Application of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Randomised Controlled Trial / 中国医学科学杂志(英文版)

Objective To explore the optimal administration route of tranexamic acid (TXA) in shoulder arthroscopic surgery. Methods Patients undergoing arthroscopic rotator cuff repair were randomly divided into four groups: control group (without TXA treatment), intravenous group (TXA was intravenously administered 10 minutes before surgery), irrigation group (TXA was added to the irrigation fluid during subacromial decompression and acromioplasty), and intravenous plus irrigation group (TXA was applied both intravenously and via intra-articular irrigation). The primary outcome was visual clarity assessed with visual analog scale (VAS) score, and the secondary outcomes included irrigation fluid consumption and time to subacromial decompression and acromioplasty procedure. Results There were 134 patients enrolled in the study, including 33 in the control group, 35 in the intravenous group, 32 in the irrigation group, and 34 in the intravenous plus irrigation group. The median and interquartile range of VAS scores for the intravenous, irrigation, and intravenous plus irrigation groups were 2.70 (2.50, 2.86) (Z = -3.677, P = 0.002), 2.67 (2.50, 2.77) (Z = -3.058, P < 0.001), and 2.91 (2.75, 3.00) (Z = -6.634, P < 0.001), respectively, significantly higher than that of the control group [2.44 (2.37, 2.53)]. Moreover, the control group consumed more irrigation fluid than the intravenous group, irrigation group, and intravenous plus irrigation group (all P < 0.05). The intravenous plus irrigation group consumed less irrigation fluid than either the intravenous group or the irrigation group (both P < 0.001). There was no difference in subacromial decompression and acromioplasty operative time among the four groups. Conclusion TXA applied both topically and systematically can improve intraoperative visual clarity, and the combined application is more effective.

Spatial-temporal clustering analysis of soil-transmitted helminth transmission risk in Jiangxi, 2016-2019 / 中国热带医学

@#Abstract: Objective　To analyze the epidemic characteristics of soil-transmitted helminth (STH) by the spatial epidemiological method in Jiangxi Province. Methods　Surveillance data of STH in Jiangxi Province from 2016 to 2019 were collected for descriptive epidemiological analysis. The space-time permutation distribution of STH infection areas was analyzed with spatial autocorrelation, hotspot analysis methods and retrospective space-time permutation scan statistics. Results　The infection rates of STH were 1.32% (947/71 766), 1.14% (803/70 547), 0.87% (604/69 507) and 0.90% (628/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The rates of hookworm infection were 0.65% (466/71 766), 0.64% (450/70 547), 0.48% (336/69 507) and 0.52% (362/69 620), respectively, and the differences were statistically significant (P<0.01). The infection rates of Ascaris lumbricoides were 0.55% (393/71 766), 0.41% (287/70 547), 0.32% (221/69 507) and 0.32% (225/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The infection rates of Trichuris trichiura were 0.17% (125/71 766), 0.10% (74/70 547), 0.08% (57/69 507) and 0.07% (49/69 620), respectively, and the differences were statistically significant among different years (P<0.01). The results of global spatial autocorrelation analysis showed that there was a spatial autocorrelation index Moran's I value of hookworm infection rate in 2016, Trichuris trichiura infection rate in 2016, 2018 and 2019, with statistical significance (P<0.05). The results of hotspot analysis, SaTScan and FleXScan spatial and temporal scanning analysis showed that there were high-value aggregation regions for each species in each year. Conclusion　The infection rates of STH, hookworm, Ascaris lumbricoides and Trichuris trichiura showed a decreasing trend and space-time clustering from 2016 to 2019. It should be taken into account in the formulation of control strategies.

