Humans ; Air Pollutants/adverse effects* ; Genotype ; China/epidemiology* ; Hypertension/epidemiology*

OBJECTIVE To systematically review the efficacy and safety of tranexamic acid （TXA） for hemostasis in cancer patients before and during surgery， and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， VIP and Wanfang databases， randomized controlled trials （RCTs） about tranexamic acid （trial group） versus 0.9% Sodium chloride injection， Lactated Ringer’s solution， Compound electrolyte solution or placebo （control group） for cancer surgery were electronically searched from the inception to June 9， 2022. After literature screening and data extraction， the quality of included RCTs were evaluated by bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0. RevMan 5.3 software was used for meta-analysis or descriptive analysis， sensitivity analysis and publication bias analysis. RESULTS A total of 2 032 patients in 22 RCTs were included for meta-analysis. Results of meta-analysis showed that the blood transfusion rate [RR＝0.59， 95%CI （0.50， 0.69）， P＜0.000 01] and the volume of erythrocyte suspension infusion [MD＝－0.53， 95%CI （－0.92， －0.14）， P＝0.007] in trial group were significantly lower than control group； there was no statistical significance in the incidence of thromboembolic events [RR＝0.44， 95%CI （0.16， 1.17）， P＝0.10] or post-operative mortality [RR＝1.27， 95%CI（0.32，5.08）， P＝0.73] between two groups. Results of descriptive analysis showed that the total blood loss and postoperative drainage volume were still controversial between two groups. The results of sensitivity analysis showed that the results were basically stable. The results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS TXA can significantly decrease the blood transfusion， reduce the volume of erythrocyte suspension infusion， whereas does not increase the incidence of thromboembolic events and post-operative mortality in cancer surgery.

Objective:To investigate the cosmetic effects of botulinum toxin type A(BTX-A) in the prevention and treatment of cicatrix on split-thickness skin graft donor site.Methods:A prospective randomized controlled study was commenced to recruit patients with functional burns and chronic wounds who were repaired with split-thickness skin graft in the Department of Burn and Plastic Surgery of Zhongshan People’s Hospital from September 2021 to September 2022. Ten days after wound healing in the donor area of the thigh (about 4 weeks after surgery), the patients were randomly divided into two groups: the experimental group and the control group. The experimental group was injected with BTX-A solution at the skin donor site by equal interval injection method 1 and 3 months after surgery, 0.1 ml (1 U) was injected at each point, and the interval of each point was 1 cm. The control group was injected with equal amount of normal saline at the skin donor area by equal spacing method 1 and 3 months after operation. The adverse reactions was observed. Follow-up was performed six months after treatment. Evaluation indicators included the doctor’s Vancouver scar scale (VSS) score (including color, vascular distribution, softness and thickness), the visual analogue scale (VAS) score of the patient’s scar pain and itching degree. Both VSS scores and VAS scores were in line with normal distribution, expressed as Mean±SD, and analyzed by independent sample t-test. Results:A total of 60 subjects were recruited, 30 in the experimental group and 30 in the control group. In the experimental group, there were 16 males and 14 females, aged (32.7±5.4) years (18-60 years). In the control group, there were 13 males and 17 females, aged (31.4±4.8) years (18-55 years). There were no significant differences in gender composition and age between the two groups (all P > 0.05). No serious adverse reactions occurred in the experimental group during and after treatment. At the follow-up six months after treatment, the total score of VSS in the experimental group [(3.57±0.60) points vs. (8.52±0.84) points] and the scores of scar color, vascular distribution, flexibility and thickness[(0.88±0.22) points vs. (2.30±0.52) points; (0.73±0.27) points vs. (2.16±0.40) points; (1.29±0.39) points vs. (2.49±0.39) points; (0.66±0.23) points vs. (1.56±0.34) points] were significantly lower than those in the control group, and the differences were statistically significant ( P < 0.01). The VAS score of scar pain and itching degree in the experimental group was also significantly lower than that in the control group [(1.06±0.34) points vs. (2.92±0.63) points], and the difference was statistically significant ( P < 0.01). Conclusion:BTX-A injection is safe and effective in preventing and treating cicatrix in the donor area of split-thickness skin graft, and also has a good effect on relieving the pain and itching symptoms of cicatrix patients.

