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Objective To analyze the research status and predict the development trend of clinical comprehensive evaluation of drugs in China, and to provide reference for clinical comprehensive evaluation. Methods CNKI, Wanfang and VIP database were used to search the published articles of clinical comprehensive evaluation. Literature searching was set from the building time of the database to 2022, the basic information about the published articles was obtained for the evaluation of the literature quality. Bibliometrics and CiteSpace 6.1.R3 software were used to visualize the research authors, research institutions, and key words. Results After data screening, a total of 126 Chinese published articles were selected. The analysis showed that the numbers of published articles were rising continuously, and China Academy of Chinese Medical Sciences and Xie Yanming were the institute and the author with the maximum number of literatures, respectively. Conclusion The clinical comprehensive evaluation of drugs was conducted based on the clinical value of drugs, guided by the policy requirements. It is suggested that researchers should conduct the comprehensive evaluation according to the focus and requirements of government agencies, the pharmaceutical industry and the clinical applications.
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Diversity-oriented synthesis is aimed to increase the chemical diversity of target natural products for extensive biological activity evaluation. Indole ring is an important functional group in a large number of drugs and other biologically active agents, and indole-containing natural products have been frequently isolated from marine sources in recent years. In this paper, a series of indole-containing marine natural hyrtioreticulin derivatives, including 19 new ones, were designed, synthesized through a key Pictet-Spengler reaction, and evaluated for their inflammation related activity. Compound 13b displayed the most promising activity by inhibiting TNF-α cytokine release with an inhibitory rate of 92% at a concentration of 20 μmol·L-1. A preliminary structure-activity relationship analysis was also discussed. This research may throw light on the discovery of marine indole alkaloid derived anti-inflammatory drug leads.
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Animals , Anti-Inflammatory Agents/pharmacology , Biological Products/pharmacology , Indole Alkaloids/pharmacology , Porifera , Structure-Activity RelationshipABSTRACT
Blood-brain barrier (BBB) damage after ischemia significantly influences stroke outcome. Compound LFHP-1c was previously discovered with neuroprotective role in stroke model, but its mechanism of action on protection of BBB disruption after stroke remains unknown. Here, we show that LFHP-1c, as a direct PGAM5 inhibitor, prevented BBB disruption after transient middle cerebral artery occlusion (tMCAO) in rats. Mechanistically, LFHP-1c binding with endothelial PGAM5 not only inhibited the PGAM5 phosphatase activity, but also reduced the interaction of PGAM5 with NRF2, which facilitated nuclear translocation of NRF2 to prevent BBB disruption from ischemia. Furthermore, LFHP-1c administration by targeting PGAM5 shows a trend toward reduced infarct volume, brain edema and neurological deficits in nonhuman primate
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Objective To optimize the manufacture process for Zhibai Anshen oral liquid. Methods The orthogonal designed experiments were conducted to monitor the effects of three factors on the content of mangiferin. The three factors included the amount of water, extraction time and alcohol precipitation concentration. Six month accelerated stability study and twelve month long term stability study were performed. Results Optimum percolation process was boiling the mixture with 10 times of water for 1 hour, followed by deposition with 60% alcohol. Conclusion This optimized process can be used for mass production.
