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【Objective】 To explore the effects of intraoperative autologous blood(ABT) transfusion on thrombelastography(TEG) in patients underwent neurosurgical procedures. 【Methods】 96 patients (49 males and 47 females) aged 15~79 years who received neurosurgical procedures in our hospital from November 2018 to November 2020 were retrospectively analyzed and divided into autologous blood transfusion group(Group A, n=52)and allogeneic blood transfusion group(Group B, n=44)according to different blood transfusion strategy in operation. The red blood transfusion status, hemoglobin (Hb), hematocrit (Hct), platelet (Plt), fibrinogen(Fib), prothrombin time (PT), activated partial thromboplastin time(APTT), and TEG parameters [activated clotting time(ACT), coagulation time (K), angle rate of clot formation(Angle), maximum amplitude(MA)] before and 1 day after surgery were compared between the two groups. 【Results】 The amount of average blood transfusion didn′t differ significantly by groups (P>0.05). The incidence of extra allogeneic blood transfusion was 17.3%(9/52) in group A, and the amount of average allogeneic blood transfusion in group A was significantly lower than that in group B(333.3±81.7 vs 639.8±258.2, P<0.05). Before operation, the differences in Hb, Hct, Plt, Fib, PT, APTT, ACT, K, MA and Angle levels between the 2 groups were not statistically significant (P>0.05). One day after operation, the Hb(g/L) (109.4±15.8 vs 97.0±15.1), Hct (%) (32.0±4.3 vs 28.3±6.1), Plt(×109/L)(154.2±54.2 vs 120.7±41.6), Fib(g/L)(2.2±0.5 vs 1.6±0.6), MA(mm)(65.0±7.2 vs 60.7±8.7) and Angle levels(deg)(69.1±5.2 vs 62.6±9.8) in group A were significantly higher than those in group B(P<0.05), and the PT(s)(11.9±1.5 vs 12.8±0.9), APTT(s)(27.4±3.3 vs 30.4±5.4), ACT(s)(111.0±14.9 vs 119.1±12.3) and K levels(min)(87.2±25.7 vs 106.4±28.0) in group A were significantly lower than those in group B (P<0.05). 【Conclusion】 Intraoperative ABT in patients underwent neurosurgical procedures can reduce allogeneic blood transfusion, has less effect on coagulation function and TEG, and is safe and effective.
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Objective To explore the surgical efficacy of meningioma patients with epilepsy as the main symptoms. Methods A retrospective analysis of 124 meningioma patients with epilepsy as the main symptoms between January 2010 and January 2016,follow-up effect of epilepsy control. Results There were 94 cases of Simpson I orⅡgrade resection,27 cases of gradeⅢresection and 3 cases of grade Ⅳ resection. The surgical out-comes of patients were evaluated based on Engel′s classification. There were 98 cases(79.0%)of EngelⅠgrade, 11 cases(8.9%)of EngelⅡgrade,Engel Ⅲ and Ⅳ grade were 12 cases(9.7%)and 3 cases(2.4%). Among them,87 of 94 patients with Simpson I orⅡ grade resection epilepsy were well controlled,the satisfaction rate of epilepsy control was 92.6%. Conclusions Epilepsy as the main symptoms of meningioma patients need to clear about the seizure onset area preoperative,need to pay special attention to whether there is an independent epilepsy starting area of the distant site of the tumor. On the basis of the tumor resection as much as possible,at the same time dealing with the abnormal release of the cortex can effectively improve the efficacy of postoperative epilepsy control.
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Objective To explore the surgical treatment of epilepsy in rolandic and immediate perirolan dic cortex.Methods 376 patients accepted surgical treatment in our hospital from January 2010 to January 2016,of whom 48 patients fulfilled eligibility criteria and were included in the study.Patients were divided into 2 groups for analysis:patients with resections in the rolandic cortex (A group,n =28),and patients with resections in immediate perirolandic cortex and simultaneous sensorimotor multiple subpial transections (B group,n =20).Postoperative seizure outcome and neurologic deficits were analyzed.Results According to classification of Engel,Engel Ⅰ was in 22 (45.8％),Engel Ⅱ in 7 (14.6％),Engel Ⅲ in 10 (20.8％) and Engel Ⅳ in 9(18.8％).Seizure outcome satisfaction rate (Engel Ⅰ +Engel Ⅱ) in the group A was significantly higher than the group B (P =0.036);temporary and transient neurological deficits in the two groups had no statistically significant (P =0.569,P =0.418).Conclusions It is possible to achieve complete dissection of epileptic foci in rolandic and immediate perirolandic cortex without damage.The good prognosis is not related to the degree of excision of epilepsy and has no definite correlation with neurological dysfunction.
