Advances in cognitive behavioral art therapy in the treatment of anxiety disorders in children and adolescents / 中国学校卫生

Abstract@#Cognitive behavior therapy (CBT) is one of the main psychotherapeutic methods used to treat anxiety disorders in children and adolescents. Art therapy, based on psychotherapy theory and methods, is rising in popularity abroad. At present, foreign scholars have started to apply cognitive behavioral art therapy (CBAT) for patients with anxiety disorders. Based on the current findings, children and adolescents with developing cognitive functions may also benefit from this therapy. This article summarizes the application status of CBAT in the treatment of anxiety disorder in patients at home and abroad, and innovatively explores its therapeutic potential for anxiety disorders in children and adolescents in China, thus providing a novel perspective that can address the shortcomings of CBT.

Preliminary Recommendations on the Timing of Lung Surgery after Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer / 中国肺癌杂志

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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Application of artificial intelligence for community-based diabetic retinopathy detection and referral / 中华实验眼科杂志

Objective:To evaluate the value of applying an artificial intelligence (AI) system for diabetic retinopathy (DR) detection and referral in community.Methods:A diagnostic test study was conducted.Four hundred and twenty-one patients (812 eyes) diagnosed with diabetes in three Dongguan community healthcare centers from January 1, 2020 to December 31, 2021 were enrolled.There were 267 males, accounting for 63.42% and 154 females, accounting for 36.58%.The subjects were 18-82 years old, with an average age of (51.72±11.28) years.The disease course of the subjects was 0-30 years, with an average course of 3.00 (1.00, 7.00) years.At least one macula-centered 50-degree fundus image was taken for each eye to build a DR image database.All the images were independently analyzed by an AI-assisted diagnostic system for DR, trained and qualified community physicians and ophthalmologists to make diagnosis including with or without DR, referable diabetic retinopathy (RDR) and referral recommendation or not.With diagnoses from ophthalmologists as the standard, sensitivity and specificity of the AI system in detecting DR and RDR were evaluated.The consistency and effective referral rate of the AI system and community physicians in detecting DR, especially in detecting RDR were evaluzted.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Dongguan Tungwah Hospital (No.2019DHLL046).Results:Of 812 eyes, 242 eyes were diagnosed with DR, including 23 with mild nonproliferative diabetic retinopathy (NPDR), 120 with moderate NPDR, 60 with severe NPDR and 39 with proliferative diabetic retinopathy (PDR). The other 570 eyes were diagnosed without DR.The sensitivity/specificity of AI system to detect DR and RDR was 87.60%/97.89% and 90.41%/96.29%, respectively.Compared with the ophthalmologists' diagnosis, the Cohen' s Kappa statistic of AI system to detect DR/RDR was 0.87/0.87, which was lower than 0.93/0.98 of community physicians.Among the referral-recommended cases by ophthalmologists, the effective referral rate of the AI system was 90.87% (199/219), which was higher than 89.50% (196/219) of community physicians, without statistically significant difference ( P=1.000). Conclusions:The AI system shows high sensitivity, specificity and consistency in DR detection, especially in RDR.The AI system is better in recognizing RDR than trained community physicians.

Exercises down regulate Toll-like receptor 4 signaling pathway in obese and overweight pregnant women / 中华围产医学杂志

