Acquired blood coagulation factor Ⅴ deficiency in a patient with severe burn / 中华烧伤杂志

In March 2017, a severely burned male patient aged 36 years with hypovolemic shock was admitted to our hospital. The patient received large quantities of antibiotics and blood products and repeated skin graft after admission, and then he suffered wound errhysis and throat congestion. The patient was healthy before without family history of bleeding or thrombosis disease. Laboratory tests showed that prothrombin time and activated partial coagulation time were remarkably prolonged, blood coagulation factor Ⅴ activity was extremely low, and the result of qualitative test of coagulation factor inhibitor was positive. Acquired blood coagulation factor Ⅴ deficiency was diagnosed. After application of dexamethasone (5 mg, twice per day) and infusion of fresh frozen plasma, blood coagulation indicators of patients recovered in 4 days, the result of qualitative test of coagulation factor inhibitor was negative, and bleeding symptoms were improved.

Evaluation of red blood cell distribution width, mean platelet volume and cardiac troponin I for early diagnosis of acute coronary syndromes by using ROC curve / 中国医师杂志

Objective To observe the changes of red blood cell distribution width, mean platelet volume and cardiac troponin I in patients with Acute Coronary Syndromes, and to evaluate the value for early diagnosis by using ROC curve. Methods 191 patients with ACS and 206 patients with the chest pain syndromes non-ACS were selected in this study. Electrocardiogram,blood routine,creatinine, LDL-C and cardiac troponin I were determined within six hours after hospitalized,meanwhile the feature of ROC curves was observed. Results There was no significant difference between ACS group and non-ACS group about red blood cell, hemoglobin, platelet,creatinine and LDL-C［(3.82±0.57)×1012/L,(101.3±3.3)g/L,195（98.6-334.8）×109/L,69（45-120）μmol/L,(2.95±0.85)mg/dl vs (3.89±0.50）×1012/L,(103.5±3.7)g/L,201（135.2-346.9）×109/L,71（49-100）μmol/L,(2.82±0.75)mg/dL］ (P＞ 0. 05). Red blood cell distribution width, mean platelet volume and the cardiac troponin I in ACS group［13.70(12.00-15.20)%,9.4（7.42-12.31）fL,(5.63±1.39)μg/L］ were significantly higher than that of non-ACS group［12.60（11.20-13.83）%,8.2（6.24-10.97）fL,(0.04.±0.01)μg/L］ (P＜0.01) .The area under ROC curves of red blood cell distribution width,mean platelet volume and cardiac troponin I were 73.5%, 78.8%, 98.1% respectively, while the best cut-off value was 13.15%, 12.45 fL, 0.06 μg/L respectively. Conclusions The combination using of red blood cell distribution width andmean platelet volume and cardiac troponin I and other conventional cardiac markers might be served as early diagnosis marker for the ACS patients admitted to emergency departments.