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Objective To investigate the risk factors and preventive strategies of patients with diffuse axonal injury(DAI) with deep veins thrombosis in lower limbs (LDVT).Methods One hundred and thirty cases of diffuse axonal injury patients with lower limb vascular were divided into LDVT group(22 cases) and non LDVT group(108 cases) based on ultrasound.The information including long-term bed,plasma fibrinogen level,varicose veins,hypertention,sex,age,smoking,alcohol drinking,diabetes,obesity,Glasgow Coma Scale (GCS) were collected.Results There were significant different between LDVT and non-LDVT group in terms of longterm bed time,hypertension,smoking,diabetes,high plasma fibrinogen,age,low GCS score correlated with LDVT (x2 =7.08,5.99,5.17,4.70,3.55,12.72,t =27.80,P ＜ 0.05).Gender,drinking,obesity,varicose vein factors had no correlation with LDVT(P ＞ 0.05).Conclusion Diffuse axonal injury in patients with LDVT is more common in patients with older age,hypertension,low GCS score,the higher the plasma fibrinogen.
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Objective To explore the effects of polyclonal antibody to lipopolysaccharide binding protein (pLBPab) on IL 10 and IL 18 mRNA expressions of alveolar macrophages in lipopolysaccharide LPS induced acute lung injury in rats. Methods A total of 40 male Wistar rats were randomly divided into 5 groups: normal control (A), LPS treated group (B), group of pLBPab preconditioning at 30 min before injection of LPS (C), group of treatment with LPS and pLBPab (D), and group of pLBPab preconditioning at 30 min after injection of LPS (E). mRNA expressions of IL 10 and IL 18 in the alveolar macrophages in each group were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR). Results The IL 10 and IL 18 mRNA expressions were highly increased respectively in the alveolar macrophage (AM?) stimulated with single LPS, but they were significantly decreased in the AM? after stimulation with LPS + pLBPab, particularly stimulation with pLBPab 30 min before LPS injection. Conclusion pLBPab can decrease the mRNA expressions such as IL 10 and IL 18 by alveolar macrophages in acute lung injury in rats induced by LPS, and LBP antibody could be used to cure some diseases such as SIRS, acute lung injury, ARDS, and septic syndrome.
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Objective To observe effects of the antisense genes of Toll-like receptor 4 (TLR4 ) and myeloid differentiation protein-2 (MD2) on the activation of NF-?B in alveolar typeⅡepithelial cells (ATⅡcells) induced by lipopolysaccharide (LPS). Methods Cultured ATⅡcells were randomized to normal cells (control) group,LPS group,LPS+empty vector group,LPS+TLR4 antisense gene group,LPS+MD2 antisense gene group,LPS+TLR4-MD2 antisense gene group. The expressions of TLR4 and MD2 mRNA and protein in ATⅡcells were detected by Northern blotting and Western blotting respectively. The activity of NF-?B in ATⅡcells was measured with electrophoretic mobility shift assay (EMSA). The TNF-? and IL-6 concentrations in the supernatant of cultured ATⅡcells were tested with ELISA.Results Compared with control groups,the expressions of TLR4 and MD2 mRNA and protein,the NF-?? activity,the levels of TNF-? and IL-6 were increased remarkably in LPS group and LPS+empty vector group (P
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To explore the effects of lipopolysaccharide binding protein (LBP) on toll like receptor 4 (TLR4) pathway in alveolar macrophages of acute lung injury induced by lipopolysaccharide (LPS) in rats. The TNF ?concentration, IL 1? and IL 18 mRNA expression in alveolar macrophages (AM?) from rats challenged with LPS or LPS + LBP or LPS+LBP+multi LBP antibody (mLBPab) were measured with ELISA and semi quantative reverse transcription polymerase chain reaction (RT PCR) respectively. The expression of TLR4 was determined with RT PCR and Western blot. The results showed that: the TNF ? concentration ,IL 1?, IL 18 mRNA expressions and TLR4 expression were increased significantly in the AM? stimulated with LPS +LBP compared with single LPS stimulation group. However, mLBPab blocked these effects. It is suggested that LBP could enhance the trans membrane transduction function of LPS via TLR4 in rat AM? and these might be the main reason that LBP could enhance the inflammatory activity of LPS, and LBP antibody could be used to alleviate such morbid conditions such as SIRS, acute lung injury, ARDS, and septic syndrome.