Safety and efficacy of tranexamic acid in spinal canal tumors: a retrospective cohort study.

Objective: The use of tranexamic acid (TXA) has become popular in spinal surgery, the purpose of this study is to investigate the effectiveness and safety of intraoperative TXA used to reduce surgical bleeding and transfusion requirements in spinal canal tumor resection.Methods: The data for patients with spinal canal tumors treated in our hospital from June 2014 to June 2017 were collected. The patients (≥18 years of age) were divided into a TXA group (group A, n = 30) and a non-TXA group (group B, n = 30). The TXA dose regimen in group A comprised a loading dose of 10 mg/kg 30 minutes before the operation, followed by a maintenance dose of 1 mg/kg per hour during the operation. Group B was not given TXA. The operation time, intraoperative blood loss, postoperative drainage, postoperative complications, coagulation function such as plasma thrombin time(PT), prothrombin time(TT), activated thromboplastin time(APTT), fibrinogen (Fib) were statistically analyzed.Results: The intraoperative blood loss and postoperative drainage volume were significant lower in group A than in group B (p<.05). There were no significant differences in the operation time, plasma thrombin time, prothrombin time, activated thromboplastin time, or fibrinogen between the two groups before and after the operation (p>.05), and no thrombotic complications occurred.Conclusion: TXA used during spinal tumor surgery can reduce the amount of intraoperative blood loss and postoperative drainage without increasing the risk of deep vein thrombosis and related complications.

[Case-control study on three spinal rotation manipulations for the treatment of lumbar disc herniation].

OBJECTIVE: To evaluate the efficacy and safety of three different spinal rotation manipulations for the treatment of lumbar disc herniation. METHODS: From September 2011 to April 2013,180 patients diagnosed as lumbar disc herniation were randomly divided into seat fixed rotation group (A), lateral position rotation group (B) and supine position rotation group (C) by using a digital table. Finally 10 patients were excluded and dropped, 170 patients were included in the study. There were 57 patients in group A, 57 patients in group B and 56 patients in group C. Baseline demographic characteristics of patients, clinical findings and indexes of health status had no statistically differences among three groups (P > 0.05). The manipulation was performed every other day, and the treatment duration for all patients was 3 weeks. Body pain (BP), Physical function (PF) in SF-36, Oswestry Disability Index (ODI) and adverse reactions were observed statistically 6 weeks, 3 months, 6 months, one year and two years after finishing treatment. RESULTS: BP, PF scores in 3 groups were significantly improved and ODI scores were significantly lower than those before treatment and the differences were statistically significant (P < 0.05); However, there was no significant difference among three groups in the BP, PF and ODI scores (P > 0.05). There were no obvious and serious adverse reactions among these groups. CONCLUSION: Based on the theory of dislocation of bone joints in TCM, three kinds of spinal rotation manipulations can be used safely for the treatment of lumbar disc herniation, and the efficacy was similar.

[Effects of fuzheng jianpi decoction combined chemotherapy on the quality of life and the survival time of children with solid tumor].

OBJECTIVE: To study the effects of Fuzheng Jianpi Decoction (FJD) combined chemotherapy on the quality of life (QOL) and the survival time of children with solid tumor. METHODS: Recruited were 167 solid tumor children patients at Department of Tumor, Beijing Children's Hospital from Jan. 2005 to Jan. 2008. They were randomly assigned to the treatment group (83 cases) and the control group (84 cases) according to the random digit table. All had chemotherapy. Those in the treatment group additionally took FJD, 50 -100 mL each time, twice daily. After chemotherapy those in the treatment group took modified FJD. The WBC, Hb, and PLT were detected in all patients before treatment, 6 months after treatment, and 1 year after treatment. The 1-, 2-, and 3-year QOL, 3-year survival rate, and the survival life of dead children patients were observed. RESULTS: Compared with the control group of the same period, the 6-month and 1-year WBC and Hb increased, the 1-year PLT increased in the treatment group, showing statistical difference (P<0.05, P<0.01). Compared with 1-year treatment in the treatment group, the 2-and 3-year psychological functions and the general symptoms scores decreased (P<0.05, P<0.01). Compared with the control group of the same period, the 2-and 3-year somatic functions, psychological functions, and the general symptoms scores decreased in the treatment group; the 2-year somatic functions and psychological functions decreased in the treatment group; the 3-year psychological functions and the general symptoms scores decreased in the treatment group, all with statistical difference (all P<0.05). Compared with the control group, the death number decreased, the survival rate increased, the life span of dead children was prolonged in the treatment group, showing statistical difference (P<0.05). CONCLUSION: FJD combined chemotherapy could effectively improve the QOL of solid tumor children patients, elevate their survival rate, and prolong their life spans.