ABSTRACT
Objective To investigate the safety and efficacy of transfusion indication in patients with massive transfusion.Methods 64 patients with surgical perioperative period from December 2014 to December 2016 were selected from our hospital and randomly divided into control group and observation group.The control group adopted the standard of clinical transfusion technology (2000) in People's Republic of China Ministry of Health,and combined with the specific conditions of patients,according to the clinical experience of physicians,the level of blood transfusion Hb was determined,usually between 7-10 g/dL.The observation group was guided by blood transfusion index.The level of 24 h after operation,the flow rate after operation,the time after the operation,the time of postoperative hospitalization,the amount of infusion,the infusion rate and the incidence of complications were compared between the 2 groups.Results The Hb level of the observation group was lower than that of the control group at 24 h after operation,and the postoperative drainage volume was less than that of the control group.The time of postoperative removal was earlier than that of the control group,and the postoperative hospitalization time was shorter than that of the control group.The difference was statistically significant (P＜0.05).The infusion rate of the observation group was less than that of the control group,and the infusion rate was lower than that of the control group,and the difference was also statistically significant(P＜0.05).The incidence of complications in the observation group (3.13％) was lower than that of the control group (15.63％),but the difference was not statistically significant (P＞0.05).Conclusion:the blood transfusion indication score of the patients with large blood transfusion is obvious,and the safety is good,and it has important clinical significance.Conclusion The blood transfusion indication score of the patients with large blood transfusion is obvious,and the safety is good,and it has important clinical significance.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship of the mutational status of the ND4 gene and the clinical features of acute myelogenous leukemia (AML) patients with ND4 mutations.</p><p><b>METHODS</b>Using PCR combined with directly sequencing, we identified somatic mutations of ND4 in 121 primary AML patients to couple with their clinical features.</p><p><b>RESULTS</b>There were 58 male patients and 63 female patients (median age 49 years, 10-86 years). Eight of 121 patients (6.6%) with de novo AML were found harboring missense mutation of ND4 gene, including 3 patients with A131V (3/8, 37.5%), 2 patients with A404T (2/8, 25%), 1 patient with F149L (1/8, 12.5%), 1 patient with G242D (1/8, 12.5%) and 1 patient with Y409H (1/8, 12.5%), respectively. Patients with ND4 mutations were associated with good karyotype (P=0.049), regardless of gender, age, white blood cell, hemoglobin, platelet, blast cells of bone marrow or immunophenotype (P>0.05). There were no statistical significance in mutations of FLT3-ITD, NPM1, CEBPA, c-KIT and DNMT3A between patients with ND4 mutation and wild-type (wt) ND4 (P>0.05). The median overall survival of patients with ND4 mutations and wt ND4 were all not reached. The median relapse-free survival were not reached and 29(2-53) months, respectively (P>0.05). There was no significance in the ratio of CR and RR patients between wt ND4 and ND4 mutated groups (P>0.05).</p><p><b>CONCLUSION</b>It was concluded that novel ND4 mutations could be found in de novo AML patients, especially in patients with good karyotype. Thus, ND4 mutations might play an important role in AML prognosis. However, whether the mitochondria dysfunction contribute to leukemogenesis needs to be further investigated.</p>