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Objective:To explore the value of thromboela-stogram (TEG) in predicting the risk of bleeding in patients undergoing thyroid cancer surgery and guiding blood transfusion therapy.Methods:46 patients with hemorrhage after thyroid cancer surgery in General Surgery Department of the Second Hospital of Shanxi Medical University from Sep. 2021 to Sep. 2022 were selected as the hemorrhage group, including 12 males and 34 females. The age ranged from 18 to 76 years old, with an average age of (45.39±8.64). A total of 46 patients with no postoperative bleeding during the same period were selected as control group, including 9 males and 37 females. The average age was (43.86±9.12) years, ranging from 18 to 75 years. Postoperative TEG parameters, thrombin time (fibrinogen), fibrinogen (FIB), prothombin time (PT), thrombin time (thrombin time, TT), activited partial thomboplastin time (APTT) ], Spearman correlation coefficient was used to analyze the correlation between TEG parameters, coagulation parameters and postoperative blood loss. The value of TEG parameters and coagulation indexes in predicting bleeding was evaluated by receiver operating characteristic (ROC) curve.Results:R value (9.81±1.39) min, K value (3.52±0.94) min, PT value (14.12±1.98) s, TT value (21.36±3.21) s and APTT value (40.29±7.18) s in hemorrhage group were higher than those in control group (7.09±1.12) min and 2.75±0.81) min, (12.86±1.74) s, (19.71±2.53) s, (36.15±6.52) s, MA value (51.67±5.13) mm, Angle (47.06±9.24) °, FIB (1.95±0.64) g/L were lower than control group (57.76±6.05) mm, (58.29±10.28) °, (2.41±0.89) g/L (t 1=10.335, t 2=4.209, t 3=3.242, t 4=2.738, t 5=2.895, t 6=5.207, t 7=5.510, t 8=2.846, all P<0.05) ; R-value (11.02±1.26) min and K-value (4.16±0.93) min in patients with high blood (≥10 ml) bleeding group were higher than those in patients with low bleeding (<10 ml) (9.28±1.19) min and (3.24±0.89) min. MA value (48.04±5.01) mm, Angle (42.15±9.14) ° were lower than those of patients with hypohemorrhage (53.26±5.29) mm, (49.21±9.53) ° (t 1=4.484, t 2=3.183, t 3=3.127, t 4=2.340, P<0.05). The amount of blood loss after thyroid cancer surgery was positively correlated with R value and K value, and negatively correlated with MA value and Angle (r 1=0.421, r 2=0.335, r 3=-0.318, r 4=-0.306, all P<0.05). The area under the curve (AUC) of R value, K value, MA value and Angle predicted perioperative bleeding of thyroid cancer surgery was>0.7. R value (7.13±1.15) min, K value (2.81±0.82) min, PT (13.01±1.76) s, TT (20.03±2.60) s, APTT (37.12±6.64) s after treatment were lower than those before treatment (9.81±1.39) min, (3.52±0.94) min, (14.12±1.98) s, (21.36±3.21) s, (40.29±7.18) s, MA value (56.89±5.94) mm, Angle (56.73±9.86) °, FIB (2.35±0.85) g/L were higher than those before treatment (51.67±5.13) mm, (47.06±9.24) °, (1.95±0.64) g/L (t 1=10.076, t 2=3.860, t 3=2.842, t 4=2.184, t 5=2.198, t 6=4.511, t 7=4.854, t 8=2.550, all P<0.05) . Conclusion:TEG parameters R value, K value, MA value and Angle have certain predictive efficacy in predicting bleeding risk of patients undergoing thyroid cancer surgery, and can guide clinical transfusion therapy.
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Objective:To investigate the expression of miR-92a-3p in senile osteoporosis (OP) and its diagnostic value in hip fragility fractures.Methods:With the help of the National Center for Biotechnology Information (NCBI) website, the data sets related to OP and miRNA were retrieved and analyzed and screened to obtain the target miRNA. Serum samples were collectedfrom 53 OP patients and 24 healthy people, and the OP patients were divided into hip fragility fracture group (OP_F; n=30) and no hip fragility fracture group (OP_WF; n=23). The subjects' bone mineral density and serum bone metabolism markers were measured: calcium, phosphorus, parathyroid hormone, 25-hydroxyvitamin D, bone alkaline phosphatase, serum C-terminal peptide. The expression levels of target miRNAs in serum samples were detected by qRT-PCR. Chi-square test, t test, Spearman rank correlation and receiver operating characteristic curve (ROC curve) were used to analyze the potential relationship between the expression level of miR-92a-3p and the clinical characteristics of patients.Results:According to the analysis of NCBI website, the expression of miR-92a-3p in OP patients was higher ( t=3.41, P=0.007) than that in healthy people, and the expression level of miR-1304-5p was lower ( t=5.13, P<0.001). qRT-PCR experiments confirmed the above results, and further found that the expression of miR-92a-3p in the OP_F group was significantly higher than that in the OP_WF group (t=3.01, P=0.004), but there was no significant difference in miR-1304-5p between the two groups (t=0.71, P=0.480). Compared with the healthy control group, the BMI ( t=2.71, P=0.008), bone mineral density score ( t=29.02, P<0.001), calcium ( t=61.20, P<0.001), phosphorus ( t=2.54, P=0.013), 25-hydroxyvitamin D (t=3.01, P=0.004) ,bone alkaline phosphatase ( t=12.56, P<0.001), and serum C-terminal peptide ( t=7.52, P<0.001) levels were statistically different between the OP patient group and the healthy control group. Compared with the OP_WF group, the bone mineral density score ( t=2.08, P=0.042), calcium ( t=15.75, P<0.001), bone alkaline phosphatase ( t=2.02, P=0.049) and serum C-terminal peptide ( t=3.39, P=0.001) levels were statistically different between the OP_F group and the OP_WF group. Bone mineral density score and bone alkaline phosphatase concentration were related to the expression of miR-92a-3p and were negatively and positively correlated ( r=0.416, P=0.022), respectively ( r=-0.403, P=0.027). The area under the ROC curve was 0.723, and the level of miR-92a-3p had potential significance in the diagnosis of hip fragility fractures ( P=0.006) . Conclusion:miR-92a-3p is highly expressed in OP and has biological significance for the diagnosis of hip fragility fractures.