Tranexamic acid-induced focal convulsions after spinal surgery: a rare case report and literature review on side effects of accidental spinal administration of tranexamic acid.

Convulsions are a neurological illness that has complexity. In clinical treatment, drug-induced convulsions appear from time to time. Drug-induced convulsions often begin as isolated acute seizures but may progress to persistent seizures. In orthopedics, topical administration of tranexamic acid is commonly used in conjunction with intravenous drip to achieve hemostasis during artificial joint replacement surgery. However, side effects induced by tranexamic acid accidental spinal administration should be taken seriously. We report a case of a middle-aged male treated with tranexamic acid locally in combination with intravenous drip for intraoperative hemostasis when undergoing spinal surgery. The patient had involuntary convulsions in both lower limbs after the operation. After symptomatic administration, the symptoms of convulsions gradually resolved. During the follow-up, the convulsions never occurred again. We reviewed the literature on cases with side effects of local tranexamic acid application in spinal surgery and discussed the mechanism of tranexamic acid-induced convulsions. Tranexamic acid is associated with an increased incidence of postoperative seizures. However, many clinicians are unaware that tranexamic acid causes seizures. This rare case summarized the risk factors and clinical features of these seizures. Moreover, it highlights several clinical and preclinical studies that offer mechanistic insights into the potential causes and treatments for tranexamic acid-associated seizures. A clear understanding of tranexamic acid-induced convulsions-related adverse reactions can help the first-line clinical screening of causes and adjustment of drug treatment. This review will aid the medical community by increasing awareness about tranexamic acid-associated seizures and translating scientific findings into therapeutic interventions for patients.

Application of low dose aspirin in pre-eclampsia.

Aspirin is widely used in the primary and secondary prevention of cardiovascular and cerebrovascular diseases. Low-dose aspirin is also widely used to prevent pre-eclampsia and fetal growth retardation in utero. However, the use of aspirin during pregnancy is controversial. Since 1985, when aspirin was reported to be effective in obstetrics, numerous studies have attempted to determine the effect of low-dose aspirin on the morbidity of pre-eclampsia but have remained inconclusive. Guidelines for aspirin in preventing pre-eclampsia are different in different countries and regions. This article summarizes the research progress, mechanism, and application prospect of aspirin in preventing pre-eclampsia, providing a theoretical basis for the rational use of aspirin in pregnancy.

Predictive value of post-operative neutrophil/lymphocyte count ratio for surgical site infection in patients following posterior lumbar spinal surgery.

OBJECTIVE: Surgical site infection (SSI) is a common complication in patients following posterior lumbar spinal surgery. Various laboratory data such as laboratory parameters derived neutrophil/lymphocyte count ratio (NLR), have been applied for the prediction of SSI, but more studies are necessary to evaluate the significance of these indicators. Here, our study aims to investigate the predictive value of total white blood cells (WBCs), count and percentages of neutrophils and leukocytes, NLR, and C-reactive protein (CRP) for surgical site infection (SSI) in patients after posterior lumbar spinal surgery. METHODS: A total of 293 patients who underwent posterior lumbar spinal surgery were enrolled in this study. Each patient's medical history was retrospectively reviewed, and patients were divided into the deep SSI group (n = 13) and the non-SSI group (n = 280). Laboratory data including total WBC, count and percentages of neutrophils and leukocytes, NLR at 1 week before the operation and the 4 and 7 days post-operation, and CRP at 4 and 7 days post-operation were analysed between the SSI and non-SSI groups. Moreover, predictive power and cut-off of NLR for SSI were determined by receiver operating characteristic curve (ROC) results. RESULTS: Data revealed that the medians of NLR were markedly increased in the SSI group as compared to that in non-SSI group at 4 days (p = 0.011) and 7 days (p = 0.047) post-operation. Moreover, the neutrophil percentage was also dramatically increased in the SSI group at both 4 and 7 days post-operation (p = 0.010 and p = 0.030) respectively compared to the non-SSI group. However, no significant difference was observed between the groups 1 week before the operation. ROC results showed that NLR at 4 days (cut-off >5.19; sensitivity: 61.5%; specificity: 77.6%; AUC = 0.708) and 7 days (cut-off >3.85; sensitivity: 69.2%; specificity: 62.7%; AUC = 0.663) post-operation could significantly discriminate the SSI and non-SSI groups. Logistic regression analysis showed that NLR at both post-operative time points (OR = 1.218; p = 0.003 and OR = 1.296; p = 0.048) could be valuable predictors for SSI. CONCLUSION: NLR at 4 and 7 days post-operation are valuable laboratory predictors for SSI in patients with posterior lumbar spinal surgery.

Syntheses, structures, and properties of a series of novel high-nuclear 3d-4f clusters with mixed amino acids as ligands: {Ln6Cu24}(Ln = Gd, Tb, Pr and Sm).

The first examples of high-nuclear 3d-4f heterometallic clusters with mixed amino acid ligands are reported. Four 30-nuclear clusters {Ln6Cu24}(Ln = Gd, Tb, Pr and Sm) were obtained through the self-assembly of Ln(III), Cu(II) and mixed amino acid ligands of glycine (HGly) and ß-alanine (HAla). The metal skeleton of clusters may be described as a huge {Ln6Cu12} octahedron connected with 12 additional Cu(II) ions. The temperature dependence of magnetic susceptibilities of compounds were also studied.

Effect of functionalized groups on gas-adsorption properties: syntheses of functionalized microporous metal-organic frameworks and their high gas-storage capacity.