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Ischemic stroke is the second leading cause of death worldwide with limited medications and neuroinflammation was recognized as a critical player in the progression of stroke, but how to control the overactive neuroinflammation is still a long-standing challenge. Here, we designed a novel SIRT6 activator MDL-811 which remarkably inhibited inflammatory response in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages and primary mouse microglia, which were abolished by silencing SIRT6. RNA-seq screening identified the forkhead box C1 (
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Objective:To observe the clinical efficacy of Shiwei Wendantang on post-ischemic stroke depression of heart and gallbladder Qi deficiency syndrome. Method:The 80 patients with post-ischemic stroke depression of heart and gallbladder Qi deficiency syndrome were divided into two groups by random number table. 40 cases in control group received oral administration of antidepressant Paroxetine, 20 mg·d-1, and 40 cases in observation group received Shiwei Wendantang, 1 dose/day. The treatment course was 4 weeks in both groups. The clinical efficacy, hamilton depression scale (HAMD-17) score, serum C-reactive protein (CRP), homocysteine (Hcy) level, traditional Chinese medicine(TCM) syndrome score and quality of life score of two groups were observed and compared. Result:After treatment, the curative effect of observation group was better than that of the control group (Z=-2.104，P<0.05), and the total effective rate in observation group was significantly higher than that of control group（χ2 =5.00，P<0.05）. After treatment, the scores of each factor of HAMD-17 scale in observation group were significantly decreased (P<0.05), and the scores of factors of HAMD-17 scale in the control group were also significantly decreased (P<0.05) except despair and anxiety. The decrease of scores in the observation group was more obvious than that in the control group (P<0.05). After treatment, the values of serum CRP and Hcy in two groups were decreased significantly (P<0.01）,and the values of serum CRP and Hcy in observation group were also decreased significantly (P<0.01）.After treatment, the scores of TCM syndromes in observation group were decreased significantly (P<0.01）， while in control group, only the score of urination was significantly decreased（P<0.05）. The scores of quality of life in observation group were all significantly higher than those before treatment (P<0.01）. The scores of SF-36 Health Survey Form in the control group were significantly decreased except for energy and social function (P<0.05). The scores of physical function, physical intelligence, physical pain, social function, and mental health in observation group were significantly higher than those in the control group (P<0.05). Conclusion:As compared with the conventional western medicine treatment, the application of Shiwei Wendantang in the treatment of post-ischemic stroke depression of heart and gallbladder Qi deficiency syndrome, can further reduce the degree of depression of patients, improve the symptoms of depression, and improve the quality of life, with more significant clinical efficacy and comprehensive effect.
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Macrophages play an important role in inflammation, and excessive and chronic activation of macrophages leads to systemic inflammatory diseases, such as atherosclerosis and rheumatoid arthritis. In this paper, we explored the anti-inflammatory effect of broussonin E, a novel phenolic compound isolated from the barks ofBroussonetia kanzinoki, and its underlying molecular mechanisms. We discovered that Broussonin E could suppress the LPS-induced pro-inflammatory production in RAW264.7 cells, involving TNF-α, IL-1β, IL-6, COX-2 and iNOS. And broussonin E enhanced the expressions of anti-inflammatory mediators such as IL-10, CD206 and arginase-1 (Arg-1) in LPS-stimulated RAW264.7 cells. Further, we demonstrated that broussonin E inhibited the LPS-stimulated phosphorylation of ERK and p38 MAPK. Moreover, we found that broussonin E could activate janus kinase (JAK) 2, signal transducer and activator of transcription (STAT) 3. Downregulated pro-inflammatory cytokines and upregulated anti-inflammatory factors by broussonin E were abolished by using the inhibitor of JAK2-STAT3 pathway, WP1066. Taken together, our results showed that broussonin E could suppress inflammation by modulating macrophages activation statevia inhibiting the ERK and p38 MAPK and enhancing JAK2-STAT3 signaling pathway, and can be further developed as a promising drug for the treatment of inflammation-related diseases such as atherosclerosis.
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Objective To explore the inhibitory mechanism of timosaponin B-Ⅱ against the proliferation and migration of human gastric cancer cell lines BGC-823 and MGC-803. Methods BGC-823 and MGC-803 cells were treated with timosaponin B-Ⅱ (50 ng/mL) for 48 h, and the mRNA and protein expressions of scavenger receptor A5 (SCARA5) were measured by qPCR and Western blotting, respectively. The binding site of hsa-miRNA-766-3p in SCARA5 gene 3′UTR was predicted by bioinformatics, and was validated by luciferase report assay. After transfecting with hsa-miRNA-766-3p mimic or siRNA-SCARA5 for 24 h, the BGC-823 and MGC-803 cells were treated with timosaponin B-Ⅱ(50 ng/mL) for 48 h. The relative levels of hsamiRNA-766-3p and SCARA5 protein expression were detected by qPCR and Western blotting, respectively. The