中国综合临床最新文献

{"title":"A case report and literature review of Abdominal Desmoplastic Small Round Cell Tumor","authors":"N. Chai, Lin Chen, Zebin Jiang, Peng Gao, Xiaojun Yang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.009","url":null,"abstract":"Objective \u0000To investigate the pathological characteristics, diagnosis, treatment decision and short-term curative effect of abdominal desmoplastic small round cell tumor. \u0000 \u0000 \u0000Methods \u0000The clinical data of a case of desmoplastic small round cell tumor admitted to Gansu provincial people′s Hospital in April 2018 were analyzed retrospectively.The clinical manifestations, pathological features, diagnosis and differential diagnosis, treatment and prognosis of desmoplastic small round cell tumor were summarized and analyzed. \u0000 \u0000 \u0000Results \u0000The patient was successfully treated with maximum tumor reduction.The operation time was 360 minutes.The estimated blood loss during operation was 200 ml, and no blood was transfused during operation.The abdominal drainage tube was removed on the 8th day after operation and the liver function recovered well.Postoperative pathology: (retroperitoneal) small round cell malignant tumor.Combined with clinical and immunohistochemical staining results: highly considered: desmoplastic small round cell tumor.The patient was discharged on the 16th day after operation.The patient was followed up for 4 months and the tumor recurred and liver metastasis.The follow-up period is now up to October 2018. \u0000 \u0000 \u0000Conclusion \u0000Desmoplastic small round cell tumor is a rare and highly malignant soft tissue small cell tumor with poor prognosis.Imaging examination and detection of tumor markers have no specificity and diagnose of it is difficult.Complete resection of the tumor and combined chemotherapy can improve the prognosis of the patients, but the prognosis is still not satisfactory, and more effective treatment decisions still need to be explored. \u0000 \u0000 \u0000Key words: \u0000Desmoplastic Small Round Cell Tumor; Chemotherapy; Histopathology","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42842995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in Gene Therapy of Hereditary Neurological Ion Channel Disease","authors":"Xiaoyi Wang, Wen-So Su, Tiankuo Xue, Yu-lan Zhu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.020","url":null,"abstract":"Current therapies for hereditary neuropathy are often difficult to control or have low patient tolerance, so it is imperative to explore new therapies.Gene therapy has been shown that in many studies it may be applied to nervous system diseases and may become an effective treatment for hereditary nervous system ion channel diseases in the future.At the same time, the continuous progress of photogenetics, chemical genetics and gene editing technology also provides a good basis for the development of gene therapy for hereditary neuropathy.We will review the methods, mechanisms, transduction vectors, promoters and administration routes of gene therapy for hereditary neurological ion channel disease. \u0000 \u0000 \u0000Key words: \u0000Ion channel disease; Gene therapy; Gene therapy; Gene editing; CRISPR/Cas9","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48098844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and clinical significance of plasma interleukin 17 and interleukin 21 in patients with immune related hematopathy","authors":"Qi Li, Hongyang Kang, Jie Liu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.006","url":null,"abstract":"Objective \u0000To investigate the changes of expression levels of interleukin-17(IL-17) and interleukin-21(IL-21) secreted by helper T cells 17 before and after treatment of three immune-related hematological diseases, and to explore the clinical significance. \u0000 \u0000 \u0000Methods \u0000Sixty patients with IRH admitted to the Department of Hematology, the First Affiliated Hospital of Hebei North University from May 2017 to October 2018 were selected as subjects.They were divided into aplastic anemia group (24 cases), immune thrombocytopenia group (20 cases) and autoimmune hemolytic anemia group (16 cases). Another 60 healthy volunteers who had physical examination in our hospital at the same time were selected as the control group.In the 3 IRH groups, patients were treated with glucocorticoids or immunologic agents, and the control group was given vitamin C. At the time of initial diagnosis, 2 weeks and 3 months after IRH treatment, all the patients in the 4 groups were examined for blood-related