Objective:To explore the effect of exercise intervention on regulation of Toll-like receptor 4 (TLR4) signaling pathway in overweight and obese pregnant women.Methods:The cohort was based on a randomized controlled trial (RCT) carried out by the same research group in Peking University First Hospital from December 2014 to July 2016. Overweight and obese patients who delivered by elective cesarean section without pregnancy complications were recruited, among which 12 cases in the exercise group and 11 cases in the control group were selected. Real-time polymerase chain reaction, Western Blot, and Luminex experiments were used to compare the expression of TLR4-myeloid differentiation factor 8(MyD88)-nuclear factor-κB(NF-κB) pathway in peripheral blood mononuclear cell (PBMC), rectus abdominis muscle, omental adipose, and subcutaneous adipose, as well as the levels of inflammatory factors (TNF-α, IL-1β, IL-10) in plasma between the two groups. Two independent samples t-test, generalized estimating equation, Chi-square test, and Pearson correlation analysis were adopted for statistical analysis. Results:(1) The expression of inflammatory factors TNF-α and IL-1β in the exercise group showed a downward trend compared with the control in the second and third trimester, but none of the differences were statistically significant (all P>0.05). (2) The mRNA expression of TLR4, MyD88, and NF-κB and the protein expression of TLR4 and NF-κB in PBMC of the exercise group were significantly lower than those in the control group during pregnancy (TLR4 mRNA: 0.06±0.03 vs 0.10±0.04 in the second trimester, 0.05±0.02 vs 0.11±0.05 in the third trimester, χ2=8.07; MyD88 mRNA: 0.09±0.03 vs 0.11±0.03 in the second trimester, 0.10±0.04 vs 0.17±0.06 in the third trimester, χ2=5.81; NF-κB mRNA: 0.10±0.03 vs 0.17±0.08 in the second trimester, 0.08±0.03 vs 0.20±0.08 in the third trimester, χ2=14.71; TLR4 protein: 1.7±0.5 vs 1.9±0.8 in the second trimester, 1.7±0.4 vs 2.3±0.8 in the third trimester, χ2=5.83; NF-κB protein: 1.0±0.4 vs 1.5±0.4 in the second trimester, 1.2±0.3 vs 1.5±0.5 in the third trimester, χ2=4.73; all P<0.05). Moreover, the differences in the mRNA expression of TLR4, MyD88, and NF-κB and TLR4 protein expression in PBMC between the two groups gradually increased. (3) NF-κB in rectus abdominis and omental adipose tissue (0.04±0.02 vs 0.08±0.04, t=－3.72; 0.25±0.05 vs 0.63±0.21, t=－5.41; both P<0.05) and TLR4 and MyD88 in subcutaneous adipose tissue (0.12±0.03 vs 0.30±0.10, t=－5.30; 0.24±0.09 vs 0.44±0.08, t=－5.38; both P<0.05) were observed a decreased mRNA level in the exercise group compared with the control group. The protein level of MyD88 and NF-κB in omental adipose tissue and NF-κB in subcutaneous adipose tissue in the exercise group were significantly lower than those in the control group (1.1±0.5 vs 2.0±0.8, t=－3.15; 1.3±0.5 vs 2.0±0.9, t=－2.23; 1.2±0.5 vs 1.9±0.8, t=－2.80, all P<0.05). (4) The expressions of TLR4 and NF-κB mRNA ( r=0.453 and 0.485) in rectus abdominis muscle, NF-κB mRNA, TLR4 and MyD88 protein ( r=0.539, 0.437 and 0.527) in omental adipose in the two groups were positively correlated with the level of fasting blood glucose ( P<0.05). Conclusions:Regular exercise during pregnancy can down-regulate the expression and activation of the TLR4-MyD88-NFκB pathway in overweight and obese pregnant women. The expression of related factors along this pathway has a certain correlation with fasting blood glucose.

A comparison of the diagnostic performance of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems by senior and junior doctors

Purpose@#This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs). @*Methods@#This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values. @*Results@#Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II). @*Conclusion@#The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.

LncRNA-TDRG1 facilitates the malignant biological behavior of cervical cancer cells / 西安交通大学学报(医学版)

