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【Objective】 To investigate the effect of optimized preoperative hemoglobin (Hb) level on clinical outcome in patients undergoing coronary artery bypass grafting (CABG). 【Methods】 Retrospective analysis was performed on patients who were selected to receive CABG from April 2020 to August 2021 in our hospital. Preoperative basic data, perioperative blood transfusion volume, blood transfusion rate, acute liver function impairment, renal function impairment (AKI), ICU stay, length of hospital stay, and in-hospital mortality of patients, meeting the inclusion criteria, were collected. According to the perioperative red blood cell transfusion, the optimal preoperative Hb threshold was calculated by receiver operating characteristic curve (ROC). According to the threshold, all patients were divided into two groups, and the blood transfusion volume and clinical outcomes of the two groups were compared to evaluate the predictive value of the optimal threshold of Hb. 【Results】 A total of 915 patients who met the inclusion criteria were enrolled in the study. The optimal threshold for predicting red blood cell transfusion rate by calculating preoperative Hb value by ROC curve was 118 g/L for males and 116g/L for females. Group A: Hb≤ threshold (n=293) was divided into the red blood cell transfusion group A1 and the red blood cell non-transfusion group A2. Group B: Hb>threshold (n=622) was divided into the red blood cell non-transfusion group B1 and no red blood cell non-transfusion group B2. The risk factors for perioperative red blood cell transfusion were age (OR=1.033 874, 95%CI 1.000 4-1.068 3, P<0.01), gender (female) (OR=3.268 5, 95%CI 2.353 1-4.540 0, P<0.01), BMI (OR=0.927 8, 95%CI 0.883 3-0.974 4, P<0.01), chronic renal insufficiency (CKD) (OR=2.041 1, 95%CI 1.347 8-3.091 0, P<0.01). Preoperative Hb≤ threshold (OR=3.517 4, 95%CI 2.502 1-4.944 7, P<0.01) was an independent risk factor for perioperative red blood cell transfusion. Perioperative red blood cell transfusion in patients with preoperative anemia further increases the incidence of postoperative complications (acute liver injury, AKI) and length of ICU stay. 【Conclusion】 Preoperative Hb≤ threshold can effectively predict perioperative red blood cell transfusion in patients with CABG, and increase the risk of postoperative acute liver injury, AKI, prolonged ICU stay and hospital stay. Optimizing the preoperative Hb level in CABG patients, increasing the Hb level to 118 g/L in males and 116 g/L in females can reduce the incidence of perioperative red blood cell transfusion and postoperative complications.
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The purpose of this paper was to introduce the factorial design and its quantitative data analysis of variance and the SAS implementation. Factorial design could not only present the main effect magnitude of all experimental factors， but also comprehensively reflected the size of each-order interaction effect among multiple factors. However， this design required a large sample size. This paper introduced the calculation formulas of the analysis of variance for quantitative data with two-factor factorial design， and realized the analysis of variance for quantitative data with two-factor and three-factor factorial design through two examples with the help of SAS software， and multiple comparisons of interaction effects were also performed.
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The purpose of this paper was to introduce the orthogonal design and its quantitative data analysis of variance and the SAS implementation. From the perspective of degrees of freedom， the orthogonal design could be divided into the saturated orthogonal design and the unsaturated orthogonal design. From the perspective of the number of factor levels， the orthogonal design could be divided into the same level orthogonal design and the mixed level orthogonal design. From the perspective of normalization， the orthogonal design could also be divided into the standard orthogonal design and the non-standard orthogonal design. Quantitative data from the standard orthogonal designs could be analyzed by the conventional methods， while quantitative data from the non-standard orthogonal designs needed to be improved. Based on three examples， this paper realized the quantitative data analysis of variance with the standard orthogonal design without repeated experiments and with repeated experiments by means of the SAS software.
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Objective: To determine optimal level of serial section in transbronchial and pleural biopsy that yield maximal definite diagnosis. Methods: A cross sectional study of 118 transbronchial biopsy and pleural biopsy specimens submitted with serial sectioning in 3 levels were performed. Specimens of 1 mm. in diameter were serially cut and slides at levels I, II, III (120, 240 and 360 µm.) from initial exposure of tissue in paraffin blocks were studied, and specimens of 2-3 mm. in diameter were cut at levels I, II, III (0, 120 and 240 µm.) after tissues in paraffin blocks were trimmed to expose maximal diameter. Comparisons of diagnoses of each level were done. Results: The percentages of definite diagnoses were 89, 95.8 and 93.2 in sections of level I, II and III, respectively. Chronic granulomatous lesions were found in section level II more than other levels, but there was no statistical significance. (P value 0.131, Chi-Square test) Conclusion: Transbronchial and pleural biopsy specimens should be cut deep to level II, one slide for hematoxylin-eosin staining and 3 unstained slides for further investigation.
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El propósito de la presente investigación fue estudiar el efecto de 3 variables en el proceso de obtención del extracto acuoso de flores de Calendula officinalis Lin., así como su optimización a partir de la maximización de los sólidos totales en el extracto y los valores de recobrado, obtenidos en un reactor cilíndrico de laboratorio con geometría desescalada de un reactor industrial. El estudio de superficie de respuesta realizado, utilizó un diseño híbrido, el cual, con 11 experimentos, logra analizar 3 factores en 5 niveles y da una respuesta adecuada a la necesidad de determinar la influencia de las variables de proceso y los valores óptimos para la extracción. La relación droga disolvente resultó ser la variable analizada que influyó con mayor significación en la extracción aunque todas fueron significativas y 100 ºC de temperatura, (1/10) como relación droga/disolvente y 2,5 h de agitación, resultaron ser los parámetros óptimos de operación, para el procedimiento propuesto.
The aim of the present research was to study the effect of three variables in the process of obtention of aqueous extract from flowers of Calendula officinalis Lin., as well their optimization, starting from the maximization of total solids present in the extract, and the recovery values obtained in a lab cylindrical reactor with a non-scale geometry of an industrial reactor. The surface study of the response used a hybrid design, which with 11 experiments attained to analyze three factors at 5 levels, and to give an appropriate response to the need of determining the influence of the process variables and the optimal values for extraction. The drug/diluent ratio proved to be the analyzed variable that influenced the most on the extraction, although all the variables were significant. The optimal parameters for the operation were: a temperature of 100 ºC, a drug/diluent ratio of 1/10, and 2.4 hours of shaking..