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Objective To evaluate the efficacy and complications of component blood transfusion combined with recombinant activated factorⅦa(rFⅦa)in treatment of severe active hemorrhage after cardiac surgery??Methods Fifty patients who suffered from severe active hemorrhage after cardiac surgery were selected from the First Affiliated Hospital of Dalian Medical University from July 2015 to May 2017??All patients were divided into GR group ( component blood transfusion combined with rFⅦa) and GA group (component blood transfusion combined with tranexamic acid) by random number table method,25 cases in each group??The changes of disseminated intravascular coagulation (DIC) were screened on admission(D1), after cessation of cardiopulmonary bypass ( D2 ), and 2 h ( D3 ), 6 h ( D4 ) and 12 h ( D5 ) after medication??The difference of activated partial thromboplastin time (APTT), international normalized ratio (INR),fibrinogen,hemoglobin and platelet of the two groups at each time point of D1,D2,D3,D4 and D5 were analyzed??Meanwhile, the postoperative drainage, postoperative blood transfusion, postoperative plasma transfusion volume, postoperative mechanical ventilation time, ICU retention time, the 30 d mortality and complications were compared between the two groups??Results There were significant differences in APTT, INR,fibrinogen,hemoglobin and platelet between the two groups ( all P＜0??05)??There was no significant difference in the indices of DIC screening between the two groups at D1, D2 and D5 time points ( all P＞0??05),but at D3 time point,APTT in GR group was significantly shorter than that in GA group((50??3 ±6??6)s vs??(60??1±6??5)s,P＝0??027),and INR in GR group at D4 time point was also significantly lower ((1??3 ± 0??3) vs??( 1??5 ± 0??3), P＝0??041)??In addition, the amount of red blood cells transfusion after treatment in GR group and GA group (( 3??2± 1??0) U vs??(4??1 ± 1??0) U,P＝0??005),the amount of fresh plasma transfusion ((303??2±98??5) ml vs??(469??6± 190??5) ml,P＝0??000),the amount of 24 h drainage after operation ((519??9±107??5) ml vs??(657??2±100??1) ml, P＝0??000) were significantly decreased,the differences were statistically significant??Conclusion Blood component transfusion combined with rFⅦa can significantly improve APTT and INR of severe active hemorrhage after cardiac surgery,at the same time,it can reduce the amount of red blood cells transfusion and plasma transfusion??
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Objective To compare the clinical effects of two different skin preparation methods for infant craniocerebral surgery. Methods Totally 120 infants who were going to receive craniocerebral surgery were divided into two groups by random number table, 60 cases in the observation group and 60 cases in the control group. The scalp of both groups was cleaned with moisturizing oil every day from 3 days before operation. On 1 day before operation, the observation group used electric shaver to shave off all hair on the head, and then rinsed with warm water. The control group was treated with skin preparation knife to shave all the hair under soap water lubrication and rinse with warm water. The skin injury rate, incision infection rate and pain score of the two groups were evaluated. Results The incidence of skin injury and incision infection were 0 and 1.7% (1/60) in the observation group, 18.3% (11/60) and 13.3% (8/60) in the control group, respectively. There were significant differences between the two groups ( χ2=12.110, 5.886, all P<0.01 or 0.05). The median score of pain in the observation group was 0 (Q1:0, Q3:0), while 1.5 (Q1:1, Q3:2) in the control group, and there were significant differences between the two groups (Z=3.286, P<0.01). Conclusion Electric shaver is superior to skin preparation knife in shaving hair of infants. It not only reduces the incidence of head skin injury, incision infection and pain in the process of skin preparation, but also reduces the incidence of incision infection after craniocerebral surgery in infants. It is worth popularizing.
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Objective@#To compare the clinical effects of two different skin preparation methods for infant craniocerebral surgery.@*Methods@#Totally 120 infants who were going to receive craniocerebral surgery were divided into two groups by random number table, 60 cases in the observation group and 60 cases in the control group. The scalp of both groups was cleaned with moisturizing oil every day from 3 days before operation. On 1 day before operation, the observation group used electric shaver to shave off all hair on the head, and then rinsed with warm water. The control group was treated with skin preparation knife to shave all the hair under soap water lubrication and rinse with warm water. The skin injury rate, incision infection rate and pain score of the two groups were evaluated.@*Results@#The incidence of skin injury and incision infection were 0 and 1.7% (1/60) in the observation group, 18.3% (11/60) and 13.3% (8/60) in the control group, respectively. There were significant differences between the two groups (χ2= 12.110, 5.886, all P < 0.01 or 0.05). The median score of pain in the observation group was 0 (Q1:0, Q3:0), while 1.5 (Q1:1, Q3:2) in the control group, and there were significant differences between the two groups (Z= 3.286, P < 0.01).@*Conclusion@#Electric shaver is superior to skin preparation knife in shaving hair of infants. It not only reduces the incidence of head skin injury, incision infection and pain in the process of skin preparation, but also reduces the incidence of incision infection after craniocerebral surgery in infants. It is worth popularizing.