Objective:To investigate the cosmetic effects of botulinum toxin type A(BTX-A) in the prevention and treatment of cicatrix on split-thickness skin graft donor site.Methods:A prospective randomized controlled study was commenced to recruit patients with functional burns and chronic wounds who were repaired with split-thickness skin graft in the Department of Burn and Plastic Surgery of Zhongshan People’s Hospital from September 2021 to September 2022. Ten days after wound healing in the donor area of the thigh (about 4 weeks after surgery), the patients were randomly divided into two groups: the experimental group and the control group. The experimental group was injected with BTX-A solution at the skin donor site by equal interval injection method 1 and 3 months after surgery, 0.1 ml (1 U) was injected at each point, and the interval of each point was 1 cm. The control group was injected with equal amount of normal saline at the skin donor area by equal spacing method 1 and 3 months after operation. The adverse reactions was observed. Follow-up was performed six months after treatment. Evaluation indicators included the doctor’s Vancouver scar scale (VSS) score (including color, vascular distribution, softness and thickness), the visual analogue scale (VAS) score of the patient’s scar pain and itching degree. Both VSS scores and VAS scores were in line with normal distribution, expressed as Mean±SD, and analyzed by independent sample t-test. Results:A total of 60 subjects were recruited, 30 in the experimental group and 30 in the control group. In the experimental group, there were 16 males and 14 females, aged (32.7±5.4) years (18-60 years). In the control group, there were 13 males and 17 females, aged (31.4±4.8) years (18-55 years). There were no significant differences in gender composition and age between the two groups (all P > 0.05). No serious adverse reactions occurred in the experimental group during and after treatment. At the follow-up six months after treatment, the total score of VSS in the experimental group [(3.57±0.60) points vs. (8.52±0.84) points] and the scores of scar color, vascular distribution, flexibility and thickness[(0.88±0.22) points vs. (2.30±0.52) points; (0.73±0.27) points vs. (2.16±0.40) points; (1.29±0.39) points vs. (2.49±0.39) points; (0.66±0.23) points vs. (1.56±0.34) points] were significantly lower than those in the control group, and the differences were statistically significant ( P < 0.01). The VAS score of scar pain and itching degree in the experimental group was also significantly lower than that in the control group [(1.06±0.34) points vs. (2.92±0.63) points], and the difference was statistically significant ( P < 0.01). Conclusion:BTX-A injection is safe and effective in preventing and treating cicatrix in the donor area of split-thickness skin graft, and also has a good effect on relieving the pain and itching symptoms of cicatrix patients.

Objective To observe the maxillary alveolar cortical bone and cancellous bone mineral density of patients with different degree of dental fluorosis.Methods According to the diagnostic criteria of dental fluorosis (WS/T 208-2011),from March 2015 to March 2017,30 orthodontic dental fluorosis patients were selected in Guiyang Stomatological Hospital.According to the degree of tooth damage,patients were divided into mild,moderate and severe fluorosis groups,10 cases per group;10 normal orthodontic patients were selected as control group.A cone beam computed tomography (CBCT) was taken preoperatively to measure the CT values (the attenuation value after absorption of X-rays through the tissue,HU) of buccal alveolar cortical bone and cancellous bone density in incisor,canine,premolar,and molar areas.Results The buccal alveolar cortical bone densities of incisor [(1 155.6 ± 80.7),(1 048.8 ± 106.7),(885.1 ± 118.1),(589.7 ± 104.6) HU],canine [(1 221.0 ± 76.l),(1 054.6 ± 95.3),(913.3 ± 109.4),(608.5 ± 131.4) HU],premolar [(1 173.5 ± 91.2),(1 020.9 ± 113.3),(894.5 ± 107.9),(593.5 ± 119.7) HU],and molar [(1 113.6 ± 89.5),(1 017.2 ± 101.3),(877.2 ± 102.9),(609.1 ± 113.5) HU] areas in control,mild,moderate and severe fluorosis groups,were significantly different statistically (F =45.557,51.411,61.200,56.845,P ＜ 0.01),CT values of dental fluorosis group were significant lower than that of control group (P ＜ 0.05).The cancellous bone mineral density of the incisor [(633.4 ± 67.7),(556.8 ± 80.1),(473.1 ± 71.7),(358.8 ± 98.7) HU],canine [(644.9 ± 70.1),(570.6 ± 73.3),(490.0 ± 85.2),(361.1 ± 93.8) HU],premolar [(630.5 ± 72.5),(554.5 ± 70.7),(477.7 ± 84.0),(353.6 ± 101.4) HU],and molar [(637.6 ± 79.8),(558.5 ± 84.3),(471.7 ± 72.8),(367.7 ± 88.7) HU] areas in control,mild,moderate and severe fluorosis groups,were significantly different statistically (F =20.183,20.245,22.751,21.268,P ＜ 0.01),CT values of dental fluorosis group were significant lower than that of control group (P ＜ 0.05).Conclusion The bone density of maxillary alveolar cortical bone and cancellous bone is reduced in dental fluorosis patients.

