Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis.

Background: High tibial osteotomy (HTO) can cause postoperative hemorrhage. The use of tranexamic acid to reduce the hemorrhage is still controversial. Purpose: To investigate the efficacy and safety of tranexamic acid in HTO. Study Design: Systematic review; Level of evidence, 4. Methods: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors conducted a comprehensive search of the Embase, Cochrane Library, PubMed, Web of Science, MEDLINE, and Foreign Medical Literature Retrieval Service databases between their inception and January 1, 2023. All clinical studies comparing the use of tranexamic acid versus no tranexamic acid during HTO were collected. The primary outcome measures were hemoglobin decrease, drainage volume, and blood loss, and the secondary outcome measures were wound complications, blood transfusion, and postoperative thrombosis. All indicators were analyzed using meta-analysis software. Results were reported as mean differences or risk ratios with 95% confidence intervals. Results: Of 152 initial results, 9 studies involving 908 patients were included. The tranexamic acid group had lower indicators for total blood loss, hemoglobin decrease, and total drainage volume (P < .00001 for all). There were no differences between patients with versus without tranexamic acid in wound complications, including hematoma (P = .21) or infection (P = .18), nor were there any group differences in the prevalence of blood transfusion (P = .21) or postoperative thrombosis (P = .36). Conclusion: Tranexamic acid was able to effectively reduce postoperative hemorrhage in patients undergoing HTO without affecting the rates of wound complications, blood transfusion, or postoperative thrombosis.

The Relationships among "STAY-GREEN" Trait, Post-Anthesis Assimilate Remobilization, and Grain Yield in Rice (Oryza sativa L.).

The mobilization and translocation of carbohydrates and mineral nutrients from vegetative plant parts to grains are pivotal for grain filling, often involving a whole plant senescence process. Loss of greenness is a hallmark of leaf senescence. However, the relationship between crop yield and senescence has been controversial for many years. Here, in this study, the overexpression and RNA interference lines of gene of OsNYC3 (Non-Yellow Coloring 3), a chlorophyll catabolism gene, were investigated. Furthermore, exogenous phytohormones were applied, and a treatment of alternate wetting and moderate drying (AWMD) was introduced to regulate the processes of leaf senescence. The results indicated that the delayed senescence of the "STAY-GREEN" trait of rice is undesirable for the process of grain filling, and it would cause a lower ratio of grain filling and lower grain weight of inferior grains, because of unused assimilates in the stems and leaves. Through the overexpression of OsNYC3, application of exogenous chemicals of abscisic acid (ABA), and water management of AWMD, leaf photosynthesis was less influenced, a high ratio of carbohydrate assimilates was partitioned to grains other than leaves and stems as labeled by 13C, grain filling was improved, especially for inferior spikelets, and activities of starch-synthesizing enzymes were enhanced. However, application of ethephon not only accelerated leaf senescence, but also caused seed abortion and grain weight reduction. Thus, plant senescence needs to be finely adjusted in order to make a contribution to crop productivity.

A simple arthroscopic technique for treatment of displaced "hinged" type of posterior cruciate ligament avulsion fractures.

BACKGROUND: The surgical technique for treatment of tibial avulsion fractures of the posterior cruciate ligament (PCL) remains challenging due to the deep-located lesion and the complexity of the anatomy. The purpose of this study was to report preliminary results of an arthroscopic technique in patients with the "hinged" type PCL tibial avulsion fractures. METHODS: Twenty-eight patients with the displaced "hinged" fractures with elevation of the posterior aspect of the bony fragment were arthroscopically treated. The bony fragment was reducted and fixed with the sutures passing through only one single tibial tunnel. The clinical outcomes were assessed by Lysholm score, Tegner activity score, and the side-to-side differences of KT-1000 measurement. The reduction and union of the fracture were assessed by radiography of the knee. RESULTS: Patients were followed up for a mean of 19 (12 to 24) months. There were no surgery-related complications, and all patients regained normal range of motion of the knees at the last follow-up. The Lysholm score significantly increased from preoperative 14.78 ± 8.23 to postoperative 96.96 ± 3.62 (P = 0.000). The Tegner score was 6.78 ± 1.35 pre-injury and 6.48 ± 1.20 at the last follow-up with no statistical difference (P = 0.688). The KT-1000 side-to-side differences significantly decreased from 8.26(SD 1.86; 6 to 12) pre-operatively to 0.91 (SD 0.85; 0 to 3) (P = 0.000). X-rays showed that satisfactory reduction and solid union was achieved in all patients. CONCLUSION: The arthroscopic suture fixation through single-tibial tunnel technique yielded good clinical and radiographic outcome for treatment of displaced "hinged" type of PCL avulsion fractures.