proliferation and migration abilities of cells were determined by MTT. Results The expressions of SCARA5 protein in BGC-823 and MGC-803 cells treated with timosaponin B-Ⅱ (50 ng/mL) for 48 h were significantly increased versus the control group (P0.01), while no significant difference was found in relative mRNA level of SCARA5 between the timosaponin B-Ⅱ treated cell group and the control group (P0.05). Compared with transfection of reporter gene expression vector alone group, the luciferase activity was significantly inhibited or enhanced in the cells co-transfected with hsa-miRNA-766-3p mimic or hsa-miRNA-766-3p inhibitor and wild-type luciferase reporter gene (P0.05, P0.01). No change was observed between the cells co-transfected with hsa-miRNA-766-3p mimic or hsa-miRNA-766-3p inhibitor and mutant-type luciferase reporter gene expression vector and the cells transfected with reporter gene expression vector alone (P0.05). Hsa-miRNA-766-3p levels were significantly decreased and SCARA5 protein expressions were significantly increased in BGC-823 and MGC-803 cells treated with 50 ng/mL timosaponin B-Ⅱ (P0.01). Compared with the timosaponin B-Ⅱ treatment group, hsa-miRNA-766-3p levels were significantly increased and SCARA5 protein expressions were significantly decreased in the BGC-823 and MGC-803 cells of the hsa-miRNA-766-3p mimic transfection＋ timosaponin B-Ⅱ treatment group (P0.01). There were no differences in the hsa-miRNA-766-3p levels between the hsa-miRNA-766-3p mimic transfection＋timosaponin B-Ⅱtreatment group and the timosaponin B-Ⅱ treatment group (P0.05), but SCARA5 protein expressions were significantly decreased (P0.01). Compared with cell control group and vehicle control group, the proliferation and migration abilities of BGC-823 and MGC-803 cells were significantly inhibited by timosaponin B-Ⅱ (P0.01). Compared with the timosaponin B-Ⅱ treatment group, the proliferation and migration abilities of BGC-823 and MGC-803 cells were significantly increased in the siRNA-SCARA5 transfection＋timosaponin B-Ⅱ treatment group (P0.01). Conclusion Timosaponin B-Ⅱ can inhibit the proliferation and migration of BGC-823 and MGC-803 cells via suppressing hsamiRNA-766-3p and upregulating the target gene SCARA5.
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Objective To evaluate the effectiveness of spectral CT with multiple parameters on the diagnosis of ovarian cancer. Methods The data of 22 patients with spectral CT enhanced scan were analyzed retrospectively.The patients were divided into two groups:ovarian cancer group (n=11)and benign tumor group (n=11),according to the pathologic results.CT values at 40 keV,iodine concentration (IC),water concentration(WC)and spectral curve slope (λHU)of arterial phase and venous phase in the tumors of two groups were measured with gemstone spectral imaging(GSI)post-processing software.The independent samples t test was used to compare these multiple parameters above between two groups.Interobserver agreement with regard to various parameters was assessed using Cohen’s Kappa . For the parameters which showed statistically different,the receiver operating characteristic(ROC)curves were further generated to calculate their diagnostic effectiveness respectively.Results CT values at 40 keV,IC andλHUmeasured in arterial and venous phases were higher in ovarian cancer group than those in benign tumor group.There were significant differences between these two groups(P<0.05). While WC had no significant difference in these two groups (P>0.05).Interobserver agreement with regard to various parameters was excellent (Kappa>0.80).CT values at 40 keV,IC andλHUhad high effectiveness on the diagnosis of ovarian cancer according to ROC curves.The optimal parameter among them was IC in arterial phase with AUC of 0.90.Using 10.92 (100 μg/cm3)as a threshold value,the sensitivity and specificity for diagnosis were 90.9% and 90.9%.Conclusion Spectral CT with multiple parameters,including CT values at 40 keV,IC and λHUhave significant differences between benign and malignant ovarian tumors.IC in arterial phase has the highest effectiveness on the diagnosis of ovarian cancer.
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Objective The purpose of this study is to estimate the body height of Sichuan Hans population by CT-VRT images of clavicle and to update the data of Stature estimation. Methods Three hundred individual CT-VRT images of clavicle were selected. The length of both side clavicles was measured and then the average clavicle length (ACL),the left clavicle length(LCL),the right clavicle length(RCL)was calculated as independent variable to establish the regression equations. The gender difference was tested by ANOVA and the correlation between the clavicle and the body height was tested by Pearson. Result The correlation between the ACL, LCL, RCL and the body height was normal in both genders (0.534 in male ACL and 0.707in female ACL; 0.484 in male LCL, 0.680in femaleLCL;0.523 in male RCL, 0.695 in female RCL). The test of accuracy showed MAD=4.48cm in the male ACL simple linear regression model and MAD=3.51cm in the female ACL simple linear regression model; MAD=4.60cm in the male LCL model, MAD=3.64cm in the female LCL simple linear regression model; MAD=4.49cm in the male RCL model, MAD=3.59cm in the female RCL model. Conclusion The regression equations derided from clavicle on the basis of CT-VRT images in this study can be used to estimate stature for Sichuan Hans population. But the R2 values were small, so it's better to combine other bone for stature estimation.