Objective To observe the effect of proximal needling at Tianzhu (BL10) plus electroacupuncture at the Balance Zone on the lower-limb motor function and walking function in cerebral stroke patients.Method A hundred cerebral stroke patients were randomized into a rehabilitation group and a proximal needling group. The rehabilitation group was intervened by balance training and conventional rehabilitation exercises; the proximal needling group was intervened by proximal needling at Tianzhu plus electroacupuncture at the Balance Zone in addition to the treatment given to the rehabilitation group. The interventions weregiven once a day, 5 times a week, successively for 4 weeks. Prior to the intervention and after 4-week treatment, the lower-limb motor function and walking function were estimated by using lower-extremity Fugl-Meyer Assessment (FMA), time taken for 10-meter walk, and Holden's Functional Ambulation Classification (FAC).Result After 4-week treatment, the FMA, 10-meter walk time and FAC were significantly enhanced in both groups compared to the indexes prior to the treatment (P<0.01); the FMA, 10-meter walk time and FAC in the proximal needling group were significantly superior to those in the rehabilitation group (P<0.05).Conclusion In addition to conventional rehabilitation and acupuncture, proximal needling at Tianzhuplus electroacupuncture at the Balance Zone can increasethe lower-limb motor function score and promote the activities of daily life in cerebral stroke patients; it can also strengthen the security in walking and keep the patients from falling down.

Objective To discuss the feasibility and effectiveness of transcatheter implantation of double-ring aortic valve stent through puncturing the tip of the heart under thoracotomy.Methods A novel double-ring aortic valve stent was independently designed by the authors.Three healthy goats were selected for this study.A small incision on the left anterolateral thoracic wall was made to expose the cardiac apex,than the puncturing of the left ventricular apex was performed to establish the working pathway.Guided by fluoroscopy,along a hard guide wire a double-ring aortic valve stent was inserted through a 22-French sheath to the site above the aortic valve.By utilizing the opened outer ring of the stent,the double-ring aortic valve stent was accurately placed at the bottom of the aortic valve sinus.Then,the balloon was inflated and the stent was released to substitute the original aortic valve of the experimental goat.The experiment results were evaluated immediately after the procedure.Results Transcatheter aortic valve implantation (TAVI) was successfully accomplished in all the three experimental goats.DSA was performed immediately after the procedure and anatomy evaluation indicated that the position of the implanted artificial aortic valve was satisfactory,which could replace the work of original valve.Conclusion It is technically feasible and clinically effective to use this novel double-ring aortic valve stent to perform TAVI through transapical route by puncturing the left ventricular apex.

