Effectiveness and safety of tranexamic acid for total knee arthroplasty: a prospective randomized controlled trial.

BACKGROUND: Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and need for transfusion. This study aimed to evaluate the effectiveness and safety of tranexamic acid (TXA) to reduce perioperative blood loss in patients receiving TKA. MATERIAL AND METHODS: A total of 92 patients who accepted unilateral TKA from May 2012 to May 2013 randomly received either 15 mg/kg TXA in 100 mL normal saline solution (TXA group, n=46) or the same amount of normal saline solution (placebo group, n=46) at 15 min before the tourniquet was loosened. The following data were recorded: intraoperative blood loss; post-operative drainage at 12 h; total drainage amount; hidden blood loss; total blood loss; transfusion volumes; number of transfusions; post-operative hemoglobin at 1, 3, and 5 days; D-dimer; number of lower limb ecchymoses; and deep vein thrombosis (DVT). RESULTS: A total of 81 patients were available for analysis (TXA group, n=41; placebo group, n=40). Post-operative12-h drainage, post-operative 24-h D-dimer values, total drainage volume, hidden blood loss, total blood loss, and the rate of postoperative ecchymosis were lower in the TXA group than in the placebo group (p<0.05). The post-operative 3-day Hgb was higher in the TXA group than in the placebo group (p=0.000). The rate of transfusion and DVT was similar in both groups (n.s.). CONCLUSIONS: Perioperative blood loss could be reduced after TKA by intravenously injecting 15 mg/kg TXA at 15 min before the tourniquet was loosened. The application of TXA is not associated with increased risk of DVT.

Relationship between anogenital distance and cryptorchidism in human newborns / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the relation of the anogenital distance (AGD) with cryptorchidism in male newborns.</p><p><b>METHODS</b>This study included 350 male infants delivered in two community hospitals between September 2013 and September 2014. Within 24 hours after birth, a pediatric surgeon measured the AGD of the neonates and determined whether they had cryptorchidism. According to the testicular position, we divided the undescended testes into three types: upper scrotal, inguinal, and non-palpable.</p><p><b>RESULTS</b>Totally 39 cases of cryptorchidism were found in the 350 newborns. The AGD of the cryptorchidism infants was significantly shorter than that of the normal neonates ([2.01 ± 0.22] vs [2.35 ± 0.19] cm, P < 0.01), and statistically significant differences remained even when preterm and low birth-weight infants were excluded ([2.32 ± 0.14] vs [2.06 ± 0.19] cm; (2.37 ± 0.17) cm vs (2.12 ± 0.12) cm, all P < 0.01). The newborns with higher-position cryptorchidism had a shorter AGD, though with no significant difference (F = 0.434, P > 0.05). No significant differences were observed in the AGD between unilateral and bilateral cryptorchidism ([1.96 ± 0.13] vs [2.02 ± 0.17] cm, P > 0.05).</p><p><b>CONCLUSION</b>Shorter AGD is associated with a higher incidence of cryptorchidism in male newborns. AGD could serve as a potential biomarker for disruption of androgen action during the male programming window period.</p>

The distribution of the growth factors FGF-2 and VEGF, and their receptors, in growing red deer antler.

The cellular distributions of the growth factors FGF-2 and VEGF, and their receptors FGFR1, FGFR2 and FGFR3, and VEGFR-2 respectively, were visualized by immunohistochemistry and light microscopy in sections of growing red deer antler. Both of these signalling systems were widely expressed in the integument and osteocartilaginous compartments. FGF-2 was found in the same cells as all three FGFRs, indicating that FGF signalling may be principally autocrine. The patterns of labelling for VEGF and its receptor were similar to those seen for FGF-2 and FGFR-3, in both compartments. Our data are consistent with the findings of others in suggesting that FGF-2 induces expression of VEGF, to stimulate and maintain high rates of neovascularisation and angiogenesis, thereby providing nutrients to both velvet and bone as they rapidly grow and develop. The presence of FGF and VEGF and their receptors in epithelial cells suggests that these signalling systems play a role in skin development, raising the possibility that one or both may be involved in the close coupling of the coordinated growth of the integument and osteocartilage of antler, a process which is poorly understood at present.

Postoperative improvement of diplopia and eyeball movement disorder in patients with reconstructive surgeries for orbital fracture / 上海第二医科大学学报

Objective To observe the postoperative changes of diplopia and eyeball movement disorder in patients with orbital fracture. Methods The clinical data of 62 patients with reconstructive surgeries for orbital fracture were retrorespectively analyzed.The position,range of fracture and incarceration of extraocular muscles were determined by CT scanning.The eyeball movement and diplopia were examined and recorded pre-operation,3,6 and 12 months after operation,respectively. Results Among the 62 cases,23 were simple orbital wall fracture and the other 39 were complex orbital fracture.Eighteen of the patients with simple orbital wall fracture had diplopia and 19 had eyeball movement disorder of Ⅰ degree or Ⅱ degree before operation.Twelve months after operation,5 had diplopia ofⅠ degree or Ⅱ degree,and 5 had eyeball movement disorder of Ⅰ degree.For those with complex orbital fracture,36 had diplopia and 38 had eyeball movement disorder.Twelve months after operation,29 had diplopia(III degree diplopia in 6) and 22 had eye movement disorder.Among the 12 patients with complex orbital fracture who received operation within 3 weeks after trauma, only one had III degree diplopia,while 5 of the 23 with complex orbital fractures repaired 3 months after trauma had III degree diplopia. Conclusion Surgical management can effectively improve diplopia and eyeball movement disorder resulted from orbital fracture.Earlier treatment is superior to later treatment in regard with the effect of surgical intervention.