To evaluate the therapeutic effects of preoperative platelet transfusion for splenectomy and devascularization / 中华肝胆外科杂志

Objectives To study the effect of preoperative platelet transfusion for splenectomy and devascularization in the prevention of intraoperative and postoperative bleeding.Methods The 230 patients with cirrhosis and portal hypertension who received splenectomy and periesophagogastric davascularization were divided into strata A,B and C according to the platelet counts.Stratum A patients had a platelet count of less than 30× 10/L,B between 30× 10/L and 50× 109/L,and C more than 50 × 109/L.The patients in each stratum were then randomly divided into a preoperative transfusion group (T group) and a non-transfusion group (NT group).The amounts of intraoperative bleeding,postoperative drainage in 48 hours after operation,rates of postoperative bleeding,and general medical conditions were compared.Results A comparison in stratum A showed lower amounts of intraoperative bleeding and 48 hour postoperative drainage,and a lower rate of bleeding in the T group (P＜0.05).There were no significant differences between the T and the NT groups in strata B and C (P＞0.05).Conclusions For patients with a platelet count lower than 30 × 109/L,preoperative platelet transfusion significantly reduced bleeding suggesting that preoperative platelet transfusion for splenectomy and periesophagogastric devascularization should be a routine.For those patients whose platelet count was above 30 × 109/L,platelet transfusion is not recommended.

A Control Study of N-acetylcysteine Therapy for Chronic Obstructive Pulmonary Disease / 医学研究杂志

Objective NAC therapy was used to observe the effect of TNF-?,hs-CRP,PaO2,PaCO2and lung function in patients with COPD,so as to evaluate the therapeutic effect. Methods 65 patients with COPD were recruited and the patients were randomly divided into 2 treatment groups:control group (n=31) and experimental group (n=34). Patients in the two groups received the conventional treatment of COPD in unchanged dosage for the duration of the study except stopping using antibotic drug after infection was resolved. NAC tablets were taken orally at a dose of 600mg once a day in experimental group. After 8 weeks treatment,we appraised lung function and the plasma level of TNF-?,hs-CRP,PaO2 and PaCO2. Results Compared with normal controls,the plasma levels of TNF-? and hs-CRP increased significantly. The higher level of those ,the higher lung function class was in 65 COPD patients,and there was significant effect(P