Objective:To analyze the relationship between tourniquet pressure and intraoperative blood loss, systolic pressure, body mass index (BMI) and other factors during total knee arthroplasty (TKA), and to provide reference for improving the safety of tourniquet use.Methods:A retrospective study was conducted on consecutive series of primary TKA in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January 2019 to December 2019.The patients who had undergone primary total knee replacement were included, those with unicondylar knee replacement and complex secondary knee revision were excluded. Demographic data, tourniquet pressure, tourniquet time, operation time, and intraoperative blood loss were collected. (±s)or M(P25, P75)were used for data description, and Spearman's correlation analysis was used. Rank sum test (Kruskal-Wallis H test) was used for comparison of blood pressure at eight observation time points: blood pressure measured one day before surgery (T1), before anesthesia (the first time in the operating room) (T2), after anesthesia (T3), before tourniquet inflation (T4), tourniquet inflation two minutes (T5), tourniquet inflation 10 min (T6), before tourniquet deflation (T7), tourniquet deflation 10 min (T8).Results:A total of 475 patients were enrolled. The tourniquet time was 52 (41, 62) min, the operation time was 96 (85, 115) min, and the intraoperative blood loss was 50 (50, 50) ml. There was a positive correlation between tourniquet pressure and body mass index (BMI) (rs=0.283, P<0.01). The systolic pressure differences among different tourniquet pressure groups were statistically significant at T2, T4, T5 and T7 (H=11.077, P=0.004; H=19.688, P<0.001; H=10.326, P=0.006; H=9.103, P<0.01). There was no intraoperative blood transfusion, no skin or tissue compression injury, deep vein thrombosis, nor other complication occurred after the surgery.Conclusions:There is a positive correlation between BMI and tourniquet pressure, suggesting that patients' BMI should be considered in setting tourniquet pressure. Tourniquet pressure changed the distribution of blood volume in the circulatory system after the tourniquet blocked lower extremity blood flow, the level of tourniquet pressure is related to the change of systolic pressure during the operation, and attention should be paid to the changes of systolic pressure.

Background: Spinal cord injury (SCI) is a common disorder of the central nervous system with considerable socio-economic burden. Andrographolide (Andro), the main active component of Andrographis paniculata, has exhibited neuroprotective effects in different models of neurological diseases. The aim of this study was to evaluate the neuroprotective effects of Andro against SCI and explore the related mechanisms. Methods: SCI was induced in rats by the Allen method, and the modeled animals were randomly divided into sham-operated, SCI, SCI + normal saline (NS) and SCI + Andro groups. The rats were injected intraperitoneally with Andro (1 mg/kg) or the same volume of NS starting day one after the establishment of the SCI model for 28 consecutive days. Post-SCI tissue repair and functional recovery were evaluated by measuring the spinal cord water content, footprint tests, Basso-Beattie-Bresnahan (BBB) scores, hematoxylin-eosin (HE) staining and Nissl staining. Apoptosis, oxidative stress and inflammation, as well as axonal regeneration and remyelination were analyzed using suitable markers. The in vitro model of SCI was established by treating cortical neurons with H2O2. The effects of Andro on apoptosis, oxidative stress and inflammation were evaluated as indicated. Results: Andro treatment significantly improved tissue repair and functional recovery after SCI by reducing apoptosis, oxidative stress and inflammation through the nuclear factor E2-related factor 2/heme oxygenase-1 (Nrf-2/HO-1) and nuclear factor-kappa B (NF-κB) signaling pathways. Furthermore, Andro treatment promoted M2 polarization of the microglial cells and contributed to axonal regeneration and remyelination to improve functional recovery after SCI. In addition, Andro also attenuated apoptosis, oxidative stress and inflammation in H2O2-stimulated cortical neurons in vitro. Conclusion: Andro treatment alleviated SCI by reducing apoptosis, oxidative stress and inflammation in the injured tissues and cortical neurons, and promoted axonal regeneration and remyelination for functional recovery.

The purpose of this study was to review the clinical characteristics, surgical instruments and sizes of implants in 172 Chinese patients undergoing unicompartmental knee arthroplasty (UKA) , so as to offer medical staff with reference for perioperative preparation of surgical instruments and implants prior to the surgery. Based on study findings, the surgical specialty team optimized the preparation of surgical packages as follows. To femoroplasty, the routine package was assigned with sizes S and M, and the alternate package with size XS and L implants for male patients; for female patients, the routine package was assigned with sizes XS and S, and the alternate package with sizes M and L implants. To tibioplasty, the routine package was assigned with sizes AA, A, B, C, and D implants, and the alternate package with sizes E and F for all patients. In conclusion, such assignment may reduce the workload and resource for instrument cleaning, packaging, and sterilization.

本文探讨超声外科吸引器（CUSA）应用于肝叶切除手术的护理配合方法，护士熟练掌握CUSA操作规程，密切关注手术进程，积极配合手术医师、麻醉医师缩短手术时间，提高肝脏手术配合效率；充分的术前准备，有效的医护沟通，密切的护理配合是手术成功的关键。

目的：观察莱菔子热奄包外敷缓解脾虚气滞型胃痞症状的疗效。方法：40例患者均采用莱菔子热奄包外敷治疗，并观察其疗效。结果：痊愈25例，显效5例，有效10例，无效0例，总有效率100.0%。结论：莱菔子热奄包外敷可有效缓解脾虚气滞型胃痞症状，值得临床推广应用。