【Objective】 To investigate the molecular mechanism of long non-coding RNA (lncRNA) TDRG1 in facilitating the malignant progression and poor prognosis of patients with cervical cancer. 【Methods】 Cervical cancer cell lines and normal cervical cell Ect1/E6E7 were collected. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of TDRG1. Cervical cancer cell lines were transfected with TDRG1-siRNA, and the proliferation of cancer cells was detected by CCK-8 method and cell plate cloning experiment. The invasion and migration of cancer cells were measured by Transwell experiment. The apoptosis of cancer cells was examined by flow cytometry, and the expressions of relevant proteins were tested by Western blot. 【Results】 Compared with Ect1/E6E7, cervical cancer cell lines showed relatively increased expression of TDRG1. Downregulation of TDRG1 expression inhibited the proliferation and colony formation (162±21 vs. 411±33, P<0.05), as well as the invasion and migration (invasion: 86±13 vs. 315±38, P<0.01; migration: 177±22 vs. 406±41, P<0.01) of Hela cells. Meanwhile, the apoptosis of Hela cells increased [(28±1.5)% vs. (16±1.2)%, P<0.05] and the expression of Bcl-2 protein reduced. In addition, TDRG1 knockdown also decreased the activity of autophagy in Hela cells. 【Conclusion】 TDRG1 facilitates the malignant biological progression of cervical cancer by inhibiting the apoptosis and providing a protective autophagy in cervical cells.

A Case Report and Literature Review of Pulmonary Wegener' Granulomatosis / 中国肺癌杂志

Wegener' granulomatosis is an autoimmune diseases, often involving the lung and kidney, has a high mortality rate in nontreatment patients. The low incidence and nonspecific features, often lead to misdiagnosis and delayed treatment. This paper reported the diagnosis and treatment of a 55-year-old female patient with primary Wegener' granuloma of the lung diagnosed by percutaneous lung biopsy of pulmonary nodules, and reviews the relevant literature.
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Lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia: a clinical analysis of 13 cases / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics of patients with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM), and the diagnosis and optimal treatment of LPL/WM.Methods:The clinical data of 13 LPL/WM patients treated in Zhongnan Hospital of Wuhan University from January 2013 to June 2018 were retrospectively analyzed, and the literature was reviewed.Results:The median age of 13 patients was 60 years old (35-79 years old). There were 12 males and 1 female. Initial symptom was fatigue or edema of both lower limbs for majority of patients. All patients had immunoglobulin M (IgM) monoclonal, 3 of them had elevated immunoglobulin G (IgG) level, including 1 patient with monoclonal IgG. LDH was increased in 2 patients. Coombs test was positive in 5 patients. MyD88 gene mutation status was detected in 8 patients, of which gene mutation in 5 patients was positive. Among 13 patients, 1 patient lost follow-up, 3 patients died, 9 patients were alive with the median survival of 36 months (19-81 months).Conclusions:Incidence of LPL/WM is relatively low with a generally indolent evolution, but heterogeneity is not negligible. Few patients have poor treatment response with a quick disease progress. The high-risk patients undergoing hematopoietic stem cell transplantation after remission-induction chemotherapy may improve the prognosis.

Contrast-enhanced ultrasound quantitative analysis in diagnosis of prostate lesions / 中国医师杂志

Objective To investigate the diagnosis value of contrast-enhanced transrectal ultrasound (CETRUS) quantitative analysis in different types of prostate lesions.Methods 104 patients suspected prostate cancer from the Second Xiangya Hospital of Central South University from Januray 2013 to March 2015 were selected to undergo biopsy.All patients underwent preoperative CETRUS before biopsy.Quantitative analysis of focal prostate was performed with QLAB software.Contrast parameters of each region of interest were recorded and the differences between parameters were compared.Results The contrast parameters of rise time (RT),peak intensity (PI),mean transit time (MTT),area under the curve (AUC),time from peak to one half (TPH),wash in slope (WiS) and time to peak (TTP) of 26 malignant nodules were significantly different from those of the contralateral isotropic glands at the same depth (P ＜ 0.05).There was no significant difference in the above parameters between 33 benign nodules and the contralateral glands of the same depth (P ＞ 0.05).There were significant difference in the above parameters except MTT between the internal gland and the external gland in 18 cases of diffuse prostatic hyperplasia (P ＜0.05).There was no significant difference in the above parameters between the internal gland and the external gland in 28 cases of diffuse prostate cancer.In addition,there was significant difference in Gleason score between diffuse and nodular prostate cancer (P ＜ 0.05).Conclusions Quantitative analysis of CETRUS is expected to be an effective method for differentiating benign and malignant prostatic lesions.

