The efficacy and safety of combined administration of intravenous and topical tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Abstract Background The combined administration of intravenous (IV) and topical tranexamic acid (TXA) in primary total knee (TKA) knee remains controversial. The purpose of this meta-analysis was to assess the efficacy and safety of combined administration of IV and topical TXA in primary TKA. Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Google Search Engine and China National Knowledge Infrastructure databases were searched for randomized controlled trials (RCTs) were comparing the combined administration of IV and topical TXA following primary TKA. The primary outcomes were total blood loss, maximum hemoglobin drop, and deep venous thrombosis (DVT) and/or pulmonary embolism (PE). The second outcomes were drainage volume and transfusion requirements. Data were analyzed using RevMan 5.3. Results A total of 6 RCTs involving 701 patients were included in the meta-analysis. The combined group provided lower total blood loss (MD − 156.34 mL, 95% CI, − 241.51 to − 71.18; P = 0.0003), drainage volume (MD − 43.54 mL, 95% CI, − 67.59 to − 19.48; P = 0.0004), maximum hemoglobin drop (MD − 0.56 g/dl, 95% CI, − 0.93 to − 0.19; P = 0.003) than IV TXA alone. No significant difference were found in terms of transfusion requirements (RR 0.48, 95% CI, 0.16 to 1.44; P = 0.19), DVT (RR 1.01, 95% CI, 0.14 to 7.12; P = 0.99) and PE (RR 0.33, 95% CI, 0.01 to 7.91; P = 0.49) between the two group. Subgroup analyses shows that the combined group was less total blood loss in non-tourniquet (P = 0.0008), topical TXA dose > 1.5 g (P  1.5 g and number of IV TXA ≥ 2 doses of TXA. There was no increase the rates of DVT and PE

Visualized Analysis of Research Progress on Soil Aggregates

[Objectives] This study was conducted to gain an in-depth understanding of the research status of fields related to soil aggregates.[Methods] The academic papers published from 2001 to 2020 in the field of soil aggregates were searched in the CNKI database serving as the statistical source using the subject terms "soil" and "aggregate" under advanced search, and visually analyzed by bibliometric statistical methods, from the perspectives of the annual number of published papers, the number of papers published by authors, and highly cited papers.[Results] The trend of the number of published papers in the past 20 years was mainly divided into three stages:2001-2007,2008-2016, and 2017-2020.There were 192 first authors in the literature related to soil aggregates.The authors with the top 3 published papers were Wang Erli, Zhang Zhengxiong, Li Yangbing, and Yang Yonghui(tied for third).Three highly cited papers were published in journals related to “ecology”,and the top 10 most cited papers focused on the “formation and stability” of soil aggregates and the relationship between gaaregates and soil organic matter and biochar. [Conclusions]The study can provide reference for further research on soil aggregates