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【Objective】 To establish a practical and feasible blood management (PBM) model for clinical liver transplant patients, so as to optimize the perioperative blood usage and improve patient prognosis and survival rate. 【Methods】 Led by the Medical Department, a questionnaire survey Establishment and Implementation of a Blood Management Model for Organ Transplant Patients on the importance of establishing a PBM model for liver transplant patients in clinical practice was conducted among 71 staff from relevant departments such as the Anesthesiology Department, Hepatobiliary Department, Blood Transfusion Department, and ICU Medical Department. After statistical analysis, the important items of PBM for liver transplant patients were determined, and a (trial) plan was organized by the Medical Department and training was conducted by Blood Transfusion Department for medical staff training from departments as Anesthesiology, Hepatobiliary and Pancreatology, and ICU; PBM measures for liver transplant patients before, during and after surgery were determined by the Anesthesiology Department, Hepatobiliary and Pancreatic Department, and ICU; PBM was fully implemented in the experimental group with liver transplant patients in our hospital in 2021 as subjects; 30 cases of liver transplantation performed in our hospital in 2020 were selected as the control group, and the general data, preoperative laboratory examination results, and preoperative, intraoperative, and postoperative blood transfusion of the two groups of patients were compared. 【Results】 Compared with the control group, the experimental group did not receive any blood component transfusion before surgery. Intraoperative blood transfusion volume of allogeneic components: red blood cells(U) were 12.75(8.75, 18.63) vs 15.25(8.38, 26.13)(P>0.05), apheresis platelet (treatment volume) was 0(0, 2) vs 1(0, 4.25)(P>0.05), plasma(U) was 2 300(1 550, 3 763) vs 3 650(2 075, 5 400)(P0.05), platelets were not transfused, plasma(U) was 0(0, 0) vs 0(0, 600)(P>0.05), and cryoprecipitates were not transfused. 【Conclusion】 The establishment of PBM model for liver transplant patients and the application of its management measures before, during and after transplantation significantly reduced the intraoperative blood transfusion volume and improved the prognosis of patients after transplantation.
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ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ2=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.
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【Objective】 To continuously improve the routine indoor quality and precision of TEG by applying Westgard multi-rule control method combined with Levey-Jennings quality control chart. 【Methods】 The parameters R, K, Angel and MA of TEG were monitored and analyzed in the laboratory for 12 consecutive months using the same batch of quality control products via Westgard multi-rule control method combined with Levey-Jennings quality control chart, and the mean(), standard deviation (SD) and coefficient of variation (CV%) were calculated to observe the control effect. 【Results】 We applied this quality control method to timely correct, analyze and improve the system errors in TEG indoor quality control.The CV% value of R, K, Angle and MA were 20.33%, 13%, 3.6% and 9.65%, respectively, during January to June 2019, but decreased to 9%, 3%, 1.28% and 5.35%, respectively, during July to December 2019. 【Conclusion】 The application of Westgard multi-rule control method and Levey-Jennings quality control chart in TEG indoor quality control test can improve the precision of TEG clinical test results.
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Postoperative intra-abdominal adhesion is one of the most common complications in the postoperative period. Current remedies are very ineffective to prevent the pathological outcomes except steroid hormones. Rhynchophylline is deemed as a pharmacologically active component from traditional Oriental medicine Uncaria rhynchophylla (Miq.) Jacks. (Rubiaceae). This study was designed to investigate the preventative effect of rhynchophylline on the abdominal adhesions in rats. Rhynchophylline relieved the experimental abdominal adhesion and decreased the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the blood serum in a dose-dependent manner. The levels of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) were reduced significantly in the peritoneal fluid. The potential mechanism of the activity is related to inhibition of the TGF-β1/Smad signaling pathway.