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【Objective】 To provide reference for formulating preoperative blood preparation plan for malignant osteosarcoma scientifically and rationally under the persistent COVID-19 epidemic by studying the high-risk influencing factors related to intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Methods】 The general data, preoperative blood routine and coagulation parameter, clinicopathological record and surgical data of 120 patients with primary malignant osteosarcoma in Beijing Jishuitan Hospital from January 2020 to January 2021 were retrospectively analyzed by univariate analysis, multivariate regression analysis and Pearson correlation analysis to determine the high risk factors for intraoperative blood transfusion in patients with primary malignant osteosarcoma. 【Results】 The incidence of intraoperative and postoperative blood transfusion of malignant osteosarcoma patients were 48.33% (58/120) and 62.50% (75/120), with the average blood transfusion units at (1.36±1.14) U and (2.93±2.26) U, respectively. The univariate analysis showed that such factors as sex, preoperative Hct (%), preoperative Plt (×109/L), location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). Multivariate logistic regression analysis showed that sex, location of lesion, Huvos classification, incision length (cm), reconstruction length(cm) and intraoperative blood loss (mL) were significantly different (P<0.05). 【Conclusion】 For primary malignant osteosarcoma with a high rate of intraoperative blood transfusion, early intervention should be carried out according to the high-risk factors of intraoperative blood transfusion, and preoperative blood preparation plan should be accurately formulated to effectively reduce the rate and units of blood transfusion in patients under the premise of surgery safety.
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Objective:To evaluate the relationship between degrees of biliary obstruction and levels of lipid peroxidation in patients.Methods:A total of 140 patients of both sexes, with biliary obstruction, without biliary puncture and drainage, aged 40-64 yr, with body mass index of 18.5-23.9 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, were selected.The patients with different degrees of biliary obstruction were divided into 4 groups ( n=35 each) according to Child-Pugh grade total bilirubin (TBIL) concentrations: group A (TBIL<17 μmol/L), group B (17 μmol/L≤TBIL<34 μmol/L), group C (34 μmol/L≤TBIL<51 μmol/L) and group D (TBIL≥51 μmol/L). The serum TBIL, direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acid (TBA) and malondialdehyde (MDA) concentrations were measured.The correlation between serum MDA concentration and degree of biliary obstruction was tested by Spearman correlation analysis. Results:Compared with group A and group B, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group C and group D ( P<0.05), and there was no significant difference in the parameters mentioned above between group A and group B ( P>0.05). Compared with group C, the serum DBIL, IBIL, ALT, AST, TBA and MDA concentrations were significantly increased in group D ( P<0.05). Serum MDA concentration was positively correlated with degree of biliary obstruction ( r=0.54, P<0.05). Conclusion:The degree of biliary obstruction can reflect the level of lipid peroxidation in patients.
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【Objective】 To explore the influencing factors of blood transfusion in burn patients during hospitalization, so as to provide references for the development of individualized blood transfusion strategies. 【Methods】 116 cases of flame burns and 46 cases of high-voltage burns from Jan 2015 to Jan 2019 were retrospectively analyzed. The gender, age, height, weight, body mass index (BMI), burn surface area, burn depth, burn site, intraoperative blood loss, postoperative flow, number of operations, hospital stays, blood transfusion amount, whether complicated with inhalation injury, stress ulcer, amalgamative infection, hypertension, diabetes, cardio-related diseases, abnormal liver and kidney function and hypoalbuminemia in those two groups were statistically analyzed. 【Results】 During hospitalization, the mean blood volume of flame burn cases was (29.26±26.18)U, significantly higher than high-voltage burn cases as (13.26±10.32)U. The mean hemoglobin concentration (g/L) before blood transfusion of flame burn cases was (91.49±15.11)g/L, significantly higher than high-voltage burn cases as (81.70±14.49)g/L. There were statistically significant differences in gender, BMI, burn surface area, burn depth and burn site between flame burn cases and high-voltage burn cases (P<0.05). The average volume of blood transfusion during hospitalization was significantly affected by such factors as large burn area, trunk involvement, total intraoperative blood loss ≥2 000 mL, number of operations ≥6 times, hospital stay≥100 days, hypertension, cardio-related diseases, abnormal liver and kidney function, hypoproteinemia and so on (P<0.05), among which the total amount of intraoperative blood loss had the most significant effect on the flame burn patients (P<0.05), and the burn site had the most significant effect on the high voltage burn patients (P<0.05). 【Conclusion】 Large burn area, deep burn depth, important organs and/or large blood vessels involvement, number of operations ≥6, and the total intraoperative blood loss ≥2 000 mL contribute to the increase of average volume of blood transfusion. The hypertension, cardio-related diseases, abnormal liver and kidney function, and hypoproteinemia were high risk factors for increased blood transfusion volume during hospitalization, which deserves great attention.
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Objective To observe the effects of Wendan decoction (WD) on depression-like behavior in a rat model of Parkinson's disease (PD) and explore the related mechanism.Methods Rodent model of PD was established by unilaterally lesioning medial forebrain bundle with 6-hydrodopamine.After intragastric administration with WD,the rats's behavior changes were detected by the open field test,sucrose preference test and forced swimming test;the contents of monoamine neurotransmitters in the rat brain were assessed by high-performance liquid chromatography with electrochemical detection.Results Compared with those of sham-operated rats,the horizontal and vertical activities of the PD model rats decreased significantly,and sucrose consumption decreased significantly,but immobility time during forced swimming was significantly prolonged.The contents of dopamine (DA),5-hydroxytryptamine (5-HT) and noradrenaline (NA) in the medial prefrontal cortex (mPFC) and DA in the striatum decreased significantly.After administration of WD for 2 weeks,the immobility time of the PD model rats was significantly decreased,sucrose consumption increased significantly;DA,5-HT and NA levels in the mPFC increased significantly.Conclusion WD improves the depression-like behavior in PD model rats,and the mechanisms may involve the regulation of monoamine neurotransmitters in mPFC.