Transoral endoscopic resection of benign tumors in parapharyngeal space via medial pterygomandibular raphe approach / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the surgical methods and effects of transoral endoscopic resection of benign tumors in parapharyngeal space via medial pterygomandibular raphe approach. Methods: The clinical data of 23 patients who underwent resection of benign tumors in parapharyngeal space by endoscopic medial pterygomandibular raphe approach from January 2016 to July 2020 in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 14 males and 9 females with a median age of 43 years. The tumors were located in the anterior space of the styloid process in 13 cases and in the posterior space in 10 cases. The smallest tumor volume was 7.3 ml and the largest was 80.2 ml. The preoperative imaging features, the characteristics and risks of this approach in the operation were analyzed, and the feasible mode of operation was explored. Results: All patients completed the operation successfully. The intraoperative blood loss was 20 to 50 ml, with an average of 28.3 ml. The operation time was 40 to 110 min, with an average of 75.4 min. The incision length was 2 to 4 cm, with an average of 3.0 cm. The postoperative pain score was 2 to 4, with an average of 3.2. The postoperative hospital stay was 4 to 9 d, with an average of 6.7 d. Postoperative pathological diagnosis included pleomorphic adenoma (n=12), neurilemmoma (n=10) and basal cell adenoma (n=1). The patients were followed up for 6 to 60 months. There was no postoperative complication such as infection or serious bleeding, and there was no tumor recurrence after operation. Conclusion: Endoscopic resection of benign tumor in parapharyngeal space via medial pterygomandibular raphe approach is a safe, effective, and minimally invasive surgical method for the treatment of tumors in parapharyngeal space.

Relations of neuropeptide Y and heme oxygenase-1 expressions with fetal brain injury in rats with intrahepatic cholestasis of pregnancy

Abstract Purpose: To investigate the relations of neuropeptide Y (NPY) and heme oxygenase-1 (HO-1) expressions with fetal brain injury in rats with intrahepatic cholestasis of pregnancy (ICP). Methods: Sixty rats pregnant for 15 days were randomly divided into experimental and control groups. The ICP model was established in experimental group. On the 21st day, the blood biochemical test, histopathological examination of pregnant rat liver and fetal brain tissues and immunohistochemical analysis of fetal rat brain tissues were performed. Results: On the 21st day, the alanineaminotransferase, aspartate aminotransferase and total bile acid levels in experimental group were significantly higher than control group (P<0.01). Compared with control group, there was obvious vacuolar degeneration in pregnant rat liver tissue and fetal brain tissue in experimental group. NPY expression in fetal brain tissue was negative in control group and positive in experimental group. HO-1 expression in fetal brain tissue was strongly positive in control group and positive in experimental group. There was significant difference of immunohistochemical staining optical density between two groups (P<0.01). Conclusion: In fetal brain of ICP rats, the NPY expression is increased, and the HO-1 expression is decreased, which may be related to the fetal brain injury.

Comparative Study on Glycosides Content in Liuwei Dihuang Decoction and Cornus Officinalis - Cortex Moutan Couple / 中国中医药信息杂志

Objective To establish an HPLC method for the content determination of morroniside, sweroside, paeoniflorin and loganin of Liuwei Dihuang Decoction and its Cornus Officinalis-Cortex Moutan couple; To discuss the relationship between the whole prescription and the couple of main pharmacodynamic components. Methods The HPLC method was used at Hypersile C18 column (4.6 mm × 250 mm, 5 μm); the mobile phase consisted of methanol-water (24:76); the detective wavelength was 236 nm; the flow rate was 1.0 mL/min; the column temperature was 30 ℃. Results The linear ranges of morroniside, sweroside, paeoniflorin and loganin were among 0.480–7.680 μg (r=0.999 3), 0.103–1.650 μg (r=0.999 5), 0.120–1.920 μg (r=0.999 1) and 0.227–3.630 μg (r=0.999 7), respectively. The average recovery rates and RSD were 102.79%, 102.29%, 100.99%, 102.48%, and 1.73%, 1.48%, 1.32%, 0.75%, respectively. The contents of morroniside, sweroside and paeoniflorin in Liuwei Dihuang Decoction were slightly higher than that in Cornus Officinalis - Cortex Moutan couple, and the contents of loganin were almost the same. Conclusion The method is simple, stable, accurate and reproducible. It can be used for content determinate of glycosides in Liuwei Dihuang Decoction and Cornus Officinalis-Cortex Moutan couple. Cornus Officinalis-Cortex Moutan couple has the glycosides with tonifying kidney effect of Liuwei Dihuang Decoction.