indicators, and the therapeutic effects of different stages and the plasma levels of IL-17 and IL-21 in the peripheral blood of the 4 groups before and after treatment were compared. \u0000 \u0000 \u0000Results \u0000At the initial diagnosis, the plasma IL-17 levels in the aplastic anemia group, immune thrombocytopenia group and autoimmune hemolytic anemia group were ((196.52±17.46), (185.69±18.19), (126.13±11.22) ng/L), respectively, which were higher than those in control group ((72.36±10.21) ng/L), the differences were statistically significant (all P 0.05). After 3 months of treatment, the total effective rates of treatment in the three groups(the aplastic anemia group 83.33% (20/24), immunological thrombocytopenia group90.00% (18/20), autoimmune hemolytic anemia group 75.00%(12/16)) were higher than 2 weekly treatment ( aplastic anemia group 41.67% (10/24), immunological thrombocytopenia group 40.00% (8/20), autoimmune hemolytic anemia group25.00% (4/16)), and the differences were statistically significant(all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The changes of plasma IL-17 and IL-21 levels are helpful to indicate the occurrence and progression of immune-related hematopathy, to find therapeutic targets and to improve prognosis, which has important clinical significance in the clinical diagnosis, prognosis and treatment of different types of IRH. \u0000 \u0000 \u0000Key words: \u0000Interleukin 17; Interleukin 21; Immune related hematopathy; Expression level; Clinical significance","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43814475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of laparoscopic salpingotomy on ovarian reserve function in patients with tubal pregnancy","authors":"Y. Zhang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.012","url":null,"abstract":"Objective \u0000To investigate the effect of laparoscopic salpingotomy and salpingectomy on ovarian reserve function in patients with tubal pregnancy. \u0000 \u0000 \u0000Methods \u0000From October 2014 to March 2017, 201 cases of tubal pregnancy in Jizhong energy Fengfeng Group Hospital were selected and divided into observation group (112 cases) and control group (89 cases) according to different treatment methods.The observation group was treated with laparoscopic salpingectomy, while the control group was treated with laparoscopic salpingectomy.The number of sinus follicles and ovarian volume were measured by color Doppler ultrasound at third days of menstruation on first, third, sixth months after the operation respectively and the ovulation was detected in 6 months after the operation.The intrauterine pregnancy of the two groups was observed one year after operation. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the number and volume of healthy ovarian antral follicles between the two groups in 1, 3 and 6 months after operation respectively (all P>0.05). The number of sinus follicles in the 1, 3 and 6 months after the operation were (7.71 ± 3.12), (7.86 ± 2.03) and (7.65 ± 1.89) in observation group respectively, while that in the control group were (4.06 ± 1.05), (3.91 ± 1.14) and (4.89±2.03)respectively.There was no significant difference in the number of sinus follicles in different time groups (Fintra-group=0.573, P>0.05). The difference between the groups was statistically significant (F inter-grouP=634.306, P 0.05). The difference between the groups was statistically significant (Finter-group=449.106, P< 0.01), F interaction=261.017, P< 0.01). The ovulation rate at 6 months (82.1%, 92/112) and intrauterine pregnancy rate at 1 year (71.8%, 79/110) in the observation group were higher than those in the control group (56.2%, 50/89) and (31.0%, 27/87). There were significant differences between the two groups(χ2=12.601, 28.753, all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Laparoscopic salpingotomy is better than salpingectomy in the treatment of tubal pregnancy.The ovulation rate and intrauterine pregnancy rate are also superior to salpingectomy.It shows that laparoscopic fenestration can protect the ovarian reserve reserve function and reproductive function of patients. \u0000 \u0000 \u0000Key words: \u0000Tubal pregnancy; Laparoscopy; Oviduct fenestration; Salpingectomy; Number of sinus follicles; Ovarian volume","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43003959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and significance of TNF-α and M-CSF in placenta tissue of early severe preeclampsia","authors":"Hongling Wang, Guo-liang Liu, Jiaojiao Zhou","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.018","url":null,"abstract":"Objective \u0000To investigate the expression and clinical significance of macrophage colony stimulating factor (M-CSF) and tumor necrosis factor α (TNF-α) in placenta of early onset severe preeclampsia (PE). \u0000 \u0000 \u0000Methods \u0000Immunohistochemical SP method was used to detect the expression of M-CSF and TNF-α in 77 cases paraffin specimens from Department of Pathology, First Affiliated Hospital of Henan University of Science and Technology from September 2015 to September 2017, including 35 cases of early-onset severe PE, 42 cases of late-onset severe PE and 30 cases of normal pregnant women. \u0000 \u0000 \u0000Results \u0000(1)The positive expression rates of M-CSF in control group, late-onset severe PE group and early-onset severe PE group were 30% (9/30), 61.90% (26/42), 82.86% (29/35), respectively.The difference was statistically significant (χ2=18.90, P<0.05). The positive expression rates of early-onset severe PE group were significantly higher than those in control group (χ2=18.59, P<0.05), and the difference was statistically significant..The positive expression of early-onset severe PE group was higher than that of late-onset severe PE group, and the difference was statistically significant (χ2=4.017, P<0.05). (2) The positive expression rates of TNF-α in control group, late-onset severe PE group and early-onset severe PE group were 33.33% (10/30), 69.05% (29/42), 91.43% (32/35), respectively.The difference was statistically significant (χ2=30.21, P<0.05). The positive expression of TNF-α in early-onset severe PE group was significantly higher than that in control group (χ2=21.37, P<0.05), and the difference was statistically significant.The positive expression of M-CSF and TNF-a in early-onset severe PE group was higher than that in late-onset severe PE group, and the difference was statistically significant (χ2=4.529, P<0.05); (3) The expression of M-CSF and TNF-α was positively correlated in PE (r=0.441, P=0.000). \u0000 \u0000 \u0000Conclusion \u0000Placental damage is higher in early-onset severe PE, and is related to the severity of the disease.The levels of M-CSF and TNF-alpha in placenta of PE patients may play a synergistic role in the occurrence and development of PE. \u0000 \u0000 \u0000Key words: \u0000Preeclampsia; Early onset severe preeclampsia; Placental tissue; Macrophage colony-stimulating factor; Tumor necrosis factor α","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46551150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the diagnosis and treatment of Peutz-Jeghers syndrome","authors":"Quan-Li Zhu, Wei Wu, Peng Chen, Diarra mohamed Diaty","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.019","url":null,"abstract":"Peutz-Jeghers syndrome (PJS) is a rare syndrome characterized by multiple polyps of gastrointestinal tract and black spots of mucosa.The etiology is unclear yet.The main clinical manifestations are digestive tract symptoms and pigmentation of skin and mucosa.The diagnosis mainly depends on clinical manifestations and auxiliary examinations.Multiple gastrointestinal polyps can often be found by endoscopy.Gene testing can often detect mutations of serine/threonine kinase 11 (STK11) or liver kinase B1 (LKB1), which has high diagnostic accuracy.At present, PJS is rarely reported, and there is still a lack of systematic understanding.This paper reviews the incidence, clinical manifestations, auxiliary examinations, diagnosis, treatment and progress of PJS. \u0000 \u0000 \u0000Key words: \u0000Peutz-Jeghers Syndrome; Diagnosis and treatment","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41294303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different grades of corpus luteum blood flow on conservative treatment in patients with unruptured tubal pregnancy","authors":"X. Song","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.017","url":null,"abstract":"Objective \u0000To study the effect of different grades of corpus luteum blood flow on conservative treatment of unruptured tubal pregnancy. \u0000 \u0000 \u0000Methods \u0000One hundred and fifty-six patients who were diagnosed with unruptured tubal pregnancy in the General Hospital of Northern War Zone and accepted conservative treatment from February 2013 to February 2018 were retrospectively analyzed.The patients were divided into corpus luteum blood level 0 group(0 grade group, 36 cases), corpus luteum blood level 1 group(1 grade group, 41 cases), corpus luteum blood level 2 group(2 grade group, 45 cases), corpus luteum blood level 3 group(3 grade group, 34 