Objective To investigate the applied value of 3.0T blood oxygen level dependent(BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury (WIRI) in rabbits.Method Twenty healthy adult New Zealand white rabbits were randomly divided into two groups by using the stochastic indicator method.In 10 rabbits enrolled in the treatment group,the model of hepatic WIRI after ischemia for 30 min followed by 6-h reperfusion was established,and the remaining 10 rabbits were chosen as the normal control group and were not subjected to any surgery.All the experimental rabbits were scanned by 3.0T MRI and BOLD MRI.T2* values were separatelymeasured by 2 considered radiologists and the R2* values were calculated (R2* =1/T2*).Thereafter,the intra-class correlation coefficient (ICC) was used to check the consistency.All rabbits were killed after MR examination and routine assays were performed for testing the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and lactate dehydrogenase (LDH) in the ear vein blood serum.The contents of total superoxide dismutase (SOD),malondialdehyde (MDA) and myeloperoxidase (MPO) in liver tissues were determined,and histopathological changes were examined.The correlation between R2 * value and clinical test index was evaluated by Spearman correlation analysis.The R2* value was evaluated by ROC curve.Result ICC =0.87 ＞ 0.75,suggesting that the repeatability of the outcome is good.Compared to the normal control group,R2*value of the warm ischemia-reperfusion injury group was increased (P =0.000).The differences in ALT,AST,LDH,total SOD,MDA and MPO between the two groups were statistically significant (P＜0.01).R2* values were significantly positively correlated with ALT,AST,LDH,MDA and MPO (r＞0.6,P＜0.05),and there was a significantly negative correlation between R2* and total SOD (r=-0.663,P=0.001).The R2* value could efficiently diagnose rabbit hepatic WIRI (AUC =0.99) with the best diagnostic threshold being 116.40 Hz.Conclusion 3.0T BOLD MRI can accurately and non-invasively assess the pathophysiologic changes caused by WIRI.It is of great importance for 3.0T BOLD MRI in dynamically monitoring and evaluating hepatic WIRI.

OBJECTIVETo evaluate the operation time and clinical effect of three types of materials (i.e., total-etching adhesive, self-etching adhesive, resin-modified glass ionomer cement) that are used to bond removable thermoplastic appliances.

METHODSThirty malocclusion patients (156 attachments) with removable thermoplastic appliances were randomly divided into three groups, with 10 individuals each. Attachments of groups A and B were bonded using 3M Adper Single Bond 2 and 3M Adper Easy One, respectively; both adhesives utilized 3M Z350 nano composite resin. Attachments of group C was directly bonded using GC Fuji Ortho LC. The operation time of each attachment was recorded. Failure rates of adhesion were evaluated during adhesion, 1 month after treatment, and 6 months after treatment.

RESULTSThe operation time of group C was shorter than those of groups A and B (P<0.01). Significant difference of adhesion failure rates was not found among the three groups (P>0.05). No significant difference of adhesion failure rates was also observed in different times of the same group (P>0.05).

CONCLUSIONThe attachment stability of the three types of materials achieved satisfactory effects. However, the operation method of resin-modified glass ionomer cement is more concise and suitable for clinical promotion.

Acrylic Resins ; Adhesives ; Aluminum Silicates ; Composite Resins ; Dental Bonding ; Dental Cements ; Glass Ionomer Cements ; Humans ; Orthodontic Appliances ; Resin Cements

Objective To assess the therapeutic effect of bone marrow‐derived mesenchymal stem cells (BMSCs) on osteoporotic fracture healing .Methods Bone marrow of the rat bilateral femur and tibia bone tissue were collected ,and BMSCs were isolated by the whole bone marrow adherence method .Sixty female 11‐week‐old SD rats were ovariectomized (OVX) to induce osteoporosis followed by bilateral fracture generation .Twenty rats were left without giving any further treatment (OVX controls) ,20 received injection of saline (OVX+placebo control) and 20 were given injection of BMSCs (OVX+BMSCs) .X‐ray scan was performed at 3‐day ,4‐week and 8‐week post‐fracture ,respectively .Results Flow cytometry analysis revealed that the isolated BMSCs express sur‐face antigens similar to those reported previously .X‐ray results showed that compared with OVX and OVX+placebo groups ,BM‐SCs treatment markedly accelerated fracture healing of in osteoporotic rats .Conclusion Transplantation of BMSCs can effectively improve the healing of primary osteoporotic fracture .