Effect analysis of topical fluoride varnish on caries prevention of first permanent molars in school-age children / 口腔疾病防治

Objective @#To investigate the effectiveness of fluoride varnish in preventing first permanent molars caries inschool-age children and provide necessary information for oral health instruction. @*Methods@#378 children aged 6-7 years old in the first grade of primary school in dahua country, hechi city, Guangxi province (1 053 first permanent molars) were randomly recruited into 2 groups. The test group (542 first permanent molars in 191 children) was treated with fluoride varnish one time in a half year and given oral hygiene instruction 3 times; The control group (511 first permanent molars in 187 children) was only given oral hygiene instruction 3 times. All first permanent molars were checked after 18 months later for caries. @*Results@#After intervention, the caries prevalence rate in the test group raised from 21.99% to 27.75% compared with the control group from 24.60% to 37.43%. The caries incidence rate in test and control group was 5.76% and 12.83% respectively. There was a significant difference between 2 groups regardless of caries prevalence, caries incidence, the DMFT reduction, the DMFs reduction, the occlusal caries prevalence, the pit and fissure caries prevalence, the proximal caries prevalence. @*Conclusion @#Semi-annual application of fluoride varnish is effective in the prevention of dental caries in first permanent molars , which was worth of being popularized in clinic.

The influence of bivalirudin in coronary blood flow during primary percutaneous coronary intervention for acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the efficacy of bivalirudin on reperfusion of coronary artery in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Methods In our study, we evaluated 245 patients with acute myocardial infarction who underwent percutaneous coronary intervention between April 2012 to May 2015. Based on the therapy during operation, bivalirudin were used in 122 patients and heparin was used in 123 patients. Study outcomes included immediate TIMI(thrombolysis in myocardial infarction)flow and CTFC(Corrected TIMI Frame Count)by angiogrophy once the target lesion was opened rates of ,in-hospital thrombocytopenia, bleeding events myocardial infarction, repeat revascularization and the incidence of MACE(major adverse cardiac events)in 30 days and 1 year. Results The mean heart rate was higher in the bivalirudin group(P=0.034). There was no significant difference between the two groups in laboratory results or interventional data(P>0.05). After the target vessel was opened, the effect of bivalirudin on slow/no-reflow in primary PCI has no difference between heparin in terms of TIMI blood evaluation or CTFC (P>0.05). Hospitalization data analysis showed that bivalirudin was able to obtain a higher activated whole blood coagulation time(ACT)value(P<0.001)with lower decrease in the number of platelets. Follow-up data of 30 days and 1 year showed no difference in the incidence of MACE and net adverse clinical events(NACE)between the two groups(P>0.05). Conclusions Bivalirudin has well efficacy and safety in patients with acute myocardial infarction in patients with acute myocardial infarction undergoing PPCI without increasing the incidence of slow/no-reflow.

Recombinant tegumental protein Shistosoma japonicum very lowdensity lipoprotein binding protein as a vaccine candidate against Schistosoma japonicum

A polyhistidine-tagged recombinant tegumental protein Schistosoma japonicum very lowdensity lipoprotein binding protein (SVLBP) from adult Schistosoma japonicum was expressed in Escherichia coli. The affinity purified rSVLBP was used to vaccinate mice. The worm numbers and egg deposition recovered from the livers and veins of the immunized mice were 33.5 percent and 47.6 percent less than that from control mice, respectively (p<0.05). There was also a marked increase in the antibody response in vaccinated mice: the titer of IgG1 and IgG2a, IgG2b in the vaccinated group was significantly higher than that in the controls (>1:6,400 in total IgG). In a comparison of the reactivity of sera from healthy individuals and patients with rSVLBP, recognition patterns against this parasite tegumental antigen varied among different groups of the individuals. Notably, the average titres of anti-rSVLBP antibody in sera from faecal egg-negative individuals was significantly higher than that in sera from the faecal egg-positives, which may be reflect SVLBP-specific protection. These results suggested that the parasite tegumental protein SVLBP was a promising candidate for further investigation as a vaccine antigen for use against Asian schistosomiasis.