Serf-abnormality in patients with depression / 中华行为医学与脑科学杂志

Self-abnormality in patients with depression has been confirmed in a lot of research results.Negative self-referential processing of depression is associated with higher follow-up depressive symptoms and predicts the recurrence of major depressive episodes.Both self-processing and self-recognition are impaired in depression.The overgeneral autobiographical memory is also a risk factor for onset and maintenance of depression.This review examined self-abnormalities of depression from self-face recognition,self-referential processing and autobiographical memory and summarized the problems of current researches and the future research trends,and may provide insight to explore the self-abnormalities of depression patients comprehensively.

Clinical value for contrast-enhanced transrectal ultrasound in diagnosis of prostate cancer / 中南大学学报(医学版)

To explore the value for contrast-enhanced transrectal ultrasound (CETRUS) in the diagnosis of prostate cancer.
 Methods: Prostate biopsy from 207 cases of suspected prostate cancer were collected between January 2013 and March 2015. These patients were performed ultrasound-guided prostate biopsy in Central Hospital of Changsha. They were randomly divided into a radiography group (n=104) and a non-radiography group (n=103) according to the order of treatment. Transrectal ultrasonography (TRUS) was the first choice in the 2 groups, and CETRUS was conducted in the radiography group. Then, the transrectal biopsy was carried out in the 2 groups. The diagnostic value of CETRUS in prostate cancer was evaluated by pathological examination, a gold standard.
 Results: The sensitivity, specificity, and coincidence rates of TRUS in diagnosing prostate cancer were 65%, 60.4%, and 62.8%, respectively, while those rates of CETRUS in diagnosing prostate cancer were 89%, 78%, and 84%, respectively, with significant difference between the above 2 groups (all P<0.05).
 Conclusion: The sensitivities, specificities, and coincidence rates for CETRUS are superior to TRUS in diagnosing prostate cancer, which can provide a clinical basis for the diagnosis and differential diagnosis of prostate cancer.

Role of PD 0332991 on the Proliferation and Apoptosis of Vascular Endothelial Cells / 中国肺癌杂志

BACKGROUND@#Angiogenesis is an important process in the development of tumor. PD 0332991, a cell cycle inhibitor, can specifically inhibit CD4/6 phosphorylation and cell cycle progression. In xeongraft mice models, PD 0332991 treated mice had significantly decreased angiogenesis and vascular density compared with the control group, but the mechanism remains unknown. The purpose of this study is to investigate the role and molecular mechanism of PD 0332991 on vascular endothelial cells.@*METHODS@#EA.hy926 cells, a kind of vascular endothelial cell, were used as the research model. The effects of PD 0332991 on the activity and proliferation of EA.hy926 cells were detected by the MTT, EdU assays. Wound-healing assays and transwell assays were used to determine the effects of PD 0332991 on the mobility of EA.hy926. The influence of PD 0332991 on cell cycle and apoptosis of endothelial cells was tested by flow cytometry, and the Western blot was applied to observe the expression of cell cycle related proteins in EA.hy926 cells treated by PD 0332991.@*RESULTS@#PD 0332991 significantly inhibited the proliferation and mobility of EA.hy926 cells, caused cell cycle arrest and apoptosis. At the same time, PD 0332991 inhibited the expression of CDK4/6 and phosphorylation of Rb, and thus inhibited the cell cycle progression of EA.hy926 cells.@*CONCLUSIONS@#PD 0332991 can inhibit the proliferation and activity of endothelial cells and induces apoptosis.