The microporous metal-organic framework (MMOF) Zn4O(L1)2⋅9 DMF⋅9 H2O (1-H) and its functionalized derivatives Zn4O(L1-CH3)2⋅9 DMF⋅9 H2O (2-CH3) and Zn4O(L1-Cl)2⋅9 DMF⋅9 H2O (3-Cl) have been synthesized and characterized (H3L1=4-[N,N-bis(4-methylbenzoic acid)amino]benzoic acid, H3L1-CH3=4-[N,N-bis(4-methylbenzoic acid)amino]-2-methylbenzoic acid, H3L1-Cl=4-[N,N-bis(4-methylbenzoic acid)amino]-2-chlorobenzoic acid). Single-crystal X-ray diffraction analyses confirmed that the two functionalized MMOFs are isostructural to their parent MMOF, and are twofold interpenetrated three-dimensional (3D) microporous frameworks. All of the samples possess enduring porosity with Langmuir surface areas over 1950 cm(2) g(-1). Their pore volumes and surface areas decrease in the order 1-H>2-CH3 >3-Cl. Gas-adsorption studies show that the H2 uptakes of these samples are among the highest of the MMOFs (2.37 wt% for 3-Cl at 77 K and 1 bar), although their structures are interpenetrating. Furthermore, this work reveals that the adsorbate-adsorbent interaction plays a more important role in the gas-adsorption properties of these samples at low pressure, whereas the effects of the pore volumes and surface areas dominate the gas-adsorption properties at high pressure.

A series of goblet-like heterometallic pentanuclear [Ln(III)Cu(II)4] clusters featuring ferromagnetic coupling and single-molecule magnet behavior.

A series of fascinating goblet-like clusters based on [Ln(III)Cu(II)(4)] cores have been assembled from a flexible carboxylate ligand, which exhibit a dominant ferromagnetic exchange coupling and single-molecule magnet behavior.

A cyanide-bridged trinuclear Fe(II)-Ru(II)-Fe(II) complex with three stable states: synthesis, crystal structures, electronic couplings and magnetic properties.

Treatment of trans-(Ph-tpy)Ru(PPh(3))(CN)(2) (Ph-tpy = 4'-phenyl-2,2':6',2''-terpyridine, PPh(3) = triphenylphosphine) with 2 equiv of Cp(dppe)Fe(NCCH(3))Br (dppe = bis(diphenylphosphino)ethane) in the presence of NH(4)PF(6) produced a trinuclear cyanide-bridged complex, trans-[Cp(dppe)Fe(CN)(Ph-tpy)Ru(PPh(3))(CN)Fe(dppe)Cp][PF(6)](2) (1[PF(6)](2)). Its one-electron oxidation product (1[PF(6)](3)) and two-electron-oxidation product (1[PF(6)](4)) were obtained by oxidation with (Cp)(2)FePF(6) and AgPF(6), respectively. Firstly, the crystal structures of the cyanide-bridged complexes with three stable states were fully characterized. The reversible electrochemistry measurement of 1(2)(+) shows the presence of a long range intervalence interaction between the external iron centres. Both 1(3)(+) and 1(4)(+) were considered to be Class II mixed valence complexes according to the classification of Robin and Day. Magnetic analysis indicated the presence of a moderately strong antiferromagnetic coupling between the two remote Fe(III) ions across the Fe-NC-Ru-CN-Fe array in 1(4)(+). This proves that the Ru(II)-dicyano complex is a bridging ligand that can transmit electro- and magneto-communication.

A one-dimensional coordination polymer constructed from planar pentanuclear copper(II) clusters with a flexible tripodal ligand.

A one-dimensional coordination polymer based on planar pentanuclear copper(II) clusters has been assembled from a flexible tripodal ligand, which exhibits a quite strong antiferromagnetic coupling between Cu(II) ions.

Bright blue emissions with temperature-dependent quantum yields from microporous metal-organic frameworks.

Two 2D microporous metal-organic frameworks have been assembled from a fluorophore ligand, whose quantum yields of strong blue emissions could vary from 40.3% to 74.5% and 13.7% to 25.8% with the decreasing temperature.

Upregulation of human leukocyte antigen-G expression and its clinical significance in ductal breast cancer.

Human leukocyte antigen(HLA)-G could inhibit functions of immune cells and induce regulatory T cells (Treg) and could be involved in antitumor immune responses. In the current study, HLA-G expression in 58 primary breast cancer lesions was analyzed with immunohistochemistry. Plasma soluble HLA-G was detected with enzyme-linked immunosorbent assay in 92 breast cancer patients and in 70 normal healthy donors. The proportion of CD4(+)CD25(+)FoxP3(+) Treg was analyzed with flow cytometry in 64 breast cancer patients and 23 normal controls. HLA-G expression was observed in 70.7% (41/58) of breast cancer lesions. Lesion HLA-G expression was more frequently observed in advanced disease stage (I/II vs III/IV, p = 0.044) and tumor grade (I/II vs III/IV, p = 0.021). sHLA-G was dramatically increased in patients when compared with normal controls (median 82.19 vs 9.65 U/ml, p < 0.001); The area under the receiver operating characteristic (ROC) curve for sHLA-G was 0.953 (95% confidence interval [CI] = 0.926-0.981, p < 0.001). However, sHLA-G was irrelevant to the disease stage and tumor grade. Moreover, CD4(+)CD25(+)FoxP3(+) Treg are markedly increased in the breast cancer patients compared with normal controls (4.46+/-1.36% vs 2.67+/-1.45%, p < 0.001), and the increased frequency of Treg was strongly correlated to sHLA-G levels (R = 0.582, p = 0.001). Our findings indicated that HLA-G could play critical roles in the progression of breast cancer, and plasma sHLA-G levels might be a useful preoperative biomarker for diagnosis.