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Objective To evaluate the effect of dexmedetomidine on the expression of antisense hypoxia-inducible factor-1α (aHIF-1α) during brain injury after asphyxial cardiac arrest and resuscitation in rats.Methods Twenty-four pathogen-free healthy male Sprague-Dawley rats,weighing 250-280 g,were divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),cardiac arrest and resuscitation group (group R) and dexmedetomidine group (group D).Asphyxial cardiac arrest and resuscitation were performed in R and D groups.The rats were tracheally intubated without clipping the trachea in group S.Dexmedetomidine 4 μg/kg was injected via the tail vein at 5 min before clipping the trachea in group D,while the equal volume of normal saline was given instead in S and R groups.Neurological deficit was assessed and scored (NDS) at 12,24,48 and 72 h after recovery of spontaneous circulation (T1 4).The rats were sacrificed after assessing neurological deficit at T4,brains were removed and hippocampi were isolated for determination of cell apoptosis (by TUNEL),HIF-1α expression (by Western blot) and expression of HIF-1α and aHIF-1α mRNA in hippocampal tissues (using polymerase chain reaction).Apoptosis rate was calculated.Results Compared with group S,the NDS at each time point and apoptosis rate of hippocampal neurons at T4 were significantly increased,and the expression of HIF-1α protein and mRNA and 5'aHIF-1α mRNA was up-regulated in R and D groups (P＜O.05).Compared with group R,the NDS at T2.4 and apoptosis rate of hippocampal neurons at T4 were significantly decreased,the expression of 5'aHIF-1α mRNA was down-regulated,and the expression of HIF-1α protein and mRNA was up-regulated in group D (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces brain injury after asphyxial cardiac arrest and resuscitation is related to down-regulation of 5'aHIF-1α expression in rats.
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Objective To analyze the present post setting situation of CDCs in Zhejiang Province, and to provide evidence for further improvement and standardization of post setting. Methods The data of post setting were collected by questionnaires from all levels of CDCs in Zhejiang Province. The compliance and rationality of post setting structure were evaluated by national and provincial normative policy documents. Results Ninety seven CDCs had implemented the post setting. Professional technical posts had the highest proportion (above 80%) among three kinds of posts. As the approved proportions of posts classification and professional titles were approved by the local government, there were differences between different levels of CDCs. The approved proportion of ground skilled posts and management posts between municipal and county CDCs had a relatively higher degree of dispersion, and the CVs of ground skilled posts and management posts of municipal CDCs were 72.3% and 65.6%, and the CVs of county CDCs were 101.6% and 82.1%. In terms of the approved professional titles structural proportion, the degree of dispersion appeared to be higher in senior titles and primary titles approved proportion of municipal CDCs (CV=29.1%, 28.5%), while the degree of dispersion was higher in senior titles and vice-senior titles of county CDCs (CV=58.9%, 21.8%) . Meanwhile, the approved proportions of senior titles in municipal and county CDCs were lower with the averages of 32.2% and 17.0%. The posts of infectious disease prevention and control and laboratory detection were accounting for the majority posts in municipal and county CDCs with average percentages of 47.8% and 45.1% . Conclusion The present situation of post structural proportion meets the relevant requirements generally. However, there are some phenomena of non-standard approved proportion of ground skilled posts and management posts and low senior titles approved proportion. Meanwhile, the percentage of infectious disease prevention and control and laboratory detection posts appears to be lower in county CDCs.
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Objective To establish the quality standard of Santeng oral solution.Method Sargentodoxa Caulis and Spatholobi Caulis were identified by thin layer chromatography.Chlorogenic acid was assayed by high performance liquid chromatography.The chromatographic column is Agilent Zorbax SB C18 (4.6 mm×250 mm, 5 μm) with a stable temperature of 35 ℃.The mobile phase in isocratic elution consists of acetonitrile and 0.1% folic acid aqueous solution with a preliminary volume ratio of 9∶91.The flow rate is 1.0 ml/min with an injection volume of 20 μl.Results Thin layer chromatography showed distinct spots of Sargentodoxa Caulis and Spatholobi Caulis with a great specificity.A regression formula Y=60.14X-6.37(r>0.999 9) was obtained with a good linearity in concentration range of 2.70~202.50 μg/ml.Conclusion A simple, stable and repeatable method was established for the quality control of Santeng oral solution.