Shear wave elastography guided biopsy in diagnosis of tuberculous peritonitis / 中国介入影像与治疗学

Objective To assess the clinical value of ultrasound shear wave elastography (SWE) guided biopsy for diagnosis of tuberculous peritonitis.Methods Clinical data of 25 tuberculous peritonitis patients who underwent SWE guided biopsy (SWE guided group) and other 25 tuberculous peritonitis patients who underwent conventional ultrasound guided biopsy (conventional ultrasound guided group) were retrospectively analyzed.The successful rate of biopsy and the complication occurrence were compared between the two groups.Results The success rate of SWE guided group was 100％(25/25),and the rate of complication occurrence was 8.00％ (2/25).The successful rate and complication occurrence in conventional ultrasound guided group was 84.00％ (21/25) and 32.00％ (8/25),respectively.There were statistical differences of success rate of biopsy (x2=4.348,P=0.037) and the complication occurrence (x2=4.500,P=0.034) between the two groups.Conclusion Compared with conventional ultrasound,SWE guidance can improve the success rate and reduce the complication occurrence of biopsy.

Forensic analysis of 44 cases caused death by aortic dissection rupture in Yunnan province / 中国法医学杂志

Objective Retrospectively analysis on death cases related with aortic dissection provides support for further forensic investigation on such cases. Methods 44 Cases on aortic dissection are collected from the Forensic Medical Center in Kunming Medical University from 2002to2017.Statistic anaylisis was applied to each case's general information,clinical stage,clinical manifestation,risk factors,pathological type,rupture state,and direct case of death. Results The results showed that aortic dissection occurs moslty in middle age male who ranges from 40 to 49 years old. Most cases were aute aortic dissection, and the death rate was the highest in winter and the lowest in spring. Furthermore, pain is shown to be the most common symptom. Atherosclerosis is a critical factor that contributes to the occurance of aortic dissection. In general, type A aortic dissection occurs more frequently than type B. The rupture, located in ascending aorta, often is in a transverse shape. Cardiac tamponade is the primary cause of death.Conclusion Definite initial symptoms arises before aortic dissection rupture and always show many high-risk factors. It is beneficial to forensic identification of the relation between aortic dissection and injury or medical behavior should be considered carefully.

Design and synthesis of photosensitizer,13,15-cycloimides chlorin p6 / 药学实践杂志

Objective To design and prepare 13 ,15-cycloimides chlorin p6 (1) ,a class of chlorin related antitumor photo-sensitizers ,which contain a more stable six-membered cyclic imide comparing to the exocyclic anhydride ring of purpurin-18 (2) .Compounds (1) exhibit strong absorption at long wavelengths near λmax 700 nm to take full advantage of greater tissue penetration .Methods Pheophorbide a (3) was obtained by acid hydrolysis of chlorophyll a ,which was from crude chlorophyll extracts of Chinese traditional herb named Silkworm excrement .Purpurin-18 (2) was prepared by air oxidation and alkali open loop simultaneously on five-membered beta-keto carboxylic ester ring of pheophorbide a (3) .Finally ,the target compounds 1a~1j were synthesized via condensation of its anhydride ring with various amines including carboxyl-protected amino acids . Results Target compounds 1a~1j were successfully synthesized in yields ranged from 32 .6% to 65 .2% .Their structures were confirmed by elemental analysis ,ESI-MS and 1 H NMR spectra .Conclusion Treatment of purpurin-18 (2) with amines can produce target compounds 1a~1j .The starting raw material was inexpensive and readily available .The reaction conditions were mild and workup was convinient .

Clinical value of CEUS guided biopsy in diagnosis of lymphoma in anterior mediastinum / 中国介入影像与治疗学

Objective To explore the clinical value of CEUS guided biopsy of lymphoma in anterior mediastinum.Methods The data of 36 patients with lymphoma of anterior mediastinum underwent biopsy guided by CEUS and 36 patients by conventional ultrasound retrospectively.The successful rate of biopsy and rate of complication occurence were compared between the CEUS group and conventional ultrasound group.Results The successful rate of biopsy in CEUS group was 100％ (36/36),including 26 non-Hodgkin's lymphoma (NHL),10 Hodgkin's lymphoma (HL).The total times of puncture were 60 in 36 patients.The rate of complication occurrence was 11.11 ％ (4/36).The successful rate in conventional ultrasound group was 88.89％ (32/36),including 22 NHL,14 HL.The times of puncture were 91 in 36 patients.The rate of complication occurrence was 41.67％ (15/36).There were significant differences in successful rate and the rate of complication occurrence between two groups (x2 =4.235,8.651,P=0.040,0.003).Conclusion CEUS can reflect the microcirculation of lymphomas in anterior mediastinum,and can guide targeted biopsy.It can improve the successful rate of biopsy and reduce the complications.