cases)according to the corpus luteum blood flow classification in pregnancy.The levels of blood β-HCG, the packet reducing and the curative effect were compared among the four groups. \u0000 \u0000 \u0000Results \u0000The time ofβ-HCG decreased to normal after treatment in 0~3 grade group was (14.4±2.7) d, (16.2±3.9) d, (23.3±4.8) d, (27.0±4.6) d respectively, there was significant difference among the four groups (F=5.338, P=0.039). The time of mass disappeared completely after treatment in 0-3 grade group was (13.2±2.2)d, (15.9±3.0)d, (21.8±2.9)d, (24.1±3.4)d respectively, there was significant difference among the four groups (F=4.229, P=0.043). The curative rate in 0-3 grade group was 91.7%(33/36), 87.8%(36/41), 82.2%(37/45), 73.5%(25/34) respectively, there was significant difference among the four groups(χ2=4.586, P=0.041). There was no significant difference in incidence of adverse reactions among the four groups (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000The different classification of corpus luteum blood flow in pregnancy of unruptured tubal pregnancy have significant influence on the conservative treatment effect.The higher the blood flow classification, the longer treatment time and the worse the curative effect. \u0000 \u0000 \u0000Key words: \u0000Tubal pregnancy; Corpus luteum of pregnancy; Blood flow classification; Conservative treatment","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45354203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and significance of Bone Morphogenetic Protein 2 and phosphatase and tensin homolog deleted on chromosome ten in incipient, recurrent and malignant salivary gland pleomorphic adenoma","authors":"Guan′e Li, Xinhao Fan, Hai-yan Li, Zhen-Zhen Dai, Jinyuan Li","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.004","url":null,"abstract":"Objective \u0000To investigate the expression and significance of bone morphogenetic protein-2 (BMP-2) and phosphatase and tensin homolog deleted on chromosome ten (PTEN) in incipient, recurrent and malignant salivary gland pleomorphic adenoma. \u0000 \u0000 \u0000Methods \u0000A total of 93 cases of salivary gland pleomorphic adenoma in Kailuan general hospital from 2008 to 2017 were collected, including 54 in incipient group (group A, 47 cases in benign group A1, 7 cases in malignant group A2), 39 cases in recurrent group (group B, 26 cases in benign group B1, 13 cases in malignant group B2). The expression of BMP-2 and PTEN were detected by immunohistochemical detection and western blot, the correlation of BMP-2 and PTEN was analyzed by Spearman analysis. \u0000 \u0000 \u0000Results \u0000The immunohistochemical and western blot analysis both showed expression of BMP-2 in recurrent group was significantly higher than that in incipient cases((129.03±15.52) vs.(87.88±18.11), t=-8.094, P=0.000), and it was lower in malignant cases than that in benign cases((100.24±25.07) vs (116.66±26.19), t=2.125, P=0.040). There was no significant difference in PTEN expression between incipient and recurrent groups((89.15±13.92) vs.(96.19±28.02), t=1.055, P=0.279), but lower PTEN expression was found in malignant cases than benign cases((76.06±11.16) vs.(109.28±17.05), t=7.543, P=0.000). BMP-2 was positively correlated with PTEN expression (r=0.313, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000BMP-2 is associated with the recurrence of salivary gland pleomorphic adenoma, and both BMP-2 and PTEN are associated with malignant in the salivary gland pleomorphic adenoma. \u0000 \u0000 \u0000Key words: \u0000Pleomorphic adenoma; Bone morphogenetic protein 2; Phosphatase and tensin homolog deleted on chromosome ten; Immunohistochemisty; Apoptosis","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43461944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of lower limbs infection caused by Helcococcus Kunzii and literature analysis","authors":"Yasi Wang, Ai-ling Dong, Yubing Fu, Lei Zhang, Junzhi Huang, H. Xing, Nanyu Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.002","url":null,"abstract":"Objective \u0000To describe a case of lower limbs infection of Helcococcus Kunzii in North China University of Science and Technology Affiliated Hospital in October 2017 and to analyze the etiology and drug susceptibility. \u0000 \u0000 \u0000Methods \u0000The bacteria were identified by French Meriere mass spectrometer and BD Phoenix-100 automatic bacterial identification/drug sensitivity system.The drug resistance of the bacteria was detected by disk diffusion method, and collected the clinical information and related literature information