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BACKGROUND: Reducing perioperative blood loss in total hip arthroplasty is a hot topic for joint surgeons. Both intravenous infusion and intra-articular injection of tranexamic acid significantly reduce perioperative blood loss, blood transfusion volume, and need for blood transfusion in patients undergoing total hip arthroplasty. However, differences between the intravenous and intra-articular methods are not clear.OBJECTIVE: To evaluate the effects of these two tranexamic acid administration methods on perioperative blood loss in patients undergoing total hip arthroplasty.METHODS: We are conducting a prospective, single-center, open-label, randomized, controlled clinical trial at the Tengzhou Central People's Hospital, China. Ninety patients undergoing unilateral total hip arthroplasty have been randomized into three groups. In the intravenous infusion group (n=30), 15 mg/kg tranexamic acid diluted in 100 mL physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. In the intra-articular injection group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and a mixture of 1.5 g tranexamic acid and 20 mL physiological saline was injected intra-articularly after deep fascia suturing. In the control group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. The primary outcome is hidden blood loss at 1 and 3 days postoperatively. The secondary outcomes are visible blood loss, need for blood transfusion, and mean blood transfusion volume intraoperatively and on days 1 and 3 postoperatively. Other outcomes are the incidence of adverse reactions and complications within 3 months of surgery. The study protocol has been approved by the Ethics Committee of Tengzhou Central People's Hospital of China, approval number 2015-026. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan.DISCUSSION: This trial was designed in April 2015. Cases were collected in July 2015. Data analysis will be finished in December 2017. This study is designed to investigate the effects of intravenous infusion versus intra-articular injection of tranexamic acid on perioperative blood loss in patients undergoing total hip arthroplasty to determine the more effective mode of administration.
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The incidence of rectal cancer gradually increased in our country in recent years.Preoperative imaging methods are used to accurately display the lesions of rectal cancer,providing accurate quantitative diagnostic information,therefore being important to formulate reasonable and individualized therapy clinically.Intra-voxel incoherent motion (IVIM) is a multi parameter imaging technology.IVIM can provide the diffusion and perfusion information from the molecular level.Theoretically,the microstructure information of internal rectal cancer cell density and the vascular density,and the tumor cell metabolism can be displayed quantitatively with IVIM imaging,which can reflect the heterogeneity of the tumor and its degree during different periods.The application status and the future development of IVIM technique in management of rectal cancer were reviewed in this article.
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Objective Toanalyzethepersonnelallocationandbasicqualitystructureofmiddle-levelcadresinCDCsof ZhejiangProvince.Methods DatawerecollectedfromthenationalbasicinformationsystemofCDCs.Anddescriptive statistics,chi-square test and Kruskal -Wallis H test were used to analyze the differences of middle -level cadres'personnelallocationandbasicqualityamongthreelevelsofCDCs.Results Theallocationratioofmiddle-levelcadresin management departments was 25.58%,27.32% and 23.58% for provincial level,city level and county level of CDCs respectively,which was 74.42%,72.68% and 76.42% in management departments respectively.There were significant differences in ages,working years,education levels,majors and titles across different levels of CDCs (P<0.05 ).And there were significant differences in education levels across counties with different economic levels (P<0.05 ). Conclusion Thepersonnelallocationofmiddle-levelcadreswithexcellentbasicqualityindifferentlevelsofCDCsin Zhejiang Province was reasonable.
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Objective To establish a quality control standard for Qingre Baidu granules .Methods Isatidis Radix ,Fruc-tus Forsythiae ,Herba Violae ,and Glycyrrhizae were identified by TLC ,and the concentration of chlorogenic acid was deter-minedbyHPLC.ThismethodwasemployedonanAgilentZORBAXSB-C18column(4.6mm×250mm,5μm)at30℃ witha mobile phase of acetonitrile (A) and 0 .2% formic acid (B) using the gradient elution program shown as follows :0-12 min , 11%-12% A run at the flow rate of 1 .0 ml/min .The injection volume was 20 μl and the detection wavelength was 327 nm . Results Characteristic spots could be detected by TLC and the specificity of the method was satisfactory .As for chlorogenic acid ,the equation of linear regression of chlorogenic acid was Y=60 .239 4X+9 .096 3 (r=0 .999 9) with the linear range of 6.19-396 .00 μg/ml .The average recovery was 99 .66% (RSD=2 .82% ) .Conclusion The established method is simple ,reli-able ,reproducible ,and can be used for the quantitative determination and quality control of Qingre Baidu granules .
