The safety of tranexamic acid administration in total knee arthroplasty: a population-based study from Taiwan.

Tranexamic acid is an effective treatment to reduce blood loss. We performed a retrospective observational study to evaluate safety in unilateral total knee arthroplasty. We utilised Taiwan's national health insurance database to identify relevant patients and to retrieve information on peri-operative blood transfusions and tranexamic acid administration within 60 days of follow-up. We examined changes in the rate of transfusions and adverse events with respect to tranexamic acid administration using logistic regression. We observed a total of 226,719 knee arthroplasty cases during 2010-2019. Transfusion and tranexamic acid administration rates were 38.9% (88,258) and 42.9% (97,237), respectively. Tranexamic acid was associated with a 50% decrease in blood transfusions (RR: 0.50, 95%CI: 0.48-0.51). After propensity-score matching, tranexamic acid was not associated with pulmonary embolism; deep vein thromboembolism; artery vein thromboembolism; acute myocardial infarction; ischaemic stroke; or in-hospital mortality, but was significantly associated with acute kidney injury. Patients with existing chronic kidney disease suffered a high absolute risk of kidney injury irrespective of tranexamic acid administration (832 per 10,000, 95%CI 797-869). Tranexamic acid was also associated with surgical site infection. There was strong interaction between blood transfusion; tranexamic aid administration; and development of surgical site infection. In conclusion, tranexamic acid use was associated with decreased blood transfusion and was not associated with thromboembolic events. However, careful consideration is required before use in patients with pre-existing renal disease. Further, our observed interaction between patients given tranexamic acid who subsequently require transfusion requires careful consideration with respect to enhanced prophylaxis against surgical site infection.

Correlation between IL-4 gene polymorphismas well as its mRNA expressionand rheumatoid arthritis.

OBJECTIVE: This study sought to explore the correlation between IL-4-590C/T polymorphism as well as mRNA expression and the occurrence of rheumatoid arthritis (RA). PATIENTS AND METHODS: IL-4-590C/T polymorphisms, detected by a TaqMan probe from 150 RA patients who were treated in Yantaishan Hospital from June 2014 to June 2016, and from 150 healthy people, all from the Han population, were selected for the study. Interleukin-4 (IL-4) mRNA expression was detected by Real-time Polymerase Chain Reaction (PCR), and the differences in IL-4mRNA expressions of different genotypes in RA patients were compared. RESULTS: The difference in CC, CT and TT genotype distributions between the RA group and the healthy group were statistically significant (p<0.05). The mutation frequency of the T allele in IL-4 of the RA group was significantly higher than that of the healthy group (p<0.01). The mRNA expression of IL-4 in the RA group was significantly lower than that in the healthy group (p<0.01). The mRNA expression of IL-4 in RA patients was gradually decreased in the following order: CC, CT and TT, and the differences among these genotypes were significant (p<0.01). CONCLUSIONS: IL-4-590C/T polymorphism may be correlated with the incidence of RA in the Chinese Han population. Carrying the T allele can significantly increase the risk of RA and reduce the mRNA expression of IL-4.

Analysis of specific serum markers of colon carcinoma using a Bhattacharyya-based support vector machine.

We aimed to evaluate the specificity of 12 tumor markers related to colon carcinoma and identify the most sensitive index. Bhattacharyya distance was used to evaluate the index. Then, different index combinations were used to establish a support vector machine (SVM) diagnosis model of malignant colon carcinoma. The accuracy of the model was checked. High accuracy was assumed to indicate the high specificity of the index. The Bhattacharyya distances of carcinoembryonic antigen, neuron-specific enolase, alpha-feto protein, and CA724 were the largest, and those of CYFRA21-І, CA125, and UGT1A83 were the second largest. The specificity of the combination of the above seven indexes was higher than that of other combinations, and the accuracy of the established SVM identification model was high. Using Bhattacharyya distance detection and establishing an SVM model based on different serum marker combinations can increase diagnostic accuracy, providing a theoretical basis for application of mathematical models in cancer diagnosis.