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Objective To study the effect of anticholinesterase agents on acantholysis in pemphigus vulgaris (PV) by using a mouse model.Methods Fifty-five neonatal BALB/c mice were divided into four groups:model group injected subcutaneously with the sera of patients with PV (n =15),pyridostigmine bromide group (n =15) and neostigmine methylsulfate group (n =15) subcutaneously injected with pyridostignine bromide and neostigmine methylsulfate respectively,in addition to the sera of PV patients,control group subcutaneously injected with sodium chloride physiological solution (n =10).The effect of anticholinesterase agents on acantholysis in PV was evaluated in terms of clinical presentation,histopathological manifestations and direct immunofluorescence findings.Results The injection of sera from PV patients induced characteristic changes of PV in neonatal BALB/c mice in the model group.The degree of acantholysis in the model group was higher than that in the pyridostigmine bromide group (H =21.584,P ＜ 0.001) and neostigmine methylsulfate group (H =20.641,P ＜ 0.001).No changes were observed in the control group.Conclusion Anticholinesterase agents can reduce the degree of acantholysis in the mouse model of PV.
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Objective To investigate the mRNA expression of toll like receptor-9 (TLR9) and interferon regulatory factors-5 (IRF5) of AS2O3 on peripheral blood mononuclear cells (PBMCs) in systemic lupus erythematosus (SLE) patients.Methods PBMCs of 15 SLE patients and 15 healthy subjects were treated with different concentrations of AS2O3 and cyclophosphamide (CTX) in vitro.Real-time quantitative polymerase chain reaction was used to amplify TLR9 and IRF5 gene before and after 12 and 24 hours drug intervention and the mRNA expressions were measured.Differences between groups were analyzed by paired t test or variance analysis.Results The mRNA expression levels of TLR9 [12 h(1.38±0.26) and 24 h (1.28±0.35)] on PBMCs in SLE patients were significantly higher than those in healthy controls [12 h(1.05±0.35) and 24 h (0.97±0.19)](t=2.37,P=0.03; t=2.44,P=0.02).The IRF5 mRNA expression levels [12 h (0.95±0.27) and 24 h (0.91 ±0.35)] in SLE patients were obviously higher than those in healthy controls [12 h (0.62 ±0.23) and 24 h (0.60±0.39)] (t =3.07,P=0.01 ; t =3.45,P＜0.01).AS2O3 could suppress the mRNA expression of TLR9 on PBMCs and the effect was gradually increasing with the increasing concentration of AS2O3 and processing time [0.2 mg/L AS2O3 group 12 h (0.430±0.110) and 24 h(0.290±0.050),0.4 mg/L AS2O3 group 12 h (0.170±0.038) and 24 h (0.090±0.017),0.8 mg/L AS2O3 group 12 h (0.023±0.011) and 24 h (0.003±0.001)].Comparing with CTX [12 h (0.814±0.081) and 24 h(0.755±0.139)],AS2O3 had a more significant strong effect on inhibiting the expression of TLR9 mRNA in SLE patients [F=165.32(12 h),P＜0.01; F=99.20 (24 h),P＜0.01].The mRNA expression of IRF5 on PBMCs was not suppressed by AS2O3 and CTX and there was no statistically significant difference between groups (P＞0.05).Conclusion There is abnormal expression of IRF5 and TLR9 mRNA in SLE patients.AS2O3 may suppress the TLR9 mRNA expression in SLE patients,which may be one mechanism of clinical effectiveness.
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Objective To study the relationship between HLA-DRB1alleles and the systematic lupus erythematosus of the Zhuang Nationality in Guangxi Province.Methods Allele polymerase chain reaction-sequence specific primers(PCR-SSP)were used to study the HLA-DRB1allele genes in52patients with SLE and70healthy controls of the Zhuang Nationality in Guangxi Province.Results The allele frequencies of HLA-DRB1*1401and HLA-DRB1*16were significantly less in SLE patients than those of the controls(RR=0.28,? 2 =5.00,P=0.02and RR=0.39,? 2 =3.95,P=0.05).HLA-DRB1*08,DRB1*11and DRB1*13alleles were not found in these two groups.Conclusion Our data suggest that the HLA-DRB1*1401and HLA-DRB1*16might be protecting genes for SLE in Guangxi Zhuang nationality.No susceptible gene is found in our study.
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Objective To investigate the role of thyroid autoimmunity in chronic urticaria. Methods The thyroid function, anti-thyroid auto-antibodies, and relevant cytokines were detected by RIA and ELISA methods in 56 patients with chronic urticaria and 40 healthy controls. Results Serum thyroid-stimulating hormone (TSH), anti-thyroglobulin antibody (TG-Ab) and anti-thyromicrosome antibody (TMA ) levels were increased in 8, 5 and 7 cases, respectively, in 56 patients, which were significantly higher than those in healthy controls (P