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OBJECTIVE:To study the inhibitory mechanism of timosaponin B-Ⅱ(TB-Ⅱ) on the proliferation and migration of human lung cancer A549 cells. METHODS:A549 cells were treated with TB-Ⅱ [0(blank control),1,10 and 100 μg/ml] for 48 h,and total RNA and total protein were extracted respectively. Real time fluorescence quantitative-PCR and Western blot were used to detect mRNA and protein levels of IL-18. IL-18 in A549 cells was silenced by transfection;the expression of IL-18 mRNA and protein were compared among untransfection group,negative control group and transfection group;and then human lung can-cer A549 cells with silenced gene were treated with 10 μg/ml TB-Ⅱ for 24,48 and 72 h. The activity of cell proliferation was de-tected with CCK-8,and the change of cell migration ability was observed by streak method. RESULTS:Compared with blank con-trol,the expression of IL-18 mRNA and protein in A549 cells all increased after treated with TB-Ⅱ(P<0.05 or P<0.01),and were positively correlated with concentration. Compared with untransfection group,the expression of IL-18 mRNA and protein de-creased in transfection group(P<0.01). Compared with untransfected cell treated with TB-Ⅱ,the viability and migration ability of A549 cells with transfection gene increased after treated with TB-Ⅱ for 72 h(P<0.01). CONCLUSIONS:TB-Ⅱ can inhibit the proliferation and migration of A549 cells by up-regulating IL-18 gene expression.
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BACKGROUND:Increasing reports have focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial. OBJECTIVE:To explore the impact of topical articular application of tranexamic acid and intravenous application of tranexamic acid on blood loss during primary unilateral total knee arthroplasty. METHODS:According to randomized control ed principle, 90 patients who received unilateral total knee arthroplasty in the Tengzhou Central People’s Hospital from October 2013 to December 2014 were enrol ed in this study, and randomly assigned to intravenous injection group and topical injection group (n=45). Patients in the intravenous injection group were given tranexamic acid by intravenous injection (10 mg/kg, maximum 1.2 g) during the induction of anaesthesia. Patients in the topical injection group were given intraarticularly tranexamic acid (2 g dissolved in 50 mL physiological saline) before articular capsule suture and after prosthesis fixation. Drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, and the number of blood transfusion population were compared between the two groups. Simultaneously, clinical symptoms of pulmonary embolism and deep vein thrombosis in the lower limb were observed. If necessary, lower extremity vascular Doppler ultrasound was conducted. RESULTS AND CONCLUSION:No significant differences in drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, the number of blood transfusion population, and the proportion of blood transfusion were detected between the two groups (P>0.05). No deep vein thrombosis was found in the lower limbs at 14 days after replacement in both groups. These findings confirm that compared with intravenous systemic application, periarticular topical application of tranexamic acid during total knee replacement could obtain identical effects on reducing blood loss and blood transfusion after surgery, and could avoid relevant complications of intravenous application of tranexamic acid.
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Objective To investigate the feasibility of reducing the radiation dose in adult pelvic CT using automatic tube current modulation (ATCM) and adaptive statistical iterative reconstruction (ASIR).Methods Totally 45 patients who underwent routine and low-dose pelvic CT examination were enrolled in our study.Three groups of images were acquired:group A (routine scan with FBP reconstruction) ;group B1 (low-dose with ASIR0) and group B2 (low-dose with ASIR50％).The scores of image quality was abtained by two radiologists.Results The CTDIvol,DLP and E of group B were significantly reduced respectively(t =12.30,12.10,12.15,P ＜ 0.05) compared with group A.Group B1 had higher noise(t =9.14,8.95,P ＜ 0.05)and lower score,SNR and CNR(t =8.72,10.62,11.83 and 8.40,9.55,11.42,P ＜ 0.05) than the others.And there was no difference in image quality between group A and group B2.Conclusions Using automatic tube current modulation and adaptive statistical iterative reconstruction could significantly reduce the noise but keep the image quality in adult pelvic CT examination.