ABSTRACT
Objective To research the efficacy and safety of sequential rivaroxaban use in reducing blood loss after applying tranexamic acid(TXA)in total hip arthroplasty(THA).Methods According to the design by the random control principle,150 pa tients undergoing unilateral primary THA from September 2012 to June 2015 were selected and randomly divided into the group A,B,C,D and E (n=30).The group A did not use TXA,the group B received intravenous drip of 10 mg/kg TXA at 10 min before skin incision,the group Creceived intravenous drip of 15 mg/kg TXA at 10 min before skin incision,the group D respectively received intravenous drip of 15mL/kg TXA at 10 min before skin incision and after 3 h,the group E received intravenous drip of 15 mL/kg TXA at 10 min before skin incision and articular cavity use of 1 g TXA before closing the incision.Oral 10 mg rivaroxaban was given at postoperative 6-12 h when the drainage volume was less than 30 mL/h and then the conventional dose was used until postoperative 35 d.The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,postoperative anticoagulation time,time of removing drainage tube,postoperative prothrombin time on postoperative 1 d,activated partial thromboplastin time,descend value of hemoglobin,and occurrence rates of postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) were observed in the group A,B,C,D and E.Results The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate and descend value of hemoglobin on postoperative 1 d had statistical differences among 5 groups(P＜0.05).The are significant differences between the group D and A in the intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,descend value of hemoglobin on postoperative 1 d,postoperative anticoagulation time and removal drainage tube time(P＜0.05).All cases had no symptomatic DVT and PE during the perioperative period and postoperative 3-month outpatient or telephone follow-up.Conclusion Sequential rivaroxaban use after applying TXA during THA perioperative period is safe and effective.Moreover intravenous drip of 15 mL/kg TXA at 10 min before skin incision and after 3 h has most significant effect in reducing bleeding volume during THA perioperative period.
ABSTRACT
Objective To study the relationship and prognosis between E-cadherin gene expression and lymphatic hyperplastic reaction in gastric cancer. Methods The degree of lymphocytosis and draining lymph node from 86 cases of gastric cancer were observed and the expression of E-cadherin gene in gastric cancer were detected by SP method of immunohistochemistry (IHC). Results Lymphocyte infiltration degree around gastric cancers was positively related to the reactive hyperplasia of the lymphnodes and was inversely related to lymphatic metastasis. The expression of E-cadherin has relationship with the infiltration degree of stomach carcinoma. To compare with T1/T2 and T3/T4 phases, the result is significantly different (P ＜0.01).Meanwhile, the expression of E-cadherin was positively correlated with tumor-infiltrated lymphocytes and reactive hyperplasia of the lymph nodes, was negatively correlated with lymphatic metastasis in drainage area.Conclusion The over-expression of E-cadherin gene is significantly related to lymphoproliferation and lymph node metastasis. The abnormal expression of E-cadherin can be used as an index to determine prognosis of gastric carcinoma.