Rapid diagnosis of venous catheterization complications: an ultrasound imaging study / 中国医师杂志

Objective To explore the value of ultrasound imaging in complications associated with venous catheterization.Methods Patients (n =853) underwent ultrasound imaging examination after venous catheterization.Ultrasonography manifestations of venous catheterization complications and clinical curative effect were analyzed and summarized.Results Phlebitis,thrombus and mechanical complications were found by ultrasound imaging examination.Pneumothorax,hemothorax,arterial puncture and hematoma were among the main mechanical complications.Among the 853 patients,85 cases (9.96％) were found to have complications by ultrasound examination,with 35 cases (4.10％) of phlebitis,26 cases (3.05％) of catheter-related thrombus and 24 cases (2.81％) of mechanical complications.Conclusions In summary,a variety of venous catheterization complications can be diagnosed using ultrasound imaging non-invasively,effectively and efficiently.Real-time ultrasound imaging examination can dynamically monitor the develop ment and evolution of venous catheterization complications and effectively evaluate outcomes.

Effects of Different Regimens of Tranexamic Acid on Perioperative Bleeding and Postoperative Compliance of Simultaneous Bilateral Total Knee Arthroplasty / 中国药房

OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.

Absorbable screw and metal screw fixation for ankle fractures:comparison of biocompatibility and ankle function / 中国组织工程研究

BACKGROUND:Previous ankle fracture surgery mainly uses the internal fixation materials such as metal screws or Kirschner wire, which can achieve a strong internal fixation, but al need to be taken out in the secondary surgery. In recent years, elastic modulus of biodegradable absorbable screw is identical to that of cancel ous bone, and has been widely used in clinic. OBJECTIVE:To compare the biocompatibility and functional recovery of ankle joint in the repair of ankle fractures with absorbable screws and metal screws. METHODS:100 patients with ankle fractures were selected, including 70 males and 30 females, at the age of 19 to 55 years old. Fifty patients were repaired with absorbable screws and fifty patients were repaired with metal screws. Clinical efficacy, Kofoed score, fracture healing time and adverse events were observed between the two groups after repair. RESULTS AND CONCLUSION:Patients were fol owed up for over 6 months in both groups, showing good bony cal us, good contraposition and alignment at the fracture end. No delayed union or nonunion occurred. The excel ent and good rate of clinical effect was 96%and 94%in the absorbable screw group and metal screw group, respectively, showing no significant difference. There was no significant difference in ankle Kofoed score, fracture healing time and incidence of adverse events between the two groups (P>0.05). These results suggest that absorbable screw fixation for ankle fractures had good biocompatibility and could effectively restore ankle function;its effects are similar to that of traditional metal screws.

Optimization of synthesis process of photosensitizer chlorin f / 药学实践杂志

Objective To improve the synthesis process of chlorine f (1).Methods A "one-pot"method was applied to prepare Photosensitizer component (1),using pheophorbide a (3) as raw material by oxidating and cracking of the E-ring of (3) with bubbling oxygen in alcoholic solution of potassium hydroxide at 0 ℃ followed by refluxing in nitrogen atmosphere.In order to obtain the optimal synthetic procedure,the orthogonal experimental design of L9 (34 ) was adopted to investigate three different levels of four main factors i.e.ring opening reaction time,alcoholic variety,alkali concentration and refluxing reaction time.Results The target compound (1) was optimizedly synthesized through treatment of raw material (3) with bubbling oxy-gen in 25% ethanol solution of potassium hydroxide at 0℃ for 30 min,followed by refluxing in nitrogen atmosphere for 20 min in yield of 40.8%.Conclusion The procedure developed has some advantages of simple and safty operation,and high synthetic yield.