of the Helcococcus Kunzi to analyze. \u0000 \u0000 \u0000Results \u0000The Gram-positive cocci was isolated from the foot secretion of a patient with venous thrombosis of lower limbs complicated with infection.The result of smear was Gram-positive cocci in double, agglomerate and varied in size.On the blood plate, there was a small colony of α hemolysis.Thixozyme negative, β galactosidase negative.The results of mass spectrometry identification and two kinds of fully automatic bacterial identification / drug sensitivity system were identified as Helcococcus Kunzii, the isolates was resistant to erythromycin and clindamycin among the 10 antibiotics tested.By searching, sorting out and analyzing the literature information, it is revealed that the infection of this bacterium is not related to sex.Middle-aged and elderly people are mostly infected.And the cocci easily infected patients with lower immunity.The infection of lower limbs is 47.37%, the infection of blood flow is 15.79% and the other ways of infection are 42.11% (lung, mammary gland, etc.). \u0000 \u0000 \u0000Conclusion \u0000Helcococcus Kunzii is a conditional pathogen, and patients with lower immunity are more common.Erythromycin resistance could identify it from the green balloon bacteria.Moreover, the bacteria could cause a wide spectrum of diseases, and easily cause sepsis and lower limbs infections, which reminds us that we should be vigilant in clinical practice. \u0000 \u0000 \u0000Key words: \u0000Helcococcus Kunzii; Lower limb infection; Mass spectrometry identification; Drug resistance detection","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42984115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect evaluation of blood component transfusion combined with recombinant activated factor VIIa in treatment of severe active hemorrhage after cardiac surgery","authors":"Qinghua Zhang, Wen-jun Zheng, Suwei Chen, X. Bian, Jun Liu, Lian-jun Gao, Peng Liu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.015","url":null,"abstract":"Objective \u0000To evaluate the efficacy and complications of component blood transfusion combined with recombinant activated factor Ⅶa(rFⅦa)in treatment of severe active hemorrhage after cardiac surgery. \u0000 \u0000 \u0000Methods \u0000Fifty patients who suffered from severe active hemorrhage after cardiac surgery were selected from the First Affiliated Hospital of Dalian Medical University from July 2015 to May 2017.All patients were divided into GR group(component blood transfusion combined with rFⅦa)and GA group(component blood transfusion combined with tranexamic acid)by random number table method, 25 cases in each group.The changes of disseminated intravascular coagulation (DIC) were screened on admission(D1), after cessation of cardiopulmonary bypass(D2), and 2 h (D3), 6 h (D4) and 12 h (D5) after medication.The difference of activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen, hemoglobin and platelet of the two groups at each time point of D1, D2, D3, D4 and D5 were analyzed.Meanwhile, the postoperative drainage, postoperative blood transfusion, postoperative plasma transfusion volume, postoperative mechanical ventilation time, ICU retention time, the 30 d mortality and complications were compared between the two groups. \u0000 \u0000 \u0000Results \u0000There were significant differences in APTT, INR, fibrinogen, hemoglobin and platelet between the two groups (all P 0.05), but at D3 time point, APTT in GR group was significantly shorter than that in GA group((50.3±6.6)s vs.(60.1±6.5)s, P=0.027), and INR in GR group at D4 time point was also significantly lower ((1.3±0.3)vs.(1.5±0.3), P=0.041). In addition, the amount of red blood cells transfusion after treatment in GR group and GA group ((3.2±1.0)U vs.(4.1±1.0)U, P=0.005), the amount of fresh plasma transfusion ((303.2±98.5) ml vs.(469.6±190.5) ml, P=0.000), the amount of 24 h drainage after operation ((519.9±107.5) ml vs.(657.2±100.1) ml, P=0.000)were significantly decreased, the differences were statistically significant. \u0000 \u0000 \u0000Conclusion \u0000Blood component transfusion combined with rFⅦa can significantly improve APTT and INR of severe active hemorrhage after cardiac surgery, at the same time, it can reduce the amount of red blood cells transfusion and plasma transfusion. \u0000 \u0000 \u0000Key words: \u0000Cardiac Surgical Procedures; Postoperative Hemorrhage; Recombinant activated factor Ⅶa; Blood transfusion; Cardiac disease","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42496811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}