ABSTRACT
OBJECTIVE To evaluate the clinical efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and VIP， randomized controlled trials （RCTs） and cohort studies about aspirin （trial group） versus other anticoagulants （control group） were collected during the inception and June 1st， 2023. After literature screening， data extraction and quality evaluation， the meta-analysis was conducted by using RevMan 5.4 software. RESULTS A total of 22 studies were included， involving 9 RCTs and 13 cohort studies. RCT results showed that the incidences of deep vein thrombosis （DVT） [RR＝1.81， 95%CI（1.36， 2.40）， P＜0.000 1] and postoperative pulmonary embolism （PE） [RR＝1.55， 95%CI（1.01， 2.40）， P＝0.05] in trial group were significantly higher than control group. There was no statistically significant difference in the incidences of postoperative massive bleeding， postoperative surgical site infection， all-cause death， or any bleeding after surgery between 2 groups. In the cohort study， the incidence of any bleeding in trial group was significantly lower than control group [RR＝0.71，95%CI （0.64， 0.79）， P＜0.000 1]， while the differences in other indicators were not statistically significant （P＞0.05）. The results of subgroup analysis based on different anticoagulants showed that in RCT， the incidences of DVT and PE after surgery in patients using low-molecular-weight heparin （LMWH） were significantly lower than using aspirin （P＜0.05）； in the cohort study， the incidences of DVT and PE after surgery were significantly lower in patients using direct oral anticoagulants （DOAC） than using aspirin （P＜0.05）. There was no statistically significant difference in the incidence of major bleeding between patients using aspirin and using DOAC and LWMH （P＞0.05） in both RCT and cohort study. CONCLUSIONS Aspirin is equally safe as other anticoagulants for the prevention of thromboembolism after orthopedic surgery， but its efficacy may not be as good as other anticoagulants. After orthopedic surgery， other anticoagulants should be preferred to prevent venous thromboembolism， and aspirin should be carefully considered.
ABSTRACT
Objective To investigate the significance of CD44v6 expression in acute leukemia( AL) and it's relation with the prognosis of AL. Methods Sixty AL patients were treated by enzyme linked immunosorbent assay( ELISA)as initial treatment group. Fourty-seven cases were remission as remission group, and 20 cases with no-remission group. Meanwhile,45 healthy people were served as the control group. The level of CD44v6 was measured by ELISA. Results The serum CD44v6 in initial treatment patients,remission group, no-remission group and control group were( 179. 34 ± 39. 41 )μg/L,( 190. 61 ± 28. 05 )μg/L,( 106. 72 ± 26. 38)μg/L and(98. 31 ± 21. 78)μg/L respectively,and the difference was significant( F =56. 303,P﹤0. 01),and the CD44v6 of initial treatment group and remission group were higher than that of no-remission group and control group(P﹤0. 05). The leukocyte levels was positive related to CD44v6 levels in 60 patients(r=0. 826,P﹤0. 01),and it was also related to disease stage,extramedullary infiltration(( r=0. 485,0. 512;P﹤0. 01). Conclusion The level of CD44v6 is closely related with the occurrence and development of acute leukemia. The assay of CD44v6 in serum of AL patients is helpful in diagnosing and predicting the risk of metastasis and prognosis in AL.