Randomized Controlled Study on Safety and Feasibility of Transfusion Trigger Score of Emergency Operations / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a result, the trigger point of blood transfusion may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future.</p><p><b>METHODS</b>From June 2013 to June 2014, patients were randomly divided into the experimental group (Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group) and the control group (control group). The between-group differences in the patients' demography and baseline information, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell (RBC) transfusion standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed.</p><p><b>RESULTS</b>During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of (34.8 ± 14.6) years. 50 underwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline information. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transfusion-related complications and mortality. Only the POTTS-E group on the 1 st postoperative day Hb was lower than group control, P < 0.05. POTTS-E group was totally (100%) conformed to the requirements of the transfusion guideline to RBC infusion, which was higher than that of the control group (81.25%), P < 0.01.There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates of allogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group (84.3%, 84.3%, and 96.8%) P < 0.05 or P < 0.01. Per capita consumption of intraoperative allogeneic RBC, total allogeneic RBC and total RBC were 0 (0, 3.0), 2.0 (0, 4.0), and 3.1 (0.81, 6.0) in POTTS-E groups were all lower than those of control group (4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]), P < 0.05 or P < 0.001.</p><p><b>CONCLUSIONS</b>Peri-operative Transfusion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is safe; Compared with doctor experience-based subjective assessment, the scoring scheme was closer to patient physiological needs for transfusion and more reasonable; Utilization rate and the per capita consumption of RBC are obviously declined, which has clinical significance and is feasible. Based on the abovementioned three points, POTTS-E scores scheme is safe, reasonable, and practicable and has the value for carrying out multicenter and large sample clinical researches.</p>

Non-invasive visualization of endolymphatic hydrops in patients with Meniere's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To visualize the endolymph in Meniere's disease by applying for non-invasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).</p><p><b>METHODS</b>With a 3 Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 h after intratympanic gadolinium through eustachian tube in seven patients with Meniere's disease. Pure tone test was performed 24 h before and after administered gadolinium. Tympanometry was performed 24 h before, 24 h and 3 months after administered gadolinium.</p><p><b>RESULTS</b>In five patients, the gadolinium could appear in parts of the perilymph inside the inner ear but not in the middle ear and mastoid, moreover, the border between the perilymph and endolymph was visible so that endolymphatic space was clearly shown on 3D-FLAIR imaging. In two patients with endolymphatic hydrops, the perilymphatic space surrounding endolymph was small or disappeared. In two patients, the gadolinium could appear in parts of the middle ear and mastoid but not in the inner ear. No significant changes in pure tone test and tympanometry were noted.</p><p><b>CONCLUSIONS</b>3D-FLAIR MRI with intratympanic gadolinium through eustachian tube could clearly reveal the visualization of endolymphatic space in Meniere's disease.</p>

Endolymphatic visualization in patients with Meniere's disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>To attempt to visualize the endolymph in patients with Meniere's disease by applying non-invasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).</p><p><b>METHODS</b>With a 3 Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 hours after intratympanic gadolinium through eustachian tube in two patients with medically active and intractable Meniere's disease. Pure tone test and tympanometry were performed 24 hours before and after the administration of gadolinium.</p><p><b>RESULTS</b>The gadolinium appeared in almost all parts of the perilymph inside the inner ear; moreover, the border between the perilymph and the endolymph was visible so endolymphatic space was clearly shown on 3D-FLAIR. No change in pure tone test and tympanometry was noted.</p><p><b>CONCLUSIONS</b>3D-FLAIR MRI with intratympanic gadolinium through eustachian tube can clearly reveal the visualization of endolymph in patients with Meniere's disease. Intratympanic gadolinium therapy through eustachian tube is a safe and effective.</p>

Development of clinical application and experimental reseach on prescription biejiajian wan / 中国中药杂志

We reviewed the modern development of clinical application and experimental reseach on the prescription Biejiajian Wan (BJ), which are the basement that we will study its anti-renal fibrosis. At present, the prescription BJ is mainly applied to the treatment of chronic heptic desease. Its experimental reseach is mainly confined to the studing of anti-heptic fibrosi. Refering the scientific and technological result of anti-heptic fibrosis, we think the prescription BJ would have the effection of anti-renal fibrosis on the basis of theory of planning treatment according to diagnosis. But it has not been reported to the prescription BJ on the clinical and experimental reseach on anti-renal fibrosis. Therefore, it is very important to take on clinical reseach of the prescription BJ and discuss the effecting mechanism of anti-renal fibrosis from the level of integration, cell and molecule, which will help to enlarge the clinical application of the prescription Biejiajianwan and explained the essence of "persistent diseases injuring collateral branch of large channel" in traditional Chinese medicine.