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Objective To investigate thrombelastogram (TEG) correlation between parameters and platelet count in perioperative period patients.Methods Selected 139 patients,69 cases with thrombocytopenia,35 cases with normal platelet number and 35 cases with thrombocytosis from 2012 January to 2014 May,monitored TEG,blood coagulation function and the change of blood routine during perioperative period.Spearman test was used to analyze the different level of platelet count and other coagulation parameters.Results The positive correlation between platelet count and TEG parameters were:MA (r=0.57,P＜0.57),Angle (r=0.54,P＜0.000 1),CI (r=0.57,P＜0.000 1),and R was negatively correlated with platelet count (r=-0.27,P＜0.000 1).There was no significant correlation between PT,APTT and platelet count.In mild lack of platelet group [(87.34 ± 10.43) × 109/L] and normal group [(198.47 ± 45.30) × 109/L],platelet count was positively correlated with MA and Angle.In severe lower [(39.33±10.63) × 109/L] and higher group [(330.34±35.43) × 109/L],there was no correlation between platelet platelet count with MA or Angle.Conclusion Platelet count was significantly correlated with CI,Angle and MA,but in patients with moderately severe lower platelet and platelet increase the platelet count do not reflect the aggregation function,MA is more sensitive response to platelet function.
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Objective To investigate the effect of fascia iliaca compartment nerve block ( FICB) to early analgesia and emergence agitation for children after the operation of femur fractures, and compare with fentanyl.Methods Totally 36 cases of children, which scheduled for the one-sided femur fractures surgery were selected after the approval from the Institutional Review Board of the hospital.They were randomly di-vided into two groups:FI group ( FICB group) and FE group ( Intravenous fentanyl group) .Patients in both groups were received ultrasound guided FICB immediately after the induction of general anesthesia, 1 ml/kg ropivacaine ( Naropin) was given in the FI group and 1 ml/kg saline in the FE group, sevoflurane was used for the anesthesia maintenance and 1 μg/kg intravenous fentanyl in FE group, instead of the same volume saline in FI group at 10 min before the surgery finished, and patients were sent to postanesthesia care unit ( PACU) after extubation.Keep a record of the duration of the operation and extubation, the pain scores and the Pediatric Agitation and Emergence Delirium ( PAED) scores were recorded at just arrived at PACU ( T0 ) , 10 min ( T1 ) , and 20 min ( T3 ) after PACU, also included the duration in PACU and the postopera-tively side effects.Results At the time of T0 and T1 , the pain scores in FI group was significantly lower than the FE( P 0.05), but it was still lower in FI group from the age of 8 to 14( P <0.05);The PAED scores at the three time points were always lower in FI group when it was compared with FE group;the same trend occurred for the duration of extubation and PACU( P <0.05).Conclusions FICB can effectively reduce emergence agitation and the pain scores for the children undergoing the surgery of femur fractures during the early time after the operation, which is better than the intravenous fentanyl.
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Objective To evaluate the effects of leukocyte-depleted allogeneic blood transfusion on perioperative cellular immunity in children.Methods Three hundred and fifty-nine ASA Ⅰ or Ⅱ children (aged 3 months-14 years and weighing 5-74 kg) requiring allogeneic blood transfusion during operation were randomly divided into two groups:163 children receiving normal allogeneic blood transfusion (control group,group C) and 196 children receiving leukocyte-depleted allogeneic blood transfusion (group D).Blood samples were collected from the peripheral vein before blood transfusion,and 2 and 6 days after blood transfusion for determination of the levels of CD3+,CD4+,CD8 +,and CD56+ by flow cytometry.CD4+ /CD8+ ratio was calculated.The volume of allogeneic blood transfusion during operation,the duration of operation,postoperative drainage,antibiotic administration,hospital stay and the incidence of postoperative infection were recorded.Rssults The levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio significantly increased at 6 days after blood transfusion while the duration of postoperative drainage,postoperative antibiotic administration,hospital stay and the incidence of postoperative infection significantly decreased in group D compared with group C.Conclusion Leukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.
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ObjectiveTo investigate the effects of leukocyte-depleted allogeneic blood transfusion on perioperafive cellular immunity in children.MethodsThree hundred and fifty-nine ASA Ⅰ or Ⅱ children aged 3 month-14 yr,weighing 5-74 kg requiring allogeneic blood transfusion during operation were randomly divided into 2 groups:control group (group C,n =163) and leukocyte depletion group (group D,n =196).In group D allogeneic blood was filtered with a leukocyte filter before being transfused during operation.Blood samples were collected from peripheral vein before blood transfusion,and at 2 and 6 d after blood transfusion for determination of levels of CD3+,CD4+,CD8+,and CD56+ by flow cytometry.CD4+/CD8+ ratio was calculated.The volume of allogeneic blood transfused during operation,the duration of operation,postoperative drainage,antibiotics administration and hospital stay and incidence of postoperative infection were recorded.ResultsThe levels of CD3+,CD4+,CD56+ and CD4+/CD8+ ratio were significantly increased at 6 d after blood transfusion while the duration of postoperative drainage,postoperative antibiotics administration and hospital stay and incidence of postoperative infection were significantly decreased in group D compared with group C.ConclusionLeukocyte-depleted allogeneic blood transfusion is helpful in improving the postoperative cellular immunity in children.
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Objective To investigate the changes in iNOS expression in brain injury induced by hepatic ischemia-reperfusion (IR) in rats.Methods Thirty-two male Wistar rats weighing 240-280 g were randomly divided into 2 groups: sham operation group (group S,n = 8) and group IB( n = 24).The hepatic IR was induced by clamping the hepatic artery and portal vein according te the method described by LONG et al.In group IR the rats were killed at 3,6 and 24 h of reperfusion after 40 min hepatic ischemia (8 rats at each time point).The rats in group S were also killed.The brains were removed for determination of NO content (by nitrate reductase assay),SOD activity (by xanthine oxidase method),MDA content(by colorimetric method),nitrotyrosine (NT) expression (by Western blot),and iNOS mRNA expression (by RT-PCR).Results Compared with group S,cerebral NO and MDA content were significantly increased at 6 and 24 h of reperfusion,expression of cerebral NT and iNOS mRNA up-regulated and SOD activity decreased at 6 h of reperfusion in group IR (P < 0.05 or 0.01).Cerebral NO and MDA content were significantly higher and SOD activity lower at 6 and 24 h of reperfusion than at 3 h of reperfusion in group IR (P < 0.05).Conclusion The expression of iNOS in brain tissues is up-regulated after hepatic IR and it produces a great amount of NO inducing brain injury through peroxynitrite (ONOO-).