper abdominal cancer,aged 45-64 yr,weighing 52-69 kg,were randomly divided into 3 groups using a random number table:single-needle NCPB using crura of diaphragm space approach group (group S,n =23),double-needle NCPB via an anterior and posterior crura of diaphragm space approach group (group D,n =22),and continuous NCPB via crura of diaphragm space approach group (group C,n =22).In S and D groups,NCPB was performed with single injection of anhydrous alcohol 25-30 ml after CT-guided successful single and double punctures,respectively.In group C,a catheter was inserted into the crura of diaphragm space and then anhydrous alcohol 25-30 ml was injected via the catheter once a day for 3 consecutive days to perform NCPB.Before treatment,at 1 week after treatment,1,2,4 and 6 months after treatment,the daily consumption of morphine and VAS score were recorded.The therapeutic efficacy was evaluated using VAS weighted value calculation.The development of adverse effects such as diarrhea,hypotension,dysuria and damage to nerves was recorded.Results Compared with S or D groups,the daily consumption of morphine was significantly decreased at 4-6 months after treatment,the rate of effective treatment was increased at 4-6 months after treatment,and the incidence of hypotension was decreased in group C.The incidence of diarrhea was significantly higher in D and C groups than in group S.Conclusion For the patients with upper abdominal cancer pain,continuous NCPB via crura ofdiaphragm space approach provides perfect efficacy with fewer adverse reactions,and the efficacy is better than that of single-needle NCPB using crura of diaphragm space approach or double-needle NCPB via an anterior and posterior crura of diaphragm space approach.

Objective: To study the role of auto-antibody in the diagnosis of patients with PBC. Methods: ANA, SMA and AMA in serum of 58 PBC patients were tested by indirect immune fluorescence and Western blot. Such auto-antibodies as Anti-type AMAM2,anti-SLA/LP, anti-LKM-1 and anti-LC-1 were also identified. Results: Auto-antibodies existing in patients with PBC were mainly AMA(96.5%) and AMAM2(93.1%) and the titer was beyond 1∶100. 8 cases of those patients were positive with ANA and SMA simultaneously. One case had positive AMA and SLA/LP in serum and the clinical appearances were the same as those of type Ⅰ and type Ⅲ autoimmune hepatitis. 19 patients with positive AMAM2 in serum had liver-puncture and the results suggested the diagnosis of PBC in 63.7%(12/9). Conclusion: Test of auto-antibodies is clinically significant for the diagnosis of autoimmune hepatitis.